The New Stewards of the American Diet: In Defense of (Some) Restaurants

For many people, eating out has become a way of life. Whether out of necessity or choice, it is no longer an occasional indulgence. On average, Americans spend over half of their food dollars on foods prepared away from home. In urban areas, some young adults consume upwards of 75 percent of their calories on meals and drinks served in restaurants and other foodservice operations. Because of the decline of in-home cooking and the increase in number of meals purchased, the foodservice industry today has an unprecedented amount of influence over our dietary habits, particularly for children during their formative years.

Restaurants and foodservice operators frequently come under attack for their contribution to our nation's food related epidemics: diabetes, obesity and cardiovascular disease. While it may be easy to condemn an industry that is guilty of serving food portions that commonly exceed the government's daily-recommended limits for calories, sodium and fat in a single entrée, it is important to remember that their behavior is shaped by incentives, as well as regulation.

A common refrain from the industry is that it is impossible to say with certainty what causes obesity and diabetes, and that restaurants are simply giving people what they want. While it is true that "experts" often do not agree on precisely what is and is not good for you, it is hard to go wrong with Michael Pollan's simple advice in his bestseller In Defense of Food: "Eat food. Not too much. Mostly plants."

When preparing food for yourself, this advice is fairly easy to follow. However, as chefs on payroll replace chefs at home, it is important to recognize that they are in many ways economically motivated to do just the opposite.

Whether it is your favorite local restaurant, a national chain or most school and hospital cafeterias, the primary driver of the ingredients being used and selections being offered is the operator's bottom-line. In other words, nutrition, health and sustainability are typically an afterthought -- if any thought at all. As in any business, the industry is economically incentivized to optimize its raw material selections for profitability, which unfortunately is often at odds with nutrition, health and environmental sustainability. As noted by agricultural historian John Ikerd in The Weight of the Nation, "The kind of food we eat in this country is the kind that is most profitable."

As the percentage of people eating out has grown and restaurant chains have become ubiquitous, the hyper-competitive nature of the business has resulted in enormous pressure to cut costs wherever possible. The supply chain has adapted, driving down the costs and increasing the consumption of low-nutrient, calorie-dense food and beverages, while there has been a dramatic rise in the price of more nutritious foods, such as vegetables and fruits, lean meats and lower fat dairy products. Sugar, salt, fat and flour are not only relatively cheap, we are all hardwired to crave them, especially in processed foods. In moderation, these ingredients are not widely considered to be unhealthful. Unfortunately, the current system promotes excess. Exacerbating the situation, restaurants are also incentivized to offer excessively large portions. Since restaurants have high fixed costs (rent and labor) compared with the relatively low raw material costs (food and beverage), the incrementally cost of larger servings is proportionally insignificant -- hence the 64-ounce soda. Furthermore, to be successful, restaurants have to serve portions that will satisfy the demands of the most voracious eaters, not the average. And as large quantities with high levels of sugar, fat and salt has become the norm, everything else has begun to feel inadequate and bland in comparison.

In other words, we have an incentive structure that has lead the industry away from the types of food that are generally recognized as best for us, which are moderate portions of real, whole foods, with a large percentage of vegetables and fruits. And this trend -- while certainly not the sole cause -- has been coincident with dramatically higher rates of diabetes, obesity and cardiovascular disease, which have come with an enormous cost to the nation.

It is difficult to overstate the implications of the current American diet. Diseases that are linked to our dietary choices kill an estimated three out of four Americans each year. For the first time in history, diseases related to lifestyle such as diabetes and heart disease kill more people than communicable ones. Obesity alone is one of the biggest drivers of preventable chronic disease and health care costs in the country. In fact, the health care crisis is in large part a crisis of American dietary habits -- roughly three quarters of over two trillion dollars we spend on health care in this country goes to treat chronic diseases, many of which are preventable.

As noted last year by Dr. Mark Hyman, "In 1900, 2 percent of meals were eaten outside the home. In 2010, 50 percent were eaten away from home and one in five breakfasts comes from McDonald's." As the new stewards of the American diet, the restaurant and foodservice industry stands in a powerful and unique position to promote healthier eating habits. And there are signs that a growing number of enlightened chefs and restaurant owners are stepping up.

Chef Jamie Oliver is using his fame and influence to campaign against processed foods in our schools and to improve diets across America and the UK. Renowned Chef Michel Nischan started a foundation to improve the accessibility and affordability of locally grown vegetables and fruits. Farm to fork restaurants are beginning to sprout up across America, and even some new fast casual and quick service chains such as True Food Kitchen, Sweetgreen and LYFE Kitchen are getting onboard.

However, if these pioneers are going to stay in business, it is imperative that we make serving healthful and sustainable food good for business. This may mean initially paying a little more. But as the broader food industry adapts by developing new supply chains, technologies and business models in order to compete on quality instead of quantity, innovation and economies of scale will bring costs down. Better for you food may not be cheapest, but it is less expensive than health care. And that is something we should all get behind.