Tulane study examines strategies to implement healthier meal options at Latin American restaurants

Small restaurants that serve immigrant communities play a big role in dietary health in Latin American communities. But convincing owners to downsize portions, advertise calorie counts or adopt other strategies to provide healthier options on their menus may be a challenge, according to a new Tulane University study.

Researchers from Tulane University School of Public Health and Tropical Medicine surveyed independently owned Latin American restaurants in New York City to see how operators would feel about different menu adjustments they could implement to improve dietary and health outcomes for patrons. They found that restaurant owners and staff were receptive to highlighting existing healthy menu options, but they were worried that offering customers the option to select smaller portion sizes would hurt business.

“That was the least accepted healthy eating promotion strategy in our study,” said lead author Melissa Fuster, PhD, associate professor of social, behavioral and population sciences at Tulane. “One might think this is a relatively simple change, compared to changing recipes or providing nutrition information on menus. Arguably, restaurants providing customers the option to buy a smaller portion may also benefit from added profit, by charging a little extra for the smaller portion.”

Resistance to this included perceived social norms, like customers expecting large portions, the potential for revenue loss from a decrease in check amount per table, and logistical barriers, including needing new containers or the need to redesign menus to present the half-portion option. 

She said more creative strategies are needed to tackle persisting diet-related health inequities, moving beyond interventions that place the focus on individuals to make the “right” food choices. 

“The Hispanic population in the U.S. is projected to increase by 61% in the next 30 years, from 60.5 million in 2019 to 99.8 million in 2050,” Fuster said. “Hispanics have a higher burden of diet-related health conditions and risk factors. Among Hispanics, as in the case of the population at large, the consumption of foods away from home is prevalent and has been associated with decreased diet quality and cardiovascular disease risk factors. This indicates a need to engage the sector in promoting healthier eating to combat prevalent diet-related conditions.”

To conduct the study, Fuster and her team met with Latin American restaurant owners and staff, predominantly from New York City, to examine current engagement, acceptability, potential barriers, and resources needed to implement healthy eating promotion strategies. 

Researchers discussed restaurant concepts and opening processes, experience with COVID-19, including past and potential future modifications to the business model, experience with and their perception of healthy eating promotion strategies, resources needed to engage in healthy eating promotion strategies and any new insights gained from the discussion. 

Fuster says future research is needed to expand on this work, including examining the influence of other sectors and stakeholders, such as food suppliers, as well as factors that influence social norms concerning expectations for Latin American Restaurants.

“The results from this study provide important insights from their perspective and experience, serving as a starting point for engagement or to potentially shape future interventions and policies to facilitate healthier offerings in these establishments, while also acknowledging their need for profit, as small community businesses,” she said.

The full study is published in the journal BMC Public Health.