Operationalizing Food Service

Guidelines to Create a Healthier

Food Environment

Joel Kimmons, Ph.D.

Centers for Disease Control and Prevention

Division of Nutrition, Physical Activity and Obesity

The conclusions in this presentation are those of the

author and do not necessarily represent the views of

the Centers for Disease Control and Prevention.

• Food Service Guidelines at the Department of Defense

• Jennifer Wallinger, Navy DoD

• Healthier Food Choices for Public Places

• Katherine Bishop, Center for Science in the Public Interest

• Part of the Solution: National Association of Blind Merchants

• Kevan Worley, National Association of Blind Merchants

Making Healthy Choices…

Default, Convenient, Easy, Immediate

Healthy

eating and

physical

activity

Exposure, norms

Skills, knowledge

Use of time

Individuality

Individual and Family

Social structures,

cultural norms, values

Policy

Legislation

Economics

Access

Advertising

Affordability

Environment

Food Service Guidelines

Definition Purpose

Food and beverage standards

and other information for

operating institutional food

service

• Sourcing

• Purchasing

• Preparing

• Presenting

• Serving

• Selling

Construct a food environment

where the norm is

• Healthy dietary choices

• Enviromentally sustainable

and ethical methods

• Equity throughout

A sustainable food system—

Integrates production, processing, distribution, and consumption

Regenerates rather than degrades natural resources

Is socially just and accessible

Supports the development of local communities

Health and Sustainability

• Atmosphere

• Architecture

• Cleaning

• Serving ware

• Cooking methods

• Foods offered

• Building design and facilities

• Energy use

• Waste

• Cleaning materials

• Packaging

• Serving ware

• Sourcing of foods

Apply Where Food is Sold,

Served, or Consumed

Cafeterias

Snack bars

Vending

Lunch rooms

Meetings

Conferences

Federal, state, local governments

School systems

Worksites

Hospitals

Institutionalized populations

Assisted-living communities

Colleges and universities

Community‐based organizations

(including faith‐based)

Day care centers

Targets

Settings

• Food

• Nutrient levels

• Other aspects of foods (ingredients, contents, contaminants, adulterants,

additives, etc)

• Methods of production (organic, local, ethical)

• Method of preparation (frying)

• Required Percentage of foods offered

• Marketing

• Pricing strategies

• Cafeteria layout, food presentation, choice architecture

• Menu labeling

• Other

Developing Standards for

Food Service Guidelines

Health and Sustainability Guidelines for

Federal Concessions and Vending

Operations (HHS/GSA Guidelines)

• Increase healthy and sustainable food and beverage choices and

practices at federal worksites

• Collaborative team: Health and Human Services (HHS) and

General Services Administration (GSA)

• Translate evidence-based recommendations into food service

practices

– Align food choices with the Dietary Guidelines for Americans,

2010

• http://www.cdc.gov/chronicdisease/resources/guidelines/food-

service-guidelines.htm

How do we establish standards as part of the basic operation of food service?

• Guidelines? standards? policy?

• Rate and methods of implementation—Gradual, gentle, flexible

• Increasing access to and choice of healthier foods

• Food vs. nutrient level

• Choice vs. restriction

• Choice architecture

• Pricing strategies

• Menu labeling

• Marketing campaigns

• Increase on-site access – farmers markets, CSAs

• Working with stakeholder

• Appropriately targeted for population and setting

• Organizational support

Operationalizing

Food Service Guideline

Operationalizing

Food Service Guidelines

Stakeholders—producers, suppliers, managers,

contracting officers, vendors, dietitians, employees, and

consumers

• Size

• Culture

• Nature

• Management structure

• The health case

• The business case

• Economic situations

• Societal needs

• Cultural acceptability

• Environmental issues

• Overall sustainability

HHS/GSA Guidelines

National Prevention Strategy

• Achieving access to healthy, affordable food within National

Prevention Council departments and (voluntarily) with

partners as appropriate

• 17 federal agencies Including the DOD

States, cities, and communities

• CTG

• CPPW

• Currently model guidelines for at least 12 states

Highlighted in the HHSinnovates award program

Full report on the development and initial contracts available

First contract: HHS Humphrey Building Cafeteria, Washington, D.C.

