Focusing on fast food restaurants alone underestimates the relationship between neighborhood deprivation and exposure to fast food in a large rural area.

PubMed

Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R; Horel, Scott A

2011-01-25

Individuals and families are relying more on food prepared outside the home as a source for at-home and away-from-home consumption. Restricting the estimation of fast-food access to fast-food restaurants alone may underestimate potential spatial access to fast food. The study used data from the 2006 Brazos Valley Food Environment Project (BVFEP) and the 2000 U.S. Census Summary File 3 for six rural counties in the Texas Brazos Valley region. BVFEP ground-truthed data included identification and geocoding of all fast-food restaurants, convenience stores, supermarkets, and grocery stores in study area and on-site assessment of the availability and variety of fast-food lunch/dinner entrées and side dishes. Network distance was calculated from the population-weighted centroid of each census block group to all retail locations that marketed fast food (n = 205 fast-food opportunities). Spatial access to fast-food opportunities (FFO) was significantly better than to traditional fast-food restaurants (FFR). The median distance to the nearest FFO was 2.7 miles, compared with 4.5 miles to the nearest FFR. Residents of high deprivation neighborhoods had better spatial access to a variety of healthier fast-food entrée and side dish options than residents of low deprivation neighborhoods. Our analyses revealed that identifying fast-food restaurants as the sole source of fast-food entrées and side dishes underestimated neighborhood exposure to fast food, in terms of both neighborhood proximity and coverage. Potential interventions must consider all retail opportunities for fast food, and not just traditional FFR.

Focusing on fast food restaurants alone underestimates the relationship between neighborhood deprivation and exposure to fast food in a large rural area

PubMed Central

2011-01-01

Background Individuals and families are relying more on food prepared outside the home as a source for at-home and away-from-home consumption. Restricting the estimation of fast-food access to fast-food restaurants alone may underestimate potential spatial access to fast food. Methods The study used data from the 2006 Brazos Valley Food Environment Project (BVFEP) and the 2000 U.S. Census Summary File 3 for six rural counties in the Texas Brazos Valley region. BVFEP ground-truthed data included identification and geocoding of all fast-food restaurants, convenience stores, supermarkets, and grocery stores in study area and on-site assessment of the availability and variety of fast-food lunch/dinner entrées and side dishes. Network distance was calculated from the population-weighted centroid of each census block group to all retail locations that marketed fast food (n = 205 fast-food opportunities). Results Spatial access to fast-food opportunities (FFO) was significantly better than to traditional fast-food restaurants (FFR). The median distance to the nearest FFO was 2.7 miles, compared with 4.5 miles to the nearest FFR. Residents of high deprivation neighborhoods had better spatial access to a variety of healthier fast-food entrée and side dish options than residents of low deprivation neighborhoods. Conclusions Our analyses revealed that identifying fast-food restaurants as the sole source of fast-food entrées and side dishes underestimated neighborhood exposure to fast food, in terms of both neighborhood proximity and coverage. Potential interventions must consider all retail opportunities for fast food, and not just traditional FFR. PMID:21266055

Proximity of fast food restaurants to schools: do neighborhood income and type of school matter?

PubMed

Simon, Paul A; Kwan, David; Angelescu, Aida; Shih, Margaret; Fielding, Jonathan E

2008-09-01

To investigate the proximity of fast food restaurants to public schools and examine proximity by neighborhood income and school level (elementary, middle, or high school). Geocoded school and restaurant databases from 2005 and 2003, respectively, were used to determine the percentage of schools with one or more fast food restaurants within 400 m and 800 m of all public schools in Los Angeles County, California. Single-factor analysis of variance (ANOVA) models were run to examine fast food restaurant proximity to schools by median household income of the surrounding census tract and by school level. Two-factor ANOVA models were run to assess the additional influence of neighborhood level of commercialization. Overall, 23.3% and 64.8% of schools had one or more fast food restaurants located within 400 m and 800 m, respectively. Fast food restaurant proximity was greater for high schools than for middle and elementary schools, and was inversely related to neighborhood income for schools in the highest commercial areas. No association with income was observed in less commercial areas. Fast food restaurants are located in close proximity to many schools in this large metropolitan area, especially high schools and schools located in low income highly commercial neighborhoods. Further research is needed to assess the relationship between fast food proximity and student dietary practices and obesity risk.

Neighborhood environments: disparities in access to healthy foods in the U.S.

PubMed

Larson, Nicole I; Story, Mary T; Nelson, Melissa C

2009-01-01

Poor dietary patterns and obesity, established risk factors for chronic disease, have been linked to neighborhood deprivation, neighborhood minority composition, and low area population density. Neighborhood differences in access to food may have an important influence on these relationships and health disparities in the U.S. This article reviews research relating to the presence, nature, and implications of neighborhood differences in access to food. A snowball strategy was used to identify relevant research studies (n=54) completed in the U.S. and published between 1985 and April 2008. Research suggests that neighborhood residents who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower levels of obesity. Results from studies examining the accessibility of restaurants are less consistent, but there is some evidence to suggest that residents with limited access to fast-food restaurants have healthier diets and lower levels of obesity. National and local studies across the U.S. suggest that residents of low-income, minority, and rural neighborhoods are most often affected by poor access to supermarkets and healthful food. In contrast, the availability of fast-food restaurants and energy-dense foods has been found to be greater in lower-income and minority neighborhoods. Neighborhood disparities in access to food are of great concern because of their potential to influence dietary intake and obesity. Additional research is needed to address various limitations of current studies, identify effective policy actions, and evaluate intervention strategies designed to promote more equitable access to healthy foods.

Evaluating the use of in-store measures in retail food stores and restaurants in Brazil.

PubMed

Duran, Ana Clara; Lock, Karen; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2015-01-01

To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context. This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool's abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants. Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods. The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these contexts.

Evaluating the use of in-store measures in retail food stores and restaurants in Brazil

PubMed Central

Duran, Ana Clara; Lock, Karen; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2015-01-01

ABSTRACT OBJECTIVE To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context. METHODS This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool’s abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants. RESULTS Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods. CONCLUSIONS The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these contexts. PMID:26538101

Development and evaluation of a food environment survey in three urban environments of Kunming, China.

PubMed

Hua, Jenna; Seto, Edmund; Li, Yan; Wang, May C

2014-03-06

Given the rapid pace of urbanization and Westernization and the increasing prevalence of obesity, there is a need for research to better understand the influence of the built environment on overweight and obesity in world's developing regions. Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China. We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city. 273 food establishments (163 restaurants and 110 stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food restaurants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity. Depending on the cutoff used, 19% to 36% of male and 10% to 22% of female 16-year old adolescents were found to be overweight. The prevalence of overweight Chinese adolescents, and the food environments they are exposed to, deserve immediate attention. To our knowledge, these are the first food environment surveys developed specifically to assess changing food availability, accessibility, and pricing in China. These instruments may be useful in future systematic longitudinal assessments of the changing food environment and its health impact in China.

Impact of neighborhood resources on cardiovascular disease: a nationwide six-year follow-up.

PubMed

Calling, Susanna; Li, Xinjun; Kawakami, Naomi; Hamano, Tsuyoshi; Sundquist, Kristina

2016-07-26

Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources. A nationwide sample of 2 040 826 men and 2 153 426 women aged 35-80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS). We found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15-1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05-1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. This six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease.

Development and evaluation of a food environment survey in three urban environments of Kunming, China

PubMed Central

2014-01-01

Background Given the rapid pace of urbanization and Westernization and the increasing prevalence of obesity, there is a need for research to better understand the influence of the built environment on overweight and obesity in world’s developing regions. Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China. Methods We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city. Results 273 food establishments (163 restaurants and 110 stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food restaurants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity. Depending on the cutoff used, 19% to 36% of male and 10% to 22% of female 16-year old adolescents were found to be overweight. Conclusions The prevalence of overweight Chinese adolescents, and the food environments they are exposed to, deserve immediate attention. To our knowledge, these are the first food environment surveys developed specifically to assess changing food availability, accessibility, and pricing in China. These instruments may be useful in future systematic longitudinal assessments of the changing food environment and its health impact in China. PMID:24602326

McDonald's restaurants and neighborhood deprivation in Scotland and England.

PubMed

Cummins, Steven C J; McKay, Laura; MacIntyre, Sally

2005-11-01

Features of the local fast food environment have been hypothesized to contribute to the greater prevalence of obesity in deprived neighborhoods. However, few studies have investigated whether fast food outlets are more likely to be found in poorer areas, and those that have are local case studies. In this paper, using national-level data, we examine the association between neighborhood deprivation and the density of McDonald's restaurants in small census areas (neighborhoods) in Scotland and England. Data on population, deprivation, and the location of McDonald's Restaurants were obtained for 38,987 small areas in Scotland and England (6505 "data zones" in Scotland, and 32,482 "super output areas" in England) in January 2005. Measures of McDonald's restaurants per 1000 people for each area were calculated, and areas were divided into quintiles of deprivation. Associations between neighborhood deprivation and outlet density were examined during February 2005, using one-way analysis of variance in Scotland, England, and both countries combined. Statistically significant positive associations were found between neighborhood deprivation and the mean number of McDonald's outlets per 1000 people for Scotland (p<0.001), England (p<0.001), and both countries combined (p<0.001). These associations were broadly linear with greater mean numbers of outlets per 1000 people occurring as deprivation levels increased. Observed associations between presence or absence of fast food outlets and neighborhood deprivation may provide support for environmental explanations for the higher prevalence of obesity in poor neighborhoods.

Body mass index, neighborhood fast food and restaurant concentration, and car ownership.

PubMed

Inagami, Sanae; Cohen, Deborah A; Brown, Arleen F; Asch, Steven M

2009-09-01

Eating away from home and particularly fast food consumption have been shown to contribute to weight gain. Increased geographic access to fast food outlets and other restaurants may contribute to higher levels of obesity, especially in individuals who rely largely on the local environment for their food purchases. We examined whether fast food and restaurant concentrations are associated with body mass index and whether car ownership might moderate this association. We linked the 2000 US Census data and information on locations of fast food and other restaurants with the Los Angeles Family and Neighborhood Study database, which consists of 2,156 adults sampled from 63 neighborhoods in Los Angeles County. Multilevel modeling was used to estimate associations between body mass index (BMI), fast food and restaurant concentration, and car ownership after adjustment for individual-level factors and socioeconomic characteristics of residential neighborhoods. A high concentration of local restaurants is associated with BMI. Car owners have higher BMIs than non-car owners; however, individuals who do not own cars and reside in areas with a high concentration of fast food outlets have higher BMIs than non-car owners who live in areas with no fast food outlets, approximately 12 lb more (p = 0.02) for an individual with a height of 5 ft. 5 in. Higher restaurant density is associated with higher BMI among local residents. The local fast food environment has a stronger association with BMI for local residents who do not have access to cars.

