title: How major restaurant chains plan their menus: the role of profit, demand, and health.
abstract: BACKGROUND
  Increased away-from-home eating is associated with lower diet quality, and may contribute to the increasing prevalence of overweight and obesity. Healthier food choices in restaurants may help mitigate the rise in obesity and improve diet quality. This study sought to understand the views of executives at major U.S. restaurant chains regarding the process, motivation for, and challenges of offering healthier options on their menus.
  
  
  METHODS
  The Healthy Menu Study used in-depth structured telephone interviews with 41 senior menu development and marketing executives at leading casual dining and fast-food restaurant chains. The interview guide covered menu trends, influences on introduction and continuation of new menu items, and barriers to adding healthy foods. Data analysis included tabulation of responses, identification of themes, and examination of subgroup differences.
  
  
  RESULTS
  Growing sales and increasing profits are the most important considerations, mentioned by 61% of respondents; health and nutrition were noted as important by 21%. Restaurants may try to avoid losing groups with a "health seeker" by offering healthier foods (low in fat and calories, more fruits and vegetables) (27% of chains), but operators believe demand for healthier foods is not widespread. Additional obstacles to including healthier menu items are short shelf life of produce (46%), increased preparation time, low sales, and high labor costs.
  
  
  CONCLUSIONS
  Not surprisingly, profit margins are the primary determinants of why restaurants do or do not add and continue to serve healthier food options. Without an increase in consumer demand, it is unlikely the restaurant industry will increase their offering of healthy food choices. Insight into the restaurant industry perspective is important for developing promising strategies to encourage healthier eating patterns.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. kglanz@sph.emory.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.forename: Jennifer
authors.initials: J
authors.lastname: Seymour
authors.forename: Kathy
authors.initials: K
authors.lastname: Hoy
authors.forename: Hayden
authors.initials: H
authors.lastname: Stewart
authors.forename: Mark
authors.initials: M
authors.lastname: Lyons
authors.forename: Jeanne
authors.initials: J
authors.lastname: Goldberg
mesh_terms: D002755:Choice Behavior; D003258:Consumer Behavior; D058870:Food, Organic; D015438:Health Behavior; D006801:Humans; D007182:Income; D040541:Marketing; D052756:Nutritional Sciences; D012147:Restaurants