Comparison of buffet and à la carte serving at worksite canteens on nutrient intake and fruit and vegetable consumption

Nudging strategies to promote plant-based and sustainable food consumption in canteens

Transitioning towards a more plant-based diet can promote sustainable food consumption while simultaneously addressing environmental and health-related issues. Integrated nudging strategies are effective in promoting healthy eating behaviours. Therefore, this study aimed to investigate the effect of an integrated nudging intervention to promote plant-based meals and determine its effect on promoting sustainable food consumption behaviour. The effects of two versions of a meal on the frequency of choosing a plant-based meal were tested through a quasi-experimental pre-post intervention at three educational context canteens. During the intervention, the priming tools were strategically positioned between the meat meal and the plant-based target meal. In total, 3870 purchases were analysed to observe their choices. Additionally, a total of 508 consumers completed a pre- or post-intervention survey. Approximately 60.5 kg (133.4 lbs) less of food waste was generated during the intervention compared to the baseline with a reduction of 6.5 % per plate. The purchase of plant-based meals increased by about 38% from pre-to during-intervention, while meat-based meals decreased by about 19%. The grams of meal consumed per meat-based plate differed significantly from pre-to post-intervention, while that of plant-based did not differ significantly. The environmental assessment reveals that adopting a more plant-based diet and minimizing food waste for each plate significantly reduces the overall environmental impact of the meal. The integrated nudging strategy indirectly influenced sustainable food consumption behaviour through its effect on attitudes and subjective knowledge. Price-health-conscious consumers exhibited higher sustainable food consumption behaviour. These findings suggest that integrated nudging interventions can effectively shift consumer choices towards sustainable food options by influencing their attitudes and knowledge, eventually benefiting environmental sustainability and public health.

More than the worksite cafeteria: the workplace food environment of small and medium-sized enterprises in the Netherlands

OBJECTIVE

To characterise the food environment of Dutch small and medium-sized enterprises (SMEs), encompassing physical, sociocultural, economic and policy features and to explore variations within SMEs according to company characteristics (number of employees, location of work and presence of worksite cafeteria).

DESIGN

Online cross-sectional survey study of a representative Dutch SME sample by a panel agency.

SETTING

Dutch SMEs.

PARTICIPANTS

Three hundred and fifteen employees of Dutch SMEs responsible for food and drink in their company.

RESULTS

Most SMEs did not have a worksite cafeteria, no provision of fruits or vegetables, and did not offer discounts on food or drinks. The food environment of these SMEs varied significantly based on company characteristics. For example, SMEs with a worksite cafeteria were significantly more likely to have fruits (OR = 8·76, 95 % CI (4·50, 17·06)), vegetables (OR = 10·29, 95 % CI (5·49, 19·31)) and company food policies (OR = 5·04, 95 % CI (2·08, 12·20)) than SMEs without. Additionally, SMEs with ≥ 50 employees were more likely to have fruits (OR = 2·39, 95 % CI (1·42, 4·03)), vegetables (OR = 1·89, 95 % CI (1·04, 3·46)) and company food policies (OR = 2·82, 95 % CI (1·09, 7·29) than SMEs with < 50 employees. Moreover, having a worksite cafeteria (B = 0·23, 95 % CI (0·08, 0·38)) and employees working mostly on-site (B = 0·14, 95 % CI (0·01, 0·28)) were associated with stronger social norms of healthy and sustainable eating at work compared to SMEs without a worksite cafeteria and working mostly off-site.

CONCLUSIONS

In SMEs, an overall comprehensive picture of the food environment points to its limited active encouragement of healthy food choices, particularly so in small SMEs without a worksite cafeteria. Company characteristics strongly influence SME food environments and should be considered when developing interventions improving SME workplace food environments.