Changes in the Neighborhood Food Store Environment and Children's Body Mass Index at Peripuberty in the United States.

PubMed

Chen, Hsin-Jen; Wang, Youfa

2016-01-01

Little is known about the relationship between changes in food store environment and children's obesity risk in the United States. This study examines children's weight status associated with the changes in the quantity of food stores in their neighborhoods. A nationally representative cohort of schoolchildren in the United States was followed from fifth grade in 2004 to eighth grade in 2007 (n = 7,090). In 2004 and 2007, children's body mass index (BMI) was directly measured in schools. ZIP Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP code area by type of store: supermarkets, limited-service restaurants, small-size grocery, and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Girls living in neighborhoods with three or more supermarkets had a lower BMI 3 years later (by -.62 kg/m(2); 95% confidence interval = -1.05 to -.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI 3 years later (by 1.02 kg/m(2); 95% confidence interval = .36-1.68) than did those living in neighborhoods with less than or equal to one limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls' lower BMI by eighth grade. The longitudinal association between neighborhood food environment and children's BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, whereas small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Changes in the neighborhood food store environment and children’s body mass index at peri-puberty in the United States

PubMed Central

Chen, Hsin-Jen; Wang, Youfa

2015-01-01

Background Little is known about the relationship between changes in food store environment and children’s obesity risk in the US. This study examines children’s weight status associated with the changes in the quantity of food stores in their neighborhoods. Methods A nationally representative cohort of schoolchildren in the US was followed from 5th grade in 2004 to 8th grade in 2007 (n=7090). In 2004 and 2007, children’s body mass index (BMI) was directly measured in schools. ZIP-Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP-code area by type of store: supermarkets, limited-service restaurants, small-size grocery and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Results Girls living in neighborhoods with ≥ 3 supermarkets had a lower BMI three years later (by −0.62 kg/m2; 95% C.I.: −1.05, −0.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI three years later (by 1.02 kg/m2; 95% C.I.: 0.36, 1.68) than did those living in neighborhoods with ≤1 limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls’ lower BMI by eighth grade. Conclusions The longitudinal association between neighborhood food environment and children’s BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, while small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys. PMID:26707233

Obesity and the Built Environment: Does the Density of Neighborhood Fast-Food Outlets Matter?

PubMed Central

Li, Fuzhong; Harmer, Peter; Cardinal, Bradley J.; Bosworth, Mark; Johnson-Shelton, Deb

2009-01-01

Purpose To examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast-food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Design Cross-sectional and multilevel design. Setting Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon. Subjects A total of 1,221 residents (mean age=65 years old) recruited randomly from 120 neighborhoods (48% response rate). Measures A Geographic Information System-based measure of fast-food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass index (BMI), frequency of visits to local fast-food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity. Analyses Multilevel logistic regression analyses. Results Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI≥30) for neighborhoods with a high-density of fast-food restaurants in comparison to those with a low density: odds ratios [OR] for obesity, 95% confidence interval [CI] were: 1.878 (CI=1.006-3.496) for weekly visits to local fast-food restaurants; 1.792 (CI=1.006-3.190) for not meeting physical activity recommendations; 1.212 (CI=1.057-1.391) for low confidence in eating healthy food; and 8.057 (CI=1.705-38.086) for non-Hispanic black residents. Conclusion Increased density of neighborhood fast-food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults. PMID:19149426

Obesity and the built environment: does the density of neighborhood fast-food outlets matter?

PubMed

Li, Fuzhong; Harmer, Peter; Cardinal, Bradley J; Bosworth, Mark; Johnson-Shelton, Deb

2009-01-01

Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Cross-sectional and multilevel design. Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon. A total of 1221 residents (mean age, 65 years) recruited randomly from 120 neighborhoods (48% response rate). A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass indices (BMI), frequency of visits to local fast food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity. Multilevel logistic regression analyses. Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI > or = 30) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density: odds ratios for obesity, 95% confidence intervals (CI), were 1.878 (CI, 1.006-3.496) for weekly visits to local fast food restaurants; 1.792 (CI, 1.006-3.190) for not meeting physical activity recommendations; 1.212 (CI, 1.057-1.391) for low confidence in eating healthy food; and 8.057 (CI, 1.705-38.086) for non-Hispanic black residents. Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults.

Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study.

PubMed

Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I; Shikany, James M; Lewis, Cora E; Popkin, Barry M

2011-07-11

A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts--neighborhoods with little or no access to healthy foods--by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of US young adults (aged 18-30 years at baseline) (n = 5115), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from 4 examination periods (n = 15,854 person-examination observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and adherence to fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within less than 1.00 km, 1.00 to 2.99 km, 3.00 to 4.99 km, and 5.00 to 8.05 km of respondents' homes. Models were sex stratified, controlled for individual sociodemographic characteristics and neighborhood poverty, and tested for interaction by individual-level income. Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed. Our findings provide some evidence for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change.

Fast food restaurants and food stores: longitudinal associations with diet in young adults: The CARDIA Study

PubMed Central

Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I.; Shikany, James M.; Lewis, Cora E.; Popkin, Barry M.

2011-01-01

Background A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts – neighborhoods with little or no access to healthy foods – by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. Methods We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of U.S. young adults (n=5,115, 18–30 years at baseline), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from four examination periods (n=15,854 person-exam observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and meeting fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within 1 kilometer (km), 1–2.9km, 3–4.9km, and 5–8km of respondents’ homes. Models were sex-stratified, controlled for individual sociodemographics and neighborhood poverty, and tested for interaction by individual-level income. Results Fast food consumption was related to fast food availability in low-income respondents, particularly within 1–2.9km of homes among men [coefficient (95% CI) up to: 0.34 (0.16, 0.51)]. Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake and relationships between grocery store availability and diet outcomes were mixed. Conclusions Our findings provide some evidence for zoning restrictions on fast food restaurants within 3km of low-income residents, but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change. PMID:21747011

Clustering of fast-food restaurants around schools: a novel application of spatial statistics to the study of food environments.

PubMed

Austin, S Bryn; Melly, Steven J; Sanchez, Brisa N; Patel, Aarti; Buka, Stephen; Gortmaker, Steven L

2005-09-01

We examined the concentration of fast food restaurants in areas proximal to schools to characterize school neighborhood food environments. We used geocoded databases of restaurant and school addresses to examine locational patterns of fast-food restaurants and kindergartens and primary and secondary schools in Chicago. We used the bivariate K function statistical method to quantify the degree of clustering (spatial dependence) of fast-food restaurants around school locations. The median distance from any school in Chicago to the nearest fast-food restaurant was 0.52 km, a distance that an adult can walk in little more than 5 minutes, and 78% of schools had at least 1 fast-food restaurant within 800 m. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations. Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods.

Clustering of Fast-Food Restaurants Around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments

PubMed Central

Austin, S. Bryn; Melly, Steven J.; Sanchez, Brisa N.; Patel, Aarti; Buka, Stephen; Gortmaker, Steven L.

2005-01-01

Objectives. We examined the concentration of fast food restaurants in areas proximal to schools to characterize school neighborhood food environments. Methods. We used geocoded databases of restaurant and school addresses to examine locational patterns of fast-food restaurants and kindergartens and primary and secondary schools in Chicago. We used the bivariate K function statistical method to quantify the degree of clustering (spatial dependence) of fast-food restaurants around school locations. Results. The median distance from any school in Chicago to the nearest fast-food restaurant was 0.52 km, a distance that an adult can walk in little more than 5 minutes, and 78% of schools had at least 1 fast-food restaurant within 800 m. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations. Conclusions. Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods. PMID:16118369

Beyond supermarkets: Food outlet location selection in four U.S. cities over time

PubMed Central

Rummo, Pasquale E.; Guilkey, David K.; Ng, Shu Wen; Popkin, Barry M.; Evenson, Kelly R.; Gordon-Larsen, P.

2017-01-01

Introduction Understanding what influences where food outlets locate is important for mitigating disparities in access to healthy food outlets. However, few studies have examined how neighborhood characteristics influence the neighborhood food environment over time, and whether these relationships differ by neighborhood-level income. Methods Neighborhood-level data from four U.S. cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA) from 1986, 1993, 1996, 2001, 2006, and 2011 were used with two-step econometric models to estimate longitudinal associations between neighborhood-level characteristics (z-scores) and the log-transformed count/km2 (density) of food outlets within real-estate-derived neighborhoods. We examined associations with lagged neighborhood-level sociodemographics and lagged density of food outlets, with interaction terms for neighborhood-level income. Data were analyzed in 2016. Results Neighborhood-level income at earlier years was negatively associated with the current density of convenience stores (β= −0.27; 95% CI: −0.16, −0.38; p<0.001). The percentage of neighborhood white population was negatively associated with fast food restaurant density in low income neighborhoods (10th percentile of income: β= −0.17; 95% CI: −0.34, −0.002; p=0.05), and the density of smaller grocery stores across all income levels (β= −0.27; 95% CI: −0.45, −0.09; p=0.003). There was a lack of policy-relevant associations between the pre-existing food environment and the current density of food outlet types, including supermarkets. Conclusions Socioeconomically-disadvantaged populations and minority populations may attract ‘unhealthy’ food outlets over time. To support equal access to healthy food outlets, the availability of ‘less healthy’ food outlets types may be relatively more important than the potential lack of supermarkets or full-service restaurants. PMID:27865651

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time.

