1. Improving Food Choices in Public Places and Workplaces Katie Bishop, MS, MPH Nutrition Policy Associate kbishop@cspinet.org

2. Growing Movement  American Heart Association Priority  CDC Chronic Disease Funding  CDC Local Sodium Reduction Funding  State and Local Health Departments  Workplaces and Institutions

4. Hospitals NC Prevention Partners Hospitals

5. Types of Food to Cover  Vending  Concessions  Cafeterias  Institutional Feeding  Meetings  Events

6. Venues to Cover  Government Buildings  Community-Based Organizations  Worksites  Parks  Community Centers  Recreational Facilities (city and non-profit)  Childcare Facilities  Hospitals  Local Universities and Colleges  Group Homes  Residential and Day Rehabilitation Programs  Homeless Shelters  Soup Kitchens and Pantries  Senior Centers

7. Why Improve Food Choices?  Lower-cost  “Walk-the-walk”  Workplace environment and individual health  Potential cost saver  Health care costs  Absenteeism  Productivity  Benefits to people with disabilities

8. Why Improve Food Choices?  Model and support healthy eating  Help shape social norms  Impact food manufacturers

9. Why Improve Food Choices?  More and more people are interested in healthier snacks  74% of consumers are trying to eat healthier  65% eating specific foods to lose weight  Sales growth of healthier snacks are outpacing traditional snack foods by 4:1

10. Which Nutrients?  Nutrients to Reduce:  Calories  Saturated Fat  Trans Fat  Sodium  Added Sugars

11. Which Nutrients/ Foods?  Nutrients and Foods to Increase:  Fruits  Vegetables  Whole Grains  Nutrients of Public Health Concern

12. What Percent Healthy?  100% Best  Different political climates and restrictions  Adopt the highest percent that is feasible  Try a phased-in approach

13. Vending Nutrition Standards

15. Typical Healthier Products  Fresh fruit and vegetables  Other fruit  Yogurt  Nuts and seeds  Granola bars  Whole grain cookies  Baked chips  Whole wheat crackers  Popcorn  Waters  100% juice  Low and fat-free milk  Fortified soy milk  Diet juice drinks  Diet and unsweetened teas or coffees  Low-calorie sports drinks  Diet soft drinks

16. Cafeterias  Nutrient based v. food based  Cooking Methods  Additional requirements  Percentage of options v. across the board  Levels of certification

17. Cafeterias  New York City Guidelines  GSA/HHS Guidelines  Washington State Guidelines

18. Institutional Feeding  Captured audience  Per meal, per day, per week requirements

19. Institutional Feeding  New York City Guidelines  Massachusetts State Guidelines  Washington State Guidelines  California State Guidelines

20. Meetings and Events  National Alliance for Nutrition and Activity Healthy Meeting Toolkit  University of MN, School of Public Health Guidelines  Healthy Meeting Pledge

21. Other Provisions  Update guidelines over time  Pricing strategies  Placement of healthy options  Promotion and marketing  Phase-In  Inclusion for people with disabilities  Acceptability of food

22. Working with Vendors  Include them early  Make sure they understand the standards  Listen to and be ready for their concerns  Product availability  Revenue

23. Revenue Impact  Baldwin Park, California  Experienced a dip in sales in the beginning, but after six months revenue returned to previous levels  Chicago Parks District  Overall have gone up and exceeded sales forecasts  Missouri Department of Health and Senior Services  Revenue increased $670 during 3 month pilot  General Services Administration  34% increase in sales

24. Revenue Impact  Rady Children’s Hospital, San Diego, California  Revenue increased  Healthier drink purchases increased 40%  Healthiest drink purchases increased 64%  Sugar-sweetened beverages decreased 35%  Connecticut Mental Health Center  Healthier beverage sales increased 44% and 74% in last two quarters  Fairview Hospital, Great Barrington, MA  No revenue loss  Vanguard Health Chicago  Revenue remained stable

25. Working with Vendors  Product lists or sample menus  Offer to partner with them on implementation  Replace products that aren’t selling well

26. Stakeholders  Leadership  Elected Officials  Vendors  Food Service Directors  Insurers  Local Advocates  American Heart Association  Health Coalitions  Disability Services  Local Health Department  Hospitals  Dietitians and Other Health professionals  Residents, Visitors, or Customers  Area Farmers and Farmers Markets

27. Tips for Successful Implementation  Stealth Health  Promotion  Front and side panel  Emails to staff, flyers, presentations at staff meetings, posters  Provide Education  Educate leadership and employees on benefits of having healthy options

28. Communication  Multiple forms  Large print  Easy to read  Less text and more pictures  Consider literacy level

29. Tips for Successful Implementation  Taste Tests  Hold taste tests to determine which healthy options are preferred in your location  Surveys  Conduct surveys to get feedback from consumers  Kick-off event  Announcement to the Community

30. Tips for Successful Implementation  Presentation  Descriptive Names  Pricing  Placement

31. H. 2011 An Act Relative to Expanding Access to Healthy Food Choices in Vending Machines on State Property  Will update with current information before the conference

32. CSPI’s Website

33. www.cspinet.org/nutritionpolicy/ foodstandards.html Email: kbishop@cspinet.org