Characteristics of Canteens at Elementary Schools, Upper Secondary Schools and Workplaces that Comply with Food Service Guidelines and Have a Greater Focus on Food Waste

Policy actions to improve the nutritional environment include the provision of official food service guidelines. This study aimed to examine compliance with food service guidelines for hot meals as well as self-evaluated focus on food waste reduction across settings, i.e., elementary schools, upper secondary schools and workplaces, and different canteen characteristics. The same five criteria for hot meals were applied for all settings with regard to serving of fruit and vegetables, fish, wholegrain product and high fat meat and dairy products. A self-administered questionnaire survey was conducted as a cross-sectional study among 680 Danish canteens. Canteens having a high degree of organic food procurement were more likely to comply with the five criteria for hot meals combined (OR 2.00 (Cl 1.13,3.53)). Also, the use of organic food together with having a meal policy was associated with reported focus on food waste reduction (OR 1.91 (CI 1.12,3.25) and 1.84 (Cl 1.31,2.59), respectively). Compliance with individual criteria varied across settings with elementary schools being more likely to comply with criteria on, e.g., maximum serving of non-wholegrain products, whereas workplaces were more likely to comply with criteria on, e.g., minimum fruit and vegetable content and serving of fish. In addition, specific characteristics, e.g., serving system, were found to predict compliance with some of the criteria. These findings highlight the need to address differences in canteen characteristics when planning implementation support for both guideline and food waste reduction initiatives.

The Nutritional Quality of Lunch Meals Eaten at Danish Worksites

Monitoring the nutritional environment is important to help inform future initiatives to improve access to healthy foods. The objective was to examine the nutritional quality of lunch meals eaten at 15 worksite canteens and then to compare with results from a study conducted 10 years before. The duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers' lunch intake. Estimated mean energy intake was 2.1 MJ/meal (95% confidence interval (CI): 1.9 to 2.4 g/meal) and estimated energy density 599 kJ/100 g (95% CI 550 to 653 kJ/100 g). Energy density of the male participants' meals were significantly higher compared with the female participants' meals (+55 kJ/100 g, 95% CI: +12 to +98 kJ/100 g, p = 0.012), whereas no gender differences were found in macronutrient distribution or fruit and vegetable intake. Compared to the study conducted 10 years before several significant changes were observed, including an increase in mean estimated intake of fruit and vegetables (+38 g/meal, 95% CI: 19 to 57 g/meal, p < 0.001) and a decrease in energy density (-76 kJ/100 g, 95% CI: -115, -37 kJ/100 g, p < 0.001). In conclusion, this study suggests an equalization of gender differences in fruit and vegetable intake and a possible improvement in the nutritional quality of canteen lunch meals over a 10-year period.

The Salt Content of Lunch Meals Eaten at Danish Worksites

Monitoring levels of sodium (salt) in meals consumed out-of-home is needed to support effective implementation of salt-reduction strategies. The objective of the study was to examine lunch salt intake at 15 worksite canteens and to compare with results from a comparable study conducted 10 years before. A duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers’ lunch salt intake. Estimated mean salt intake was 2.6 g/meal (95% Cl: 2.2 to 3.0 g/meal) and 0.78 g/100 g (95% Cl: 0.69 to 0.88 g/100 g). Salt intake measured both as g per meal and per 100 g was found to be significantly higher for male compared with female participants (+0.10 g/100 g, 95% Cl: +0.02 to +0.17 g/100 g, p = 0.011). Compared with the study conducted 10 years before, there was a significantly lower estimated salt intake of 0.5 g/meal (95% CI: −0.8 to −0.2 g/meal, p = 0.001), suggesting a possible reduction in canteen lunch salt intake during a 10-year period. Still, 40% of the meals exceeded the Nordic Keyhole label requirements of maximum 0.8 g salt per 100 g for ready meals. A further reduction of salt intake is warranted to comply with salt reduction targets.

The influence of meal and food markets in fruit and vegetable consumption among adults in the city of São Paulo

INTRODUCTION

Despite the increased consumption of fruits and vegetables in the Brazilian population, a great proportion of people do not meet the recommendations. Purchasing sites associated with fruit and vegetable consumption has not been widely explored.

