1. Operationalizing Food Service
Guidelines to Create a Healthier
Food Environment
Joel Kimmons, Ph.D.
Centers for Disease Control and Prevention
Division of Nutrition, Physical Activity and Obesity
The conclusions in this presentation are those of the
author and do not necessarily represent the views of
the Centers for Disease Control and Prevention.

2. • Food Service Guidelines at the Department of Defense
• Jennifer Wallinger, Navy DoD
• Healthier Food Choices for Public Places
• Katherine Bishop, Center for Science in the Public Interest
• Part of the Solution: National Association of Blind Merchants
• Kevan Worley, National Association of Blind Merchants

3. Making Healthy Choices…
Default, Convenient, Easy, Immediate
Individual and Family Environment
Exposure, norms Policy Access
Skills, knowledge Legislation Advertising
Use of time Economics Affordability
Individuality Healthy
eating and
physical
activity
Social structures,
cultural norms, values

4. Food Service Guidelines
Definition Purpose
Food and beverage standards Construct a food environment
and other information for where the norm is
operating institutional food
service • Healthy dietary choices
• Sourcing • Enviromentally sustainable
• Purchasing and ethical methods
• Preparing • Equity throughout
• Presenting
• Serving
• Selling

5. Health and Sustainability
• Atmosphere • Building design and facilities
• Architecture • Energy use
• Cleaning • Waste
• Serving ware • Cleaning materials
• Cooking methods • Packaging
• Foods offered • Serving ware
• Sourcing of foods
A sustainable food system—
 Integrates production, processing, distribution, and consumption
 Regenerates rather than degrades natural resources
 Is socially just and accessible
 Supports the development of local communities

6. Apply Where Food is Sold,
Served, or Consumed
Settings
Federal, state, local governments
Targets
School systems
Worksites Cafeterias
Hospitals Snack bars
Institutionalized populations Vending
Assisted-living communities Lunch rooms
Colleges and universities Meetings
Community‐based organizations Conferences
(including faith‐based)
Day care centers

7. Developing Standards for
Food Service Guidelines
• Food
• Nutrient levels
• Other aspects of foods (ingredients, contents, contaminants, adulterants,
additives, etc)
• Methods of production (organic, local, ethical)
• Method of preparation (frying)
• Required Percentage of foods offered
• Marketing
• Pricing strategies
• Cafeteria layout, food presentation, choice architecture
• Menu labeling
• Other

8. Health and Sustainability Guidelines for
Federal Concessions and Vending
Operations (HHS/GSA Guidelines)
• Increase healthy and sustainable food and beverage choices and
practices at federal worksites
• Collaborative team: Health and Human Services (HHS) and
General Services Administration (GSA)
• Translate evidence-based recommendations into food service
practices
– Align food choices with the Dietary Guidelines for Americans,
2010
• http://www.cdc.gov/chronicdisease/resources/guidelines/food-
service-guidelines.htm

9. Operationalizing
Food Service Guideline
How do we establish standards as part of the basic operation of food service?
• Guidelines? standards? policy?
• Rate and methods of implementation—Gradual, gentle, flexible
• Increasing access to and choice of healthier foods
• Food vs. nutrient level
• Choice vs. restriction
• Choice architecture
• Pricing strategies
• Menu labeling
• Marketing campaigns
• Increase on-site access – farmers markets, CSAs
• Working with stakeholder
• Appropriately targeted for population and setting
• Organizational support

10. Operationalizing
Food Service Guidelines
Stakeholders—producers, suppliers, managers,
contracting officers, vendors, dietitians, employees, and
consumers
• The health case
• Size • The business case
• Culture • Economic situations
• Nature • Societal needs
• Management structure • Cultural acceptability
• Environmental issues
• Overall sustainability

11. HHS/GSA Guidelines
National Prevention Strategy
• Achieving access to healthy, affordable food within National
Prevention Council departments and (voluntarily) with
partners as appropriate
• 17 federal agencies Including the DOD
States, cities, and communities
• CTG
• CPPW
• Currently model guidelines for at least 12 states
Highlighted in the HHSinnovates award program
Full report on the development and initial contracts available

