Originally published in The Huffington Post on February 7, 2013 by Joe Satran.

The conventional wisdom on restaurants and health is that eateries intentionally serve up high-calorie, low-nutrition dishes because they think they’re the best way to draw customers in and maximize profit. This theory of menu design certainly provides a convincing explanation for the success of unhealthy fast-food chains like McDonald’s and Taco Bell.

But a new study released Thursday by the Hudson Institute suggests that, if this theory was ever really valid, its power has waned in recent years.

The researchers examined sales figures from 21 major chain restaurants, some of which had recently introduced more lower-calorie options to their menu, and some of which had cut such items. (For a nice primer on some of the healthy dishes that chains have introduced, by the way, check out Stephanie Strom’s story on the trend in today’s New York Times.) They discovered that the chains that had added more low-cal items had performed strikingly better than the ones that hadn’t. Between 2006 and 2011, visits went up 10.9 percent at the chains that had beefed up their healthy offerings, while they dropped by 14.7 percent at the restaurants that had decreased their low-cal offeries.

We know, we know: correlation, not causation. Maybe, you might posit, the restaurants that had the means to develop healthy recipes were already doing better than those that didn’t? Or maybe they all did a bunch of marketing using their healthy items, but people actually ordered the unhealthy ones anyway!

Nope. At least not mostly. The study also found that sales of the actual healthy items went up by over 470,000 units in the five-year time span studied, while sales of unhealthy items plummeted by about 1.3 million units. The study found that sales of French fries and high-calorie drinks (like sugary, as opposed to diet, sodas) had gone down particularly fast.

There may certainly be other factors lurking in the background. It possible, for example, that a few people are buying two of the “low-calorie’ main dishes, defined in the study as those under 500 calories, and eating them both at once, boosting sales without cutting caloric intake. But this study does, at least, provide fodder for restaurant R&D workers who are pushing their bosses to agree to add more healthy items to their menus. Which may be good news for diners’ health down the road.

Originally published in The Wall Street Journal on February 7, 2013 by Julie Jargon.

People are placing fewer orders for french fries and sugary drinks at restaurants, giving a boost to establishments that sell more low-calorie items, according to a study scheduled for release Thursday.

An analysis of 21 fast-food and sit-down restaurant chains between 2006 and 2011 found that lower-calorie food and beverages fueled the chains’ growth. The study was funded by the Robert Wood Johnson Foundation and conducted by the Hudson Institute, a policy-research organization.

The study found that restaurants that increased lower-calorie servings experienced an average 5.5% increase in same-store sales. That compared with a 5.5% decrease among chains selling fewer lower-calorie servings.

“The bottom line is, if restaurants don’t get more aggressive behind these low-calorie products, they’re leaving sales on the table,” said Henry Cardello, director of the Hudson Institute’s Obesity Solutions Initiative and lead author of the report. “It’s a business imperative.”

The findings might make restaurant chains feel better about efforts around the U.S. to get them to post calorie information.

The Hudson study found that the number of lower-calorie food and beverage servings sold increased 2.5% to 18.7 billion, while the number of higher-calorie servings sold fell 4.2% to 31.2 billion. The analysis examined restaurant servings and traffic from market-research firm NPD Group Inc. and publicly available sales data from the restaurant chains.

Lower-calorie servings were defined as sandwiches and entrees containing 500 or fewer calories, beverages with 50 or fewer calories per eight ounces and side dishes, appetizers and desserts with 150 or fewer calories.

Federal regulations requiring operators of restaurants with 20 or more outlets to post calorie counts are expected to take effect early next year. Some chains, including McDonald’s Corp. and Panera Bread Co., already post calorie information on menu boards nationwide.

Several chains have created sections on their menus featuring smaller portions and low-calorie offerings, such as Fit Fare at Denny’s Corp. restaurants and Au Bon Portions at ABP Corp.’s Au Bon Pain chain.

Early studies on how posting calorie information affects consumer behavior have proved mixed. Some have found that providing calorie information has steered consumers toward healthier options, while others have found no noticeable shift.

After Panera posted calorie counts on its menu boards in 2010, the company noticed that 20% of customers began ordering lower-calorie items.

Chili’s Grill & Bar, a unit of Brinker International Inc., said sales of items containing less than 675 calories increased after it featured two new items on that Lighter Choices lineup on menu inserts in December.