OBJECTIVE

To explore the association between fruit and vegetable purchasing and consumption sites and the consumption of these foods among adults living in the city of São Paulo, Brazil.

METHODS

Cross-sectional study with 2 thousand individuals living in the city of São Paulo, aged between 20 and 59 years, participants of the "Obesogenic Environment Study in São Paulo". The outcome was fruit and vegetable consumption measured by weekly consumption. Exposure variables included purchasing sites (supermarkets, open-air food markets, fruit and vegetable specialized markets, and corner stores) and consumption sites (full service restaurants and fast food restaurants).

RESULTS

The sample comprises women (52.3%) aged between 25 and 34 years (30.2%), with at least 8 years of schooling (42.8%) receiving 2 to 5 minimum wages (34.6%). Demographic and socioeconomic variables showed association with regular consumption of fruits and vegetables (p < 0.05). The regular consumption of meals in full service restaurant was associated with vegetables consumption. The regular consumption of meals in fast-food restaurants was not associated with vegetables consumption. Food purchasing sites were not associated with fruit or vegetable consumption.

CONCLUSION

The choice of restaurant type was associated with vegetable consumption. In the studied population, food purchasing sites were not associated with fruit or vegetable consumption.

Impact of worksite cafeteria interventions on fruit and vegetable consumption in adults

Purpose

Increasing obesity rates and health care costs have prompted worksites to investigate interventions to improve employee health. The purpose of this paper is to determine the effect of worksite cafeteria interventions on fruit and vegetable (F/V) consumption.

Design/methodology/approach

This review was guided by the preferred reporting items for systematic reviews and meta-analyses method. After a thorough literature search and screening process, 18 studies were included in the review. Data were extracted, and a risk of bias assessment was created for the primary studies. An un-weighted average was used to determine the overall ranking for each study.

Findings

There appears to be a moderately strong association toward a positive impact of cafeteria interventions to increase F/V consumption. Of the 18 studies in the review, 13 reported a statistically significant increase, one reported a significant decrease, three reported mixed results, and one did not assess a change in consumption.

Research limitations/implications

Most of the data were self-reported and is subject to error. Furthermore, the heterogeneity of study design, method, and outcome measures among the studies warrants additional research with consistent methodology.

Practical implications

A positive impact on F/V consumption may be realized by the following techniques: price-point subsidies, point-of-purchase materials, and menu modification.

Originality/value

This new information on increasing F/V consumption in workplace cafeterias may improve employee health and reduce the risk of chronic disease.

A picture's worth a thousand words: a food-selection observational method

Issue addressed: Methods are needed to accurately measure and describe behaviour so that social marketers and other behaviour change researchers can gain consumer insights before designing behaviour change strategies and so, in time, they can measure the impact of strategies or interventions when implemented. This paper describes a photographic method developed to meet these needs.Methods: Direct observation and photographic methods were developed and used to capture food-selection behaviour and examine those selections according to their healthfulness. Four meals (two lunches and two dinners) were observed at a workplace buffet-style cafeteria over a 1-week period. The healthfulness of individual meals was assessed using a classification scheme developed for the present study and based on the Australian Dietary Guidelines.Results: Approximately 27% of meals (n = 168) were photographed. Agreement was high between raters classifying dishes using the scheme, as well as between researchers when coding photographs. The subset of photographs was representative of patterns observed in the entire dining room. Diners chose main dishes in line with the proportions presented, but in opposition to the proportions presented for side dishes.Conclusions: The present study developed a rigorous observational method to investigate food choice behaviour. The comprehensive food classification scheme produced consistent classifications of foods. The photographic data collection method was found to be robust and accurate. Combining the two observation methods allows researchers and/or practitioners to accurately measure and interpret food selections. Consumer insights gained suggest that, in this setting, increasing the availability of green (healthful) offerings for main dishes would assist in improving healthfulness, whereas other strategies (e.g. promotion) may be needed for side dishes.So what?: Visual observation methods that accurately measure and interpret food-selection behaviour provide both insight for those developing healthy eating interventions and a means to evaluate the effect of implemented interventions on food selection.

