A few weeks after many Americans made their annual resolution to make healthier food choices in the new year, the Center for Science in the Public Interest (CSPI), Washington, unveiled its latest Xtreme Eating Awards winners. These are sit-down restaurant menu items that promote obesity, diabetes and heart disease, said Michael Jacobson, executive director.

“You’d think that the size of their [restaurant chains] profits depended on their increasing the size of your pants,” he said.

Interestingly, when CSPI describes the calorie, fat, sodium and sugar contents of the winners, comparisons are often made to quick-service restaurant (QSR) offerings that turn out being the chain’s better-for-you option.

By no means have QSRs gone unscathed, but the menu improvements many have made have reduced the likelihood of them being targeted by consumer groups. Further, the CSPI has praised some QSRs for posting nutrition information prior to being mandated by the federal government.

Such nutrition labeling not only allows consumers to make informed choices, according to proponents of such initiatives, but it also provides an incentive for companies to reformulate products and introduce healthier options. This is something most QSRs are actively doing.

According to The Healthy Eating Consumer Trend Report, which was published in 2012 by Technomic Inc., Chicago, 64 percent of the consumers polled, up from 57 percent in 2010, agree that it is important to eat healthy and pay attention to nutrition.

“Leading chains are trying to align with consumers’ changing expectations for health,” said Mary Chapman, director of product innovation for the food service market research firm. “McDonald’s, for example, rolled out new menu boards with calorie counts to stay ahead of nutrition-disclosure legislation. Other major QSRs are creating lighter, better-for-you options in order to keep up with consumers’ demands for having these options available to them.

“Additionally, consumers’ definitions of health — and the interest they show in different health-related terms — have broadened and shifted over the past two years. Low-calorie, low-fat and low-sugar descriptors remain highly important to consumers’ health perceptions, but consumers are also increasingly interested in local, natural, organic and sustainable attributes for food and drink — all of which are strongly tied to their contemporary definitions of health.”

Real or perceived health benefits, consumers are attracted toward a more holistic, nourishing approach to wellness. Maybe it’s a Greek yogurt-based sandwich spread or sweet potato fries. If a food is perceived as inherently healthy, it attracts consumers seeking better-for-you options in the highly competitive QSR world.

Chapman said Technomic’s research shows the leading health-oriented descriptor listed on today’s menus is gluten-free.

“Limited-service pizza and sandwich chains, as well as full-service varied-menu operators, have been very active in their development of new gluten-free options since 2010,” she said. “The other big ones are vegetarian and low-fat, which tend to be attached to offerings at sandwich chains. And options simply tagged as ‘lighter’ are also very prevalent in all types of QSRs.”

Keep in mind the term “light” is defined by the Food and Drug Administration, and its use is limited to foods that meet the requirements published in Title 21 of the Code of Federal Regulations section 101.56.

“Organic is also a frequently listed health-halo descriptor,” Chapman said. “This is followed by claims around whole wheat content and seasonal ingredients.”

Consumers indicate ingredients perceived as wholesome may enhance the taste of food as well. Two-thirds of consumers say foods containing a full serving of fruit are slightly or much more flavorful and about two-fifths of consumers say the same for whole wheat foods and foods with a serving of vegetables, according to Technomic.

“These health and taste perceptions also impact consumers’ price thresholds; about a third of consumers are willing to pay extra for foods that incorporate fruits, vegetables and whole wheat,” Ms. Chapman said.

Ron Ahlert, executive director of the Community Culinary School of Charlotte, Charlotte, NC, recognizes that, “It is no secret that diners today are looking for ways to enjoy healthier food. That means that chefs must look for great ingredients with which to create delicious, healthy options.”

The major players forge ahead

No one knows this better than the No. 1 QSR in the world: McDonald’s Corp., Oak Brook, Ill.

“Nutrition at McDonald’s is a continuous journey,” said Cindy Goody, senior director of nutrition. “Our goal is to help customers make easy, informed choices from a balanced menu of food and beverage choices that include a variety of portion sizes from the recommended food groups.”

Goody cited a new entrée choice called the McWrap, which features vegetables, chicken, and sauces wrapped in a flour tortilla.

“We will also introduce a new breakfast sandwich, the Egg White Delight, featuring white cheddar cheese, freshly cooked 100% egg whites and lean Canadian bacon served on an English muffin made with 8 grams of whole grain,” she said. “In addition to introducing new options, we are taking steps to improve customer favorites while ensuring our food and beverages taste great, are affordable and convenient.

