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Hill A, Nara D, Sorscher S, Musicus AA, Lurie P. How Salty Is Too Salty? Designing Sodium Warning Label Policies to Identify High-Sodium Items on Restaurant Menus in the United States. Nutrients 2024; 16:1797. [PMID: 38931152 PMCID: PMC11206306 DOI: 10.3390/nu16121797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Two U.S. cities require chain restaurants to label menu items that exceed 100% of the Daily Value (DV) for sodium, informing consumers and potentially prompting restaurant reformulation. To inform policy design for other localities, this study determined the percentage of the top 91 U.S. chain restaurants' menu items that would be labeled if a warning policy were established for menu items exceeding the thresholds of 20%, 33%, 50%, 65%, and 100% of the sodium DV for adults. We obtained U.S. chain restaurants' nutrition information from the 2019 MenuStat database and calculated the percentage of items requiring sodium warning labels across the food and beverage categories at all the restaurants and at the full- and limited-service restaurants separately. In total, 19,038 items were included in the analyses. A warning label covering items with >20%, >33%, >50%, >65%, and >100% of the sodium DV resulted in expected coverage of 42%, 30%, 20%, 13%, and 5% of menu items at all the restaurants, respectively. At each threshold, the average percentage of items labeled per restaurant was higher among the full-service restaurants than the limited-service restaurants. These results suggest that restaurant warning policies with a threshold of 100% of the sodium DV per item would cover a minority of high-sodium menu items and that lower thresholds should be considered to help U.S. consumers reduce their sodium consumption.
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Affiliation(s)
- Alla Hill
- Center for Science in the Public Interest, 1250 I Street NW, Suite 500, Washington, DC 20005, USA; (D.N.); (S.S.); (A.A.M.); (P.L.)
| | - DeAnna Nara
- Center for Science in the Public Interest, 1250 I Street NW, Suite 500, Washington, DC 20005, USA; (D.N.); (S.S.); (A.A.M.); (P.L.)
| | - Sarah Sorscher
- Center for Science in the Public Interest, 1250 I Street NW, Suite 500, Washington, DC 20005, USA; (D.N.); (S.S.); (A.A.M.); (P.L.)
| | - Aviva A. Musicus
- Center for Science in the Public Interest, 1250 I Street NW, Suite 500, Washington, DC 20005, USA; (D.N.); (S.S.); (A.A.M.); (P.L.)
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
| | - Peter Lurie
- Center for Science in the Public Interest, 1250 I Street NW, Suite 500, Washington, DC 20005, USA; (D.N.); (S.S.); (A.A.M.); (P.L.)
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Ferrante MJ, Johnson SL, Miller J, Bellows LL. Switching up sides: Using choice architecture to alter children's menus in restaurants. Appetite 2022; 168:105704. [PMID: 34547347 DOI: 10.1016/j.appet.2021.105704] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/27/2021] [Accepted: 09/17/2021] [Indexed: 11/02/2022]
Abstract
U.S. children's frequent consumption of restaurant foods has been associated with low vegetable consumption. Use of choice architecture in restaurants has been shown to increase children's orders of healthy sides, but what children consume when healthy sides are included is unknown. The purpose of the present study was to investigate whether altering the choice architecture of children's meals by restructuring the menu, using optimal defaults and vice-virtue bundles, would impact ordering of side dishes and consumption of a vegetable side dish during a restaurant meal. Families with a child between 4-8y attended three dinners at a university-based restaurant. Children's meals included choice of entree (macaroni-and-cheese or chicken tenders) and default side: all carrots (150 g; Menu-1), small fries (50 g)/large carrots (100 g; Menu-2), and small carrots (50 g)/large fries (100 g; Menu-3). Participants could opt-out of the default side for: only fries (Menu-1) or only fries or carrots (Menus-2/3). All foods were pre- and post-weighed to determine consumption. Descriptive statistics examined children's ordering behavior. Repeated measures ANOVA examined differences in consumption of study foods. A paired samples t-test examined differences in french fry consumption (Menus-2/3). Forty-eight children (6.2 ± 1.3 years; 25 male) participated. Most children remained with the default side (Meal-1: 90%; Meal-2: 88%; Meal-3: 85%). Significant differences were seen in children's consumption of french fries (t = -2.57, p = .014) where children ate more during meal 3 compared to meal 2. There were no significant differences in carrot consumption. Use of optimal defaults led to increased orders of healthy sides and steady consumption across the meal conditions. However, use of an optimal, vice-virtue bundle led to a decrease in consumption of french fries. Further investigation of optimal default use on children's menus is warranted.