The intake of energy and selected nutrients by thai urban sedentary workers: an evaluation of adherence to dietary recommendations

Rapid changes in Thailand's nutrition and lifestyles have led to increasing diet-related pathologies among people with sedentary occupations. This study examines the extent to which the dietary intake of nutrients and energy by a sample of Thai sedentary workers conforms to the Thai Dietary Reference Intakes (Thai DRIs). The nutrients and energy intake estimates were based on self-reported information collected with a single 24-hour dietary recall and nonweighed 2-day food record. The study participants were Thai adults aged 20-50 years employed in sedentary occupations. A convenience sample of 215 healthy individuals (75 males and 140 females) was based on four randomly selected worksites in the Bangkok metropolitan area. For male participants, the study found a median energy intake of 1,485 kcal/day, with 54.4% of energy coming from carbohydrate, 15.9% from protein, and 29.6% from fat. Females' median energy intake was 1,428 kcal/day, 56% of which came from carbohydrate, 16.2% from protein, and 28.6% from fat. Both genders showed insufficient intake of fiber and most micronutrients. This study provides the material for preventive public health interventions focusing on nutrition-related diseases affecting Thailand's rapidly growing sedentary workforce.

Effectiveness of offering healthy labelled meals in improving the nutritional quality of lunch meals eaten in a worksite canteen

Healthier meal selections at restaurants and canteens are often limited and not actively promoted. In this Danish study the effectiveness of a healthy labelling certification program in improving dietary intake and influencing edible plate waste was evaluated in a quasi-experimental study design. Employees from an intervention worksite canteen and a matched control canteen were included in the study at baseline (February 2012), after completing the certification process (end-point) and six month from end-point (follow-up) (total n=270). In order to estimate nutrient composition of the consumed lunch meals and plate waste a validated digital photographic method was used combining estimation of food intake with food nutrient composition data. Food satisfaction was rated by participants using a questionnaire. Several significant positive nutritional effects were observed at the intervention canteen including a mean decrease in energy density in the consumed meals from 561kJ/100g at baseline to 368 and 407kJ/100g at end-point and follow-up, respectively (P<0.001). No significant changes were seen with regard to food satisfaction and plate waste. In the control canteen no positive nutritional effects were observed. The results of the study highlight the potential of using healthy labelling certification programs as a possible driver for increasing both the availability and awareness of healthy meal choices, thereby improving dietary intake when eating out.

Does workplace health promotion in Denmark reach relevant target groups?

The aim of the current study was to investigate whether Workplace Health Promotion (WHP) is available for workers with poor health status (overweight, musculoskeletal disorders, sickness absence and poor self-rated health) or health behaviour (smoking, poor diet and sedentarism) and whether they participate in WHP. In total, 9835 workers responded to questions regarding availability to 6 different types of WHP through The Danish Work Environment Cohort Study in 2010. Logistic regression analyses adjusted for age, gender and industry were performed to calculate odds ratios for availability and participation of WHP among groups with different health behaviours and health status. In general, poor health behaviours were associated with reduced availability of and participation in WHP. In contrast, poor health status was generally associated with higher availability of WHP and increased participation. However, poor self-rated health was associated with lower availability of several types of WHP and reduced participation. In general, workers with health challenges that are visible to others had WHP available, whereas workers with less visible health challenges had WHP less frequently available. Health challenges visible to others were associated with higher participation in WHP, whereas poor health behaviour and reduced self-rated health were associated with reduced participation in WHP programmes.

Can worksite nutritional interventions improve productivity and firm profitability? A literature review

Aims: This paper investigates whether and how worksite nutrition policies can improve employee productivity.