McDonald’s declined to comment on the Hudson study, but when the company in September said it would begin posting calorie information nationwide, Jan Fields, then-president of McDonald’s USA, said the company hadn’t noticed a change in behavior in the cities that already required posted calorie counts.

Mr. Cardello, a former food-and-beverage industry executive, said he was surprised to find that fast-food chains sold a slightly higher percentage of lower-calorie food servings than sit-down restaurants did.

Margo Wootan, the director of nutrition policy at the Center for Science in the Public Interest, said the report was consistent with what she has seen in restaurants. “Americans are more interested than ever in healthy eating,” she said.

But she warned that consumers still aren’t as good about watching their calories when they dine out as when they eat at home, in part because large serving sizes at restaurants lead to overconsumption. Her nonprofit advocacy group wasn’t involved in the Hudson study.

Ms. Wootan said several studies have linked frequent restaurant visits with higher obesity rates. One showed that women who eat out more than five times a week consume about 290 more calories on average each day than women who eat out less often.

“My biggest concern is that oftentimes, there are only a few healthy options at restaurants amid a much larger array of unhealthy choices,” she said.

Originally published in The New York Times on February 6, 2013 by Stephanie Strom.

Driven by pressures like consumer demand and looming federal regulations that will require them to post calorie counts on menus, restaurant chains around the country are adding more nutritious choices and shrinking portion sizes.

The smaller portions, which are not necessarily cheaper, are the first step toward reversing the practice of piling more food on a plate than anyone needs in a single meal, a trend that began nearly three decades ago. Besides making a contribution to customers’ health, restaurant owners are finding that the move is paying off financially.

Sbarro for example, is offering a “skinny slice,” with a different mix of cheese and more vegetables at 270 calories. Longhorn Steakhouse has smaller portions of beef that qualify for its lower calorie Flavorful Under 500 menu.

“Menu labeling is part of it, but there’s also been a lot of finger-pointing at the industry by the media and others, including customers, that is spurring the movement,” said Anita Jones-Mueller, a registered dietitian who is president and founder of Healthy Dining Finder, a Web site that helps users find restaurants with healthy options using ZIP codes.

One gauge — the number of restaurants with vetted healthy options listed on the site — has increased more than 2,000 percent, and many have been added just in the last couple of years, Ms. Jones-Mueller said. “Customers really want these items, so restaurants are working to make them more appealing,” she said.

Hank Cardello, director of the obesity solutions initiative at the Hudson Institute, a public policy research organization, has been studying the impact that lower-calorie menu options have on restaurants’ business. “Lower-calorie menu items were driving restaurant growth over the last several years, no doubt about it,” Mr. Cardello said.

The results of his research were published Thursday in a report financed in part by the Robert Wood Johnson Foundation.

The Obama administration’s health care act, which was passed in 2010, included a provision requiring restaurants and food establishments with 20 or more locations to post the calorie counts of standard items on their menus. The final regulations are expected soon, with compliance likely to be required by 2014.

Some restaurant chains have already begun posting calorie counts.

After perusing Longhorn Steakhouse’s lower-calorie menu, Denise Garbinski, a registered dietitian in San Francisco, said the portion sizes were bigger than the four ounces she typically recommended, but that it was “a step in the right direction.”

“What they’re trying to do here is cut back on portion size, which is brilliant,” Ms. Garbinski said. “I always tell people to ask for a to-go container when they first order and then put half of the meal in it before they eat, but this takes that step out of the process.”

While the move by restaurants to more nutritional menu offerings is driven by external factors, many operators are finding that cutting calories, sodium, sugar and fat pays off.

“It’s doing great,” Brian Bailey, co-founder and chief executive of the Ichor Restaurant Group, said of the company’s new restaurant concept, Baja Pizzafish. “To serve fish tacos in Ohio is testament not only that the food tastes good, but that people really want it.”

The chain, which opened in July, offers the option of brown rice in its rice bowls, and three ounces of grilled salmon, steak or shrimp can be added. Mr. Bailey describes the dishes as, “smaller amounts of protein and more fresh vegetables.” Other menu items include thin-crust pizzas with potatoes and other lean toppings, salads and tortilla wraps.