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Affiliation(s)
- Mackenzie J Ferrante
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, USA.
| | - Susan L Johnson
- University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave, Mail Stop F-561, Academic Office Building, Room 2609, Aurora, CO, USA.
| | - Jeffrey Miller
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, USA.
| | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, USA; Division of Nutritional Sciences, Cornell University, 3107 Martha Van Rensselaer Hall, Ithaca, NY, 14853, USA.
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Lee K, Caine-Bish N. Understanding Restaurant Healthfulness in Food Deserts. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:511-516. [PMID: 33487567 DOI: 10.1016/j.jneb.2020.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/30/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine differences in restaurant environments between neighborhood and restaurant type to understand better a food desert's eating environments. METHODS The Nutrition Environment Measures Survey for restaurants was used to assess restaurant healthfulness. Kruskal-Wallis compared healthy index scores, and Pearson chi-square compared individual items. RESULTS Healthy index scores were consistently low across neighborhoods (total mean = 4.6 out of 23). Fast-food restaurants (mean = 5.7) were more healthful than sit-down restaurants (mean = 3.1). Individual comparisons showed more healthy eating facilitators (eg, nutrition information at point-of-purchase, P = 0.004) in food deserts and more available healthful items (eg, whole grain bread, P < 0.001) in the neighborhoods with high incomes. CONCLUSIONS AND IMPLICATIONS Findings indicate equities in restaurant environments across all neighborhoods but inequities across restaurant types, thus conclude the importance of restaurant type in understanding restaurant healthfulness. Policymakers can use these findings to develop healthy eating strategies in varying neighborhoods.
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Affiliation(s)
- Kiwon Lee
- Department of Hospitality Management, College of Education, Health, and Human Services, Kent State University, Kent, OH.
| | - Natalie Caine-Bish
- Department of Nutrition, College of Education, Health, and Human Services, Kent State University, Kent, OH
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Love DC, Turvey C, Harding J, Young R, Ramsing R, F Tlusty M, Fry JP, Nguyen L, Asche F, Nussbaumer EM, Thorne-Lyman AL, Bloem M. Nutrition and origin of US chain restaurant seafood. Am J Clin Nutr 2021; 113:1546-1555. [PMID: 33693458 PMCID: PMC8168351 DOI: 10.1093/ajcn/nqaa437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Seafood has a nutritional profile that can be beneficial to human health, which gives it a role to play in healthy diets. In addition, because its production and harvesting can have fewer environmental impacts than some forms of animal protein, it can contribute to sustainable diets. However, the positive health and environmental outcomes are not guaranteed-they depend on how seafood is prepared and served and whether it is sourced from sustainable fisheries and aquaculture industries. OBJECTIVES We examined the availability and nutritional attributes of seafood meals at chain restaurants in the United States. We assessed nutritional attributes by store type and geography. We also assessed menu labeling for species, production methods, and origin. METHODS The study population was 159 chain restaurants with 100,948 branch locations in the United States. Data were harvested from online restaurant menus, and the nutritional profile of seafood meals was calculated. RESULTS The average seafood menu item provides up to 49-61% of the total daily limit of saturated fat, 65% of the total daily limit of sodium, and 58-71% of total daily protein requirement for adult men and women. Restaurant chains located in the Deep South and Ohio River Valley, and casual dining chains nationally, carry seafood meals with more total calories and saturated fat per 100 g than other regions or chain types. Most menu items did not list origin or production methods, which is information that would help consumers make informed decisions. CONCLUSIONS The added ingredients and cooking methods used at chain restaurants can attenuate the health benefits of seafood. We recommend reformulating menus to reduce portion sizes, total calories, added fat, and sodium content per meal and to improve consumer-facing information about origin and production methods.
