Food
What we eat is well known to affect our health, but how we obtain and prepare our food and where and when we eat can affect our health in other ways. And as consumer technology becomes infused in the food system and new services become available, all of these dimensions of food are shifting. For the food industry, we reviewed three categories of products and services: 1) chain restaurants; 2) food and grocery delivery services; and 3) meal kit delivery services.
Overall Ratings
Highlights
Chain restaurants, with very few exceptions, scored negatively on all five behaviors. Food and grocery delivery services scored somewhat better on eating, but also contribute to the trend of staying in, being less social and less active. Meal kit delivery services scored quite well for their healthy food, but likewise reinforce a more home-centered lifestyle.
Chain Restaurants
Highlights and Opportunities
Sweetgreen game out head and shoulders above the other chain restaurants due not just to their focus on fresh food, but also their emphasis on walkable locations, their lack of drive-thru service (in all but one of their locations), and their commitment to seating (data suggest that many customers eat at their locations). While there was variation, other chains scored negatively on their influence on eating habits due to poor nutrition quality, high-calorie meals, and ordering experiences that promote greater consumption.
Recent industry trends, adopted variably by the different chains, include emphasizing digital ordering, via app or kiosk, emphasizing drive-thru and delivery service, and de-emphasizing on-premise seating. These practices negatively affect physical activity, social connection and time spent outdoors. Some of the chains, such as Domino's and Taco Bell, which have busy late-night service, scored poorly for their influence on sleep.
Key opportunities for the chains include:
featuring healthy menu items more prominently
defaulting to healthier sides and drinks for combo meals
offering more seating and communal tables (including outdoor seating)
focusing on the social interactions between customers and staff
Methodology
In order to assess the influences of chain restaurants on customers’ diets, we used their published nutrition information for menu items to assess 1) calories (as compared to USDA recommended amounts) and 2) restaurant nutrition quality (RNQ) scores developed by Dr. Abigail Horn and her colleagues(1) and modified by Building H. The RNQ is based on measures of nutritional quality of individual menu items and we modified it so that for each chain, we focused on a basket of featured meal combos. This approach emphasizes what is encouraged and likely consumed as opposed to what’s available on the full menu. We also reviewed the online ordering experiences to understand the degree to which the chains encourage the purchasing of additional items.
We used a variety of other sources to gather data on how chain restaurants influence other behaviors. For each chain, we selected a sample of locations and reviewed Google Maps data on hours of operation, distribution of time customers spend at the locations, and the presence of outdoor seating and drive-thru service. For each sample location we assessed neighborhood walkability, using the EPA’s National Walkability Index.(2)
Product Profiles
Food/Grocery Delivery Services
Highlights and Opportunities
The services we reviewed ranged from those that focused exclusively on grocery pickup and delivery to those that typically focused on food or meal deliveries, but have added grocery delivery. Generally, because home cooking tends to be healthier, nutritionally, than restaurant food (especially fast food), the range of scores for these services tends to reflect the relative emphasis on groceries vs. prepared meals from restaurants. FreshDirect, a regional delivery service that focuses on fresh groceries and Misfits Market and Imperfect Foods, two brands of similar services that emphasize affordable produce, came out highest. DoorDash and Grubhub, which emphasize meal delivery, scored among the lowest in the Index.
The distinctions among the services were largely due to different ratings in their influences on eating. Most of the services scored negatively on physical activity and getting outdoors as they substitute for either going out to grocery stores or restaurants or, in the case of those that emphasized prepared meals, the physical activity associated with cooking. The stay-at-home nature of these services led to negative ratings for engaging socially as well.
There is an important opportunity for food and grocery delivery services to develop industry-wide standards for nutrition quality ratings that can be embedded in online searching and ordering processes, enabling users to sort, filter and otherwise align their purchases with their health preferences. The nutrition science community has made great progress in developing rating systems that assess the healthfulness of food items (see, for example, the Food Compass,(3) developed by researchers at Tufts University) and these systems could be leveraged to make it easier for users to prioritize healthy eating. There are opportunities to support more social engagement through party planning, group ordering, and preferred shopper/deliverer features.
Methodology
For food and grocery delivery services, we also reviewed the ordering experiences to understand what types of foods are most prominently featured. We used results from our 2020 consumer survey on food/grocery deliveries services and meal kit services that included questions on the frequency of use of different modes, the healthfulness of meals ordered and social experiences with the services.(4)
Product Profiles
Meal Kit Services
Highlights and Opportunities
The meal kit delivery services were rated highly for the healthfulness of the meals they provide. All five of the services scored higher on nutrition quality than all but one (Sweetgreen) of the chain restaurants and each featured meals with moderate calorie counts. Purple Carrot, which exclusively offers plant-based meals, and HelloFresh scored highest in terms of nutrition. The meal kits were also rated positively for social engagement, as our research showed that most meal kit customers share meals with others. On the negative side, the meal kit delivery option does contribute to the trend of ordering from home and staying inside, and thus the services scored poorly on getting their customers to spend time outdoors.
Key opportunities for meal kit services include making it even easier, through defaults, to help users prioritize healthy meals and offering services and features that facilitate dinner parties.
Methodology
To assess the healthfulness of the meals offered by the meal kit delivery services, we reviewed the calories of and applied the RNQ (see above) to a set of meals – a random sample of meals offered over a three week period or, if available, a list of the service’s most popular meals. For other behaviors, we drew heavily on the service designs and results from our 2020 consumer survey on food/grocery deliveries services and meal kit services.
Product Profiles
Team
Research, analysis and writing by Cheryl Collins and William Henry, MPH (chain restaurants and meal kits services) and by Steve Downs (food/grocery delivery services). Abigail Horn, PhD provided consultation and data on the use of the RNQ and modified RNQ. Scientific review and consultation on influences and opportunities relating to social engagement by Julianne Holt-Lunstad, PhD, Carla Perissinotto, MD, MHS, Matthew Smith, PhD, MPH and Abigail Barth, MPH.
Notes
Iris Liu et al. A continuous indicator of food environment nutritional quality. MedRxiv. November 26, 2021.
See U.S. Environmental Protection Agency. National Walkability Index: Methodology and User Guide.
Food Compass, Tufts University website.
Steve Downs. A Survey of Modern Life: Food; Delivery Apps, Meal Kits, Groceries and Cooking Dinner. Building H on Medium. January 20, 2022.