What is "stealth health?"

Term may seem foreign, but the concept isn’t.

Fifty-two percent of operators aren’t familiar with the term “stealth health,” according to research from The Big Picture. But that doesn’t mean they aren’t practicing it in their operations.

For some, like Joann Shearer, food and nutrition services director at Avera Heart Hospital in Sioux Falls, S.D., the reasoning lies in the definition. “I wasn’t sure how stealth health was defined,” she says. “After I started talking about what we do to improve the nutritional quality of what we serve, I got to thinking maybe that is stealth health.

When Avera Heart Hospital opened 12 years ago the café was designed as a healthy dining location. Shearer says the department was up front with customers about its healthy dining philosophy, so she didn’t think any stealth health was actually taking place. In reality, Shearer has been practicing stealth health—sneaking in better-for-you items or preparation, often in small ways that customers don’t notice. For example, Shearer adds beans to entrées to cut down on the amount of red meat an item contains, and she substitutes ground flax seeds for flour in baked items.

For Shearer’s meat and potato crowd, she found she can’t use the word “vegetarian” to market her nonmeat options. Instead she finds other ways to describe them that don’t draw attention to the fact that they contain no meat.

Maryann Lazzaro, R.D., foodservice director at Plum Borough (Pa.) School District, says she wasn’t familiar with the stealth health concept, but notes she was using stealth health tactics, such as adding spinach to spaghetti sauce and beans to taco meat.

Lazzaro is also packing more vegetables into her students’ diets. She’s reviving an old recipe for a sweet potato cake. “Nobody has to know it’s a sweet potato cake,” she says. “It’s a spice cake.

She’s also trying to add blueberries to syrup to cut down on the calories, a tactic Lazzaro learned at a recent dietetics conference.

Some respondents—8%— say they know what stealth health is but don’t believe in the practice because they don’t think healthy items should be disguised. But Lazzaro says she doesn’t have a problem with using stealth health tactics as long as there isn’t an allergy problem that could be involved. “It’s like with whole grain,” she explains. “We didn’t really publicize [when we added these items]. We just did it, and students learned to accept it.

B&I operators were the most likely to use stealth health, with 36% saying they employ this concept whenever possible. Joan Homrich, general manager with Bon Appétit at Hill Country Café in San Antonio, uses stealth health in her operation, such as substituting 2% or skim milk for heavy cream in her soups.

Homrich isn’t surprised that so few of her non-commercial colleagues are familiar with stealth health. “There are so many people out there who don’t understand the concept of doing this without being noticed and still being able to create flavors and tastiness,” she says. “That’s the challenge. How can we do this and not lose the flavor?

Fast Facts

  • 51% of LTC/senior living facilities do not promote their healthy menu items. Anita Mays, dietary manager at Ridgewood Manor in Maumee, Ohio, says she doesn’t market her healthy choices because her residents—who are mostly older individuals—aren’t looking to change the way they eat at this stage in their lives.
  • 33% of operators don’t post nutritional information for the items they serve. LTC/senior living is the most likely not to offer this service, at 57%.