“For example, sodium reduction is a key component of our menu evolution. We are committed to reducing sodium by an average of 15% across our national menu of food choices by 2015.”

The Milford, Conn.-based Subway sandwich chain was one of the earliest QSRs to embrace better-for-you menu options, inspiring others to follow. It was in 2000, when Indiana University student Jared Fogle attributed his significant weight loss to a combination of exercise and the smarter choices he learned to make as a frequent Subway diner, including lean meats, vegetables and nonfat condiments. The marketing campaign Subway developed around Mr. Fogle showed Americans fast-food may be healthy.

Today, the company claims it never stops trying to find ways to improve the nutritional aspects of its offerings.

“For example, we changed the way we packaged combo and kids meals,” said Chris Martone, executive chef at Subway. “These meals include a low-fat sandwich paired with better-for-you sides and drinks, such as apple slices, yogurt, low-fat milk and bottled water.

“The Subway brand also now offers avocado and spinach, which are rich in nutrients, in addition to the host of other fresh vegetables that have been on our menu for years. Subway bread has been fortified with both calcium and vitamin D, so now all six-inch sandwiches provide the equivalent calcium level of a glass of milk. In fact, each sandwich, when made according to our standard formula, provides two full servings of fresh vegetables and is rich in complex carbohydrates, as well as a source of various essential nutrients. When served on our nine-grain wheat or honey oat bread, each sandwich contains at least 20 percent of the daily recommended value of fiber.”

Another forerunner in the healthier options QSR movement is Wendy’s, Dublin, Ohio, which at one point in time featured an extensive salad bar. The company has always tried to set itself apart from other QSRs through premium offerings as well as non-traditional QSR menu items, such as baked potatoes and chili.

“Our research and taste testing reveal that consumers crave fresh ingredients and new, zesty flavors that they can’t find in other fast-food restaurants,” said Lori Estrada, vice president of culinary development. “For example, in 2011 we introduced a limited-time item that would capture the best in fresh ingredients: the berry almond chicken salad. By marrying fresh berries with gourmet ingredients, this salad is only served during the peak growing season for strawberries and blueberries. And while other chain restaurants typically offer two types of salad greens — iceberg and romaine — this salad includes 11 freshly chopped greens.

“Something else that’s important to our customers is that we prepare our salads fresh every day, from chopping the lettuce to slicing the fresh strawberries. And the warm grilled chicken breast is sliced and added to the top of the salad once an order is placed.”

A full-size berry almond chicken salad provides a one-cup serving of fruit, with the strawberries and blueberries being an excellent source of vitamin C. They are also rich in antioxidants, which research suggests promote health and prevent disease, Estrada said.

“Berries also provide anthocyanins, which are unique antioxidants that give them their red and blue hues,” she said. “And we pair this salad with a fat-free raspberry vinaigrette dressing made with nutrient-rich juice from the acai berry.”

A few years ago, Denver-based Quiznos took an innovative approach to add nutrition to its menu. The company teamed with a supplier of docosahexaenoic acid (DHA) to develop a line of salad dressings and sandwich toppings enhanced with the long-chain omega-3 fatty acid that serves as building block for the brain and the eyes and supports brain, eye and cardiovascular health. Inclusion of DHA was prominently displayed on in-restaurant packaging and promotions, and in numerous marketing efforts. Unfortunately, Elizabeth Sapp, senior vice president of communications, said that adding DHA to the company’s condiment line was an operational challenge and was discontinued.

Quiznos continues to offer its customers better-for-you options, so for the new year, the company introduced the chef-inspired honey bourbon chicken sandwich. Far from a typical January compromise, said Sapp, the small-size sub contains just under 400 calories. It features oven-roasted chicken layered with honey bourbon mustard grille sauce, and is topped with tomatoes, red onions and lettuce on artisan bread.

The executives leading Dunkin’ Brands, Canton, Mass., have made sure its namesake offering does not alienate consumers who want something more substantial for a meal or snack.

“The DDSMART menu includes several better-for-you options,” said Stan Frankenthaler, Dunkin’ Brands’ executive chef and vice president of product innovation. “For example, the egg white wake-up wraps — either veggie or turkey sausage — are just 150 calories. They are designed for value-conscious, on-the-go people who want a fast, freshly prepared breakfast option in a smaller portion size and with fewer calories than the usual breakfast sandwich.

“In October we added oatmeal with dried fruit to our permanent menu and just this January, select markets now feature the new turkey sausage breakfast sandwich.”

To stay under 400 calories and still be satisfying, the sandwich features a pepper fried egg, turkey sausage patty and a slice of reduced-fat cheddar cheese on a toasted English muffin.

