Presented by Leah Sarris ’05 and Walter Zuromski ’76 at the Research Chefs Association 2016 conference.

1. Culinary Medicine: Re-Tooling
Your Menu and Your Health
Chef Leah Sarris, Executive Chef GCCM
Walter Zuromski, Culinary Director
Culinary Medicine

2. 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

3. • 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.

4. 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

5. 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

6. 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

7. • 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

8. • 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

9. 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

10. At the end of the day, this is about creating
healthier, sustainable, delicious food choices.
Conclusion

11. 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

12. 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

13. 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

14. 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

15. 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

16. Heart Disease

17. Obesity
Obesity Trends* Among U.S. Adults
BRFSS, 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

18. Heart Disease

19. Obesity Comorbidities:
• Type II Diabetes
• Hypertension
• Heart Disease
• Stroke
• Cancers
• All cause mortality
• Social stigmatization and discrimination
Obesity

20. Comorbidities
High
Cholesterol
Heart
Disease
Hypertension
Diabetes

21. Why?
Great. Now…
What can I do about this?

22. ObesityHypertensionDiabetes
-Heart Failure
-Kidney Failure
StrokesHeart
Disease
-Kidney
failure
-Amputations
-Blindness 140,000
616,000
$245,000,000,000 $500,000,000,000
Why?
Poor
Lifestyles

23. ObesityHypertensionDiabetes
-Heart Failure
-Kidney Failure
StrokesHeart
Disease
-Kidney
failure
-Amputations
-Blindness 140,000
616,000
$245,000,000,000 $500,000,000,000
DOCTORS
Why?
Poor
Lifestyles

24. FOOD
ObesityHypertensionDiabetes
-Heart Failure
-Kidney Failure
StrokesHeart
Disease
-Kidney
failure
-Amputations
-Blindness 140,000
616,000
$245,000,000,000 $500,000,000,000
Why?

25. FOOD
ObesityHypertensionDiabetes
-Heart Failure
-Kidney Failure
StrokesHeart
Disease
-Kidney
failure
-Amputations
-Blindness 140,000
616,000
$245,000,000,000 $500,000,000,000
Why?
YOU

26. FOOD
ObesityHypertensionDiabetes
-Heart Failure
-Kidney Failure
StrokesHeart
Disease
-Kidney
failure
-Amputations
-Blindness 140,000
616,000
$245,000,000,000 $500,000,000,000
Why?
YOU

27. You can have a DIRECT impact on the health of
our population.
Why?

28. Industry Trends

29. 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

30. Truth or Myth?
To serve healthy food, you must stop making foods
consumers love.
Barriers to Eating Healthy

31. Myth
You can make small adaptations to your product
offerings and make a big impact.
Barriers to Eating Healthy

32. Mediterranean Diet is about ingredients.
Mediterranean Diet

33. There are 9 components to this diet.
Mediterranean Diet

34. There are 9 components to this diet.
.
Mediterranean Diet
Vegetables
Legumes
Fruits & Nuts
Cereals and Whole Grains
Fish
Oils/Fats
Dairy
Meats
Alcohol

35. Adherence to a Mediterranean
Diet and Survival in a Greek
Population - Antonia
Trichopoulou
22,000 study population
Prospective Design
Significant reduction coronary disease AND cancer
Mediterranean Diet

36. 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

37. 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

38. 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.