PubMed

Rummo, Pasquale E; Guilkey, David K; Ng, Shu Wen; Popkin, Barry M; Evenson, Kelly R; Gordon-Larsen, Penny

2017-03-01

Understanding what influences where food outlets locate is important for mitigating disparities in access to healthy food outlets. However, few studies have examined how neighborhood characteristics influence the neighborhood food environment over time, and whether these relationships differ by neighborhood-level income. Neighborhood-level data from four U.S. cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA) from 1986, 1993, 1996, 2001, 2006, and 2011 were used with two-step econometric models to estimate longitudinal associations between neighborhood-level characteristics (z-scores) and the log-transformed count/km 2 (density) of food outlets within real estate-derived neighborhoods. Associations were examined with lagged neighborhood-level sociodemographics and lagged density of food outlets, with interaction terms for neighborhood-level income. Data were analyzed in 2016. Neighborhood-level income at earlier years was negatively associated with the current density of convenience stores (β= -0.27, 95% CI= -0.16, -0.38, p<0.001). The percentage of neighborhood white population was negatively associated with fast food restaurant density in low-income neighborhoods (10th percentile of income: β= -0.17, 95% CI= -0.34, -0.002, p=0.05), and the density of smaller grocery stores across all income levels (β= -0.27, 95% CI= -0.45, -0.09, p=0.003). There was a lack of policy-relevant associations between the pre-existing food environment and the current density of food outlet types, including supermarkets. Socioeconomically disadvantaged and minority populations may attract "unhealthy" food outlets over time. To support equal access to healthy food outlets, the availability of "less healthy" food outlets types may be relatively more important than the potential lack of supermarkets or full-service restaurants. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Exploring obesogenic food environments in Edmonton, Canada: the association between socioeconomic factors and fast-food outlet access.

PubMed

Hemphill, Eric; Raine, Kim; Spence, John C; Smoyer-Tomic, Karen E

2008-01-01

To explore the relationship between the placement of fast-food outlets and neighborhood-level socioeconomic variables by determining if indicators of lower socioeconomic status were predictive of exposure to fast food. A descriptive analysis of the fast-food environment in a Canadian urban center, using secondary analysis of census data and Geographic Information Systems technology. Edmonton, Alberta, Canada. Neighborhoods were classified as High, Medium, or Low Access based on the number of fast-food opportunities available to them. Neighborhood-level socioeconomic data (income, education, employment, immigration status, and housing tenure) from the 2001 Statistics Canada federal census were obtained. A discriminant function analysis was used to determine if any association existed between neighborhood demographic characteristics and accessibility of fast-food outlets. Significant differences were found between the three levels of fast-food accessibility across the socioeconomic variables, with successively greater percentages of unemployment, low income, and renters in neighborhoods with increasingly greater access to fast-food restaurants. A high score on several of these variables was predictive of greater access to fast-food restaurants. Although a causal inference is not possible, these results suggest that the distribution of fast-food outlets relative to neighborhood-level socioeconomic status requires further attention in the process of explaining the increased rates of obesity observed in relatively deprived populations.

Restaurants in the Neighborhood, Eating Away from Home and BMI in China.

PubMed

Tian, Xu; Zhong, Li; von Cramon-Taubadel, Stephan; Tu, Huakang; Wang, Hui

2016-01-01

To investigate the association between environmental risk factors, eating away from home, and increasing BMI of Chinese adults. Participants were selected from the recent four waves (2004, 2006, 2009, and 2011) of the China Health and Nutrition Survey (CHNS). 10633 participants, including 5084 men and 5549 women, were used in the analysis. 24-h dietary recall data for three consecutive days with information on the time and place of consumption were collected. Nearby restaurants were measured by the number of fast food outlets, indoor restaurants, and food stands in the neighborhood. Random effects multivariable regression was used to assess associations between these variables. People living in neighborhoods with large numbers of indoor restaurants are more likely to eat away from home (p<0.05). Higher frequency of eating away from home is positively associated with BMI, but this effect is only significant for men (p<0.05). Moreover, while eating dinner or breakfast away from home contributes to BMI increase for men (p<0.05), no such association is found for lunch. Eating dinner and breakfast away from home is positively associated with BMI for Chinese men. Labeling energy and portion size for the dishes served in indoor restaurants is recommended in China.

Built Environment and Changes in Blood Pressure in Middle Aged and Older Adults

PubMed Central

Li, Fuzhong; Harmer, Peter; Cardinal, Bradley J.; Vongjaturapat, Naruepon

2009-01-01

Objective Few studies have examined interaction effects between person and environment, especially for cardiovascular disease (CVD) risk. The purpose of this study was to examine built environment characteristics and resident health behaviors as they relate to change in blood pressure, an important component of CVD. Methods Participants (N=1,145, aged 50–75 at baseline) were recruited from 120 neighborhoods in Portland, Oregon. Using a longitudinal design, we assessed changes in participants’ systolic and diastolic blood pressure from baseline to 1-year follow-up (2006–2007 to 2007–2008). Independent variables included baseline neighborhood-level measures of GIS-constructed neighborhood walkability and density of fast-food restaurants, and resident-level measures of meeting physical activity recommendations and eating fruits and vegetables. Results There was a small but significant resident-level increase in both systolic and diastolic blood pressure (P<0.001) over the 1-year observation period. A similar trend was also observed at the neighborhood level (P<0.001). Significant differences in change in blood pressure, by neighborhood walkability, were observed, with decreases in systolic and diastolic blood pressure for those living in high walkable neighborhoods (P<0.001). Neighborhoods of low walkability but with a high density of fast-food outlets and residents making visits to fast-food restaurants were significantly associated with increases in blood pressure measures over time. The negative effect of fast-food restaurants on blood pressure was diminished among high-walkable neighborhoods, with benefits observed among residents meeting guidelines for physical activity and eating fruits and vegetables. Conclusions Neighborhoods with high walkability may ameliorate the risk of hypertension at the community level and promotion of neighborhood walkability could play a significant role in improving population health and reducing CVD risk. PMID:19297686

Restaurants in the Neighborhood, Eating Away from Home and BMI in China

PubMed Central

Tian, Xu; Zhong, Li; von Cramon-Taubadel, Stephan; Tu, Huakang; Wang, Hui

2016-01-01

Background To investigate the association between environmental risk factors, eating away from home, and increasing BMI of Chinese adults. Methods Participants were selected from the recent four waves (2004, 2006, 2009, and 2011) of the China Health and Nutrition Survey (CHNS). 10633 participants, including 5084 men and 5549 women, were used in the analysis. 24-h dietary recall data for three consecutive days with information on the time and place of consumption were collected. Nearby restaurants were measured by the number of fast food outlets, indoor restaurants, and food stands in the neighborhood. Random effects multivariable regression was used to assess associations between these variables. Results People living in neighborhoods with large numbers of indoor restaurants are more likely to eat away from home (p<0.05). Higher frequency of eating away from home is positively associated with BMI, but this effect is only significant for men (p<0.05). Moreover, while eating dinner or breakfast away from home contributes to BMI increase for men (p<0.05), no such association is found for lunch. Conclusion Eating dinner and breakfast away from home is positively associated with BMI for Chinese men. Labeling energy and portion size for the dishes served in indoor restaurants is recommended in China. PMID:27959893

Marriage and parenthood in relation to obesogenic neighborhood trajectories: The CARDIA Study

PubMed Central

Boone-Heinonen, Janne; Howard, Annie Green; Meyer, Katie; Lewis, Cora E.; Kiefe, Catarina I.; Laroche, Helena H.; Gunderson, Erica P.; Gordon-Larsen, Penny

2015-01-01

Marriage and parenthood are associated with weight gain and residential mobility. Little is known about how obesity-relevant environmental contexts differ according to family structure. We estimated trajectories of neighborhood poverty, population density, and density of fast food restaurants, supermarkets, and commercial and public physical activity facilities for adults from a biracial cohort (CARDIA, n=4,174, aged 25–50) over 13 years (1992–93 through 2005–06) using latent growth curve analysis. We estimated associations of marriage, parenthood, and race with the observed neighborhood trajectories. Married participants tended to live in neighborhoods with lower poverty, population density, and availability of all types of food and physical activity amenities. Parenthood was similarly but less consistently related to neighborhood characteristics. Marriage and parenthood were more strongly related to neighborhood trajectories in whites (versus blacks), who, in prior studies, exhibit weaker associations between neighborhood characteristics and health. Greater understanding of how interactive family and neighborhood environments contribute to healthy living is needed. PMID:26093081

Change in trans fatty acid content of fast-food purchases associated with New York City's restaurant regulation: a pre-post study.

PubMed

Angell, Sonia Y; Cobb, Laura K; Curtis, Christine J; Konty, Kevin J; Silver, Lynn D

2012-07-17

Dietary trans fat increases risk for coronary heart disease. In 2006, New York City (NYC) passed the first regulation in the United States restricting trans fat use in restaurants. To assess the effect of the NYC regulation on the trans and saturated fat content of fast-food purchases. Cross-sectional study that included purchase receipts matched to available nutritional information and brief surveys of adult lunchtime restaurant customers conducted in 2007 and 2009, before and after implementation of the regulation. 168 randomly selected NYC restaurant locations of 11 fast-food chains. Adult restaurant customers interviewed in 2007 and 2009. Change in mean grams of trans fat, saturated fat, trans plus saturated fat, and trans fat per 1000 kcal per purchase, overall and by chain type. The final sample included 6969 purchases in 2007 and 7885 purchases in 2009. Overall, mean trans fat per purchase decreased by 2.4 g (95% CI, -2.8 to -2.0 g; P < 0.001), whereas saturated fat showed a slight increase of 0.55 g (CI, 0.1 to 1.0 g; P = 0.011). Mean trans plus saturated fat content decreased by 1.9 g overall (CI, -2.5 to -1.2 g; P < 0.001). Mean trans fat per 1000 kcal decreased by 2.7 g per 1000 kcal (CI, -3.1 to -2.3 g per 1000 kcal; P < 0.001). Purchases with zero grams of trans fat increased from 32% to 59%. In a multivariate analysis, the poverty rate of the neighborhood in which the restaurant was located was not associated with changes. Fast-food restaurants that were included may not be representative of all NYC restaurants. The introduction of a local restaurant regulation was associated with a substantial and statistically significant decrease in the trans fat content of purchases at fast-food chains, without a commensurate increase in saturated fat. Restaurant patrons from high- and low-poverty neighborhoods benefited equally. However, federal regulation will be necessary to fully eliminate population exposure to industrial trans fat sources. City of New York and the Robert Wood Johnson Foundation Healthy Eating Research program.

Neighborhood influences on recreational physical activity and survival after breast cancer.

PubMed

Keegan, Theresa H M; Shariff-Marco, Salma; Sangaramoorthy, Meera; Koo, Jocelyn; Hertz, Andrew; Schupp, Clayton W; Yang, Juan; John, Esther M; Gomez, Scarlett L

2014-10-01

Higher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients. Our study included 4,345 women diagnosed with breast cancer (1995-2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers' markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009. Women residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22% higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p(trend) = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods. Certain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors.

