WASHINGTON, DC - NAMA Knowledge Source consultant Ruth Lahmayer-Chipps tackled the issue of obesity and the steps vending operators can take to address current concern over the nationwide epidemic at the NAMA National Expo. The registered dietician, who has worked extensively with vending operators on menu improvement to meet wellness objectives, led two interactive sessions at the convention.
Titled "Obesity In Vending Update: Ask the Dietician" and "Enhancing Your Foodservice Image Through Variety and Healthy Eating Options," the workshops were designed to update operators on mainstream dietetic thought, and provide guidance and tools with which to review their own product mixes and deal confidently with customer questions.
The first presentation dealt with snack and beverage as well as food vending. The widely-publicized warning that obesity has become a national health crisis is not an overstatement of the problem. With 15.3% of children age 6 to 11 and 15.5% of 12- to 19-year-olds, overweight or obese , and 64.5% of adults suffering from these conditions , there is no doubt that something has gone wrong. And the numbers continue to rise at an alarming rate.
When something goes wrong, it's natural to look for a culprit, which accounts for the attacks on a wide range of away-from-home retail outlets, from fast-food restaurants to vending machines. But the he causes of obesity are multi-faceted and complex, with psychological, cultural, dietary and other factors contributing to the problem and genetics playing a role. Lahmayer-Chipps emphasized the importance of vendors helping to dispel some of the myths associated with obesity, not only in self-defense, but to contribute toward sound policy prescriptions and workable solutions to the problem.
"Banning potato chips or outlawing pizza will not solve childhood obesity," Lahmayer-Chipps stressed. "The fact is that young and old alike need to adhere to the tried and true principle of 'everything in moderation.' As long as people balance their food choices and get regular physical activity, any food, including vending items, can be part of a healthy, enjoyable diet. Good nutrition habits, when taught early in life, can provide a solid foundation for a healthy weight throughout life." She identified the lack of physical activity as the principal contributor to the increase in overweight and obesity. Greater inactivity certainly is an important difference between the present and the past.
The nutrition expert emphasized that there are no "good" or "bad" foods. All foods can fit a healthy lifestyle, according to the American Dietetic Association. "There are also no 'good' and 'bad' beverages, and there's no need to legislate or ban a whole category. The fact is that students drink less than three fl.oz. per day of soft drinks in secondary schools. It's important to look at the big picture of diet, and not attack one food or drink; the issue is so much more complex."
And while media attention has led to growing consumer focus on reducing dietary fat , often worth doing , totally eliminating fat from the diet is not advisable. But there is a tendency to go overboard, the speaker noted; the old error of assuming that if a little is good, a lot will be better has been succeeded by the fallacious belief that if less is better, none is best of all. Thus, it's possible to lose sight of the essential role played by fat. A diet that features a mix of low-fat and high-fat foods is ideal, because fat is necessary to the body's ability to absorb vital nutrients.
LOW PER CAPITA SALES
Lahmayer-Chipps added that a recent survey revealed that, on average, school children do not even make snack purchases on a daily basis from their vending machines; fewer than one candy bar and one snack item are purchased per student, per week. "Educate your customers that it's all about moderation and that if they take away the kids' favorite foods, they'll just revolt and go find those items elsewhere," she urged.
The speaker informed seminar participants that NAMA is now offering operators a flyer entitled A Healthy Balance for Life that reinforces to school decision-makers the message that all foods, including snacks and carbonated beverages, can fit into a healthy diet if consumed in moderation, and provides a list of healthy snacking alternatives.
The new NAMA handout also emphasizes the importance of physical activity, and communicates the message that the vending community is a partner in the ultimate goal: the health and wellbeing of the nation's children.
Lahmayer-Chipps cited a recent study conducted by the Institute of Medicine (November, 2002) that correlates television watching, video games, computer usage and similar sedentary activities with rising obesity rates.
Children under age 17 spend 51/2 hours a day on "screen time," when they should be focusing on "lean time" activities, according to Lahmayer-Chipps. Those activities should involve a minimum of 30 minutes of physical activity each day; strenuous workouts are not necessary, and even moderate movement can reap big benefits when enjoyed every day.