39. Truth or Myth?
Healthy foods mean very small portions, and
lowered customer satisfaction.
Barriers to Eating Healthy

40. Myth
You can actually serve MORE food for LESS
calories- it’s all about the INGREDIENTS and
presentation!
Barriers to Eating Healthy

41. Plate Size

42. Snack Bowl
40 people
Super Bowl Party
Served snacks from 4 medium
or 2 large bowls
Plates & Waist

43. Snack Bowl
Larger bowl:
took 53% more food
consumed 56% more food
Plates & Waist

44. Ice Cream Illusions
85 people
17 oz or 34 oz bowl
2 oz or 3 oz ice cream scoop
Served themselves
Plates & Waist

45. Ice Cream Illusions
Larger bowl
31% more food
Larger scoop
15% more food
Plates & Waist

46. Bottomless Soup Bowl
54 people
Normal bowl, or self-refilling bowl
Plates & Waist

47. Bottomless Soup Bowl
Self-refilling bowl participants
ate 73% more soup!
They did not perceive actually eating
more.
Plates & Waist

48. Calorie Reduction
Energy Density

49. 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

50. Energy Density

51. • 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

52. Example

53. Example

54. 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

55. 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

56. Truth or Myth?
Serving healthy food is more expensive.
Barriers to Eating Healthy

57. Myth
Believe it or not, eating well can actually SAVE you
money.
Barriers to Eating Healthy

58. 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

59. Energy Density
Chicken Salad #1
Energy Dense
Nutrients (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

60. Energy Density
Chicken Salad #1
Energy Dense
Nutrients (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

61. Lunch – Energy Density
Chicken Salad #1
Energy Dense
Nutrients (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

62. Lunch – Energy Density
Chicken Salad #1
Energy Dense
Nutrients (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

63. Energy Density
Chicken Salad #1
Energy Dense
Nutrients (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

64. Truth or Myth?
Consumers will be less satisfied if I provide
healthier food.
Barriers to Eating Healthy

65. Myth
It’s all about how you market it…
Barriers to Eating Healthy

66. Fine as North Dakota Wine
Diner’s Perceptions
Two Buck Chuck
Noah’s Winery
California Cabernet

67. 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)

68. Fine as North Dakota Wine
Diner’s Perceptions
Two Buck Chuck
North Dakota Cabernet
Ate less food

69. Fine as North Dakota Wine
Diner’s Perceptions
Two Buck Chuck
North Dakota Cabernet
Ate less food
Consumed more wine

70. Fine as North Dakota Wine
Diner’s Perceptions
Two Buck Chuck
North Dakota Cabernet
Ate less food
Consumed more wine
Less satisfied

71. The Solution?
Consumer Perceptions

72. The Solution?
Consumer Perceptions
Stop marketing
“healthy” food!

73. Menuing
Curried Cauliflower Bisque
Prepared with Yogurt and White Beans. Gluten-free!
Indonesian Pan-Seared Mahi Mahi
Low-Fat Roasted Pineapple Coulis, Barley Risotto
Pumpkin Bread Pudding
with Vanilla Almond Milk Rum Sauce. Our dairy-free, reduced
sugar version, made with whole wheat bread!

74. Menuing
Curried Cauliflower Bisque
Toasted Pistachios, Cilantro Oil
Indonesian Pan-Seared Mahi Mahi
Roasted Pineapple Coulis, Creamy Barley Risotto
Pumpkin Bread Pudding
Vanilla Rum Sauce

75. 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

76. 3 things to feel full & satisfied:
1. Protein
1. Fiber
1. Fat
To Consider- Satiation

77. It’s not just about meat:
• Beans & legumes
• Nuts & Seeds
• Whole Grains (Quinoa & Amaranth)
• Cheese/Dairy
• Eggs
• Seafood
1. Protein

78. • Whole Grains
• Beans/legumes
• Nuts & Seeds
• Vegetables
• Fruits
2. Fiber

79. Carbohydrates
Carbohydrates
Complex
Slowly turned
into energy
Slowly
increases
blood sugar
Fiber
Simple
Quickly turned
into energy
Spikes blood
sugar
Carbohydrates are good for us!
Goal: Improve the quality of carbohydrates

80. • 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

81. • 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

82. 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

83. • 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

84. • 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

85. 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

86. Good Reads

87. www.culinarymedicine.org
lsarris@tulane.edu
www.chefservicesgroup.com
walterz@chefservicesgroup.com
Thank you!