Methods: The questions are pursued through a literature review, including a systematic search of literature – combined with literature identified from backward references – on randomized controlled or quasi-experimental worksite intervention trials and observational cross-sectional studies. Studies were selected on the basis of topic relevance, according to publication title and subsequently according to abstract content. A quality appraisal of the studies was based on study design and clarity in definition of interventions, as well as environmental and outcome variables.

Results: The search identified 2,358 publications, 30 of which were found suitable for the review. Several of the reviewed studies suggest that diet-related worksite interventions have positive impacts on employees’ nutritional knowledge, food intake and health and on the firm’s profitability, mainly in terms of reduced absenteeism and presenteeism.

Conclusions: Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%–2%. On larger worksites, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field.

Os Restaurantes por peso no contexto de alimentação saudável fora de casa

O consumo de refeições fora de casa é uma tendência em diferentes regiões do mundo, mas há indícios de que essa prática possa apresentar riscos à saúde. É reconhecido que os comportamentos e as escolhas alimentares dos indivíduos são complexos e estão condicionados a diversos fatores. O fator ambiental vem recebendo crescente atenção dentre as variáveis que envolvem as escolhas alimentares. Nesse contexto, este artigo discute a possibilidade de os restaurantes por peso, modalidade de serviço muito utilizada na realidade brasileira, representarem uma alternativa saudável de alimentação fora de casa. Os dados científicos disponíveis relativos aos restaurantes por peso ainda são escassos, não permitindo uma avaliação sistematizada sobre o tema. Assim, com base em pesquisa bibliográfica, discutem-se os modelos praticados e alguns estudos que comparam a possibilidade de escolhas saudáveis em restaurantes com diferentes modalidades de distribuição. Sugere-se que, devido às suas características - que incluem a diversidade, a possibilidade da prática de preços acessíveis, a rapidez e a conveniência -, os restaurantes por peso possam estimular a escolha de alimentos saudáveis nas refeições realizadas fora de casa. Ressalta-se, também, a importância de intervenções nutricionais tanto na disponibilização dos alimentos quanto na orientação à população para escolhas saudáveis nesse contexto.

Losing weight without dieting. Use of commercial foods as meal replacements for lunch produces an extended energy deficit

High-protein liquid meal replacements have proven to be effective in reducing caloric intake and body weight. Recently, substituting high fiber breakfast cereals for the more expensive high-protein drinks has been found to be equally effective to reduce weight. The following study tested the hypothesis that the mechanism responsible for the reduced intake was not the dietary composition of the meal replacement, but the controlled portion sized meals. Seventeen volunteers ate all of their meals and snacks from foods provided by the research unit from Monday to Friday for five consecutive weeks. For the first week, all participants selected their food from a buffet where each food was weighed before and after eating. For the next two weeks, half of the group selected their lunch by choosing one food from a selection of six commercially available portion controlled foods. They could eat as much as they wished at other meals or snacks. For final weeks four and five, the conditions were reversed for the two groups. Consuming the portion controlled lunches resulted in about a 250 kcal reduction in energy intake. More importantly, no sign of caloric compensation was evident across the 10 days of testing, an observation substantiated by a significant loss of body weight. The results suggest that the mere substitution of one smaller portioned meal each day is sufficient to cause reduction in daily energy intake and a significant amount of weight.

Improving the diet of employees at blue-collar worksites: results from the ‘Food at Work’ intervention study

Objective

To examine the impact of a 6-month participatory and empowerment-based intervention study on employees’ dietary habits and on changes in the canteen nutrition environment.

Design

Worksites were stratified by company type and by the presence or absence of an in-house canteen, and randomly allocated to either an intervention group (five worksites) or a minimum intervention control group (three worksites). The study was carried out in partnership with a trade union and guided by an ecological framework targeting both individual and environment levels. Outcome measures included: (i) changes in employees’ dietary habits derived from 4 d pre-coded food diaries of a group of employees at the worksites (paired-data structure); and (ii) the canteen nutrition environment as identified by aggregating chemical nutritional analysis of individual canteen lunches (different participants at baseline and at endpoint).