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Affiliation(s)
- David C Love
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Catherine Turvey
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- The George Washington University, Milken Institute School of Public Health, Washington DC, USA
| | - Jamie Harding
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ruth Young
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rebecca Ramsing
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Michael F Tlusty
- School for the Environment, University of Massachusetts Boston, Boston, MA, USA
| | - Jillian P Fry
- Department of Health Sciences, Towson University, Towson, MD, USA
| | - Ly Nguyen
- Food Systems Institute and School of Forest Resources and Conservation, University of Florida, Gainesville, FL, USA
| | - Frank Asche
- Food Systems Institute and School of Forest Resources and Conservation, University of Florida, Gainesville, FL, USA
- Department of Industrial Economics, University of Stavanger, Stavanger, Norway
| | - Elizabeth M Nussbaumer
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Andrew L Thorne-Lyman
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Martin Bloem
- Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Prevalence and nutrient composition of menu offerings targeted to customers with dietary restrictions at US fast casual and full-service restaurants. Public Health Nutr 2021; 24:1240-1247. [PMID: 33431097 DOI: 10.1017/s1368980021000112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the prevalence and nutrient composition of menu offerings targeted to customers with dietary restrictions at US fast casual and full-service chain restaurants. DESIGN We used 2018 data from MenuStat, a database of nutrient information for menu items at large US chain restaurants. Five alternative diets were examined: gluten-free, low-calorie, low-carbohydrate, low-fat and vegetarian. Diet offerings were identified by searching MenuStat item descriptions and reviewing online menus. For each diet, we reported counts and proportions. We used bootstrapped multilevel models to examine differences in predicted mean kilojoules, saturated fat, Na and sugars between diet and non-diet menu items. SETTING Forty-five US fast casual and full-service chain restaurants in 2018 (including 6419 items in initial analytic sample across small plates, salads and main dishes). PARTICIPANTS None. RESULTS The most prevalent diets were gluten-free (n 631, 9·8 % of menu items), low-calorie (n 306, 4·8 %) and vegetarian (n 230, 3·6 %). Compared with non-diet counterparts, low-calorie main dishes had significantly lower levels of all nutrients examined and vegetarian main dishes had significantly lower levels of all nutrients except saturated fat. Gluten-free small plates had significantly fewer kilojoules, grams of saturated fat and milligrams of Na compared with non-diet small plates. CONCLUSIONS A small proportion of fast casual and full-service restaurant menus are targeted towards customers with dietary restrictions. Compared with non-diet items, those classified as gluten-free, low-calorie or vegetarian generally have healthier nutrient profiles, but overall nutrient values are still too high for most menu items, regardless of dietary label.
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Trends in the healthiness of U.S. fast food meals, 2008-2017. Eur J Clin Nutr 2020; 75:775-781. [PMID: 33110191 DOI: 10.1038/s41430-020-00788-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 09/08/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to examine trends in the healthiness of U.S. fast food restaurant meals from 2008 to 2017, using the American Heart Association's Heart-Check meal certification criteria. METHODS Data were obtained from MenuStat, an online database of the leading 100 U.S. restaurant chains menu items, for the years 2008 and 2012 through 2017. All possible meal combinations (entrées + sides) were created at the 20 fast food restaurants that reported entrée and side calories, total fat, saturated fat, trans fat, cholesterol, sodium, protein, and fiber. Chi-square tests compared the percent of meals meeting each American Heart Association (AHA) nutrient criterion; and the number of AHA criteria met for each year, by menu focus type. RESULTS Compared with 2008, significantly fewer fast food meals met the AHA calorie criterion in 2015, 2016, and 2017, and significantly fewer met the AHA total fat criterion in 2015 and 2016. Significantly more meals met the AHA trans fat criterion from 2012 to 2017, compared to 2008. There were no significant changes over time in the percent of meals meeting AHA criteria for saturated fat, cholesterol, or sodium. CONCLUSIONS Efforts to improve the healthiness of fast food meals should focus on reducing calories, total fat, saturated fat, and sodium.
