Culinary Medicine: Retooling Your Menu and Your Health

Culinary Medicine: Re-Tooling

Your Menu and Your Health

Chef Leah Sarris, Executive Chef GCCM

Walter Zuromski, Culinary Director

Culinary Medicine

Leverage technology with the use of functional

ingredients and portion to maximize the delivery

of change, to stay current and innovative so that

the consumer expectations are always exceeded.

Create healthier, sustainable , delicious food

choices.

Feel Good versus Better for You

• A food & beverage

consultancy rooted in

true culinary innovation,

providing services to

many segments of

industry.

• Work with companies to

provide solution based

R&D, managing change,

to deliver out-of-the-box

results

Chef Services Group, Inc.

Menu Trends

Tag Lines

• Food with integrity

• Live consciously & eat

deliciously

• Feel Good vs. Better for You

Food True to Its Roots

• Nose-to-tail

• Root-to-stalk

• Pickling

• Comfort Foods

• Ancient Grains

• Dark greens

• Flavor authenticity

Field Green Salad with Dried Fruit and

Roasted Walnuts

Ethnic / Ethnic Fusion

• Southeast Asian: starches,

vegetables, lemongrass,

coconut

• South American: Brazilian

meats & seasoning rubs,

Peruvian chilies, techniques

• Korean: BBQ, pickled

vegetables

• Fusion of ethnic influence on

classic favorites

Healthy “Feel Good Cuisine”

• Health conscious menu offerings

• Lighter options

• Controlled portion size

• Alternative grains

• Less saturated fat & sodium

• Clean up - purification

Menu Trends

More Appealing – Capturing the Value Proposition

• Key cues are more subtle for the better-for-you offerings on the

menu and product offerings.

Our Consumers:

• We know that at the altar of health, they may sacrifice portion size,

calories, fat and sodium but they will not surrender “flavor”!

• Identifying the next steps in the evolution of health and wellness

• More esoteric, feel-good platform

• This is not about calories, it’s about nutrient density.

• The emphasis has moved from weight loss to feel-good.

Menu Strategy

• Fad diets and diet menu icons are no

longer in trend.

• These overall product development

strategies are replaced by nutrient-

rich offerings.

• Its about feeling good – which has a

clear focus on delivering “flavor”

Nutrient Rich Offerings

• Our consumers care about the food they put in their body.

• “Feel Good” also pertains to sustainable food sources.

• Trends: gluten-free, allergen-free, probiotics, raw diets,

juicing, Carb to Fiber Ratio - the Eat Tank culture

eattank.org

• This ties to the trend for authenticity local, seasonal,

sustainability and transparency.

Food is the Foundation of Health & Wellness

1. Be transparent.

2. Utilize fresh and seasonal ingredients.

3. Reward good agricultural practices.

4. Focus on whole, minimally processed foods

5. Promote health and sustainability.

6. Target an appropriate serving size.

7. Develop authenticity in flavor, preparation and

diversity.

8. Globally inspired, largely plant-based foods

Top 8 Directives for a Feel Good Directive

At the end of the day, this is about creating

healthier, sustainable, delicious food choices.

Conclusion

1. The need for change

2. Nutrition for Foodservice 101

3. Customer satisfaction & marketing of “healthy”

products

4. Methods to increase nutrition in food

What We’ll Cover

Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI ≥30 kg/m2)

Diabetes

1994

1994

2000

2000

No Data <14.0% 14.0%–17.9% 18.0%–21.9% 22.0%–25.9% > 26.0%

No Data <4.5% 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% >9.0%

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at

http://www.cdc.gov/diabetes/statistics

Now

Now

Lowers life expectancy by up to 15 years

Increases risk of heart disease by 2-4%

Is the leading cause of kidney failure, lower limb

amputations and blindness in adults

Affects 9.3% of population

Costs over $245 BILLION per year

Healthy People 2020

Centers for Disease Control and Prevention

Diabetes

17.7% Obesity

Shorter life expectancy than parents

Increased Type II (“Adult Onset”) Diabetes

Healthy People 2020

Centers for Disease Control and Prevention

American Diabetes Association

Children

Number one and three causes of death in US

Affects 40% of population

Most people have a second event

Costs over $500 BILLION per year

Healthy People 2020

Centers for Disease Control and Prevention

Heart Disease and Stroke

Heart Disease

Obesity

Obesity Trends* Among U.S. AdultsBRFSS, 2010

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Centers for Disease Control and Prevention; www.cdc.gov

Heart Disease

Obesity Comorbidities:

• Type II Diabetes

• Hypertension

• Heart Disease

• Stroke

• Cancers

• All cause mortality

• Social stigmatization and discrimination

Obesity

Comorbidities

High Cholesterol

Heart Disease

Hypertension

Diabetes

Why?