Setting

Eight blue-collar worksites (five of these with canteens).

Subjects

Employees.

Results

In the intervention group (n102), several significant positive nutritional effects were observed among employees, including a median daily decrease in intake of fat (−2·2 %E,P= 0·002) and cake and sweets (−18 g/10 MJ,P= 0·002) and a median increase in intake of dietary fibre (3 g/10 MJ,P< 0·001) and fruit (55 g/d,P= 0·007 and 74 g/10 MJ,P= 0·009). With regard to the canteen nutrition environment, a significant reduction in the percentage of energy obtained from fat was found in the intervention group (median difference 11 %E,P< 0·001,n144).

Conclusions

The present study shows that moderate positive changes in dietary patterns can be achieved among employees in blue-collar worksites.

A workplace feasibility study of the effect of a minimal fruit intervention on fruit intake

Objective

The main purpose of the study was to investigate the feasibility of using workplaces to increase the fruit consumption of participants by increasing fruit availability and accessibility by a minimal fruit programme. Furthermore, it was investigated whether a potential increase in fruit intake would affect vegetable, total energy and nutrient intake.

Design

A 5-month, controlled, workplace study where workplaces were divided into an intervention group (IG) and a control group (CG). At least one piece of free fruit was available per person per day in the IG. Total fruit and dietary intake was assessed, using two 24 h dietary recalls at baseline and at endpoint.

Setting

Eight Danish workplaces were enrolled in the study. Five workplaces were in the IG and three were in the CG.

Subjects

One hundred and twenty-four (IG, n 68; CG, n 56) healthy, mainly normal-weight participants were recruited.

Results

Mean daily fruit intake increased significantly from baseline to endpoint only in the IG by 112(se 35) g. In the IG, mean daily intake of added sugar decreased significantly by 10·7(se 4·4) g, whereas mean daily intake of dietary fibre increased significantly by 3·0(se 1·1) g. Vegetable, total energy and macronutrient intake remained unchanged through the intervention period for both groups.

Conclusions

The present study showed that it is feasible to increase the average fruit intake at workplaces by simply increasing fruit availability and accessibility. Increased fruit intake possibly substituted intake of foods containing added sugar. In this study population the increased fruit intake did not affect total energy intake.

Salt content in canteen and fast food meals in Denmark

Background

A high salt (=NaCl) intake is associated with high blood pressure, and knowledge of salt content in food and meals is important, if the salt intake has to be decreased in the general population.

Objective

To determine the salt content in worksite canteen meals and fast food.

Design

For the first part of this study, 180 canteen meals were collected from a total of 15 worksites with in-house catering facilities. Duplicate portions of a lunch meal were collected from 12 randomly selected employees at each canteen on two non-consecutive days. For the second part of the study, a total of 250 fast food samples were collected from 52 retail places representing both city (Aarhus) and provincial towns. The canteen meals and fast food samples were analyzed for chloride by potentiometric titration with silver nitrate solution, and the salt content was estimated.

Results

The salt content in lunch meals in worksite canteens were 3.8±1.8 g per meal and 14.7±5.1 g per 10 MJ for men (n=109), and 2.8±1.2 g per meal and 14.4±6.2 g per 10 MJ for women (n=71). Salt content in fast food ranged from 11.8±2.5 g per 10 MJ (burgers) to 16.3±4.4 g per 10 MJ (sausages) with a mean content of 13.8±3.8 g per 10 MJ.

Conclusion

Salt content in both fast food and in worksite canteen meals is high and should be decreased.

Development and validation of a new simple Healthy Meal Index for canteen meals

OBJECTIVE

Nutrition evaluation tools should be developed both for scientific purposes and to encourage and facilitate healthy nutritional practices. The purpose of the present study was to develop and validate a simple food-based Healthy Meal Index (HMI) reflecting the nutritional profile of individual canteen meals.

