Impact of a health and sustainability menu option on consumer perception of Food Service in Portugal

Introduction Food Service aims to provide nutritionally balanced, safe and increasingly sustainable meals for specific population groups. In recent years, the sector has faced growing challenges driven by changing consumer expectations, public health priorities and sustainability demands, particularly regarding menu composition and dietary patterns. Objective To evaluate the association between the implementation of a health and sustainability menu option (flexitarian menu) and consumers' perceptions of Food Service in Portugal. Methods A quasi-experimental repeated cross-sectional study was conducted among adult consumers attending a Food Service unit in Portugal. Consumer perceptions were assessed using paper-based questionnaires administered to three independent samples before implementation of the intervention and 3 and 9 months afterwards. The questionnaires evaluated perceptions of Food Service products, services, companies and overall sector performance. Descriptive and inferential statistical analyses were performed. Results Overall, the implementation of the flexitarian menu option was associated with generally favorable trends in consumer perceptions over time. After 9 months, more favorable evaluations were observed for perceived product quality, innovation, adequacy of meals to consumers' needs and expectations, and organizational attributes related to environmental and social responsibility. Although only limited statistically significant differences were identified, overall consumer evaluations of Food Service became progressively more favorable following implementation. Conclusions/Originality This study provides real-world evidence suggesting that the sustained implementation of a health and sustainability menu option may be associated with more favorable consumer perceptions of Food Service. The findings contribute to the emerging evidence supporting menu-based sustainability interventions as a feasible strategy for promoting healthier and more sustainable institutional food environments.