The company also operates the Old Carolina Barbecue Company, a chain of six restaurants. It has added a new menu for its catering operation, the Lighter Side of Old Carolina, that features grilled chicken wraps, carved turkey sandwiches and chicken salad made with light mayonnaise.

“I don’t want to describe this as the anti-barbecue,” he said. “It’s more like I’m hedging my bets on comfort food.”

Matt Friedman, founder and chief executive of Wing Zone, said the company’s decision to add Skinny Dippers, fried chicken breast nuggets with no breading, to its menu in January was as much about business as about offering customers a healthier choice.

The price of chicken wings, the company’s bread and butter, has risen, Mr. Friedman said, so Skinny Dippers are more profitable for the chain. “From a business perspective, when the core product and its price have an impact on profitability, you diversify the menu,” he said.

The chain already offered grilled chicken sandwiches and salads with grilled chicken, but those are “somewhat mainstream,” Mr. Friedman said. “What distinguishes Skinny Dippers is that you can get them in any one of the 17 flavors our regular wings come in,” like Nuclear Habanero and Sweet Samurai.

Skinny Dippers are a limited time offer — or maybe not. “If this is a massive success, we’re going to keep it,” Mr. Friedman said.

Similarly, James Greco, chief executive of Sbarro, said that while the pizza chain had added the lower-calorie slice to capitalize on New Year’s dieting resolutions, the slice now outsells all other slice varieties but cheese and pepperoni. “Although our plan was to have it through March, we’re actually thinking about keeping it,” Mr. Greco said.

Mooyah, a build-a-burger chain based in Frisco, Tex., that dedicates itself to burgers, fries and 100 percent ice cream shakes, put lower-calorie options on its menu to attract a group of customers that Alexis Barnett Gillette, the marketing director, nicknamed “the veto vote.”

“What we found is if you limit yourself to the beef hamburger, there are certainly a growing number of folks who wouldn’t even consider our restaurants,” Ms. Barnett Gillette said. “It could be mom, who’s a vegetarian and may not want to go to a burger restaurant, or turkeytarians or someone with a health restriction of some sort.”

So Mooyah offers the choice of a 200-calorie turkey burger with fewer than 10 grams of fat on a choice of a white or whole wheat bun. It also has a black bean vegetable burger and sweet potato fries, a small portion of which is 255 calories, compared with 278 calories in the same size portion of regular French fries.

Still other restaurants are finding ways to highlight existing options on their menus that make a healthier meal, like Pita Pit’s Resolution Solution. The menu helps customers who build their pitas better understand how to create a healthy option, said Jack Riggs, chief executive of Pita Pit USA.

“When the public starts saying it wants healthier options — and we are hearing that — we have an obligation to help show you what that means in our restaurant and give you choices to help you achieve that,” Dr. Riggs said. “That’s good business.”

Originally published in Forbes Magazine on October 3, 2012.

With two-thirds of American adults tipping the scales these days as overweight or obese, the same lawyers and activists who took on Big Tobacco are now sharpening their knives for their next target: Big Food. A look at activist crusades against the automobile, tobacco, and other industries over the last century provides three lessons: The war will be long, both sides will dig in, and the losses will be unnecessarily heavy all around.

History shows there is a better way, but it will demand unusual cooperation by all, especially by the $1.2 trillion food industry, whose primary challenge is to recognize the attack not as a threat but rather as an incredible new profit opportunity. The activists, for their part, must engage the industry not with diatribe, which can lead to protracted legal battles, but by understanding the industry’s pressures and playing to its best interests. Common ground abounds for both sides. If the activists discover it, they will see that the industry’s marketing savvy and financial clout can be turned into instruments for benefiting consumers.

More than a dozen law firms that took on tobacco firms in the last decade now have filed suits against companies like ConAgra and PepsiCo, charging them with misleading labeling and health claims. In September, New York City’s Board of Health approved Mayor Michael Bloomberg’s ban on sales of sodas bigger than 16 ounces at restaurants, movie theaters, and food carts. It will go into effect next March if the soda lobby fails to contest it successfully. And Bloomberg isn’t finished. He’s crusading against junk food in prisons and potato chips in Bronx bodegas. The Federal Trade Commission recently won a settlement against Dannon over claims about its products’ health benefits. In July, the Center for Science in the Public Interest sued General Mills for allegedly putting artificial ingredients in Nature Valley products marketed as natural.

