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Health on the Restaurant Menu: Foodservice Trends in the U.S.

Health on the Restaurant Menu: Foodservice Trends in the U.S. helps foodservice industry participants align their branding and menu development strategies with evolving consumer health perceptions and expectations; the quickly evolving health education landscape; and the effects of nationwide menu regulation.

The report does the following:

1. Identifies drivers and trends that have helped cause the industry to reflect on its role in addressing America’s health.

  • This helps participants better understand new menu regulations and menu item trends.

2. Analyses health-related menu trends, including salt and added sugar reduction; healthy menu claim trend analysis; “mini” menu item trend analysis; fruit and vegetable menu trend analysis; and health & anti-health menu analysis of specific restaurants.

  • This helps participants stay on top of menu development.

3. Draws from a variety of industry and academic research to help the restaurant industry gauge the effect and result of menu labeling legislation.

  • This helps participants frame the impact of menu regulation on industry segments, major chains, and independent restaurant operators.

4. Analyses consumer attitudes toward diet food and health from the perspectives of their healthful propensities; not-so-healthful propensities; and knowledge, money & time.

  • This helps participants understand shifting consumer health & wellness propensities and respond accordingly.

5. Creates and analyzes four consumer groups, each of which share common health-driven characteristics: Health First, Health Maintainers, Health Endorsers and Carefree Eaters. Each group isolates populations having distinct degrees of food health interest and distinct degrees of restaurant interaction. Data on restaurant frequency, brand usage, and presence of children are included.

  • This helps industry participants target groups according to their healthful propensities, as well as to their restaurant loyalty, the effect of their having children, and their brand usage.

6. Studies the degree of importance restaurant goers ascribe to various food health attributes as applied to two distinct dining occasions: getting food for a “quick bite” and getting food for a “special occasion.”

  • This helps participants shape health-driven strategies around occasions for use.

Coverage includes snack and beverage restaurant concepts, limited-service restaurants (QSR and fast casual), and full-service restaurants (family, casual and fine dining).