St. Louis-based Panera Bread is not promoting its new better-for-you offerings on menu boards at its bakery-cafes. Rather, the company is sharing its “hidden” menu to customers via the MyPanera rewards program and through social media. Aware guests have to tell a Panera associate that they want to order off the hidden menu.

Overall, the hidden menu emphasizes protein and limits processed carbohydrates. Offerings include breakfast and lunch/dinner items such as an egg white bowl with roasted turkey that features 180 calories and 25 grams of protein, and a Mediterranean chicken salad with 360 calories and 35 grams protein.

Niche market trends

There’s nothing secretive about what Fresh Brothers, a Los Angeles pizza chain, is doing to help reduce calories for health-conscious pizza aficionados. They’ve made the crust skinny. This skinny crust began as something the brothers would cook for themselves.

“My brother Scott would roll out half the dough of a regular pizza crust, and we’d load it up with our favorite toppings, just for ourselves,” said Adam Goldberg, CEO. “Pretty soon, we got to thinking: people would love this as much as we do.

“We are recommending that our customers order their usual toppings on the skinny crust, but what we have learned is that due to its extreme thinness, the topping flavors are more prominent in every bite.”

So, in theory, you can reduce the amount of toppings, and still get the same great taste.

Demetrios Haralambaros, corporate executive chef for Kontos Foods Inc., Peterson, NJ, has his own skinny idea: crepes.

“With less than half the carbs of a plain wrap, and one-third the carbs of a hoagie roll, our new ready-to-use crepes offer operators a healthier alternative to create a delicious sandwich wrap,” he said. “They can also be used to create better-for-you desserts, where the crepe contains fresh fruits, maybe mixed with Greek yogurt.”

The crepes carry the tagline: "Lite, elegant skinny wrap." They come in traditional and savory varieties, with the primary difference between the two being that the savory ones are not sweetened.

He explained that in France, where the crepe originated, sandwich makers never knew of tortillas or other flatbreads.

“The crepe was what they used as an alternative to bread when creating premium wraps,” he said. “What operators here will learn is that the egg proteins in crepes provide integrity and elasticity, something tortillas and flatbreads lack. This prevents them from falling apart and allows for more creative fillings, vs. cold cuts and grilled meats.”

The French are also responsible for white potato fries — a challenge for QSR operators, because they provide little nutritional value. This is why so many operators offer options.

“Fries are the ideal way to serve sweet potatoes in the QSR,” said John Ricks, director of technology and product development for Trinity Frozen Foods, Charlotte, NC. “They provide guests with a healthier option in a form that they are familiar with in that setting. And they don’t require significant changes to the restaurants’ operations.”

Their nutritional value has earned them the title of “super food” by the American Heart Association, Chicago, and the American Diabetes Association, Chicago.

“Using the production technology we have developed, our sweet potato fries retain their nutritional content, their natural color and sweetness,” Ricks said. “They are delicious without any added sugar or salt. With a light dusting of seasoning and a healthy dipping sauce, they can be designed to complement any menu profile — sweet, savory or spicy.”

Chef Ahlert, of the Culinary School of Charlotte, added, “The sweet potato is one of the most versatile, healthiest ingredients you can add to a menu. This is a big reason that CCSC features sweet potatoes in our curriculum. We are located in North Carolina, which happens to be the nation’s leading producer of sweet potatoes, and we like to encourage our future chefs to create dishes with local ingredients.

“Baked, french fried or souffled, sweet potatoes can be incorporated in many places on almost any menu. They are low in sodium, cholesterol free, fat-free, high in fiber, and loaded with minerals and vitamins A, C and E. For those with special dietary needs, they have a low-glycemic index and are great for gluten-free cooking as well.”

Whole grain side dishes are also a creative option.

“We suggest substituting brown rice or other cooked whole grains for fries or pasta on kids’ menus,” said Joe Gozzi, director of sales and product development with Village Harvest, an Otis McAllister company, San Francisco. "For more mature palates, operators can include pre-cooked whole grains on salad bars or use them as toppers in prepared salads. Why not offer whole grain cups with a topping bar that’s geared to the time of day? Breakfast may have dried fruits, nuts and maple syrup. Lunch could have cut veggies, diced roasted chicken and crumbled cheeses.”

Progressive food service operators are getting creative and providing customers with real or perceived better-for-you options.

“People want and enjoy a variety of great-tasting foods that are also healthy,” said Jere Null, CEO of Trinity Frozen Foods. “The healthy element will be more important as we become more educated about nutrition and its long-term impact on health.”