The Quest to Provide “Healthy” Food
By Gina Hinch and Rachel Thomas
© Can Stock Photo Inc. / mandygodbehear
In the summer of 2013, staff members of Kanakuk Kamps in Branson, Mo., were confronted with a challenge—the frequency of requests for food that was gluten-free was leading to chaos in the dining hall. A menu traditionally skewed toward calories, carbohydrates, and fats was truly out of sync with a society fighting obesity, a clientele striving to lead a fit lifestyle, and an organizational mantra of good health. Lessons the Kanakuk staff learned on its quest to change the paradigm and meet changing guest expectations, yet still honor camp tradition, may help others.
Lesson #1: Define the paradigm: What is healthy eating? For a diabetic, “healthy” means tabulating sugar grams correctly; for a Celiac, it means practicing a gluten-free regimen; and for someone with a food allergy, it means avoiding a particular food. What does it mean for an athletic camp that encourages good health as part of good stewardship? Team Nutrition, an initiative of the USDA Food and Nutrition Service, defines “healthy eating” in terms of five behaviors:
- Eat a variety of foods.
- Eat more fruits, vegetables, and grains.
- Eat lower-fat foods more often.
- Consume calcium-rich foods.
- Be physically active. 
This definition provided a foundation communicated through the My Plate Program. 
After defining the term “healthy,” the next step was determining exactly what each kitchen served. This seemed simple enough, for menus and recipe files could be examined, but truly knowing required analyzing ingredient labels and food processes. Kanakuk Kamps needed a reliable, easily accessible tool to communicate nutritional facts to dining-hall employees, health-services staff members, and families. Based upon the frequency of information requests, Kanakuk identified the following nutritional facts:
- Allergens present
- Gluten content
- Sugar grams
- Trans fat grams
- Food dyes.
Developing this communication tool required a template understandable by health professionals, laymen, and dining-hall staff. After reviewing the grocery-order guide, the camp created a template organized into four categories:
- Main dishes
- Side dishes
Each camp kitchen had a separate Excel spreadsheet, printed and bound for use in the kitchen and nurses stations, and posted online for parent, camper, and staff year-round use. Table 1 provides a template illustration.
This tool streamlined processes in food preparation; nursing care of diabetic, hypoglycemic, and hyperglycemic individuals; and food-service manager/parent planning.
The ingredient analysis further defined the paradigm by counting sugar grams for diabetics and gluten for celiac campers, and identifying all trans fats. The next step required defining critical control points and successful outcomes. Cross-contamination, availability of desired food, method of preparation, and adequate staffing and training presented opportunities for unsuccessful outcomes, which were defined as a camper stay requiring more than 1 hour total visits to the HealthCenter. Proper planning included written, standardized recipes in Hazard Analysis and Critical Control Point Principles form, adequate staffing for a family-style format (one server/cleaner for every 25 persons eating at each seating), and proper food procurement. Traditionally, the family provided 100 percent of all replacement foods. This was not a user-friendly system, and occasionally resulted in kitchen staff overload to accommodate gluten-free, dairy-free, poultry-free, and combinations of meals. Kanakuk needed a more sustainable solution.
Lesson #2: Abraham Lincoln was right. You can’t make all of the people happy all of the time. Kanakuk dining halls enjoy a reputation for delicious, kid-friendly food. Plentiful desserts and no vegetable-eating requirement delighted kids. However, a very vocal group of parents began advocating for a gluten-free menu. Much discussion ensued among camp directors, operations employees, and business office staff. Even the distributor rep and his corporate dietitian contributed. The food desires of kids and staff, the ways a Christian athletic camp encourages stewardship by providing healthier food, and special dietary needs were all considered topics. Kanakuk traditionally balanced a female tendency to limit caloric intake with a male tendency to desire increased muscle mass and perhaps gain weight. However, in the last 5 years, Kanakuk received many requests for lean protein and fewer carbohydrates. But a 2010 study of the top 25 sources of calories reflected that most people were still eating high-carbohydrate, high-calorie, and high-fat foods. The following table reflects food choices by age group. 
