Eating in the Workplace: Creating a Healthy Food EnvironmentSuzanne G Fultz, MS, RD, CDNNicole Hallissey, MS, RDN, CDNEmployee Wellness DietitiansMemorial Sloan Kettering Cancer Center

Health of Employees

Cardiovascular Disease Diabetes

Cancer

Chronic Obstructive Pulmonary Disease

Smoking

HTN

Obesity

Poor dietary habits

↑Lipids

↑Glucose

Physical inactivity

The Food Environment in the Workplace245‐520 meals 520 

snacks

49‐52 weeks/ye

ar 

5 days/week

1‐2 meals 

2 snacks

Why?

• Healthy People 2020 goals– “Create social and physical

environments that promote good health for all.”

• American Hospital Association charged hospitals

• CDC and Prevention Division of Nutrition Physical Activity and Obesity expert panel

Healthy Hospital Food Initiative

Evidence‐based nutrition criteria that ensure employees, visitors, and patients have better access to healthy food.

Cafeterias Standards:

Fruits and Vegetables1. Offer at least four different fruit choices. 2. Offer leafy green salads and at least one 

vinegar‐based salad dressing.

Cafeteria Standards

Sandwiches, Salads and Entrees

3. Calories 4. Sodium  5. Whole Grain 

All have no more than 700 calories with at least 50% having no more than 500

At least 50% offered have no more than 800 mg sodium

At least 50% are made with whole grains

Cafeteria Standards Soups and Sides

6. Offer at least one steamed, baked, or grilled vegetable option daily that has no more than 200 mg sodium per serving. 7. All soups offered have no more than 480 mg sodium per 8 ounce portion

Cafeteria StandardsBreakfast, Breads, Desserts and Snacks

8. At least 50% of all breakfast breads have no more than 300 calories.9. At least 50% of all desserts have no more than 200 calories.

Cafeteria Standards Breakfast, Breads, Desserts and Snacks10. All pre-packaged snacks meet the following criteria, per package:

– no more than 200 calories – Total fat: no more than 7 grams *– Saturated fat: no more than 2 grams * – Trans fat: 0 grams trans fat – Sodium: no more than 200 mg (except cottage cheese) – Sugar: no more than 10 grams – Yogurt: no more than 30 grams of sugar per 8 ounces – Fiber: contain at least 2 grams of fiber, if product is grain/potato-based

* Nuts, seeds, nut butters, and cheese are exempt

Cafeteria Standards Cooking method:

11. No use of deep fryers; no deep frying. Trans fats:

12. Trans Fat: All items contain 0 grams trans fat per serving.

Cafeteria Standards

Beverages:13. Water is available at no charge 14. At least 75% of all beverage options are low calorie beverages 15. All high calorie beverages are sold in 16 ounce containers or smaller.

Cafeteria Standards

Placement, Promotion, and Pricing16. Stock only healthy options near the entrance to the cafeteria and at the registers.17. Advertising, promotional, and/or marketing materials in the cafeteria can only be for healthy food and beverage options.

Cafeteria Standards

Placement, Promotion, and Pricing18. Post calorie information for items that do not have a Nutrition Facts label.

Cafeteria Standards

Placement, Promotion, and Pricing19. Ensure at least one healthy value meal is available daily. The whole meal should contain:

• No more than 800 mg sodium • A fresh fruit or serving of a non‐starchy vegetable

20. Sandwiches are available in half‐size portions at half the price of a full‐size sandwich.

Healthy Vending Standards

• Require water and seltzer be placed at eye level, or in the highest selling position.

• High calorie beverages should be placed farthest from eye level, or in the lowest selling position. Require all high calorie beverages are sold in 12-ounce containers or smaller.

• Prohibit advertisements of high calorie beverages on vending machines.

Healthy Vending

Implementation Guide

Promotional Materials

FoodWise

• Offered at breakfast and lunch at a discounted price

vegetables, whole grains, 

and lean protein

Meatless MondayLower Risk of Heart Disease and Stroke

Limit Cancer Risk

Budget Friendly

Curb Obesity

Better for the environment

Improved Nutrition 

Quality of Diet

Helping you stop 

and make the right choice

Navigate the cafeteria menu to select healthier options with ease.

Select healthier food based on their 

color code.