The history of activist movements against an industry’s controversial products and practices is a study of long, costly battles with little quick relief, especially to consumers. Consider that by the 1960s more than 50,000 people a year were dying in car crashes, despite the fact that crash experts had been sounding the alarm about safer car designs since as early as the 1930s. The alarm went unheeded by U.S. automakers for many more decades; they embraced safety only when they lost market share to more safety-conscious competitors. Consider, too, that more than 2.5 million lives could have been saved if everyone had quit smoking when the U.S. Surgeon General first unveiled tobacco’s dangers back in the 1960s. The tobacco industry fought for 50 years to stave off public health efforts to tax and ban smoking, and many lives were lost.

Well-meaning activists are dusting off their old strategies of research, regulation, and litigation to use against Big Food. Trying to force the risk-averse food industry to jettison time-proven brands and add healthier products will be a slow process. The industry has long memories of expensive, high-profile flops. Even countering the lawsuits will be less costly than risking another debacle such as New Coke or McDonald’s McLean Deluxe sandwich.

Yet both sides are overlooking a golden opportunity that could help everybody win, food companies and consumers alike. In fact, the obesity crisis may just be the food industry’s biggest market opportunity over the next 10 years.

Hard to swallow? Consider what might have happened if American automakers in the 1960s had begun designing and building safer and more fuel-efficient cars just after Ralph Nader first published his seminal book, Unsafe at Any Speed. Instead, their response to activists like Nader (whose book took the industry to task for resisting safety features) was to dig in their heels. They resisted adopting voluntary safety improvements because, they claimed, “safety doesn’t sell.”

So the U.S. auto industry let foreign competitors like Volvo and Mercedes-Benz take the lead in adding features such as three-point seat belts, crumple zones, and side air bags. It also allowed Japanese automakers to make strides in safety and fuel-efficiency and rapidly gain new U.S. customers. U.S. automakers found out the hard way that safety did indeed sell. By 2009, when two-thirds of the public said that safety was the most important factor in buying a new car, U.S. car manufacturers’ share of the American market had plunged by more than half since 1965, from 91% to 44%. Safety turned out to be a huge moneymaker for the auto industry, not an immense financial burden.

In contrast to automakers, look at how the beer industry responded to activist groups such as Mothers Against Drunk Driving, which began targeting the alcoholic beverage companies about three decades ago. Top brewing companies got ahead of the issue. They worked to lighten up both the alcohol content and the calories in their beer, and they began a campaign to encourage people to drink responsibly. Light beer now accounts for four of the top five best-selling beers. The top brewers have doubled their profit margins, even while losing market share to wine and liquor and spending $875 million over the past three decades—and while telling people not to drink too much.

The soft drink industry has been fighting activists who paint it as the bad guy in the obesity crisis. It should take a cue from its brethren in beer, and, indeed, from its own success in selling more water and fewer sugar-sweetened products. Consider that soft-drink makers today enjoy some of the highest operating profit margins in the food industry, even though some have reduced their calorie footprint (the average calories sold per capita) by a quarter over the last decade. Zero-calorie carbonated beverages and bottled water are now a bigger part of the mix, and consumers are clamoring for them. Instead of fighting the campaign against Big Gulps, the soft drink industry should be looking for the next big opportunity.

New research is already proving that the profit opportunities are there. One study by my organization, the Hudson Institute, has found that food companies with higher percentages of healthier food sales in their portfolios report healthier bottom lines. Hudson, an independent policy research organization, recently looked at 15 consumer goods companies that sold varying percentages of “better for you” products—ones with reduced calories, marketed in smaller portion sizes, or whole-grain and other foods generally recognized as more wholesome. These products accounted for less than 40% of the companies’ sales between 2007 and 2011 but drove more than 70% of their sales growth. Companies selling above-average levels of better-for-you foods and beverages enjoyed higher operating profits, larger returns to shareholders, and a better image among consumers, branding studies have shown.

In short, the food industry can still enjoy healthy profits while doing the right thing, urging restraint and selling products that deliver more nutrients or fewer calories.

What will it take to get the entire food industry to hear this message, instead of spending time and resources fending off its attackers? First, activists and the industry need to change the rules of engagement. When hardcore activists begin to oppose an industry, industry executives become defensive and competitive. Under attack, they grow even more opposed to change and dig in and fortify their positions. Message to activists: Pursuing harsh regulations and litigation only prolongs the time it takes to reach a solution.