Top 10 Sources of Calories Among Americans Ages 2 Plus Years Old
2-18 years 19+ years
1. Grain-based desserts 1. Grain-based desserts
2. Pizza 2. Yeast breads
3. Soda/energy/sports drinks 3. Chicken/mixed chicken dish
4. Yeast breads 4. Soda/energy/sports drinks
5. Chicken/mixed Chicken Dish 5. Alcoholic beverages
6. Pasta and pasta dishes 6. Pizza
7. Reduced-fat milk 7. Tortillas/burritos/tacos
8. Dairy desserts 8. Pasta and pasta dishes
9. Potato/corn/other chips 9. Beef/beef mixed dish
10. Ready-to-eat cereal 10. Dairy desserts
15. Burgers 11. Burgers
From this study, Kanakuk concluded that a mainstream offering of healthy foods, with choices available from existing inventory, would meet the Dietary Guidelines for Americans and most guest expectations. A wide variety of fresh fruit was already served at each meal, and should continue. Salad bars featuring a wide variety of fresh vegetables, lean protein choices (low-fat cheese, legumes, eggs, and chicken/turkey/ham) were added to every lunch and dinner served in the dining hall. Fried chicken and chicken-fried steak remained on the menu, but grilled chicken was made available as an alternate choice. As always, peanut butter, jelly, and honey were made available at each meal. While many desserts and ice cream treats remained, some were changed to homemade fruit-based offerings. Sugary punch drinks were removed and replaced with Agua Fresco (water with sliced fresh fruit).
Lesson #3: Practice the plan with integrity. Using fresh ingredients and those from scratch, and offering as many choices as budget and staffing would allow addressed many food requests. However, 4 percent of Americans live with food allergies and thus dietary considerations are required.  If additional steps are necessary, use existing inventory and change a production method or a recipe. Cost-control measures, like standardized recipes, centralized menus, accurate forecasting, monitoring for plate waste, and productivity standards, must be established, communicated to all staff, and monitored for execution.  Kanakuk, inundated with guests requesting gluten-free by choice and not medical necessity, took a lesson from the School Nutrition Association. Food allergies diagnosed as a disability and accompanied with a physician’s statement requesting alternate food must be provided for. If food allergies are not diagnosed as a disability, there is no liability. Options may be made available (for example, a salad bar with many options, or peanut butter and jelly).  Staffing patterns, skill sets, and indirect considerations such as housing, mentoring, and training availability must be considered before making promises to guests. If the decision is made to honor requests not medically required, a fee could be charged for additional inventory items, more staff, or a more sharpened skill set. Benchmarks (productivity factors, plate and meal costs, satisfaction survey results, staff recruitment) must be identified to determine sustainability.
Table #3: Kanakuk Bench Marks
Bench Mark Area of Impact
1. All sanitation inspection scores >90% Kitchen/Dining hall
2. Staff: Kamper family-style service1:25 Dining-hall serving staff and cleanup crew
3. Actual grocery budget +/- 2% budget Directors, kitchen staff, accounting, FS manager
4. Plate food waste tracked at <2% Dining-hall serving/cleaning crews, FS manager
5. Plate and meal costs clearly defined and tracked FS manager, directors, program staff
6. New concepts evaluated for liability impact FS manager, risk manager, directors
7. New foods have ZERO net budget impact FS manager and food distributor
8. Initiatives do not occur in a vacuum Directors, health services, accounting, marketing
9. Successful outcome <1 hour unplanned
food-related health-center visit per camper stay Dining hall, health services
Planned and executed with integrity, a meal-replacement program can become a marketing and communication tool. Inclusion Further, inclusion on a web page or blog may help with staff and camper recruitment. Incorporated into the training, this operational consideration becomes a communication tool putting seamless integration of the dining-hall mission, vision, and goals into perspective. Bench marks, training programs, and statistics make excellent communication tools to establish realistic expectations and pave the way to successful outcomes.
Gina Hinch , MA, DTR, is the Food Service Manager at Kanakuk Kamps in Branson, Mo. Reach her at VLHinch@kanakuk.com .
Rachel Thomas , BS, is a Kanakuk Intern.
 While this information was compiled by the National Cancer Institute, it is included in chapter two of Dietary Guidelines for Americans, 2010 . https://fnic.nal.usda.gov/dietary-guidance/dietary-guidelines .
 Best Practice: C7.2, and Insight #10, “Revenue Generation and Cost Control Measures Currently Used in Financially Successful Child Nutrition Programs,” National Foodservice Management Institute. http://www.nfsmi.org/documentlibraryfiles/PDF/20080225031016.pdf
 “Keys to Excellence: Standards of Practice for Nutrition Integrity.” School Nutrition Association, 2013 revised p. 54.