12. HHS/GSA Guidelines
First contract: HHS Humphrey Building Cafeteria, Washington,
D.C.
• Revenues are up
Nationwide: In the contracts at 28 facilities managed by GSA by
the end of 2013. Additionally, 25 GSA commercial
cafeteria operators are voluntarily using guidelines.
GSA National Capital Region: More than 20-million
annual transactions
CDC facilities in Atlanta are mostly in line with the guidelines

13. Implementing HHS/GSA Guidelines at CDC
Connecting the
right people
Leadership
Office of Sustainability Staff, Go Green Get Healthy
Customers
Management Analysis,
Service Operations

14. Health and Sustainability Guidelines
for Institutional Food Service
Direct
• Influence individuals by changing the food environment
• Adults spend considerable time at work as do children in school
• More than 100 million Americans eat at work daily1,2
Indirect
• Influence family behavior and community norms
System
• Couple the production and demand of healthy foods
• Develop social structures and cultural norms and values
1 Bureau of Labor Statistics
2 Linnan L, Bowling M, Childress J, et al. Results of the 2004 National
Worksite Health Promotion Survey. Am J Public Health. 2008;98(8):1503-9.

15. Resources
HHS and GSA Health and Sustainability Guidelines for Federal Concessions and
Vending Operations
http://www.cdc.gov/chronicdisease/resources/guidelines/food-service-guidelines.htm
GSA: Concessions and Cafeterias: Healthy Food in the Federal Workplace
http://www.gsa.gov/portal/content/104429
www.health.gov/dietaryguidelines
http://www.cdc.gov/nutritionreport/
www.nutrition.gov

16. DoD Food Service Guidelines
 Menu Standards
 Food Acquisition Standards
 Color-coding Food Identification
 Nutrition Environment Assessment
• Action Plan Toolkits

17. Color-coded Food Identification
17

18. Healthier Food Choices for
Public Places
Katie Bishop, M.S., M.P.H.
Nutrition Policy Associate
www.cspinet.org/nutritionpolicy

19. What is healthier food choices for
public places?
• Implementing food and nutrition standards
for food sold or served in public places
• National, state, and local government
property
– Government buildings, parks, high rest
stops, libraries
– Corrections, child care, senior centers,
homeless shelters
• Workplaces, hospitals, universities

20. Why get healthier food in public
places?
• Two-thirds of Americans are overweight or obese,
which contributes to heart disease, diabetes,
cancer, etc.
• Diet-related diseases, such as diabetes, stroke, and
osteoporosis, are leading causes of disabilities.
– For example, nationally, 12,000 to 24,000
people with diabetes become blind each year.
• Americans not as healthy as
they could be

21. Why get healthier food in public
places?
• Helps makes healthier options available
• Emerging as a promising low cost public health
strategy
• Model for healthy eating
• Help shape social norms
• Helps governments and organizations to “walk the
walk”
• Ultimately impact food manufacturers

22. What Does CSPI Do?
• Provide support and technical assistance to
state, localities, and other venues to
implement policies for healthier food
choices for public places
• National Alliance for Nutrition and Activity
(NANA) developed Model Vending Standards
– Includes nutrition, labeling, pricing, placement,
and promotion standards
– List of products the meet the standards
– Gathering revenue data

23. Future Plans
• Guidelines for meeting and
conferences
• Nutrition standards for concessions
and cafeterias

24. For More Information
• http://www.cspinet.org/nutritionpolicy/foodstand
ards.html
– Model standards
– Model policies
– Our resources
– Links to resources
• Email: kbishop@cspinet.org

25. National Association of Blind
Merchants
• National Association of Blind Merchants (NABM)
– Membership organization of blind persons employed in either
self-employment work or the Randolph-Sheppard Vending
Program.
– NABM provides information regarding rehabilitation, social
security, tax, and other issues which directly affect blind
merchants and their vending businesses.
• NABM intends to work with stakeholders and be
at the forefront of healthy concessions initiatives.
• www.blindmerchants.org