Poor nutrition in the UK is of growing concern. Recent government statistics estimate that over half adults in the UK are overweight, with a quarter actually obese. Furthermore, NHS data published in December 2023 showed that more than 800,000 patients were admitted to hospital with malnutrition and nutritional deficiencies last year. This means there has been a threefold increase in diagnoses linked to poor diet in past decade.
Whilst many caterers promote healthy and nutritious food, current approaches are clearly not being effective in tackling the nutritional challenges we’re facing. Despite many positive efforts from chefs and management teams, more can be done to improve the nation’s health.
At this point in time, few organisations can boast of a specific nutrition policy that details their stance and commitment to providing food of a high nutritional standard. It may be true that food procurement and selection is often incorporated into sustainability initiatives, but specific, measurable commitments to improving nutrition are few and far between.
Even in organisations where nutrition is clearly valued, the implementation of a formal framework to define and monitor key nutritional performance measures is often lacking.
A key issue is the overuse of terms like ‘healthy’ and ‘nutritious’, which are vague and open to interpretation. In reality, food doesn’t exist in convenient categories such as ‘healthy’ or ‘unhealthy’. All foods sit on a spectrum of healthiness, with each individual food being more or less healthy depending on what it’s being compared to and in what context it’s being eaten.
We need to start being more specific in our discussions about nutrition. Instead of talking generally about ‘healthy’ food, it is often much more useful to talk about how menus support specific food-based dietary guidelines. This removes some of the subjectivity and starts to provide measurable outcomes.
Questions can be asked such as ‘is each meal occasion providing at least two portions of fruit and vegetables?’. If not, then what else is being used to justify any claim that it is ‘healthy’?
The UK’s food-based dietary guidelines provided by the ‘Eatwell Guide’ are a useful resource and can form the starting point for defining how healthy a meal or menu may be. For example, it is the Eatwell Guide that recommends eating at least five portions of a variety of fruits and vegetables each day. Implementing a menu template that actively supports this should be a minimum standard for anything being promoted as healthy.
Other key features of the Eatwell Guide, such as eating oily fish on a weekly basis and focusing on higher fibre whole grains can all be integrated into menu development policies and monitoring frameworks. Frameworks that include measurable indicators such as ‘portions of fruits and vegetables in each meal’, ‘percentage of wholemeal pasta used in recipes’ can give a much clearer picture of how nutrition is being managed and also how it is improving.
A second issue is that even when the healthiest food is available, it doesn’t mean that people will choose to eat it. This means we need to extend our nutritional thinking beyond simply the food to the wider food environment and activities that can nudge people into making better choices. We know that no matter how healthy a food may be, if it remains uneaten on a plate, left in a serving dish or unchosen on a menu, it’s not doing anyone any good. Therefore, the key to providing good nutrition lies in both the provision of healthier foods and also the creation of an eating environment where these foods are most likely to be chosen.
Having measures in place to ensure that the healthier or healthiest options are the most appealing and easiest choices is the first indicator of responsible catering. Application of culinary skills should be focused on enhancing the appearance, flavour and texture of those foods that offer greatest nutritional value. Displays should be organised to enhance visibility and remove barriers between the customer and the healthiest options.
Conversely, less healthy options should be less visible and carefully controlled through recipe management and portion control to discourage over consumption.
There are many factors that influence how and why we make the food choices we do. Some factors may be very personal, but many are within the scope of influence of a proactive caterer. The communications that are made (verbal and non-verbal) and the expectations that are set can all have a significant impact on what people choose to eat. Tools such as the Five Aspect Meal Model (FAMM) create useful frameworks for evaluating how an eating environment can influence eating behaviour and choices.
Examples of how manipulation of the five aspects (the room, the meeting, the product, the management system and the atmosphere) have an impact on eating behaviour will be discussed in a follow-up article in the March issue of Public Sector Catering). The insights gained from health psychology and the drivers of eating behaviour can be as important as the food itself in encouraging people to make better choices.
In summary, we need to move away from simply relying on ‘nutritious’ food and ‘healthy options’ if we are to tackle the growing problem of malnutrition in all its forms. Caterers, who want to, and in the public sector have a responsibility to, contribute to the growing improvement of the nation’s nutrition now need to do three things.
Firstly, publish a clear policy that outlines their commitment to raising nutritional standards within their organisation; secondly, implement a menu framework to ensure the food they provide measurably supports the UK food-based dietary guidelines; and thirdly, put initiatives in place to actively nudge people towards making healthier food choices.