Incremental Costs and Diners' Satisfaction Associated with Improvement in Nutritional Value of Catering Dishes.

Eating in catering systems has been identified as a driver of poor diet quality. Interventions within catering systems increase the nutrient density of dishes. Little is known about the incremental costs associated with this strategy. One part of the NEKST (Nutrition Environmental Kibbutzim Study) intervention was nutritional improvement of recipes (decreasing the amount of energy, sodium, and saturated fat). We evaluated the nutritional content of dishes per 100 g and the incremental costs associated with these changes from the catering system's perspective, as well as diners' satisfaction with the catering system before and after the intervention. Our results revealed that as energy and saturated fat decreased, the associated incremental cost increased (rs = -0.593, p = 0.010 and rs = -0.748, p < 0.001, respectively). However, the decrease in sodium was not associated with increased costs (rs = 0.099, p = 0.696). While diners' satisfaction decreased in the control group, it did not change in the intervention group following the intervention ( p = 0.018). We concluded that recipe modification improved the nutritional value of dishes without increasing cost. This intervention was not associated with decreased diner satisfaction. This evidence encourages the implementation of policies to improve the nutritional quality of food served by caterers without jeopardizing sales and with the potential to improve public health.