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Hua S, Tucker AC, Santos SR, Thomas AE, Mui Y, Velez-Burgess V, Poirier L, Cheskin LJ, Matsuzaki M, Williamson S, Colon-Ramos U, Gittelsohn J. The Quality of Menu Offerings in Independently Owned Restaurants in Baltimore, Maryland: Results from Mixed-Methods Formative Research for the FRESH Trial. Nutrients 2024; 16:1524. [PMID: 38794762 PMCID: PMC11123881 DOI: 10.3390/nu16101524] [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: 04/30/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Independently owned restaurants (IORs) are prevalent in under-resourced racial and ethnic minority communities in the US and present a unique setting for public health nutrition interventions. (2) Methods: We conducted 14 in-depth interviews with IOR owners in Baltimore about their perceptions of healthy food, and customers' acceptance of healthier menus and cooking methods and concurrent observations of the availability of healthy options on their menus. Qualitative data were coded and analyzed using ATLAS.ti. Observations were analyzed with statistical analysis performed in R. (3) Results: Owners perceived non-fried options, lean proteins, and plant-based meals as healthy. While open to using healthier cooking fats, they had mixed feelings about reducing salt, adopting non-frying methods for cooking, and adding vegetables and whole grains to the menu, and were reluctant to reduce sugar in recipes and beverages. Only 17.5% of 1019 foods and 27.6% of 174 beverages in these IORs were healthy, with no significant differences in the healthfulness of restaurant offerings within low-healthy-food-access/low-income neighborhoods and those outside. (4) Conclusion: Healthy options are generally scarce in Baltimore's IORs. Insights from owners inform future interventions to tailor healthy menu offerings that are well-received by customers and feasible for implementation.
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Affiliation(s)
- Shuxian Hua
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Anna Claire Tucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Sydney R. Santos
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Audrey E. Thomas
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Veronica Velez-Burgess
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Lisa Poirier
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Lawrence J. Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA;
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Mika Matsuzaki
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Stacey Williamson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
| | - Uriyoan Colon-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA;
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.C.T.); (S.R.S.); (Y.M.); (V.V.-B.); (L.P.); (M.M.); (S.W.); (J.G.)
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Jeyakumar A, Kesa H, Godbharle S. Auditing causality of the multiple-burden of malnutrition in India and South Africa: a critical need for directions. Public Health Nutr 2023; 26:3038-3040. [PMID: 37690809 PMCID: PMC10755433 DOI: 10.1017/s1368980023001921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
Developing economies are shaped by the current predicament of urbanisation and its impact on health is inevitable. In the post-pandemic times, India and South Africa witnessed a GDP growth rate of about 1·7 % and 1·9 %, respectively, while the developed economies like Europe and the USA have bounced back with more than 2 % GDP. The similarities and differences between India and South Africa provide potential candidates to study nutrition transition with the elements of urbanisation. In both countries, increased access to convenience foods is a consequence of the rapid expansion of small and medium enterprises, open international markets and expanding food supply chains. Also, there has been significant acculturation and people have moved away from traditional diets in these two countries. A spate of similar changes in the food environment is a telling sign of serious ill-health consequences in both countries. Generating evidence on causality is fundamental to informing policy. India and South Africa qualify as potential candidates to study the multiple burdens of malnutrition. Collaborating with different disciplines such as data sciences and capacitating analytic skills are key to progress in this direction.
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Affiliation(s)
- Angeline Jeyakumar
- Department of Nutrition, University of Nevada, Reno, Nevada, USA
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Auckland Park, 2006, South Africa
- Department of Health Sciences, Savitribai Phule Pune University, Pune411007, MH, India
| | - Hema Kesa
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Auckland Park, 2006, South Africa
| | - Swapnil Godbharle
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Auckland Park, 2006, South Africa
- Department of Health Sciences, Savitribai Phule Pune University, Pune411007, MH, India
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Lyu W, Seok N, Chen X, Xu R. Using Crowdsourced Food Image Data for Assessing Restaurant Nutrition Environment: A Validation Study. Nutrients 2023; 15:4287. [PMID: 37836570 PMCID: PMC10574450 DOI: 10.3390/nu15194287] [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: 08/26/2023] [Revised: 09/18/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
Crowdsourced online food images, when combined with food image recognition technologies, have the potential to offer a cost-effective and scalable solution for the assessment of the restaurant nutrition environment. While previous research has explored this approach and validated the accuracy of food image recognition technologies, much remains unknown about the validity of crowdsourced food images as the primary data source for large-scale assessments. In this paper, we collect data from multiple sources and comprehensively examine the validity of using crowdsourced food images for assessing the restaurant nutrition environment in the Greater Hartford region. Our results indicate that while crowdsourced food images are useful in terms of the initial assessment of restaurant nutrition quality and the identification of popular food items, they are subject to selection bias on multiple levels and do not fully represent the restaurant nutrition quality or customers' dietary behaviors. If employed, the food image data must be supplemented with alternative data sources, such as field surveys, store audits, and commercial data, to offer a more representative assessment of the restaurant nutrition environment.
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Affiliation(s)
- Weixuan Lyu
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Nina Seok
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
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Rios FJ, Montezano AC, Camargo LL, Touyz RM. Impact of Environmental Factors on Hypertension and Associated Cardiovascular Disease. Can J Cardiol 2023; 39:1229-1243. [PMID: 37422258 DOI: 10.1016/j.cjca.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/24/2023] [Accepted: 07/02/2023] [Indexed: 07/10/2023] Open
Abstract
Hypertension is the primary cause of cardiovascular diseases and is responsible for nearly 9 million deaths worldwide annually. Increasing evidence indicates that in addition to pathophysiologic processes, numerous environmental factors, such as geographic location, lifestyle choices, socioeconomic status, and cultural practices, influence the risk, progression, and severity of hypertension, even in the absence of genetic risk factors. In this review, we discuss the impact of some environmental determinants on hypertension. We focus on clinical data from large population studies and discuss some potential molecular and cellular mechanisms. We highlight how these environmental determinants are interconnected, as small changes in one factor might affect others, and further affect cardiovascular health. In addition, we discuss the crucial impact of socioeconomic factors and how these determinants influence diverse communities with economic disparities. Finally, we address opportunities and challenges for new research to address gaps in knowledge on understanding molecular mechanisms whereby environmental factors influence development of hypertension and associated cardiovascular disease.
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Affiliation(s)
- Francisco J Rios
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
| | - Augusto C Montezano
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Livia L Camargo
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Rhian M Touyz
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
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