• Revenues are up

Nationwide: In the contracts at 28 facilities managed by GSA by

the end of 2013. Additionally, 25 GSA commercial cafeteria operators are voluntarily using guidelines.

GSA National Capital Region: More than 20-million

annual transactions

CDC facilities in Atlanta are mostly in line with the guidelines

HHS/GSA Guidelines

Implementing HHS/GSA Guidelines at CDC

Management Analysis,

Service Operations

Go Green Get Healthy

Leadership

Connecting the

right people

Staff,

Customers Office of Sustainability

Health and Sustainability Guidelines

for Institutional Food Service Direct

• Influence individuals by changing the food environment

• Adults spend considerable time at work as do children in school

• More than 100 million Americans eat at work daily1,2

Indirect

• Influence family behavior and community norms

System

• Couple the production and demand of healthy foods

• Develop social structures and cultural norms and values

1 Bureau of Labor Statistics

2 Linnan L, Bowling M, Childress J, et al. Results of the 2004 National

Worksite Health Promotion Survey. Am J Public Health. 2008;98(8):1503-9.

Resources

HHS and GSA Health and Sustainability Guidelines for Federal Concessions and

Vending Operations

http://www.cdc.gov/chronicdisease/resources/guidelines/food-service-guidelines.htm

GSA: Concessions and Cafeterias: Healthy Food in the Federal Workplace

http://www.gsa.gov/portal/content/104429

www.health.gov/dietaryguidelines

http://www.cdc.gov/nutritionreport/

www.nutrition.gov

DoD Food Service Guidelines

Menu Standards

Food Acquisition Standards

Color-coding Food Identification

Nutrition Environment Assessment

• Action Plan Toolkits

Color-coded Food Identification

17

Healthier Food Choices for

Public Places

Katie Bishop, M.S., M.P.H.

Nutrition Policy Associate

www.cspinet.org/nutritionpolicy

What is healthier food choices for

public places?

• Implementing food and nutrition standards

for food sold or served in public places

• National, state, and local government

property

– Government buildings, parks, high rest

stops, libraries

– Corrections, child care, senior centers,

homeless shelters

• Workplaces, hospitals, universities

Why get healthier food in public

places?

• Two-thirds of Americans are overweight or obese,

which contributes to heart disease, diabetes,

cancer, etc.

• Diet-related diseases, such as diabetes, stroke, and

osteoporosis, are leading causes of disabilities.

– For example, nationally, 12,000 to 24,000

people with diabetes become blind each year.

• Americans not as healthy as

they could be

Why get healthier food in public

places?

• Helps makes healthier options available

• Emerging as a promising low cost public health

strategy

• Model for healthy eating

• Help shape social norms

• Helps governments and organizations to “walk the

walk”

• Ultimately impact food manufacturers

What Does CSPI Do?

• Provide support and technical assistance to

state, localities, and other venues to

implement policies for healthier food

choices for public places

• National Alliance for Nutrition and Activity

(NANA) developed Model Vending Standards

– Includes nutrition, labeling, pricing, placement,

and promotion standards

– List of products the meet the standards

– Gathering revenue data

Future Plans

• Guidelines for meeting and

conferences

• Nutrition standards for concessions

and cafeterias

For More Information

• http://www.cspinet.org/nutritionpolicy/foodstand

ards.html

– Model standards

– Model policies

– Our resources

– Links to resources

• Email: kbishop@cspinet.org

National Association of Blind

Merchants

• National Association of Blind Merchants (NABM) – Membership organization of blind persons employed in either

self-employment work or the Randolph-Sheppard Vending Program.

– NABM provides information regarding rehabilitation, social security, tax, and other issues which directly affect blind merchants and their vending businesses.

• NABM intends to work with stakeholders and be at the forefront of healthy concessions initiatives.

• www.blindmerchants.org