Great. Now…

What can I do about this?

ObesityHypertensionDiabetes

-Heart Failure

-Kidney Failure

StrokesHeart

Disease

-Kidney

failure

-Amputations

-Blindness 140,000616,000

$245,000,000,000 $500,000,000,000

Why?

Poor

Lifestyles

ObesityHypertensionDiabetes

-Heart Failure

-Kidney Failure

StrokesHeart

Disease

-Kidney

failure

-Amputations

-Blindness 140,000616,000

$245,000,000,000 $500,000,000,000

DOCTORS

Why?

Poor

Lifestyles

FOOD

ObesityHypertensionDiabetes

-Heart Failure

-Kidney Failure

StrokesHeart

Disease

-Kidney

failure

-Amputations

-Blindness 140,000616,000

$245,000,000,000 $500,000,000,000

Why?

FOOD

ObesityHypertensionDiabetes

-Heart Failure

-Kidney Failure

StrokesHeart

Disease

-Kidney

failure

-Amputations

-Blindness 140,000616,000

$245,000,000,000 $500,000,000,000

Why?

YOU

FOOD

ObesityHypertensionDiabetes

-Heart Failure

-Kidney Failure

StrokesHeart

Disease

-Kidney

failure

-Amputations

-Blindness 140,000616,000

$245,000,000,000 $500,000,000,000

Why?

YOU

You can have a DIRECT impact on the health of

our population.

Why?

Industry Trends

Calories:

Breakfast 300-400

Lunch 400-500

Dinner 500-600

Snacks 100-200

Fiber:

5-10 grams

Sodium:

<600 mg

Chef Leah’s Guidelines to Healthy Options

Truth or Myth?

To serve healthy food, you must stop making foods consumers love.

Barriers to Eating Healthy

Myth

You can make small adaptations to your product offerings and make a big impact.

Barriers to Eating Healthy

Mediterranean Diet is about ingredients.

Mediterranean Diet

There are 9 components to this diet.

Mediterranean Diet

There are 9 components to this diet.

.

Mediterranean Diet

Vegetables

Legumes

Fruits & Nuts

Cereals and Whole Grains

Fish

Oils/Fats

Dairy

Meats

Alcohol

Adherence to a Mediterranean Diet and Survival in a Greek Population - Antonia Trichopoulou

22,000 study populationProspective Design

Significant reduction coronary disease AND cancer

Mediterranean Diet

A 2 point improvement

confers a 25% reduction in death from

all causes including heart disease and cancer.

(Trichopoulou NEJM 2003; 348: 2599 - 2608)

Mediterranean Diet

Research

There have been hundreds of studies looking at how

effective the Mediterranean diet can be.

• A study of over 200 diabetic patients found that after 4 years only

about half (44%) of those on the Mediterranean diet needed to take

medication compared to almost three-fourths of the control group

who followed a low-fat diet.

• This is a big improvement for those with diabetes and reinforces how

important diet can be in treating blood sugar levels.

Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients With Newly Diagnosed Type 2 Diabetes, Ann

Intern Med. 2009;151:306-314

Mediterranean Diet

However, the Mediterranean diet does not mean

Mediterranean recipes!

Americans eating American foods can have great

success on the Mediterranean diet using the 9 point

scoring system – it’s all about quality ingredients.

Truth or Myth?

Healthy foods mean very small portions, and lowered customer satisfaction.

Barriers to Eating Healthy

Myth

You can actually serve MORE food for LESS calories- it’s all about the INGREDIENTS and presentation!

Barriers to Eating Healthy

Plate Size

Snack Bowl

40 people

Super Bowl Party

Served snacks from 4 medium

or 2 large bowls

Plates & Waist

Snack Bowl

Larger bowl:

took 53% more food

consumed 56% more food

Plates & Waist

Ice Cream Illusions

85 people

17 oz or 34 oz bowl

2 oz or 3 oz ice cream scoop

Served themselves

Plates & Waist

Ice Cream Illusions

Larger bowl

31% more food

Larger scoop

15% more food

Plates & Waist

Bottomless Soup Bowl

54 people

Normal bowl, or self-refilling bowl

Plates & Waist

Bottomless Soup Bowl

Self-refilling bowl participants

ate 73% more soup!

