The prevalence of nutrition-related conditions (overweight/obesity, cancer, diabetes, heart disease, etc.) among Americans is widely documented. During the last twenty years, the frequency of dining out has increased, with Americans currently eating restaurant-prepared foods an average of five to six times per week. Compared to meals prepared at home, restaurant fare tends to contain more calories, total fat, saturated fat, and sodium. Conventional efforts aimed at addressing the situation described above have focused on encouraging consumers to minimize eating out and/or guiding diners in identifying and selecting healthier menu options, approaches fraught with challenges. Instead, the """"""""default strategy"""""""" approach proposed here seeks to test the feasibility of modifying standard restaurant recipes to include less cheese, oil, butter, mayonnaise, salad dressings, etc., to a degree that is not detected and/or is acceptable to restaurant customers. The modifications will result in corresponding reductions in the levels of calories, fat, saturated fat, and sodium. The advantage of the proposed approach is that restaurant consumers will benefit from the modified preparation methods without having to be knowledgeable about nutrition or motivated to make healthier choices. The consumer does not even need to take any specific action to benefit. Instead, this approach relies on the participation and cooperation of restaurants. The appeal of this approach to restaurants includes (1) lower food costs, and (2) the fact that, as menu legislation is requiring more restaurants to reveal nutrient values for their menu items, there is more interest by restaurants to improve the nutrition profiles. Restaurant chefs and RandD teams will work with HEALTHY DINING, a California-based company with nearly two decades'experience in restaurant nutrition, to revise and then test modified recipes. During Phase I, three restaurant companies participated in establishing feasibility for the project. Several ingredients tested were successfully reduced by 12 to 25 percent and found to be acceptable to consumers. During Phase II, the research will (1) expand to examine the effect of modifying more restaurant meals from more restaurants, specifically prepared salads, sandwiches, burgers, soups, pasta dishes, and heavily buttered side dishes;(2) investigate ways to improve measurement accuracy when small-to- moderate ingredient modifications are made (3) calculate nutrition improvement achieved by the successful modification as well as cost savings to the restaurants and estimated impact on public health if adopted by the restaurant industry. If this approach is found to be successful, HEALTHY DINING will collaborate with the National Restaurant Association to publicize the effectiveness of the """"""""default strategies"""""""" to restaurant chains throughout the nation.

Public Health Relevance

Obesity and poor nutrition contribute significantly to four of the ten leading causes of death in the United States (cancer, heart disease, stroke and diabetes) and cost an estimated $200 billion in health care costs each year. The fact that Americans are eating restaurant-prepared foods four to five times per week, along with the fact that restaurant meals tend to be less healthful and larger than meals prepared at home, contribute significantly to the health problems stated above. Therefore, it is increasingly important for overall public health that restaurants provide and promote healthier meals.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HDM-K (10))
Program Officer
Weber, Patricia A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Accents on Health, Inc.
San Diego
United States
Zip Code
Patel, Anjali A; Lopez, Nanette V; Lawless, Harry T et al. (2016) Reducing calories, fat, saturated fat, and sodium in restaurant menu items: Effects on consumer acceptance. Obesity (Silver Spring) 24:2497-2508
Lawless, Harry T; Patel, Anjali A; Lopez, Nanette V (2016) Mixed Messages: Ambiguous Penalty Information in Modified Restaurant Menu Items. Food Qual Prefer 52:232-236