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Healthy and unhealthy food environments are linked with neighbourhood socio-economic disadvantage: an innovative geospatial approach to understanding food access inequities. Public Health Nutr 2020; 23:3190-3196. [DOI: 10.1017/s1368980020002104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:This study examined the separate relationships between socio-economic disadvantage and the density of multiple types of food outlets, and relationships between socio-economic disadvantage and composite food environment indices.Design:Cross-sectional data were analysed using geospatial kernel density techniques. Food outlet data included convenience stores, discount stores, fast-food and fast casual restaurants, and grocery stores. Controlling for urbanicity and race/ethnicity, multivariate linear regression was used to examine the relationships between socio-economic disadvantage and density of food outlets.Setting:This study occurred in a large Southeastern US county containing 255 census block groups with a total population of 474 266, of which 77·1 % was Non-Hispanic White, the median household income was $48 886 and 15·0 % of residents lived below 125 % of the federal poverty line.Participants:The unit of analysis was block groups; all data about neighbourhood socio-economic disadvantage and food outlets were publicly available.Results:As block group socio-economic disadvantage increased, so too did access to all types of food outlets. The total food environment index, calculated as the ratio of unhealthy food outlets to all food outlets, decreased as block group disadvantage increased.Conclusions:Those who reside in more disadvantaged block groups have greater access to both healthy and unhealthy food outlets. The density of unhealthy establishments was greater in more disadvantaged areas; however, because of having greater access to grocery stores, disadvantaged populations have less obesogenic total food environments. Structural changes are needed to reduce access to unhealthy food outlets to ensure environmental injustice and reduce obesity risk.
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Alexander E, Rutkow L, Gudzune KA, Cohen JE, McGinty EE. Healthiness of US Chain Restaurant Meals in 2017. J Acad Nutr Diet 2020; 120:1359-1367. [DOI: 10.1016/j.jand.2020.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 01/02/2020] [Indexed: 11/29/2022]
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Ho DE, Mbonu O, McDonough A, Pottash R. Menu labeling, calories, and nutrient density: Evidence from chain restaurants. PLoS One 2020; 15:e0232656. [PMID: 32379786 PMCID: PMC7205205 DOI: 10.1371/journal.pone.0232656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 03/24/2020] [Indexed: 11/26/2022] Open
Abstract
The Food and Drug Administration's menu labeling rule requires chain restaurants to prominently display calories, while leaving other nutritional information (e.g., fat, sodium, sugar) to the request of consumers. We use rich micronutrient data from 257 large chain brands and 24,076 menu items to examine whether calories are correlated with widely used "nutrient profile" scores that measure healthfulness based on nutrient density. We show that calories are indeed statistically significant predictors of nutrient density. However, as a substantive matter, the correlation is highly attenuated (partial R2 < 0.01). Our findings (a) suggest that the promise of calorie labeling to improve nutrient intake quality at restaurants is limited and (b) clarify the basis for transparency of nutrient composition beyond calories to promote healthy menu choices.
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Affiliation(s)
- Daniel E. Ho
- William Benjamin Scott and Luna M. Scott Professor of Law, Professor of Political Science, Senior Fellow, Stanford Institute for Economic and Policy Research, Stanford University, Stanford, CA, United States of America
| | - Oluchi Mbonu
- Ph.D. Student, Harvard University, Cambridge, MA, United States of America
| | - Anne McDonough
- Research Fellow, Stanford Law School, Stanford, CA, United States of America
| | - Rebecca Pottash
- J.D., Stanford Law School, Stanford, CA, United States of America
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Muc M, Jones A, Roberts C, Sheen F, Haynes A, Robinson E. A bit or a lot on the side? Observational study of the energy content of starters, sides and desserts in major UK restaurant chains. BMJ Open 2019; 9:e029679. [PMID: 31594875 PMCID: PMC6797243 DOI: 10.1136/bmjopen-2019-029679] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Our objective was to examine the kilocalorie (kcal) content of starters, sides and desserts served in major UK restaurant chains, comparing the kcal content of these dishes in fast-food and full-service restaurants. DESIGN Observational study. SETTING Menu and nutritional information provided online by major UK restaurant chains. METHOD During October to November 2018, we accessed websites of restaurant chains with 50 or more outlets in the UK. Menu items that constituted starters, sides or desserts were identified and their kcal content was extracted. Accompanying beverages were not included. We used multilevel modelling to examine whether mean kcal content of dishes differed in fast-food versus full-service restaurants. MAIN OUTCOME MEASURES The mean kcal content of dishes and the proportion of dishes exceeding public health recommendations for energy content in a main meal (>600 kcal). RESULTS A total of 1009 dishes (212 starters, 318 sides and 479 desserts) from 27 restaurant chains (21 full-service, 6 fast-food) were included. The mean kcal content of eligible dishes was 488.0 (SE=15.6) for starters, 397.5 (SE=14.9) for sides and 430.6 (SE=11.5) for desserts. The percentage of dishes exceeding 600 kcal was 26.4% for starters, 21.7% for sides and 20.5% for desserts. Compared with fast-food chains, desserts offered at full-service restaurants were on average more calorific and were significantly more likely to exceed 600 kcal. CONCLUSIONS The average energy content of sides, starters and desserts sold in major UK restaurants is high. One in four starters and one in five sides and desserts in UK chain restaurants exceed the recommended energy intake for an entire meal.