  • Executive Summary
    • Scope and Methodology
      • Scope of coverage
    • Methodology
      • Consumer survey methodology
      • Menu item analysis
      • Other resources
      • Restaurant categories
      • Definitions
    • Report synopsis
      • Foodservice Health Drivers & Macro Trends
      • Insight Capsule
      • Fast Facts
    • Restaurant Cuisine and Menu Trends
      • Insight Capsule
      • Fast Facts
    • Menu Transparency and Regulation
      • Insight Capsule
      • Fast Facts
    • Consumer Attitudes Toward Diet, Health & Food
      • Insight Capsule
    • Health Driven Psychographic Analysis
      • Insight Capsule
    • Food Healthfulness and Dining Occasion
      • Insight Capsule
    • Obesity Trends: Demographic Analysis
  • Foodservice Health Drivers & Macro Trends
    • Making health a priority
    • The argument in dollars and cents: $150 billion a year
    • Obesity rates trending higher
    • Calories trending higher
      • Long term calories trend: negative; short term trend: positive
      • Flour and cereal products the calorie contribution leader
    • Snacking trend brings calories with it
      • A quarter of all calories
      • More snacking, more calories
      • No tie to better food choices
      • Foods contributing the most snack calories
        • Table Contribution of Selected Foods and Beverages to Total Snack Calories
      • Nutrient analysis reveals caloric skews to alcohol, sugar, and carbs
      • Gender analysis
      • For women, more fruit but more sugar
    • Socioeconomic factors shaping obesity trend
      • Lower incomes
      • Hispanic culture and practices significantly influence obesity perceptions
      • Burst and bust short time financial cycle leads to food sharing
      • In Hispanic communities, feeding children a symbol of nurturing and achievement
      • Obesity not perceived as negative
    • Self perceptions of diet quality shift
      • Diet self perception does not match reality
      • But change is in the wind
      • Worsening diet or greater awareness?
      • Awareness tied to HH income
    • Restaurant industry growth and the obesity connection
      • Frequency of restaurant use correlates with negative diet self perception
      • Fast food correlation even stronger
      • Consumers do not associate calorie cost with diet healthfulness
      • Eating out and calories: 1 meal out a week
      • Impact weighted toward specific food groups
      • Daypart dependent
      • Fat, sugar and obesity
      • Diet and health tied to type of restaurant frequented
      • Burgers and fries
      • Sandwich/sub
      • Full service
    • Government and industry initiatives quickly gathering steam
      • Patient Protection and Affordable Care Act of 2010
      • Health professionals' hopes
      • MyPlate
      • HealthierUS School Challenge
      • Kids LiveWell
      • Menu item guidelines
      • Guidelines to join the program
      • Charging the obese more for healthcare
      • Penalties to become the new norm?
  • Restaurant Cuisine and Menu Trends
    • Introduction
      • How to promote health on the menu
        • Table Successful Health and Nutrition Promotion Strategies, 2011
    • Ditch the added sugar
      • How much is too much?
      • Come out, come out, wherever you are!
    • Hold the salt
      • Strategy
      • The cost savings: $32.1 billion?
      • Restaurants on the hook?
      • FDA regulation on the horizon?
    • On the menu: healthy menu claim analysis
      • Healthy menu items forecast to grow
      • Menu claims can shape how consumers respond to health
      • Studies reinforces power of menu placement
      • Healthy menu item placement: an experiment
      • Prominence of lower calorie information and placement next to other choices matters
      • Make "light" the new norm?
      • And dump the negative labels!
      • Healthy claims: inherent health leads the pack
        • Table Top Healthy Claims: Restaurant Penetration by Segment, 2011
      • Healthy claims: trend leaders
        • Table Top Healthy Claims: Restaurant Penetration, 2007 11
      • Mini trend tapers
      • Next step: portion control without labels
      • A casual phenomenon
        • Table Top "Mini" Appetizers & Entrees: Restaurant Penetration by Segment, 2011
      • From mini quiches to mini crab cakes
        • Table Top "Mini" Appetizers & Entrees:Restaurant Penetration, 2007 11
      • Mini desserts: incenting use while limiting food content
      • A trend with legs
        • Table Top "Mini" Desserts: Restaurant Penetration by Segment, 2011
      • Infuse the menu with fruit
      • Why? Consumer interest
      • Why? Underuse at restaurants
      • Why? The USDA says so
      • Why? It's a trend in motion
      • Top produce trends
        • Table Top Produce Menu Trends, 2011
      • Top fruits on the menu
        • Table Top 10 Sides: Restaurant Penetration by Segment, 2011
      • Top vegetables on the menu
        • Table Top 10 Proteins:Restaurant Penetration by Segment, 2011
    • What price for health?
      • Don't charge me for it
        • Table Paying for Healthy Items
      • Full service versus limited service distinction
      • Desire for more healthy options
      • Recession and food choice
      • Result: strong migration to money saving strategies
      • Result: change in restaurant behavior
      • But is "healthy" really more expensive?
        • Table Natural, Free Range & "Any" Entrée Pricingby Menu Item Type, 2011
      • Restaurant segment analysis reveals significant price differences
        • Table Natural, Free Range & "Any" Entrée Pricing by Restaurant Segment, 2011
      • "Natural" QSR menu items do exist; but does natural mean "healthy"?
        • Table "Natural" Menu Items:Quick Service Restaurants, 2011
      • Family restaurants follow similar suit
        • Table "Natural" Menu Items:Family Restaurants, 2011
      • Restaurants hitting health themes
        • Table Au Bon Pain Gluten Free Menu Items, 2011
      • Fat free, from fast casual to . . . ice cream
        • Table Fat Free Menu Items: Selected Examples, 2011
      • Sugar free still trying to save desserts
        • Table Golden Corral Sugar Free Menu Items, 2011
      • Whole grain, meet pizza and more
        • Table California Pizza Kitchen Whole Grain Menu Items, 2011
      • Free range: poultry's domain
        • Table Heartland Café Free Range Menu Items, 2011
      • Bar fare and upscale dining
        • Table Free Range Menu Items: Selected Examples, 2011
    • Other menu strategies and introductions
      • Quick service restaurants
      • Popeye's Louisiana Kitchen launches Louisiana Leaux
      • Boston Market
      • Family restaurants
      • Denny's Fit Fare update
      • Casual restaurants
      • Other activity
    • Anti health trends still alive and well
      • High fat, high calorie, high sodium dining alive and well across restaurant segments