Store and Restaurant Advertising and Health of Public Housing Residents

ERIC Educational Resources Information Center

Heinrich, Katie M.; Li, Dongmei; Regan, Gail R.; Howard, Hugh H.; Ahluwalia, Jasjit S.; Lee, Rebecca E.

2012-01-01

Objectives: To determine relationships between food and beverage signs and health. Methods: In 12 public housing neighborhoods, food and alcohol signs were counted for stores and restaurants. Health and demographic data were from 373 adults. Results: Multilevel modeling showed higher BMI was related to more store and restaurant alcohol signs,…

Neighborhood influences on recreational physical activity and survival after breast cancer

PubMed Central

Shariff-Marco, Salma; Sangaramoorthy, Meera; Koo, Jocelyn; Hertz, Andrew; Schupp, Clayton W.; Yang, Juan; John, Esther M.; Gomez, Scarlett L.

2014-01-01

Purpose Higher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients. Methods Our study included 4,345 women diagnosed with breast cancer (1995–2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers’ markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009. Results Women residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22 % higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p trend = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods. Conclusion Certain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors. PMID:25088804

Food Environments and Childhood Weight Status: Effects of Neighborhood Median Income

PubMed Central

Sharifi, Mona; Sequist, Thomas; Block, Jason; Duncan, Dustin T.; Melly, Steven J.; Rifas-Shiman, Sheryl L.; Taveras, Elsie M.

2015-01-01

Abstract Background: A key aspect of any intervention to improve obesity is to better understand the environment in which decisions are being made related to health behaviors, including the food environment. Methods: Our aim was to examine the extent to which proximity to six types of food establishments is associated with BMI z-score and explore potential effect modification of this relationship. We used geographical information software to determine proximity from 49,770 pediatric patients' residences to six types of food establishments. BMI z-score obtained from the electronic health record was the primary outcome. Results: In multivariable analyses, living in closest proximity to large (β, −0.09 units; 95% confidence interval [CI], −0.13, −0.05) and small supermarkets (−0.08 units; 95% CI, −0.11, −0.04) was associated with lower BMI z-score; living in closest proximity to fast food (0.09 units; 95% CI, 0.03, 0.15) and full-service restaurants (0.07 units; 95% CI, 0.01, 0.14) was associated with a higher BMI z-score versus those living farthest away. Neighborhood median income was an effect modifier of the relationships of convenience stores and full-service restaurants with BMI z-score. In both cases, closest proximity to these establishments had more of an adverse effect on BMI z-score in lower-income neighborhoods. Conclusions: Living closer to supermarkets and farther from fast food and full-service restaurants was associated with lower BMI z-score. Neighborhood median income was an effect modifier; convenience stores and full-service restaurants had a stronger adverse effect on BMI z-score in lower-income neighborhoods. PMID:25923838

Neighborhood food environment role in modifying psychosocial stress-diet relationships.

PubMed

Zenk, Shannon N; Schulz, Amy J; Izumi, Betty T; Mentz, Graciela; Israel, Barbara A; Lockett, Murlisa

2013-06-01

Exposure to highly palatable foods may increase eating in response to stress, but this behavioral response has not been examined in relation to the neighborhood food environment. This study examined whether the neighborhood food environment modified relationships between psychosocial stress and dietary behaviors. Probability-sample survey (n=460) and in-person food environment audit data were used. Dietary behaviors were measured using 17 snack food items and a single eating-out-of-home item. Chronic stress was derived from five subscales; major life events was a count of nine items. The neighborhood food environment was measured as availability of large grocery stores, small grocery stores, and convenience stores, as well as proportion of restaurants that were fast food. Two-level hierarchical regression models were estimated. Snack food intake was positively associated with convenience store availability and negatively associated with large grocery store availability. The measures of chronic stress and major life events were generally not associated with either dietary behavior overall, although Latinos were less likely to eat out at high levels of major life events than African Americans. Stress-neighborhood food environment interactions were not statistically significant. Important questions remain regarding the role of the neighborhood food environment in the stress-diet relationship that warrant further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Neighborhood food environment role in modifying psychosocial stress-diet relationships

PubMed Central

Zenk, Shannon N.; Schulz, Amy J.; Izumi, Betty T.; Mentz, Graciela; Israel, Barbara A.; Lockett, Murlisa

2013-01-01

Exposure to highly palatable foods may increase eating in response to stress, but this behavioral response has not been examined in relation to the neighborhood food environment. This study examined whether the neighborhood food environment modified relationships between psychosocial stress and dietary behaviors. Probability-sample survey (n=460) and in-person food environment audit data were used. Dietary behaviors were measured using 17 snack food items and a single eating-out-of-home item. Chronic stress was derived from five subscales; major life events was a count of 9 items. The neighborhood food environment was measured as availability of large grocery stores, small grocery stores, and convenience stores, as well as proportion of restaurants that were fast food. Two-level hierarchical regression models were estimated. Snack food intake was positively associated with convenience store availability and negatively associated with large grocery store availability. The measures of chronic stress and major life events were generally not associated with either dietary behavior overall, although Latinos were less likely to eat out at high levels of major life events than African Americans. Stress-neighborhood food environment interactions were not statistically significant. Important questions remain regarding the role of the neighborhood food environment in the stress-diet relationship that warrant further investigation. PMID:23415977

Obesity and fast food in urban markets: a new approach using geo-referenced micro data.

PubMed

Chen, Susan Elizabeth; Florax, Raymond J; Snyder, Samantha D

2013-07-01

This paper presents a new method of assessing the relationship between features of the built environment and obesity, particularly in urban areas. Our empirical application combines georeferenced data on the location of fast-food restaurants with data about personal health, behavioral, and neighborhood characteristics. We define a 'local food environment' for every individual utilizing buffers around a person's home address. Individual food landscapes are potentially endogenous because of spatial sorting of the population and food outlets, and the body mass index (BMI) values for individuals living close to each other are likely to be spatially correlated because of observed and unobserved individual and neighborhood effects. The potential biases associated with endogeneity and spatial correlation are handled using spatial econometric estimation techniques. Our application provides quantitative estimates of the effect of proximity to fast-food restaurants on obesity in an urban food market. We also present estimates of a policy simulation that focuses on reducing the density of fast-food restaurants in urban areas. In the simulations, we account for spatial heterogeneity in both the policy instruments and individual neighborhoods and find a small effect for the hypothesized relationships between individual BMI values and the density of fast-food restaurants. Copyright © 2012 John Wiley & Sons, Ltd.

A spatial analysis of the association between restaurant density and body mass index in Canadian adults.

PubMed

Hollands, Simon; Campbell, M Karen; Gilliland, Jason; Sarma, Sisira

2013-10-01

To investigate the association between fast-food restaurant density and adult body mass index (BMI) in Canada. Individual-level BMI and confounding variables were obtained from the 2007-2008 Canadian Community Health Survey master file. Locations of the fast-food and full-service chain restaurants and other non-chain restaurants were obtained from the 2008 Infogroup Canada business database. Food outlet density (fast-food, full-service and other) per 10,000 population was calculated for each Forward Sortation Area (FSA). Global (Moran's I) and local indicators of spatial autocorrelation of BMI were assessed. Ordinary least squares (OLS) and spatial auto-regressive error (SARE) methods were used to assess the association between local food environment and adult BMI in Canada. Global and local spatial autocorrelation of BMI were found in our univariate analysis. We found that OLS and SARE estimates were very similar in our multivariate models. An additional fast-food restaurant per 10,000 people at the FSA-level is associated with a 0.022kg/m(2) increase in BMI. On the other hand, other restaurant density is negatively related to BMI. Fast-food restaurant density is positively associated with BMI in Canada. Results suggest that restricting availability of fast-food in local neighborhoods may play a role in obesity prevention. © 2013.

Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA

PubMed Central

Hurvitz, Philip M; Moudon, Anne V; Rehm, Colin D; Streichert, Laura C; Drewnowski, Adam

2009-01-01

Background Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates. Objective To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA. Methods Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses. Results Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite. Conclusion No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas. PMID:19630979

Store and restaurant advertising and health of public housing residents.

PubMed

Heinrich, Katie M; Li, Dongmei; Regan, Gail R; Howard, Hugh H; Ahluwalia, Jasjit S; Lee, Rebecca E

2012-01-01

To determine relationships between food and beverage signs and health. In 12 public housing neighborhoods, food and alcohol signs were counted for stores and restaurants. Health and demographic data were from 373 adults. Multilevel modeling showed higher BMI was related to more store and restaurant alcohol signs, higher blood pressure, nonsmokers, and females. Higher dietary fat consumption was related to more store and restaurant alcohol and fewer low-calorie healthy signs, lower fruit consumption, fewer minutes walked, and white and Hispanic/Latino ethnicity. Signs in stores and restaurants are related to BMI and dietary fat consumption among residents.

Child-directed marketing inside and on the exterior of fast food restaurants.

PubMed

Ohri-Vachaspati, Punam; Isgor, Zeynep; Rimkus, Leah; Powell, Lisa M; Barker, Dianne C; Chaloupka, Frank J

2015-01-01

Children who eat fast food have poor diet and health outcomes. Fast food is heavily marketed to youth, and exposure to such marketing is associated with higher fast food consumption. To examine the extent of child-directed marketing (CDM) inside and on the exterior of fast food restaurants. Data were collected from 6,716 fast food restaurants located in a nationally representative sample of public middle- and high-school enrollment areas in 2010, 2011, and 2012. CDM was defined as the presence of one or more of seven components inside or on the exterior of the restaurant. Analyses were conducted in 2014. More than 20% of fast food restaurants used CDM inside or on their exterior. In multivariate analyses, fast food restaurants that were part of a chain, offered kids' meals, were located in middle- (compared to high)-income neighborhoods, and in rural (compared to urban) areas had significantly higher odds of using any CDM; chain restaurants and those located in majority black neighborhoods (compared to white) had significantly higher odds of having an indoor display of kids' meal toys. Compared to 2010, there was a significant decline in use of CDM in 2011, but the prevalence increased close to the 2010 level in 2012. CDM inside and on the exterior of fast food restaurants is prevalent in chain restaurants; majority black communities, rural areas, and middle-income communities are disproportionately exposed. The fast food industry should limit children's exposure to marketing that promotes unhealthy food choices. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Do Adolescents Who Live or Go to School Near Fast Food Restaurants Eat More Frequently From Fast Food Restaurants?