They did not perceive actually eating more.

Plates & Waist

Calorie Reduction

Energy Density

Calorie Reduction

Energy Density Energy Dense - foods that are high in calories and generally

provide few nutrients

Nutrient Dense - foods that are low in calories and high in

nutrients

By eating foods lower in energy and higher in nutrients, one can

eat more food and less calories

Energy Density

• Fruit, vegetable and legume-based sauces

- Coulis, chutney, compote, confit, salsa, pistou/pesto,

yogurt sauce, bean spreads

- Greek yogurt > heavy cream

- Flavorful oils > butter

• Thickeners

- Pureed beans, nuts

- Grains

- Pureed vegetables

- Yogurt, sour cream, Keffir, cottage cheese

• Less refined sugar

– Fruit purees (apple, prune, banana) for less sugar and fat

– 25% reduction in sugar

– Vanilla flavors

Increasing Nutrient Density with Fresh Food

Example

Example

Energy Density

4 different recipes

(Appetite 51 (2008) 50–57 )

(Appetite 51 (2008) 50–57 )

Recipe Calories Fat 4 ounce cost

Meat Lasagna 1026 57 0.54

Mushroom Lasagna 451 19 0.40

Meat Savory Mille-feuille 679 45 0.54

Mushroom Savory Mille-feuille 359 17 0.40

Meat Sloppy Joe 822 14 0.54

Mushroom Sloppy Joe 248 4 0.40

Meat Chili 604 31 0.54

Mushroom Chili 300 5 0.40

Diner’s Perceptions

Energy Density

Satisfaction is key!

Meat Mushroom

Portion test meal consumed

(%) 93.2 91.3

Palatability 13.4 13.0

Satiety (general fullness) 6.0 5.8

Appetite 4.4 4.3

Physical activity (daily kcal) 186.60 192.2

Truth or Myth?

Serving healthy food is more expensive.

Barriers to Eating Healthy

Myth

Believe it or not, eating well can actually SAVE you money.

Barriers to Eating Healthy

Diner’s Perceptions

Energy Density

Total calories

Meat Mushroom

Price per Lb. $2.14 $1.60

Savings per serving $0.14

50 dishes per day $6.75

Per year $2,464.00

Energy Density

Chicken Salad #1

Energy DenseNutrients (g)

Chicken Salad #2

Nutrient Dense

320 Calories 220

2 g Fiber 7 g

31 g Total Fat 6 g

6 g Saturated Fat .5 g

$2.52 Cost $1.62

Energy Density

Chicken Salad #1

Energy DenseNutrients (g)

Chicken Salad #2

Nutrient Dense

320 Calories 220

2 g Fiber 7 g

31 g Total Fat 6 g

6 g Saturated Fat .5 g

$2.52 Cost $1.62

Lunch – Energy Density

Chicken Salad #1

Energy DenseNutrients (g)

Chicken Salad #2

Nutrient Dense

320 Calories 220

2 g Fiber 7 g

31 g Total Fat 6 g

6 g Saturated Fat .5 g

$2.52 Cost $1.62

Lunch – Energy Density

Chicken Salad #1

Energy DenseNutrients (g)

Chicken Salad #2

Nutrient Dense

320 Calories 220

2 g Fiber 7 g

31 g Total Fat 6 g

6 g Saturated Fat .5 g

$2.52 Cost $1.62

Energy Density

Chicken Salad #1

Energy DenseNutrients (g)

Chicken Salad #2

Nutrient Dense

320 Calories 220

2 g Fiber 7 g

31 g Total Fat 6 g

6 g Saturated Fat .5 g

$2.52 Cost $1.62

Truth or Myth?

Consumers will be less satisfied if I provide healthier food.

Barriers to Eating Healthy

Myth

It’s all about how you market it…

Barriers to Eating Healthy

Fine as North Dakota Wine

Diner’s Perceptions

Two Buck Chuck

Noah’s Winery

California Cabernet

Fine as North Dakota Wine

Diner’s Perceptions

Two Buck Chuck

Noah’s Winery

California Cabernet

Noah’s Winery

North Dakota Cabernet

(Physiology & Behavior 90 (2007) 712–716)

Fine as North Dakota Wine

Diner’s Perceptions

Two Buck Chuck

North Dakota Cabernet

Ate less food

Fine as North Dakota Wine

Diner’s Perceptions

Two Buck Chuck

North Dakota Cabernet

Ate less food

Consumed more wine

Fine as North Dakota Wine

Diner’s Perceptions

Two Buck Chuck

North Dakota Cabernet

Ate less food

Consumed more wine

Less satisfied

The Solution?