      • Kids' meals on the health watch
      • McDonald's, Burger King, Wendy's, KFC and A&W make the list
        • Table Five Most Unhealthful Fast Food Kids Meals, 2010
  • Menu Transparency and Regulation
    • Introduction
    • Menu labeling is upon us
      • Patient Protection and Affordable Care Act of 2010
      • Health professionals' hopes
    • Rationales for change
      • More eating out means lower diet quality
      • And increases weight
      • Consumers underestimate restaurant meal calories
      • Kids affected
      • Eating out frequently lowers diet quality
      • Larger portions
      • Consumers' healthful menu expectations rising?
      • Majority of consumers on board with portion size and nutrition labeling
    • Not effective: why?
      • King County lessons and learnings
      • No change in transaction volume or calories per transaction
      • Increased consumer awareness
      • Consumer confusion
      • Health apathy at POS
      • Website as knowledge supplement
      • Just not paying attention
      • A lesson taken from the grocery aisle
      • So who will use the labels?
      • Education, education, education
    • But expect some behavioral change
      • 1 in 6 diners alter eating habits because of calorie information
      • NPD says calorie information will have little effect on consumer ordering: we disagree
      • Changes in food choices and spend
        • Table Menu Ordering Behavior, Preand PostMenu Regulation
      • Fewer calories at Starbucks
    • Lack of transparency will get restaurants nowhere
      • Calorie underreporting raises concerns
      • Restaurants are starting with an "A"
      • Lack of portion uniformity a culprit?
      • Menu reformulations: restaurants may follow in food retail's footsteps
      • It's been done already: trans fat
      • Industry migration to healthier food products
      • Restaurants ahead of the curve
      • Subway
      • Saladworks
      • Energy Kitchen
  • Consumer Attitudes Toward Diet, Health & Food
    • Introduction
      • Recession be damned: propensity to health and nutrition is on the upswing
      • But interest in food health is there
      • And it's on the upswing
      • The upside
      • The downside
      • Thinking more about food content-and acting on it?
      • The context
      • Self care on the upswing
  • Health Driven Psychographic Analysis
    • Meet the psychographic groups
      • Health First
        • Table Health First Psychographic Group: Key Attitudes & Behaviors
      • Health Maintainers
        • Table Health Maintainer Psychographic Group: Key Attitudes & Behaviors
      • Health Endorsers
        • Table Health Endorsers Psychographic Group:Key Attitudes & Behaviors
      • Carefree Eaters
        • Table Carefree Eater Psychographic Group:Key Attitudes & Behaviors
      • Laying out the demographics
        • Table Demographic Analysis: Health Driven Psychographic Groups
    • Restaurant usage and usage frequency
      • Table Health Driven Psychographic Groups: Restaurant Usage by Segment Usage Frequency
      • Restaurant sub segment by primary cuisine
        • Table Health Driven Psychographic Groups: Restaurant Usage by Full Service Restaurant Segment & Sub Segment
      • Limited service
        • Table Health Driven Psychographic Groups: Restaurant Usage by Limited Service Restaurant Segment & Sub Segment and by Snack and Beverage Restaurant
    • The Kid Factor
      • Presence of children
        • Table Health Driven Psychographic Groups: Segment Restaurant Usage Frequency by Presence and Number of Children
      • Psychographic groups: Restaurant usage frequency analysis Among Health First members, kids make a difference
        • Table Health First: Segment Restaurant Usage Frequency by Number of Children
      • Among Health Maintainers, large households tip the scales
        • Table Health Maintainers: Segment Restaurant Usage Frequency by Number of Children
      • Fast food health endorsement tied to usage frequency
        • Table Health Endorsers: Segment Restaurant Usage Frequency by Number of Children
      • Carefree Eating does not translate to increased visits
        • Table Carefree Eaters: Segment Restaurant Usage Frequency by Number of Children
    • Restaurant brand preferences
      • Health First: limited service restaurant preferences
        • Table Health First Psychographic Group: Restaurant Preference by Fast Food Brand
      • Health First: full service restaurant preferences
        • Table Health First Psychographic Group: Restaurant Preference by Full Service Restaurant Brand
      • Health Maintainers: limited service restaurant preferences
        • Table Health Maintainers Psychographic Group: Restaurant Preference by Fast Food Brand
      • Health Maintainers: full service restaurant preferences
        • Table Health Maintainers Psychographic Group: Restaurant Preference by Full Service Restaurant Brand
      • Health Endorsers: limited service restaurant preferences
        • Table Health Endorsers Psychographic Group: Restaurant Preference by Fast Food Brand
      • Health Endorsers: full service restaurant preferences
        • Table Health Endorsers Psychographic Group: Restaurant Preference by Full Service Restaurant Brand
      • Carefree Eaters: limited service restaurant preferences
        • Table Carefree Eaters Psychographic Group: Restaurant Preference by Fast Food Brand
      • Carefree Eaters: full service restaurant preferences
        • Table Carefree Eaters Psychographic Group: Restaurant Preference by Full Service Restaurant Brand
  • Food Healthfulness and Dining Occasion
    • Overview
    • Food health attribute analysis: getting a quick bite vs. special occasion dining
      • Fruits and vegetables and health of highest importance
      • But a variety of food health attributes distinguished by eating occasion
      • Naturally, women ascribe restaurant food attributes with greater importance
      • But not across the board
      • Women to drive restaurant nutrition change?
        • Table Health Attribute Ratings by Gender:Quick Bite versus Special Occasion
      • Age analysis
        • Table Health Attribute Ratings by Age Bracket:Special Occasion
        • Table Health Attribute Ratings by Age Bracket:Quick Bite
      • HH income analysis
        • Table Health Attribute Ratings by HH Income:Special Occasion
        • Table Health Attribute Ratings by HH Income:Quick Bite
      • Race/ethnicity analysis
        • Table Health Attribute Ratings by Race/Ethnicity:Special Occasion
        • Table Health Attribute Ratings by Race/Ethnicity:Quick Bite
  • Obesity Trends: Demographic Analysis
    • Introduction
    • Obesity and overweight rates for men and women
    • Racial/ethnic differences
    • Children
    • Significant regional disparities
      • A more granular regional perspective

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