PubMed Central

Forsyth, Ann; Wall, Melanie; Larson, Nicole; Story, Mary; Neumark-Sztainer, Dianne

2012-01-01

This population-based study examined whether residential or school neighborhood access to fast food restaurants is related to adolescents’ eating frequency of fast food. A classroom-based survey of racially/ethnically diverse adolescents (n=2,724) in 20 secondary schools in Minneapolis/St. Paul, Minnesota was used to assess eating frequency at five types of fast food restaurants. Black, Hispanic, and Native American adolescents lived near more fast food restaurants than white and Asian adolescents and also ate at fast food restaurants more often. After controlling for individual-level socio-demographics, adolescent males living near high numbers fast food restaurants ate more frequently from these venues compared to their peers. PMID:23064515

Childhood Obesity and Neighborhood Food Store Availability in an Inner City Community

PubMed Central

Galvez, Maida P.; Hong, Lu; Choi, Elizabeth; Liao, Laura; Godbold, James; Brenner, Barbara

2009-01-01

Background Prior studies have shown an association between fast food restaurants and adolescent body size. Less is known about the influence of neighborhood food stores on a child's body size. We hypothesized that in the inner-city, minority community of East Harlem, New York, the presence of convenience stores and fast food restaurants near a child's home is associated with increased risk for childhood obesity as measured by body mass index (BMI). Design/Methods Baseline data of 6-8 year old East Harlem boys and girls (n=323) were utilized. Anthropometry (height and weight) were conducted with a standardized protocol. Food store data were collected via a walking survey. Stores located within the same Census block as the child's home address were identified using ArcGIS 8.3. We computed age- and sex-specific BMI-percentiles using CDC national norms. Using odds ratios, we estimated risk of a child's BMI-percentile being in the top tertile based on number and types of food stores on their Census blocks. Results Convenience stores were present in 55% of the surveyed blocks in which a study participant lived, and fast food restaurants were present in 41%. Children (n=177) living on a block with one or more convenience stores (range 1-6) were more likely to have a BMI-percentile in the top tertile (odds ratio 1.90, 95% CI 1.15-3.15), compared with children having no convenience stores (n=146). Conclusions The presence of convenience stores near a child's residence was associated with a higher BMI-percentile. This has potential implications for both child and neighborhood level childhood obesity interventions. PMID:19560992

Store and Restaurant Advertising and Health of Public Housing Residents

PubMed Central

Heinrich, Katie M.; Li, Dongmei; Regan, Gail R.; Howard, Hugh H.; Ahluwalia, Jasjit S.; Lee, Rebecca E.

2015-01-01

Objectives To determine relationships between food and beverage signs and health. Methods In 12 public housing neighborhoods, food and alcohol signs were counted for stores and restaurants. Health and demographic data were from 373 adults. Results Multilevel modeling showed higher BMI was related to more store and restaurant alcohol signs, higher blood pressure, nonsmokers, and females. Higher dietary fat consumption was related to more store and restaurant alcohol and fewer low-calorie healthy signs, lower fruit consumption, fewer minutes walked, and white and Hispanic/Latino ethnicity. Conclusions Signs in stores and restaurants are related to BMI and dietary fat consumption among residents. PMID:22251784

The association between neighborhood economic hardship, the retail food environment, fast food intake, and obesity: findings from the Survey of the Health of Wisconsin.

PubMed

Laxy, Michael; Malecki, Kristen C; Givens, Marjory L; Walsh, Matthew C; Nieto, F Javier

2015-03-13

Neighborhood-level characteristics such as economic hardship and the retail food environment are assumed to be correlated and to influence consumers' dietary behavior and health status, but few studies have investigated these different relationships comprehensively in a single study. This work aims to investigate the association between neighborhood-level economic hardship, the retail food environment, fast food consumption, and obesity prevalence. Linking data from the population-based Survey of the Health of Wisconsin (SHOW, n = 1,570, 2008-10) and a commercially available business database, the Wisconsin Retail Food Environment Index (WRFEI) was defined as the mean distance from each participating household to the three closest supermarkets divided by the mean distance to the three closest convenience stores or fast food restaurants. Based on US census data, neighborhood-level economic hardship was defined by the Economic Hardship Index (EHI). Relationships were analyzed using multivariate linear and logistic regression models. SHOW residents living in neighborhoods with the highest economic hardship faced a less favorable retail food environment (WRFEI = 2.53) than residents from neighborhoods with the lowest economic hardship (WRFEI = 1.77; p-trend < 0.01). We found no consistent or significant associations between the WRFEI and obesity and only a weak borderline-significant association between access to fast food restaurants and self-reported fast food consumption (≥ 2 times/week, OR = 0.59-0.62, p = 0.05-0.09) in urban residents. Participants reporting higher frequency of fast food consumption (≥ 2 times vs. <2 times per week) were more likely to be obese (OR = 1.35, p = 0.06). This study indicates that neighborhood-level economic hardship is associated with an unfavorable retail food environment. However inconsistent or non-significant relationships between the retail food environment, fast food consumption, and obesity were observed. More research is needed to enhance methodological approaches to assess the retail food environment and to understand the complex relationship between neighborhood characteristics, health behaviors, and health outcomes.

Does intolerance of smoking at school or in restaurants or corner stores decrease cigarette use initiation in adolescents?

PubMed

Pabayo, Roman; O'Loughlin, Jennifer; Barnett, Tracie A; Cohen, Joanna E; Gauvin, Lise

2012-10-01

In addition to individual-level characteristics, the social and physical environment may influence the initiation of cigarette smoking in adolescents. The objective of this paper is to describe the association between smoking intolerance in schools, and in restaurants and corner stores located near schools, and initiation of cigarette smoking among adolescents. Data on cigarette smoking were collected in self-report questionnaires every 3 months from 1999 to 2005 in a sample of 1,293 Grade 7 students in 10 secondary schools in Montreal, Canada. Baseline never-smokers (n = 868) were retained for analysis. School administrators completed questionnaires on tobacco control policies and activities within schools. Data on access to tobacco products and smoking restrictions in restaurants and corner stores located in school neighborhoods were collected through direct observation. Schools, restaurants, and corner stores were classified as smoking tolerant or intolerant. Time to initiation of cigarette smoking was modeled as a function of smoking intolerance in schools, restaurants, and corner stores in survival analyses (Cox proportional hazards modeling). Students in smoking-intolerant schools were less likely to initiate smoking than students in smoking-tolerant schools (hazard ratio [HR; 95% CI] = 0.83 [0.68, 1.01]). Students attending schools located in neighborhoods with smoking-intolerant restaurants were less likely to initiate smoking (HR [95% CI] = 0.85 [0.68, 1.07]). There was no association between corner store smoking intolerance and initiation. Smoking intolerance in schools and restaurants may protect against initiation of cigarette smoking and could be useful targets for more intense tobacco control efforts.

Fast food price, diet behavior, and cardiometabolic health: Differential associations by neighborhood SES and neighborhood fast food restaurant availability in the CARDIA study.

PubMed

Rummo, Pasquale E; Meyer, Katie A; Green Howard, Annie; Shikany, James M; Guilkey, David K; Gordon-Larsen, Penny

2015-09-01

Little research has addressed whether neighborhood context influences associations between fast food price, diet, and cardiometabolic health. We investigated these associations using 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data (n=4,469, observations=21,134). We found a negative association between fast food price and consumption, with stronger inverse associations in more (vs. less) deprived neighborhoods [3rd tertile: β=-0.68 (95% CI: (-0.85, -0.51); 1st tertile: β=-0.22 (95% CI: -0.42, -0.02); p-interaction-0.002], and a similar association for BMI [3rd tertile: β=-1.34 (95% CI: -1.54, -1.14); 1st tertile: β=-0.45 (95% CI: -0.66, -0.25); p-interaction<0.001], but not insulin resistance [3rd tertile: β=-0.07 (95% CI: -0.24, 0.09); 1st tertile: β=0.09 (95% CI: -0.08, 0.26); p-interaction=0.40]. We observed no modification of fast food price by fast food availability. Future research on obesity disparities should consider potential differences in the association between fast food prices and health outcomes across neighborhood socioeconomic levels. Copyright © 2015 Elsevier Ltd. All rights reserved.

Harmony Park: A Decision Case on Gardening on a Brownfield Site

ERIC Educational Resources Information Center

Harms, Ashley Marie Raes; Presley, DeAnn Ricks; Hettiarachchi, Ganga M.; Attanayake, Chammi; Martin, Sabine; Thien, Steven J.

2014-01-01

In March of 2009, Mr. John Holloway and his neighbors in the Harmony Park district of Kansas City, MO, were excited to begin gardening on a vacant city lot in their neighborhood. The neighborhood, like many in urban areas, had once been residential interspersed with small establishments including restaurants, shops, and businesses such as auto…

Fast-food restaurants, park access, and insulin resistance among Hispanic youth.

PubMed

Hsieh, Stephanie; Klassen, Ann C; Curriero, Frank C; Caulfield, Laura E; Cheskin, Lawrence J; Davis, Jaimie N; Goran, Michael I; Weigensberg, Marc J; Spruijt-Metz, Donna

2014-04-01

Evidence of associations between the built environment and obesity risk has been steadily building, yet few studies have focused on the relationship between the built environment and aspects of metabolism related to obesity's most tightly linked comorbidity, type 2 diabetes. To examine the relationship between aspects of the neighborhood built environment and insulin resistance using accurate laboratory measures to account for fat distribution and adiposity. Data on 453 Hispanic youth (aged 8-18 years) from 2001 to 2011 were paired with neighborhood built environment and 2000 Census data. Analyses were conducted in 2011. Walking-distance buffers were built around participants' residential locations. Body composition and fat distribution were assessed using dual x-ray absorptiometry and waist circumference. Variables for park space, food access, walkability, and neighborhood sociocultural aspects were entered into a multivariate regression model predicting insulin resistance as determined by the homeostasis model assessment. Independent of obesity measures, greater fast-food restaurant density was associated with higher insulin resistance. Increased park space and neighborhood linguistic isolation were associated with lower insulin resistance among boys. Among girls, park space was associated with lower insulin resistance, but greater neighborhood linguistic isolation was associated with higher insulin resistance. A significant interaction between waist circumference and neighborhood linguistic isolation indicated that the negative association between neighborhood linguistic isolation and insulin resistance diminished with increased waist circumference. Reducing access to fast food and increasing public park space may be valuable to addressing insulin resistance and type 2 diabetes, but effects may vary by gender. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Beyond Neighborhood Food Environments: Distance Traveled to Food Establishments in 5 US Cities, 2009–2011

PubMed Central

Han, Bing; Cohen, Deborah A.