"One key to a healthy lifestyle is to balance calories taken in with calories burned. Physical activity is fundamental to good health," emphasized the speaker.
"Portion distortion" is another contributing factor to the rise in obesity. Lahmayer-Chipps noted that the Food Pyramid, introduced in 1992 by the U.S. Department of Agriculture, has come under attack for contributing to overeating. However, she emphasized, if people who follow it consume appropriate portions, they will not gain weight. For example, one cup of pasta is considered a portion on the Food Pyramid, but most restaurants serve portions of three cups.
The decline in family meals also must bear some blame as a contributing factor to the nation's growing waistline, as more time-starved families turn to fast food, and "super-sized" portions of high-fat foods, as a regular part of their diets.
The nutrition expert added that parents, healthcare professionals and educators are critical partners in teaching children that a healthy lifestyle results from both a balanced diet and exercise. Just as there is no single cause of the obesity epidemic, no one entity can fire the magic bullet that will cure it, she emphasized; teamwork is essential.
"As vending operators, get involved in promoting the health of your communities," suggested Lahmayer-Chipps. "Vending companies can become community health centers, and it's a win-win for everyone."
The speaker urged operators to be part of the solution by volunteering to take part in local health fairs, providing refreshments and snack samples at community events and offering assistance with health-related school initiatives.
Vending operators must be proactive because consumers are increasingly aware of the obesity crisis and their expectations are high, she urged. Manufacturers are responding with changes in fat and overall calorie content, and diversification for healthier choices. "Even the fast food restaurants are taking a step toward becoming part of the solution by changing their menus," added Lahmayer-Chipps.
DIET OF THE MONTH
An unfortunate result of increased awareness of the obesity crisis is an explosion of fad-diet followers, said Lahmayer-Chipps, reiterating that "'diet' doesn't have to be a four-letter word" , moderation is the key. "Atkins is the latest craze. People lose a lot of weight quickly, but they lose muscle mass and water weight. That puts stress on their kidneys and is not good for the heart, long term. And 90% of people on fad diets gain the weight back in a year."
The solution is simple: eat less, burn more, according to Lahmayer-Chipps. It's important for operators to help get that message out to the public.
"Today's society has nearly unlimited access to good-tasting, calorie-dense foods, and very little energy expenditure occurs during a typical day," observed the speaker. She added that, by burning 50 extra calories per day by walking a half a mile, it's simple to shed five pounds per year, without changing one's diet at all. "Weight loss is achieved by eating a balanced diet, and burning up more calories than consumed. Sounds simple, but it's a major challenge for most Americans," said Lahmayer-Chipps.
Inactivity is at an all-time high. Fewer than 30% of high school children are involved in any physical activity at all, and only 25% of students attend physical education class daily. The percentage of children who are overweight or obese has more than doubled in the past 30 years. While schools are fully aware of the rise in obesity, and looking for solutions, only one state requires K-12 daily participation in a physical education class.
The speaker added that schools that opt to pull out vending machines with the hopes of obliterating obesity are likely to further cripple physical education programs that already are underfunded.
The schools' decreased emphasis on physical education, in turn, mirrors a change in social priorities, the speaker noted. "Sixty percent of adults do not engage in the recommended amount of activity. How are kids going to be active with no role models?" asked the speaker. "The solution is as complex as the problem."
Nevertheless, school clients are demanding healthier vending programs. An operator attending the seminar asked Lahmayer-Chipps to suggest some foods that would fit into such a program.
Her recommendations included pretzels, nuts, dried fruit, muffins, crackers, cereal, popcorn, cereal bars, graham crackers and baked chips. For fresh food machines, the nutrition expert suggested baby carrots, celery and radishes with low-fat dip; milks, flavored milks, string cheese and cottage cheese; bagels; lean meat and tuna sandwiches; and fresh or canned fruit.
She urged operators to be proactive by featuring healthier foods in their machines and making their presence known, and meeting special requests for "better-for-you" options. The speaker emphasized that operators should provide educational materials to their customers, especially schools, to drive home the importance of balance and moderation and exercise, and to dispel some of the myths that contribute to the negative image associated with vending and its impact on obesity.