Allow for all foods in moderation

Identify what makes one choice healthier than 

another. 

Use the tool to make educated 

decisions.

Green-Light Foods• Steamed, baked or grilled• Less than 300 calories• Less than 200 mg sodium

Side Dishes

• Less than 400 calories per 8 ounces• Less than 480 mg sodium per 8 ounces• Broth‐based rather than cream‐based

Soups

• Less than 800 calories• Less than 800 mg sodium• Less than 25 grams fat• At least 8 grams fiber• Made with whole grains• Contains a side of veggies

Meals

Yellow-Light Foods

• Lightly sautéed or pan‐seared • 300‐450 calories • 200‐400 mg sodium 

Side Dishes

• 400 ‐550 calories per 8 ounces• 480 ‐680 mg sodium per 8 ounces • Broth‐based or contain light cream

Soups

• Less than 800 calories • Less than 800 mg  sodium • No fiber requirement• No whole grain requirement• No veggie requirement

• Less than 25 g fat 

Meals

Red-Light Foods

• Fried or deep‐fried• More than 450 calories  • More than 400 mg of sodium 

Side Dishes

• More than 550 calories per 8 ounces• More than 680 mg sodium per 8 ounces• Made with heavy cream

Soups

• More than 800 calories • More than 800 mg  sodium• No fiber requirement• No whole grain requirement• No veggie requirement

• More than 25 g fat 

Meals

Text

MSK Café Grill Breakfast1 EggAny Style on ToastCalories‐ Sodium‐ Fat‐

1 Egg on Bagel, Roll, English MuffinCalories‐ Sodium‐ Fat‐

1 Egg on CroissantCalories‐ Sodium‐ Fat‐

Add Meat (Bacon, Sausage, Ham)Calories‐ 90‐180 Sodium‐ 410‐550 mg  Fat‐ 7‐16  g

Add EggCalories‐ 70 Sodium‐ 70 mg   Fat‐ 5 g

Add CheeseCalories‐ 180  Sodium‐ 600 mg    Fat‐ 14 g   

Add Tomato or OnionCalories‐ 7 Sodium‐ 0  mg   Fat‐ 2 g    

French ToastCalories‐ 368  Sodium‐ 384 mg    Fat‐ 19 g

PancakeCalories‐ 150 Sodium‐ 450  mg  Fat‐ 1.5 g

Pancake with ToppingCalories‐ 200‐500  Sodium‐ 500‐700  mg Fat‐ 2‐10 g   

Employee$1.55

$1.80

$2.35

$1.20

$0.85

$0.35

$0.25 

$1.25

$1.05

$1.95

Visitor$2.30

$2.50

$2.80

$1.90 

$1.20

$0.50

$0.50

$1.95

$1.50

$2.50Augustine Grantley, Sous Chef

Working with Sustainability

Cafeteria Sourcing

• Certified Local Pledge – Baldor Foods• Populate foods from vendors

– Jersey Fresh– Local Roots – works with farms in

tristate area• Report to Key Green

– Tracks local, sustainable, antibiotic-free and grass-fed spending

• Source organic coffee directly through Starbucks

• Areas of change

• Implement incrementally

Apply a Systemati

c Approach

• Local• Seasonal• Organic

Focus Your Program

• Set up expectations

• Be flexible

Lean on Vendors

Locally Grown Farmers Market – Sourced through vendors– Featured fruits and produce

from New Jersey and New York

– Available every other week (June-October)

– Excess used in daily production

Challenges

SeasonalityHot House 

Items

Watch Trends Menu Changes

Community Sustainable Agriculture

• Sustainability partnership with Employee Wellness, Food & Nutrition

• Local Roots NYC

• Food safety concerns

• Forgotten shares

Practice Greenhealth

Healthy Catering Make argument for a healthy catering menu

Make argument for a healthy catering menu

Plan food/beverage choices

Plan food/beverage choices

☐ Be creative for competitive pricing☐ Be creative for competitive pricing

Creating a Culture of Wellness

Support from Leadership

Create a Wellness Brand

Wellness Advocates

Be Consistent Be Present

Steps to Take in Your Facility

Expertise

• Trained in health/wellness• Individuals who walk the walk

Support

• Cost savings• Productivity 

Track Success

• Unique visits• Change in behavior• Participation in Wellness