2015-01-01

Introduction Accurate conceptualizations of neighborhood environments are important in the design of policies and programs aiming to improve access to healthy food. Neighborhood environments are often defined by administrative units or buffers around points of interest. An individual may eat and shop for food within or outside these areas, which may not reflect accessibility of food establishments. This article examines the relevance of different definitions of food environments. Methods We collected data on trips to food establishments using a 1-week food and travel diary and global positioning system devices. Spatial-temporal clustering methods were applied to identify homes and food establishments visited by study participants. Results We identified 513 visits to food establishments (sit-down restaurants, fast-food/convenience stores, malls or stores, groceries/supermarkets) by 135 participants in 5 US cities. The average distance between the food establishments and homes was 2.6 miles (standard deviation, 3.7 miles). Only 34% of the visited food establishments were within participants’ neighborhood census tract. Buffers of 1 or 2 miles around the home covered 55% to 65% of visited food establishments. There was a significant difference in the mean distances to food establishments types (P = .008). On average, participants traveled the longest distances to restaurants and the shortest distances to groceries/supermarkets. Conclusion Many definitions of the neighborhood food environment are misaligned with individual travel patterns, which may help explain the mixed findings in studies of neighborhood food environments. Neighborhood environments defined by actual travel activity may provide more insight on how the food environment influences dietary and food shopping choices. PMID:26247426

Building a National Neighborhood Dataset From Geotagged Twitter Data for Indicators of Happiness, Diet, and Physical Activity.

PubMed

Nguyen, Quynh C; Li, Dapeng; Meng, Hsien-Wen; Kath, Suraj; Nsoesie, Elaine; Li, Feifei; Wen, Ming

2016-10-17

Studies suggest that where people live, play, and work can influence health and well-being. However, the dearth of neighborhood data, especially data that is timely and consistent across geographies, hinders understanding of the effects of neighborhoods on health. Social media data represents a possible new data resource for neighborhood research. The aim of this study was to build, from geotagged Twitter data, a national neighborhood database with area-level indicators of well-being and health behaviors. We utilized Twitter's streaming application programming interface to continuously collect a random 1% subset of publicly available geolocated tweets for 1 year (April 2015 to March 2016). We collected 80 million geotagged tweets from 603,363 unique Twitter users across the contiguous United States. We validated our machine learning algorithms for constructing indicators of happiness, food, and physical activity by comparing predicted values to those generated by human labelers. Geotagged tweets were spatially mapped to the 2010 census tract and zip code areas they fall within, which enabled further assessment of the associations between Twitter-derived neighborhood variables and neighborhood demographic, economic, business, and health characteristics. Machine labeled and manually labeled tweets had a high level of accuracy: 78% for happiness, 83% for food, and 85% for physical activity for dichotomized labels with the F scores 0.54, 0.86, and 0.90, respectively. About 20% of tweets were classified as happy. Relatively few terms (less than 25) were necessary to characterize the majority of tweets on food and physical activity. Data from over 70,000 census tracts from the United States suggest that census tract factors like percentage African American and economic disadvantage were associated with lower census tract happiness. Urbanicity was related to higher frequency of fast food tweets. Greater numbers of fast food restaurants predicted higher frequency of fast food mentions. Surprisingly, fitness centers and nature parks were only modestly associated with higher frequency of physical activity tweets. Greater state-level happiness, positivity toward physical activity, and positivity toward healthy foods, assessed via tweets, were associated with lower all-cause mortality and prevalence of chronic conditions such as obesity and diabetes and lower physical inactivity and smoking, controlling for state median income, median age, and percentage white non-Hispanic. Machine learning algorithms can be built with relatively high accuracy to characterize sentiment, food, and physical activity mentions on social media. Such data can be utilized to construct neighborhood indicators consistently and cost effectively. Access to neighborhood data, in turn, can be leveraged to better understand neighborhood effects and address social determinants of health. We found that neighborhoods with social and economic disadvantage, high urbanicity, and more fast food restaurants may exhibit lower happiness and fewer healthy behaviors.

Multicultural Education Through the Arts.

ERIC Educational Resources Information Center

Shehan, Patricia K.

1986-01-01

Afterschool and weekend activities to promote understanding and supplement a multicultural curriculum are suggested. Home activities include making musical instruments and puppets, while other suggestions involve visits to museums, city neighborhood festivals, and international restaurants. (MT)

Calorie postings in chain restaurants in a low-income urban neighborhood: measuring practical utility and policy compliance.

PubMed

Cohn, Elizabeth Gross; Larson, Elaine L; Araujo, Christina; Sawyer, Vanessa; Williams, Olajide

2012-08-01

Current strategies for combating obesity include recent federal legislation mandating calorie count postings in chain restaurants. This study describes the current practice of menu board calorie postings in a low-income urban neighborhood, identifies the extent to which current practice complies with existing policy, and evaluates the practical utility of menu boards to consumers. We conclude that although most postings were legally compliant, they did not demonstrate utility. Menu postings for individual servings are easily understood, but complex math skills are needed to interpret meals designed to serve more than one person. In some items, calories doubled depending on flavor and the calorie posting did not give enough information to make healthier selections. We identified specific strategies to improve practical utility and provide recommendations for policy implementation.

Characteristics of the Built Environment and the Presence of the Norway Rat in New York City: Results From a Neighborhood Rat Surveillance Program, 2008-2010.

PubMed

Johnson, Sarah; Bragdon, Caroline; Olson, Carolyn; Merlino, Mario; Bonaparte, Sancia

2016-06-01

Characteristics of an urban setting such as New York City (NYC), including readily available putrescible waste and ample underground infrastructure, make it highly attractive to the Norway rat (Rattus norvegicus). To identify property and neighborhood characteristics associated with rat presence, recent inspectional results were analyzed from over 77,000 properties in the Bronx and Manhattan. Variables capturing the location and density of factors believed to promote rat populations were tested individually and in combination in models predicting rat activity. We found that property-specific characteristics typically associated with high garbage volume, including large numbers of residential units, public ownership, and open-space designation (parks, outdoor recreation, or vacant land) were the most important factors in explaining increased rat presence across neighborhoods in NYC. Interventions that involved improved garbage management and street sanitation within a designated area reduced the likelihood of finding rats, especially in medium- and high-poverty neighborhoods. Neighborhood characteristics, such as being near a railroad or subway line, having a school nearby, the presence of numerous restaurants, or having older infrastructure, also contributed to the increased likelihood of rats. Our results support the use of built environment data to target community-level interventions and capture emerging rat infestations.

Fast food price, diet behavior, and cardiometabolic health: differential associations by neighborhood SES and neighborhood fast food restaurants in the CARDIA Study

PubMed Central

Gordon-Larsen, Penny; Rummo, Pasquale E.; Meyer, Katie A.; Howard, Annie Green; Shikany, James M.; Guilkey, David K.

2015-01-01

Little research has addressed whether neighborhood context influences associations between fast food price, diet, and cardiometabolic health. We investigated these associations using 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data (n=4,469, observations=21,134). We found a negative association between fast food price and consumption, with stronger inverse associations in more (vs. less) deprived neighborhoods [3rd tertile: β=−0.68 (95% CI: (−0.85, −0.51); 1st tertile: β=−0.22 (95% CI: −0.42, −0.02) ; p-interaction-0.002], and a similar association for BMI [3rd tertile: β=−1.34 (95% CI: −1.54, −1.14); 1st tertile: β=−0.45 (95% CI: −0.66, −0.25); p-interaction<0.001], but not insulin resistance [3rd tertile: β=− 0.07 (95% CI: −0.24, 0.09); 1st tertile: β=0.09 (95% CI: −0.08, 0.26); p-interaction=0.40]. We observed no modification of fast food price by fast food availability. Future research on obesity disparities should consider potential differences in the association between fast food prices and health outcomes across neighborhood socioeconomic levels. PMID:26319447

Building a National Neighborhood Dataset From Geotagged Twitter Data for Indicators of Happiness, Diet, and Physical Activity

PubMed Central

Li, Dapeng; Meng, Hsien-Wen; Kath, Suraj; Nsoesie, Elaine; Li, Feifei; Wen, Ming

2016-01-01

Background Studies suggest that where people live, play, and work can influence health and well-being. However, the dearth of neighborhood data, especially data that is timely and consistent across geographies, hinders understanding of the effects of neighborhoods on health. Social media data represents a possible new data resource for neighborhood research. Objective The aim of this study was to build, from geotagged Twitter data, a national neighborhood database with area-level indicators of well-being and health behaviors. Methods We utilized Twitter’s streaming application programming interface to continuously collect a random 1% subset of publicly available geolocated tweets for 1 year (April 2015 to March 2016). We collected 80 million geotagged tweets from 603,363 unique Twitter users across the contiguous United States. We validated our machine learning algorithms for constructing indicators of happiness, food, and physical activity by comparing predicted values to those generated by human labelers. Geotagged tweets were spatially mapped to the 2010 census tract and zip code areas they fall within, which enabled further assessment of the associations between Twitter-derived neighborhood variables and neighborhood demographic, economic, business, and health characteristics. Results Machine labeled and manually labeled tweets had a high level of accuracy: 78% for happiness, 83% for food, and 85% for physical activity for dichotomized labels with the F scores 0.54, 0.86, and 0.90, respectively. About 20% of tweets were classified as happy. Relatively few terms (less than 25) were necessary to characterize the majority of tweets on food and physical activity. Data from over 70,000 census tracts from the United States suggest that census tract factors like percentage African American and economic disadvantage were associated with lower census tract happiness. Urbanicity was related to higher frequency of fast food tweets. Greater numbers of fast food restaurants predicted higher frequency of fast food mentions. Surprisingly, fitness centers and nature parks were only modestly associated with higher frequency of physical activity tweets. Greater state-level happiness, positivity toward physical activity, and positivity toward healthy foods, assessed via tweets, were associated with lower all-cause mortality and prevalence of chronic conditions such as obesity and diabetes and lower physical inactivity and smoking, controlling for state median income, median age, and percentage white non-Hispanic. Conclusions Machine learning algorithms can be built with relatively high accuracy to characterize sentiment, food, and physical activity mentions on social media. Such data can be utilized to construct neighborhood indicators consistently and cost effectively. Access to neighborhood data, in turn, can be leveraged to better understand neighborhood effects and address social determinants of health. We found that neighborhoods with social and economic disadvantage, high urbanicity, and more fast food restaurants may exhibit lower happiness and fewer healthy behaviors. PMID:27751984

From neighborhood design and food options to residents' weight status.