Countering these myths takes some doing, the speaker pointed out. Although some critics believe sugar, in particular, is directly associated with obesity, the truth is that excess calories from any source will cause weight gain. Sugar per se does not cause the body to make or store fat, Lahmayer-Chipps pointed out.
The Institute of Medicine, she added, recently released a "dietary reference intakes" report, which concludes that sweetened foods and beverages can be a part of a balanced, healthy diet for adults and young people alike. After reviewing all the available evidence, IOM concluded that it's acceptable for young people and adults to get up to 25% of their recommended daily allotment of calories from sweetened food and beverages.
"Carbonated beverages do not cause obesity, and contain no harmful ingredients," added the dietician.
NAMA is involved with the American Council for Fitness and Nutrition, and encourages the balanced moderation approach advocated by that group. "It's important to educate consumers to moderate, not eliminate. Decrease portion sizes and be active!" concluded the nutrition professional.
During her presentation titled "Enhancing Your Foodservice Image Through Variety and Healthy Eating Options," Lahmayer-Chipps emphasized that foodservice operators should be aware of the trends driving consumer appetites in order to best meet changing and diverse demands.
These eating patterns include "grabbing" foods for on-the-go consumption; a perhaps "retro" fondness for comfort foods high in fat, sugar and sodium; and an expectation that foods will satisfy "casual indulgence," or eating gourmet every day.
Consumers also seek simple solutions, which the speaker defined as foods that are "somewhat home cooked" for consumption at home. They also desire foods that are custom-prepared to their liking, and foods known to prevent or alleviate illness. Also higher in demand than in recent years past are foods that are perceived as exceptionally pure because "organic." And a consumer trend favoring snacks and "mini-meals" ties right in with vending, added the nutrition expert.
"Media attention to obesity is driving a change in foodservice which is obvious through the product innovation on the market," she pointed out. "There are more 'kid-friendly' foods with reduced fat. Chicken, salmon and turkey are being served burger-style to add variety, taste and nutrition," commented the speaker. "Many chains have meatless burgers. Another example is Schwan's new 'Tony's Smart Pizza,' formulated with 22% less fat and 35% less sodium, in response to demand for healthier foods."
Lahmayer-Chipps stressed that foodservice operators should concentrate on catering to the new breed of health-conscious consumers, and by doing it right, help dissipate the fallacy that "healthy" foods cannot taste good.
She suggested operators hire professionally trained chefs who have a flair for preparing exceptional food and a knack for upgrading menus and visual presentation along with adding excitement by presenting special theme days and meal-related events. She recommended three resources: The American Culinary Federation (acfchefs.org), and the culinary employment services, ihirechefs.com and chefjobs.com.
The speaker also recommended that operators work with a registered dietician to identify healthier eating choices, analyze recipes and develop "better-for-you" menus. "Foodservice is changing; bring in a dietician to be your spokesperson," Lahmayer-Chipps advised. Operators can locate a dietitian by visiting the American Dietetics Association website at eatright.org.
Lahmayer-Chipps heads up the "500 Club" program at Gundersen Lutheran Medical Center (La Crosse, WI), a healthy eating program coordinated by the center's registered dietitians and recommended by physicians. Selections feature controlled fat and calories, and are formulated to make healthy eating easy and enjoyable. The "500 Club" was developed at Gundersen Lutheran in response to a growing demand from consumers and medical center patients who desired dietitian-approved healthy eating options at local restaurants and other food retailers. Responding to inquires from Wisconsin vending operators, Gundersen Lutheran extended the program to vending with great success. Information is available at gundluth.org/nutrition or by calling (608) 775-3816.
"This kind of program takes the guesswork away when people eat away from home. It's available at local restaurants, grocery store delis, vending machines and quick-service restaurants," said Lahmayer-Chipps. "In vending, we identify better choices with shelf markers and static clings indicating that marked snack choices are recommended by dieticians and physicians. It gives people a good feeling about eating from a vending machine."