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Affiliation(s)
- Magdalena Muc
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Andrew Jones
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Carl Roberts
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Florence Sheen
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Ashleigh Haynes
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Eric Robinson
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
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Nutrient composition of Australian fast-food and fast-casual children's meals available in 2016 and changes in fast-food meals between 2010 and 2016. Public Health Nutr 2019; 22:2981-2988. [PMID: 31514763 DOI: 10.1017/s1368980019001897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE A quarter of Australian children are overweight or obese. Research conducted in 2010 found that fast-food children's meals were energy-dense and nutrient-poor. Since then, menu labelling and self-regulation of marketing have been introduced in Australia. The present study aimed to: (i) investigate the nutrient composition of children's meals offered at fast-food chains; (ii) compare these with children's daily requirements and recommendations and the food industry's own criteria for healthier children's meals; and (iii) determine whether results have changed since last investigated in 2010. DESIGN An audit of nutrition information for fast-food children's meals was conducted. Meals were compared with 30 % (recommended contribution for a meal) and 100 % of children's daily recommendations and requirements. A comparative analysis was conducted to determine if the proportion of meals that exceeded meal requirements and recommendations, and compliance with the food industry's own criteria, changed between 2010 and 2016. SETTING Large Australian fast-food chains. PARTICIPANTS All possible children's meal combinations. RESULTS Overall, 289 children's meals were included. Most exceeded 30 % of daily recommendations and requirements for a 4-year-old's energy, saturated fat, sugars and Na. Results were also substantial for 8- and 13-year-olds, particularly for Na. When compared with mean energy and nutrient contents from 2010, there were minimal changes overall. CONCLUSIONS Children's meals can provide excess energy, saturated fat, sugar and Na to children's diets. Systematic reformulation of energy, saturated fat, sugars and Na would improve the nutrient composition of the meals.
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Kraak V, Rincón-Gallardo Patiño S, Renukuntla D, Kim E. Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000-2018: A Scoping and Systematic Review to Inform Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2732. [PMID: 31370229 PMCID: PMC6695776 DOI: 10.3390/ijerph16152732] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/12/2019] [Accepted: 07/20/2019] [Indexed: 11/16/2022]
Abstract
Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000-2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants' practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide.