PubMed

Cerin, Ester; Frank, Lawrence D; Sallis, James F; Saelens, Brian E; Conway, Terry L; Chapman, James E; Glanz, Karen

2011-06-01

This study examined associations of accessibility, availability, price, and quality of food choices and neighborhood urban design with weight status and utilitarian walking. To account for self-selection bias, data on adult residents of a middle-to-high-income neighborhood were used. Participants kept a 2-day activity/travel diary and self-reported socio-demographics, height, and weight. Geographic Information Systems data were used to objectively quantify walking-related aspects of urban design, and number of and distance to food outlets within respondents' 1km residential buffers. Food outlets were audited for availability, price, and quality of healthful food choices. Number of convenience stores and in-store healthful food choices were positively related to walking for errands which, in turn, was predictive of lower risk of being overweight/obese. Negative associations with overweight/obesity unexplained by walking were found for number of grocery stores and healthful food choices in sit-down restaurants. Aspects of urban form and food environment were associated with walking for eating purposes which, however, was not predictive of overweight/obesity. Access to diverse destinations, food outlets and healthful food choices may promote pedestrian activity and contribute to better weight regulation. Accessibility and availability of healthful food choices may lower the risk of overweight/obesity by providing opportunities for healthier dietary patterns. Copyright © 2011 Elsevier Ltd. All rights reserved.

A multifocal outbreak of hepatitis A traced to commercially distributed lettuce.

PubMed Central

Rosenblum, L S; Mirkin, I R; Allen, D T; Safford, S; Hadler, S C

1990-01-01

From February 1 through March 20, 1988, 202 cases of hepatitis A were reported in and around Jefferson County, Kentucky. The epidemic curve indicated a common-source exposure. However, there was no apparent single source of exposure from a restaurant, or community gathering; nor was there a geographic clustering by residence. Cases were mainly adults 20-59 years old (89 percent); 51 percent were female. A case-control study using neighborhood controls found that factors associated with hepatitis A were: having eaten downtown (odds ratio [OR] = 4.0) and having dined at any one of three restaurants (OR = 21.0). Case-control studies of patrons of two of these restaurants found that eating green salad was strongly associated with acquiring hepatitis A: OR = 11.6 and OR = 4.4. The three implicated restaurants accounted for 71 percent of the cases. All three restaurants were supplied by the same fresh produce distributor; however, investigation suggested that contamination most likely occurred prior to local distribution. This outbreak of hepatitis A is the first in the United States apparently associated with fresh produce contaminated before distribution to restaurants, and raises important public health issues regarding the regulation of fresh produce. PMID:2382744

Neighborhood food outlets, diet, and obesity among California adults, 2007 and 2009.

PubMed

Hattori, Aiko; An, Ruopeng; Sturm, Roland

2013-01-01

Varying neighborhood definitions may affect research on the association between food environments and diet and weight status. The objective of this study was to examine the association between number and type of neighborhood food outlets and dietary intake and body mass index (BMI) measures among California adults according to the geographic size of a neighborhood or food environment. We analyzed data from 97,678 respondents aged 18 years or older from the 2007 and 2009 California Health Interview Survey through multivariable regression models. Outcome variables were BMI, weight status of a BMI of 25.0 or more and a BMI of 30.0 or more, and the number of times per week the following were consumed: fruits, vegetables, sugar-sweetened soft drinks, fried potatoes, and fast food. Explanatory variables were the number of fast-food restaurants, full-service restaurants, convenience stores, small food stores, grocery stores, and large supermarkets within varying distances (0.25 to 3.0 miles) from the survey respondent's residence. We adopted as a measure of walking distance a Euclidean distance within 1 mile. Control variables included sociodemographic and economic characteristics of respondents and neighborhoods. Food outlets within walking distance (≤ 1.0 mile) were not strongly associated with dietary intake, BMI, or probabilities of a BMI of 25.0 or more or a BMI of 30.0 or more. We found significant associations between fast-food outlets and dietary intake and between supermarkets and BMI and probabilities of a BMI of 25.0 or more and a BMI of 30.0 or more for food environments beyond walking distance (> 1.0 mile). We found no strong evidence that food outlets near homes are associated with dietary intake or BMI. We replicated some associations reported previously but only for areas that are larger than what typically is considered a neighborhood. A likely reason for the null finding is that shopping patterns are weakly related, if at all, to neighborhoods in the United States because of access to motorized transportation.

MORE NEIGHBORHOOD RETAIL ASSOCIATED WITH LOWER OBESITY AMONG NEW YORK CITY PUBLIC HIGH SCHOOL STUDENTS

PubMed Central

Bader, Michael D. M.; Schwartz-Soicher, Ofira; Jack, Darby; Weiss, Christopher C.; Richards, Catherine A.; Quinn, James W.; Lovasi, Gina S.; Neckerman, Kathryn M.; Rundle, Andrew G.

2014-01-01

Policies target fast food outlets to curb adolescent obesity. We argue that researchers should examine the entire retail ecology of neighborhoods, not just fast food outlets. We examine the association between the neighborhood retail environment and obesity using Fitnessgram data collected from 94,348 New York City public high school students. In generalized hierarchical linear models, the number of fast food restaurants predicted lower odds of obesity for adolescents (OR:0.972 per establishment; CI:0.957--0.988). In a “placebo test” we found that banks – a measure of neighborhood retail ecology – also predicted lower obesity (OR:0.979 per bank; CI:0.962–0.994). Retail disinvestment might be associated with greater obesity; accordingly, public health research should study the influence of general retail disinvestment not just food-specific investment. PMID:23827943

More neighborhood retail associated with lower obesity among New York City public high school students.

PubMed

Bader, Michael D M; Schwartz-Soicher, Ofira; Jack, Darby; Weiss, Christopher C; Richards, Catherine A; Quinn, James W; Lovasi, Gina S; Neckerman, Kathryn M; Rundle, Andrew G

2013-09-01

Policies target fast food outlets to curb adolescent obesity. We argue that researchers should examine the entire retail ecology of neighborhoods, not just fast food outlets. We examine the association between the neighborhood retail environment and obesity using Fitnessgram data collected from 94,348 New York City public high school students. In generalized hierarchical linear models, the number of fast food restaurants predicted lower odds of obesity for adolescents (OR:0.972 per establishment; CI:0.957-0.988). In a "placebo test" we found that banks--a measure of neighborhood retail ecology--also predicted lower obesity (OR:0.979 per bank; CI:0.962-0.994). Retail disinvestment might be associated with greater obesity; accordingly, public health research should study the influence of general retail disinvestment not just food-specific investment. © 2013 Elsevier Ltd. All rights reserved.

Availability, Location, and Format of Nutrition Information in Fast-food Chain Restaurants in Ontario, Canada.

PubMed

Hobin, Erin; Lebenbaum, Michael; Rosella, Laura; Hammond, David

2015-03-01

To assess the availability, location, and format of nutrition information in fast-food chain restaurants in Ontario. Nutrition information in restaurants was assessed using an adapted version of the Nutrition Environment Measures Study for Restaurants (NEMS-R). Two raters independently visited 50 restaurants, 5 outlets of each of the top-10 fast-food chain restaurants in Canada. The locations of the restaurants were randomly selected within the Waterloo, Wellington, and Peel regions in Ontario, Canada. Descriptive results are presented for the proportion of restaurants presenting nutrition information by location (e.g., brochure), format (e.g., use of symbols), and then by type of restaurant (e.g., quick take-away, full-service). Overall, 96.0% (n = 48) of the restaurants had at least some nutrition information available in the restaurant. However, no restaurant listed calorie information for all items on menu boards or menus, and only 14.0% (n = 7) of the restaurants posted calorie information and 26.0% (n = 13) of restaurants posted other nutrients (e.g., total fat) for at least some items on menus boards or menus. The majority of the fast-food chain restaurants included in our study provided at least some nutrition information in restaurants; however, very few restaurants made nutrition information readily available for consumers on menu boards and menus.

77 FR 16895 - Announcement of Competition Under the America COMPETES Reauthorization Act of 2011: Project REACH...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... find shelters in the neighborhood of the JBJ Soul Kitchen, a community restaurant in Monmouth County... not explicitly contemplated on the contest Web site. Selection of the winner is in the sole discretion... random. In the unlikely event that more than two competitors tie and all entrants meet the selection...

Interactive effects of reward sensitivity and residential fast-food restaurant exposure on fast-food consumption.

PubMed

Paquet, Catherine; Daniel, Mark; Knäuper, Bärbel; Gauvin, Lise; Kestens, Yan; Dubé, Laurette

2010-03-01

Local fast-food environments have been increasingly linked to obesity and related outcomes. Individuals who are more sensitive to reward-related cues might be more responsive to such environments. This study aimed to assess the moderating role of sensitivity to reward on the relation between residential fast-food restaurant exposure and fast-food consumption. Four hundred fifteen individuals (49.6% men; mean age: 34.7 y) were sampled from 7 Montreal census tracts stratified by socioeconomic status and French/English language. The frequency of fast-food restaurant visits in the previous week was self-reported. Sensitivity to reward was self-reported by using the Behavioral Activation System (BAS) scale. Fast-food restaurant exposure within 500 m of the participants' residence was determined by using a Geographic Information System. Main and interactive effects of the BAS and fast-food restaurant exposure on fast-food consumption were tested with logistic regression models that accounted for clustering of observations and participants' age, sex, education, and household income. Regression results showed a significant interaction between BAS and fast-food restaurant exposure (P < 0.001). Analysis of BAS tertiles indicated that the association between neighborhood fast-food restaurant exposure and consumption was positive for the highest tertile (odds ratio: 1.49; 95% CI: 1.20, 1.84; P < 0.001) but null for the intermediate (odds ratio: 1.03; 95% CI: 0.80, 1.34; P = 0.81) and lowest (odds ratio: 0.84; 95% CI: 0.51, 1.37; P = 0.49) tertiles. Reward-sensitive individuals may be more responsive to unhealthful cues in their immediate environment.

The neighborhood environment and obesity: Understanding variation by race/ethnicity.