Materials science provides the perfect analogy for this problem. When it is backed into a corner, the food industry, which is highly traditional, can become an immovable, impervious solid. The activists display combustible gas behaviors. They’re highly reactive, sometimes explosive, but unable to change the solid very much. Only a liquid state can get anything done, but neither side is willing to undergo a fundamental change.

The public health outcry over less nutritious food promises to be very combustible. Many have compared it to the fight against Big Tobacco, which is now paying a $206 billion settlement to states that claim that smoking-related illnesses increased their Medicare costs. Activists hope to paint food as, like tobacco, a highly addictive threat to public health.

The escalating war against Big Food has a key difference: Unlike tobacco, food companies manufacture a necessity to public health, and nobody can argue that it shouldn’t exist. Its antagonists need to approach this industry differently. Most of all, food executives need to look behind the vitriol and see a very real opportunity, to make more money and do good at the same time.

I spoke on the recent BBC series “The Men Who Made Us Fat”. Around the world, obesity levels are rising. More people are now overweight than undernourished according to the documentary. My appearance times are noted below.

The Men Who Made Us Fat Part 2 of 12 (The Beginning)

The Men Who Made Us Fat Part 4 of 12 (11:00)
 
The Men Who Made Us Fat Part 6 of 12 (7:55)

Today it was revealed that a number of food companies have been quietly lowering the amount of salt in their products over the past few years. Icon brands such as V8 vegetable juice, Chef Boyardee canned pasta and Orville Redenbacher microwave popcorn have each shed more than 30% of their sodium content.  They got caught doing the right thing.

This Stealth Health approach offers a more enlightened way to ensure that consumers really do stick with changes intended to improve the nutrition of packaged foods and beverages. This is in contrast to the “stick” approach of taxing consumers or banning favorite ingredients to force changes in eating habits which rarely are adhered.

Why do I like Stealth Health? For one, food corporations have been deploying “stealth” tactics for many years to reduce costs.  Little by little, tweak by tweak, the iconic brands that we enjoy have all been tinkered with over the decades – all without us knowing so that we don’t abandon ship.

Stealth Health also avoids overtly depriving the public of the foods and beverages they enjoy. This is why diets fail. Instead of expecting consumers to abandon their favorite foods, improving the nutrition and/or reducing calories below the radar does not upset this delicate balance.

And, it sidesteps consumer suspicions that if a food is “healthy” it can’t taste good (witness cereals that have tasted like cardboard or the first soy hot dogs). Virtually every piece of research I have encountered confirms that, for foods that are typically more indulgent, the consumer believes that making these foods more healthy results in poorer taste.

For a half century, the food industry has quietly produced 29% more calories per person to eat every day.  It’s time to reverse that trend in the same way – quietly. Obesity will not be solved overnight, but by taking cues from the Salt Wars, food companies now have the blueprint on how to secretly perform nutritional surgery on their brands and go about taking the calories out without compromising their profits.

Here’s a press release outlining my position on why tax incentives make better sense than taxing soft drinks in order to lower rates of obesity:

 

FOR IMMEDIATE RELEASE
September 22, 2009
 
Author Stirs “Fat” Tax Debate with Controversial Proposal
Anti-Obesity Advocate and Former Food Executive Says Tax Incentives for Food Corporations a Better Way to Trim the Fat
 
Chapel Hill, N.C. – (September 22, 2009) Hank Cardello, a well-known author, advocate for addressing America’s obesity epidemic and former food industry executive has spent more than thirty years as a senior executive for some of America’s largest food and beverage manufacturers. While Cardello is the first to admit that the food industry has played some role in the proliferation of obesity in America, Cardello’s position highlights the importance of engaging the food industry to solve the problem – through incentives rather than ineffective taxes on select products deemed “unhealthy” by government and health advocates. Cardello also wants to tap into the marketing power of the food industry to help educate consumers about portion control.

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Check out my perspective as published in the September 12 edition of The New York Times on how to address America’s obesity epidemic:
 
In response to “Big Food vs. Big Insurance” September 9
 
To the Editor:
 
I applaud Michael Pollan’s recognition that obesity is the “elephant in the room” in the health care debate, but dissent on his solutions.

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