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Affiliation(s)
- Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | | | | | - Eojina Kim
- Department of Hospitality and Tourism Management, Pamplin College of Business, Virginia Tech, Blacksburg, VA 24061, USA
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Morgan Hughey S, Kaczynski AT, Porter DE, Hibbert J, Turner-McGrievy G, Liu J. Development and testing of a multicomponent obesogenic built environment measure for youth using kernel density estimations. Health Place 2019; 56:174-183. [DOI: 10.1016/j.healthplace.2019.01.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/28/2018] [Accepted: 01/14/2019] [Indexed: 02/03/2023]
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Martin BL, Thompson LC, Kim Y, Williams W, Snow SJ, Schladweiler MC, Phillips P, King C, Richards J, Haykal-Coates N, Higuchi M, Ian Gilmour M, Kodavanti UP, Hazari MS, Farraj AK. Acute peat smoke inhalation sensitizes rats to the postprandial cardiometabolic effects of a high fat oral load. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 643:378-391. [PMID: 29940449 PMCID: PMC7003129 DOI: 10.1016/j.scitotenv.2018.06.089] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/04/2018] [Accepted: 06/08/2018] [Indexed: 05/11/2023]
Abstract
Wildland fire emissions cause adverse cardiopulmonary outcomes, yet controlled exposure studies to characterize health impacts of specific biomass sources have been complicated by the often latent effects of air pollution. The aim of this study was to determine if postprandial responses after a high fat challenge, long used clinically to predict cardiovascular risk, would unmask latent cardiometabolic responses in rats exposed to peat smoke, a key wildland fire air pollution source. Male Wistar Kyoto rats were exposed once (1 h) to filtered air (FA), or low (0.36 mg/m3 particulate matter) or high concentrations (3.30 mg/m3) of peat smoke, generated by burning peat from an Irish bog. Rats were then fasted overnight, and then administered an oral gavage of a HF suspension (60 kcal% from fat), mimicking a HF meal, 24 h post-exposure. In one cohort, cardiac and superior mesenteric artery function were assessed using high frequency ultrasound 2 h post gavage. In a second cohort, circulating lipids and hormones, pulmonary and systemic inflammatory markers, and circulating monocyte phenotype using flow cytometry were assessed before or 2 or 6 h after gavage. HF gavage alone elicited increases in circulating lipids characteristic of postprandial responses to a HF meal. Few effects were evident after peat exposure in un-gavaged rats. By contrast, exposure to low or high peat caused several changes relative to FA-exposed rats 2 and 6 h post HF gavage including increased heart isovolumic relaxation time, decreased serum glucose and insulin, increased CD11 b/c-expressing blood monocytes, increased serum total cholesterol, alpha-1 acid glycoprotein, and alpha-2 macroglobulin (p = 0.063), decreased serum corticosterone, and increased lung gamma-glutamyl transferase. In summary, these findings demonstrate that a HF challenge reveals effects of air pollution that may otherwise be imperceptible, particularly at low exposure levels, and suggest exposure may sensitize the body to mild inflammatory triggers.
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Affiliation(s)
- Brandi L Martin
- Oak Ridge Institute for Science and Education, 1299 Bethel Valley Rd, Oak Ridge, TN 37830, United States
| | - Leslie C Thompson
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Yongho Kim
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Wanda Williams
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Samantha J Snow
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Mette C Schladweiler
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Pamela Phillips
- Toxicity Assessment Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, RTP, NC, United States
| | - Charly King
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Judy Richards
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Najwa Haykal-Coates
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Mark Higuchi
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - M Ian Gilmour
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Urmila P Kodavanti
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Mehdi S Hazari
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States
| | - Aimen K Farraj
- Environmental Public Health Division, US EPA, 109 TW Alexander Drive, Research Triangle Park, NC, United States.
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15
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Kraak V, Englund T, Misyak S, Serrano E. Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E760. [PMID: 28704965 PMCID: PMC5551198 DOI: 10.3390/ijerph14070760] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/01/2017] [Accepted: 07/04/2017] [Indexed: 12/02/2022]
Abstract
Consumption of restaurant food and beverage products high in fat, sugar and sodium contribute to obesity and non-communicable diseases. We evaluated restaurant-sector progress to promote healthy food environments for Americans. We conducted a desk review of seven electronic databases (January 2006-January 2017) to examine restaurant strategies used to promote healthful options in the United States (U.S.). Evidence selection (n = 84) was guided by the LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) and verified by data and investigator triangulation. A marketing-mix and choice-architecture framework was used to examine eight voluntary strategies (i.e., place, profile, portion, pricing, promotion, healthy default picks, priming or prompting and proximity) to evaluate progress (i.e., no, limited, some or extensive) toward 12 performance metrics based on available published evidence. The U.S. restaurant sector has made limited progress to use pricing, profile (reformulation), healthy default picks (choices), promotion (responsible marketing) and priming and prompting (information and labeling); and some progress to reduce portions. No evidence was available to assess progress for place (ambience) and proximity (positioning) to promote healthy choices during the 10-year review period. Chain and non-chain restaurants can apply comprehensive marketing-mix and nudge strategies to promote healthy food environments for customers.
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Affiliation(s)
- Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Tessa Englund
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Sarah Misyak
- Virginia Cooperative Extension's Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
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