DESIGN

The development process included overall model selection, setting nutritional goals and defining scoring systems and thresholds. Three index components were included: (i) contents of fruit and vegetables, (ii) fat content and quality and (iii) contents of wholegrain products and potatoes. The development was built on the principles embodied by the Plate Model, but providing more specificity in some areas. The simple HMI was validated against weighed and chemically analysed food and nutrient content of a representative sample of canteen meals. The sample was split into four categories according to the total index score and compared across categories.

SETTING

A total of 180 meals from fifteen worksite canteens.

RESULTS

Average energy density decreased significantly across categories (from 876 kJ/100 g to 537 kJ/100 g, P < 0.001). Also, the content of total and saturated fat, carbohydrate and fruit and vegetables varied across categories with higher score values being closer to dietary guidelines (P < 0.001).

CONCLUSIONS

The simple HMI was successful in ranking canteen meals according to their nutritional quality. The index provides a valuable tool to both researchers and food and nutrition professionals, e.g. caterers and dietitians, who wish to evaluate nutritional quality of meals in line with the recommendations for healthier eating without the use of nutrition calculation programs.

Workforce gender, company size and corporate financial support are predictors of availability of healthy meals in Danish worksite canteens

OBJECTIVE

Environmental strategies at worksites may help consumers change dietary behaviour towards a more healthy diet. The present study aimed to evaluate the availability of healthy meal options at Danish worksite canteens and to identify predictors of worksite canteens providing healthy meals.

DESIGN

A self-administered questionnaire was randomly mailed to 1967 worksite canteen managers. Besides information and characteristics about the canteen and the worksite, the canteen managers specified the menus available. Two different health groups (Healthy and Less Healthy) were defined in three different meal categories (Sandwiches, Hot meals and Salads) as well as a combined category (Combined) combining all the three meal categories. The characteristics of the worksites were compared with regard to the different health groups.

SETTING

Randomly selected Danish worksite canteens.

SUBJECTS

553 Danish worksite canteen managers replied, resulting in a response rate of 29 %.

RESULTS

Only 12 % of the canteens applied to the Healthy group combining all the three meal categories. In particular, worksites with more than 75 % female employees served healthy menus on a frequent basis. The size of the worksite was positively correlated with more healthy meal options. Furthermore, the present study suggests a positive relationship between corporate financial support and the availability of healthy meal options.

CONCLUSIONS

Among the selected variables studied, workforce gender, company size and corporate financial support were significant predictors of the availability of healthy meal options in worksite canteens. More research is needed on the role that variance in organisation environment plays for the potential of worksite intervention, to make a difference in terms of healthy eating.

Measures of the food environment: a compilation of the literature, 1990-2007

BACKGROUND

Valid and reliable measures are required to assess any effect of the food environment on individual dietary behavior, and form the foundation of research that may inform obesity-related policy. Although many methods of measuring the food environment exist, this area of research is still relatively new and there has been no systematic attempt to gather these measures, to compare and contrast them, or to report on their psychometric properties.

EVIDENCE ACQUISITION

A structured literature search was conducted to identify peer-reviewed articles published between January 1990 and August 2007 that measured the community-level food environment. These articles were categorized into the following environments: food stores, restaurants, schools, and worksites. The measurement strategies in these studies were categorized as instruments (checklists, market baskets, inventories, or interviews/questionnaires) or methodologies (geographic, sales, menu, or nutrient analyses).

EVIDENCE SYNTHESIS

A total of 137 articles were identified that included measures of the food environment. Researchers focused on assessing the accessibility, availability, affordability, and quality of the food environment. The most frequently used measure overall was some form of geographic analysis. Eighteen of the 137 articles (13.1%) tested for any psychometric properties, including inter-rater reliability, test-retest reliability, and/or validity.

CONCLUSIONS

A greater focus on testing for reliability and validity of measures of the food environment may increase rigor in research in this area. Robust measures of the food environment may strengthen research on the effects of the community-level food environment on individual dietary behavior, assist in the development and evaluation of interventions, and inform policymaking targeted at reducing the prevalence of obesity and improving diet.