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Abstract

Americans rely on foods prepared away from home for an estimated 33 percent of caloric intake. Most restaurants serve foods that have excessive calories, fat, sugar, and salt while omitting fruit, vegetables, and whole grains, the very foods needed to meet the Dietary Guidelines for Americans. In an effort to offer guidance to restaurants and communities as they seek to promote healthy food choices, a conference was held on March 14–15, 2012, in Santa Monica, California, that was funded, in part, by the National Institutes of Health/National Institute of Minority Health and Health Disparities and was organized by the RAND Corporation. A group of 38 national experts in nutrition and public health met to develop performance standards that could guide restaurants toward facilitating healthier choices among consumers.

The guidelines are based on the best available science, while also considering feasibility and acceptability. They recommend limiting a single meal to 700 calories or less for adults and 600 calories or less for children. Adult meals should include at least 1.5 cups of fruits or vegetables, less than 10 percent of calories from saturated fat, less than 770 mg of sodium, and less than 35 percent of calories from sugars. Children's meals should include at least 0.5 cup of fruits or vegetables. Neither meal should include a sugar-sweetened beverage. In addition, the expert panel developed common-sense guidelines discouraging serving practices that increase caloric consumption or undermine a nutritious diet.

Local communities or states could develop and implement certification programs to evaluate adherence to these guidelines on a voluntary or mandatory basis. For example, restaurants could be certified as "healthier" by adopting enough of these guidelines to meet a specified threshold. While offering healthier choices may improve dietary quality, studies are needed to evaluate the economic impact on businesses that adopt them and their effectiveness in reducing caloric intake among diners.

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