Towards a healthy food transition in the Netherlands, the case of third-level education catering

Abstract

Introduction An increasing percentage of Dutch students aged 18-25, currently standing at 25 percent, is overweight. Unhealthy dietary habits are the primary cause of this increase (CBS, 2023). Young adults enrolled in tertiary education spend considerable time on campus, making the role of campus caterers significant in shaping their food behavior (Tam et al., 2017). Unfortunately, many third-level education institutions are currently filled with unhealthy food options, and transitioning to a healthier food environment is a complex process due to the conflicting goals of the stakeholders involved. To understand and solve this issue, this study answers the research question: "To what extent are there mismatches between the goals of third-level education caterers, the organizations they cater to, and the customers' wants, and which pathways can be taken to transition to a healthier food environment?". This is supported by sub-questions that focus on identifying stakeholders, finding barriers, and formulating pathways for transition. The findings of this study will serve as valuable input for the pilot study that the Healthy Food Coalition plans to launch in the upcoming year. With this study, the Healthy Food Coalition aims to demonstrate the profitability of offering healthy food options in the catering industry. The input from this thesis will be used to design an optimal food environment that supports this goal.

Theoretical framework Transitioning to a healthier food environment is a complex process. To facilitate this, the following theories were used: system thinking (Arnold & Wade, 2015) and the leverage points framework by Meadows (1999) and Abson et al. (2017). These theories seek to find barriers and leverage points for change at different ‘depths’ within a system. This not only contributed to a comprehensive understanding of the goals (intent) of the different actor groups but also dived deeper into the other levels of the system, such as design, feedback, and parameters. These helped identify key areas where interventions could have a significant impact on the system, and from these levers, and ultimately pathways were formulated.

Method A total of 33 semi-structured interviews were conducted, which were structured according to the four levels of the 12-point leverage system. From these, 5 were held with caterers, 9 with third-level education organizations, and 19 with students. The interviews with the caterers and stakeholders took place individually, whereas the student interviews took place in focus groups to facilitate discussion. Afterwards, the interviews were transcribed and coded to gather detailed insight from the three different stakeholders regarding the system characteristics and their perceived barriers and solutions. This was complemented with a workshop where interview participants were invited back (2 caterers and 2 third-level education organizations) to identify the most important leverage points and levers to formulate pathways for this transition.

Results Third-level education organizations and caterers strive to provide healthy, sustainable, and inclusive meals. However, these goals are often hindered by the demands of students. They prioritize affordability and portion size over health, conflicting with the goals of third-level education organizations and caterers, complicating the transition to a healthier food environment. Additionally, conflicting goals within caterers and universities, such as balancing sustainability, healthiness, and profitability, further hinder this process. This raises the question: how can these goals be aligned? Using the 12-point leverage system, three key barriers were identified during the workshop: ‘Difficult to change behavior,’ ‘Decreasing student retention,’ and ‘The attractiveness of healthy items.’ From these three barriers, the following pathways were fo