Consumer Perceptions

The Solution?

Consumer Perceptions

Stop marketing

“healthy” food!

Menuing

Curried Cauliflower BisquePrepared with Yogurt and White Beans. Gluten-free!

Indonesian Pan-Seared Mahi MahiLow-Fat Roasted Pineapple Coulis, Barley Risotto

Pumpkin Bread Puddingwith Vanilla Almond Milk Rum Sauce. Our dairy-free, reduced

sugar version, made with whole wheat bread!

Menuing

Curried Cauliflower BisqueToasted Pistachios, Cilantro Oil

Indonesian Pan-Seared Mahi MahiRoasted Pineapple Coulis, Creamy Barley Risotto

Pumpkin Bread PuddingVanilla Rum Sauce

Consider:

1.Textures

Aim for a variety of textures, and to mimic textures of

items you may be replacing (i.e. mushrooms for meat).

2. Flavors

Meat = umami; look to add depth of flavors in other

ways (soy sauce, Worcestershire, parmesan, cured/

brined foods, smoked paprika, etc).

3. Satiation

Consumers should feel satisfied when done eating.

When Cutting Out

3 things to feel full & satisfied:

1. Protein

1. Fiber

1. Fat

To Consider- Satiation

It’s not just about meat:

• Beans & legumes

• Nuts & Seeds

• Whole Grains (Quinoa & Amaranth)

• Cheese/Dairy

• Eggs

• Seafood

1. Protein

• Whole Grains

• Beans/legumes

• Nuts & Seeds

• Vegetables

• Fruits

2. Fiber

Carbohydrates

Carbohydrates

Complex

Slowly turned into energy

Slowly increases

blood sugar

Fiber

SimpleQuickly turned

into energySpikes blood

sugar

Carbohydrates are good for us!

Goal: Improve the quality of carbohydrates

• Quinoa

• Corn products (cornmeal, polenta,

grits, corn tortillas)

• Brown & Wild Rice

• Farro

• Barley

• Bulghur

• Amaranth

• Buckwheat

• Wheat Berries

• Oats/Steel cut oats

• Millet

Whole Grains

• Stop hiding sugar

– Flavored yogurts, beverages, baked goods, sauces,

dressings

• Limit added sugar

– Reduce sugar by 25%

– Rely on “natural” sugars (fruits, caramelized onions,

roasted and grilled fruits & vegetables)

4 g sugar = 1 teaspoon

Sugar Reduction

Improve the quality of fats:

• Nuts & Seeds (Nut Butters)

• Cheese & Reduced Fat Dairy

• Eggs

• Seafood

• Vegetable Oils

• Avocados

• Cashew cheese/cream, coconut, soy/tofu

• Heavy Cream replacers- Qimiq, DairyFair

3. Fat

• Umami for sodium reduction

– Seaweed powder, dried mushroom, roasted flavors, soy,

miso, yeast extracts

– https://www.chefsteps.com/activities/umami-bomb-

vegetarian-demi-glace

– Potassium substitutes- flavor & cost

• Reduction of fat in frying

– Choice Batter- up to 50% less oil reduction

– 2-step frying process- bake & fry

Ingredients to Improve Nutrition

• Steam/Moisture Technology

-C-Vap, Combi, Sous Vide

-Combi Oven reduction of 21-28% of oil when “frying”

• Reduced Fat Fryers

• Turbochef/Ovention

• Vacuum Tumbling

Improved Cooking Methods with Technology

Combi Ovens Improve Sailor Nutrition, Reduce Labor and Safety Hazards and Capitol

Equipment Costs, Systems Equipment and Engineering Team at Natick Laboratories

1. Developers can have a direct impact on the nation’s health.

2. Stop advertising “healthy” offerings.

3. Better options can be extremely cost-effective.

4. Focus on packaging.

5. Incorporate fruits, vegetables, whole grains and legumes

into existing menu items; small changes = big impact.

6. Utilize healthier fats, reduce saturated fat (end the low-fat

myth).

7. Stop heavily relying on meat.

8. Increase vegetarian and seafood offerings.

9. Offer satiating meals with protein, fiber and fat.

10. Don’t rely on salt, fat and sugar for flavor-building.

11. Utilize technology & cooking methods.

Take-aways

Good Reads

www.culinarymedicine.org

lsarris@tulane.edu

www.chefservicesgroup.com

walterz@chefservicesgroup.com

Thank you!