Convincing low-cost lunch truck operators and their customers to embrace healthier food is possible, but regulation of menus and better marketing may be needed to make long-lasting changes, according to a new RAND Corporation study.
An effort to encourage "loncheras" in Los Angeles to provide healthier meals to their predominately Latino customers showed that such change can happen, but over time the efforts lapsed despite positive feedback from customers, according to the study.
"Getting people to change their away-from-home eating habits is difficult, even after they try and like healthier options," said Dr. Deborah Cohen, the study's lead author and a physician scientist at RAND, a nonprofit research organization. "For lunch truck operators, offering healthy meals is no more difficult than meeting basic sanitation rules. We may need a mix of rules and incentives to improve eating habits in these settings."
The findings are published online by the journal Public Health Nutrition.
Latinos in the United States have disproportionately high rates of overweight and obesity, both of which are associated with a diet that lacks sufficient whole grains, fruits and vegetables. Latinos' diets also contains excessive amount of sugary beverages and sweetened baked goods.
Mobile food trucks called loncheras are common sources of inexpensive away-from-home foods among working-class Latinos and others in Los Angeles. The food trucks usually park at a single location each day while serving ready-to-eat Mexican food and other types of food.
In 2013, there were 2580 licensed and an estimated 2,000 unlicensed food trucks in Los Angeles County, compared with 26,000 restaurants in the region.
RAND researchers worked with a trade association of lonchera operators to identify those willing to offer healthier food options on their menu. Participating food truck operators worked with nutritionists to design healthier meals and received modest subsidies to provide customers with coupons to discount the price of the healthier food.
Researchers faced some trouble finding truck owners willing to participate, eventually studying the experiences of 11 truck operators.
The healthy meals created for the loncheras were balanced with recommended amounts of protein, vegetables and fruit. The cost of ingredients for the healthy meals was slightly higher than comparable standard meals, but profit margins were higher. However, the healthier meals likely required more labor to prepare.
Audits of the food trucks showed the meals accounted for about 2 percent of all sales. A common concern from customers about the healthier meals was that they offered too much food, as customers often just sought a snack. But consumers who bought the healthy items gave them high ratings and said they would recommend them to others.
Sales of the healthier meals were most successful among trucks that already specialized in serving meals for a lunch or dinner crowds in white collar or residential areas.
Cohen says the project shows that it's possible to convince lonchera operators to provide balanced meals based on the federal My Plate guidelines, if they receive proper training and support.
"It seems that any good outlet should be able to offer at least one meal choice that complies with the My Plate criteria," Cohen said. "But food outlets will need to be convinced that the items will sell and they will turn a profit on the effort."
One option local jurisdictions might consider is requiring all licensed food outlets to have at least one healthy option available, which Cohen compares to following sanitation standards that loncheras and other licensed food establishments must follow.
In addition, more marketing will be needed to convince consumers to break unhealthy eating habits to try healthier options, according to the study.
Support for the study was provided by the National Heart, Lung and Blood Institute. Other authors of the study are Ben Colaiaco, Bing Han and Sandy H. Berry of RAND, Mary Martinez-Wenzl of Educational Northwest and Monica Montes of New Health Consultants.
RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.