Vending operators who participate in the "500 Club" provide their recipes for analysis, and Gundersen Lutheran's dietitians identify the ones that fit into the program, and modify the others appropriately. The program has been so successful for Stansfield Vending (La Crosse, WI) that today, 30% of the company's offerings meet "500 Club" criteria.
The speaker asked operators to consider featuring a healthy eating choice of the day as a starting point , one that contains 12 to 15 grams of fat , and to use low-fat cooking methods such as baking, broiling, grilling or steaming rather than frying or sautÃ©ing whenever possible.
To accommodate patrons seeking healthy alternatives, foodservice providers should include at least one vegetable, fresh or cooked, with no butter or cream sauces added, and should serve salads with dressings on the side, with at least one low-fat or fat-free dressing available.
Other selections that are lower in fat and other caloric content suggested by Lahmayer-Chipps include reduced fat/calorie desserts, such as cut up fresh fruit with low-fat fruit yogurt dip; low-fat ice cream or frozen yogurt; sherbet or sorbet; or angel food cake with fruit topping.
Sandwiches can be made both leaner and more appealing by using whole grain breads or pita wraps, and by going light on the butter, margarine or mayonnaise. The speaker also recommended filling sandwiches with lean meats, poultry or marinated tofu, and keeping cheese portions to one ounce at most. A chef's salad that's not too heavy on the meat or cheese portions with light dressing can be another healthful alterative.
Given the heightened awareness of the benefits of healthier eating, customers should have the option of purchasing "lighter" snacks, such as baked chips or pretzels, fresh fruit, crisp rice or granola bars, or a small slice of cake to accompany their sandwich or entrÃ©e.
The speaker also proposed that foodservice operators consider offering a self-serve breakfast bar to appeal to patrons focused on wellness, with fresh fruits, dried fruits, low-fat yogurt, bagels, mini muffins, low-fat granola bars, and spreads that include light margarine, low-fat cream cheese, and jam or jelly. Hot breakfast items that fit "500 Club" guidelines include whole-grain waffles and French toast, lean ham or Canadian bacon, vegetarian bacon substitutes, and egg dishes prepared from an egg substitute.
At catered events, more customers are seeking healthier options. Operators can satisfy a wide range of dietary constraints by offering fresh fruit, raw vegetables with fat-free or low-fat dip or salsa, and pasta, tofu and vegetable salads with fat-free or low-fat dressing. For appetizers, Lahmayer-Chipps suggested vegetable spring rolls (fresh, not fried); sushi rolls; mushroom caps with low-fat cheese stuffing; small cubes of cheese and whole-grain crackers; and miniature pizzas made with part-skim mozzarella cheese.
Also acceptable and appetizing for those watching their diets, according to the dietitian, are lean beef and turkey slices, grilled or broiled skinless chicken brochettes, and miniature meatballs made with lean meat. Poached, steamed or broiled shrimp, scallops, oysters and clams also offer appealing and healthful selections.
Following the "everything fits in moderation" approach, Lahmayer-Chipps recommends topping off the meal with fresh fruit as an option, or cake, cut into small squares.
Healthy eating is more enjoyable when foodservice operators go the extra mile to host special events that generate excitement. "Have a day where you feature all kinds of exotic fruits to promote good choices. Invite guest restaurants from the community to come in and serve a 'signature' healthier item. It's fun for diners and great PR for the restaurant," suggested Lahmayer-Chipps. "Our local Wendy's comes in and serves their new salads, and people love it. It's great to give customers a break from the routine; it boosts employee morale and it's good public relations for you."
Once operators commit to a healthier eating program, communicating the new better-for-you offerings is pivotal to its success. Foodservice providers should use every resource at their disposal to generate publicity, including posters, e-mail, flyers, websites and even designated spokespersons. Operators should also take every opportunity to hand out samples at community fairs and fitness events, to get the word out that they're committed to good health."Tell your story to the media. Be newsworthy! Hold your own health fair. Have a recipe contest and then make a cookbook of healthy recipes," suggested the nutrition expert. "Take it one step at a time; build a few new angles into your program with a focus on health, and communicate the importance of physical activity. You'll please your customers, and you'll be doing your part to help get the obesity epidemic under control."