PubMed

Wong, Michelle S; Chan, Kitty S; Jones-Smith, Jessica C; Colantuoni, Elizabeth; Thorpe, Roland J; Bleich, Sara N

2018-06-01

Neighborhood characteristics have been associated with obesity, but less is known whether relationships vary by race/ethnicity. This study examined the relationship between soda consumption - a behavior strongly associated with obesity - and weight status with neighborhood sociodemographic, social, and built environments by race/ethnicity. We merged data on adults from the 2011-2013 California Health Interview Survey, U.S. Census data, and InfoUSA (n=62,396). Dependent variables were soda consumption and weight status outcomes (body mass index and obesity status). Main independent variables were measures of three neighborhood environments: social (social cohesion and safety), sociodemographic (neighborhood socioeconomic status, educational attainment, percent Asian, percent Hispanic, and percent black), and built environments (number of grocery stores, convenience stores, fast food restaurants, and gyms in neighborhood). We fit multi-level linear and logistic regression models, stratified by individual race/ethnicity (NH (non-Hispanic) Whites, NH African Americans, Hispanics, and NH Asians) controlling for individual-level characteristics, to estimate neighborhood contextual effects on study outcomes. Lower neighborhood educational attainment was associated with higher odds of obesity and soda consumption in all racial/ethnic groups. We found fewer associations between study outcomes and the neighborhood, especially the built environment, among NH African Americans and NH Asians. While improvements to neighborhood environment may be promising to reduce obesity, null associations among minority subgroups suggest that changes, particularly to the built environment, may alone be insufficient to address obesity in these groups. Published by Elsevier Inc.

School and residential neighborhood food environment and diet among California youth.

PubMed

An, Ruopeng; Sturm, Roland

2012-02-01

Various hypotheses link neighborhood food environments and diet. Greater exposure to fast-food restaurants and convenience stores is thought to encourage overconsumption; supermarkets and large grocery stores are claimed to encourage healthier diets. For youth, empirical evidence for any particular hypothesis remains limited. This study examines the relationship between school and residential neighborhood food environment and diet among youth in California. Data from 8226 children (aged 5-11 years) and 5236 adolescents (aged 12-17 years) from the 2005 and 2007 California Health Interview Survey were analyzed in 2011. The dependent variables are daily servings of fruits, vegetables, juice, milk, soda, high-sugar foods, and fast food, which were regressed on measures of food environments. Food environments were measured by counts and density of businesses, distinguishing fast-food restaurants, convenience stores, small food stores, grocery stores, and large supermarkets within a specific distance (varying from 0.1 to 1.5 miles) from a respondent's home or school. No robust relationship between food environment and consumption is found. A few significant results are sensitive to small modeling changes and more likely to reflect chance than true relationships. This correlational study has measurement and design limitations. Longitudinal studies that can assess links between environmental, dependent, and intervening food purchase and consumption variables are needed. Reporting a full range of studies, methods, and results is important as a premature focus on correlations may lead policy astray. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The association between obesity and urban food environments.

PubMed

Bodor, J Nicholas; Rice, Janet C; Farley, Thomas A; Swalm, Chris M; Rose, Donald

2010-09-01

Several studies have examined associations between the food retail environment and obesity, though virtually no work has been done in the urban South, where obesity rates are among the highest in the country. This study assessed associations between access to food retail outlets and obesity in New Orleans. Data on individual characteristics and body weight were collected by telephone interviews from a random sample of adults (N = 3,925) living in New Orleans in 2004-2005. The neighborhood of each individual was geo-mapped by creating a 2-km buffer around the center point of the census tract in which they lived. Food retailer counts were created by summing the total number of each food store type and fast food establishment within this 2-km neighborhood. Hierarchical linear models assessed associations between access to food retailers and obesity status. After adjusting for individual characteristics, each additional supermarket in a respondent's neighborhood was associated with a reduced odds for obesity (OR 0.93, 95% CI 0.88-0.99). Fast food restaurant (OR 1.01, 95% CI 1.00-1.02) and convenience store (OR 1.01, 95% CI 1.00-1.02) access were each predictive of greater obesity odds. An individual's access to food stores and fast food restaurants may play a part in determining weight status. Future studies with longitudinal and experimental designs are needed to test whether modifications in the food environment may assist in the prevention of obesity.

Walking for transportation in Hong Kong Chinese urban elders: a cross-sectional study on what destinations matter and when.

PubMed

Cerin, Ester; Lee, Ka-yiu; Barnett, Anthony; Sit, Cindy H P; Cheung, Man-chin; Chan, Wai-man; Johnston, Janice M

2013-06-20

Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. Identifying destinations and environmental conditions that facilitate this type of walking has public health significance. However, most findings are limited to Western, low-density locations, while a larger proportion of the global population resides in ultra-dense Asian metropolises. We investigated relationships of within-neighborhood objectively-measured destination categories and environmental attributes with walking for transport in 484 elders from an ultra-dense metropolis (Hong Kong). We estimated relationships of diversity (number of different types) and prevalence of within-neighborhood destination categories (environmental audits of 400 m buffers surrounding residential addresses) with transport-related walking (interviewer-administered questionnaire) in 484 Chinese-speaking elders able to walk unassisted and living in 32 neighborhoods stratified by socio-economic status and transport-related walkability. We examined the moderating effects of safety and pedestrian infrastructure-related neighborhood attributes on destination-walking associations. Participants reported on average 569 and 254 min/week of overall and within-neighborhood walking for transport, respectively. The prevalence of public transit points and diversity of recreational destinations were positively related to overall walking for transport. The presence of a health clinic/service and place of worship, higher diversity in recreational destinations, and greater prevalence of non-food retails and services, food/grocery stores, and restaurants in the neighborhood were predictive of more within-neighborhood walking for transport. Neighborhood safety-related aspects moderated the relationship of overall walking for transport with the prevalence of public transit points, this being positive only in safe locations. Similar moderating effects of safety-related attributes were observed for the relationships of within-neighborhood walking for transport with diversity of recreational and entertainment destinations. Pedestrian-infrastructure attributes acted as moderators of associations of within-neighborhood walking for transport with prevalence of commercial destination categories. Composite destinations indices consisting of destination categories related to the specific measures of walking were positively associated with walking for transport. The availability of both non-commercial and commercial destinations may promote within-neighborhood walking for transport, while recreational facilities and public transit points may facilitate overall walking for transport. However, destination-rich areas need to also provide adequate levels of personal safety and a physically-unchallenging pedestrian network.

Walking for transportation in Hong Kong Chinese urban elders: a cross-sectional study on what destinations matter and when

PubMed Central

2013-01-01

Background Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. Identifying destinations and environmental conditions that facilitate this type of walking has public health significance. However, most findings are limited to Western, low-density locations, while a larger proportion of the global population resides in ultra-dense Asian metropolises. We investigated relationships of within-neighborhood objectively-measured destination categories and environmental attributes with walking for transport in 484 elders from an ultra-dense metropolis (Hong Kong). Methods We estimated relationships of diversity (number of different types) and prevalence of within-neighborhood destination categories (environmental audits of 400 m buffers surrounding residential addresses) with transport-related walking (interviewer–administered questionnaire) in 484 Chinese-speaking elders able to walk unassisted and living in 32 neighborhoods stratified by socio-economic status and transport-related walkability. We examined the moderating effects of safety and pedestrian infrastructure-related neighborhood attributes on destination-walking associations. Results Participants reported on average 569 and 254 min/week of overall and within-neighborhood walking for transport, respectively. The prevalence of public transit points and diversity of recreational destinations were positively related to overall walking for transport. The presence of a health clinic/service and place of worship, higher diversity in recreational destinations, and greater prevalence of non-food retails and services, food/grocery stores, and restaurants in the neighborhood were predictive of more within-neighborhood walking for transport. Neighborhood safety-related aspects moderated the relationship of overall walking for transport with the prevalence of public transit points, this being positive only in safe locations. Similar moderating effects of safety-related attributes were observed for the relationships of within-neighborhood walking for transport with diversity of recreational and entertainment destinations. Pedestrian-infrastructure attributes acted as moderators of associations of within-neighborhood walking for transport with prevalence of commercial destination categories. Composite destinations indices consisting of destination categories related to the specific measures of walking were positively associated with walking for transport. Conclusions The availability of both non-commercial and commercial destinations may promote within-neighborhood walking for transport, while recreational facilities and public transit points may facilitate overall walking for transport. However, destination-rich areas need to also provide adequate levels of personal safety and a physically-unchallenging pedestrian network. PMID:23782627

Food and park environments: neighborhood-level risks for childhood obesity in east Los Angeles.

PubMed

Kipke, Michele D; Iverson, Ellen; Moore, Deborah; Booker, Cara; Ruelas, Valerie; Peters, Anne L; Kaufman, Francine

2007-04-01

The rapid increase in obesity over the past two decades suggests that behavioral and environmental influences, including poor nutrition and physical inactivity, are fueling what is now widely recognized as a public health crisis. Yet, limited research has been conducted to examine how environmental factors, such as neighborhood-level characteristics, may be associated with increased risk for obesity. Community-level risk associated with childhood obesity was examined in East Los Angeles, a community with one of the highest rates of childhood obesity in Los Angeles by triangulating: 1) spatial data for the number and location of food establishments relative to the location of schools; 2) observations regarding the availability and quality of fruits and vegetables in local grocery stores; and 3) observations regarding the quality and utilization of local parks. The findings revealed that there were 190 food outlets in the study community, of which 93 (49%) were fast-food restaurants. Of the fast-food restaurants, 63% were within walking distance of a school. In contrast, there were 62 grocery stores, of which only 18% sold fresh fruits and/or vegetables of good quality. Of the stores that did sell fruits and/or vegetables, only four were within walking distance of a school. Although well maintained, the five parks in this community accounted for only 37.28 acres, or 0.543 acres per 1000 residents. These findings suggest that children have easy access to fast food, and limited access to both healthy food options and parks in which to engage in physical fitness activities. This was particularly true in areas around schools. The implications for these findings with regards to policy-related prevention and future research are discussed.

Unexpected Neighborhood Sources of Food and Drink: Implications for Research and Community Health.

PubMed

Lucan, Sean C; Maroko, Andrew R; Seitchik, Jason L; Yoon, Dong Hum; Sperry, Luisa E; Schechter, Clyde B

2018-06-11

Studies of neighborhood food environments typically focus on select stores (especially supermarkets) and/or restaurants (especially fast-food outlets), make presumptions about healthfulness without assessing actual items for sale, and ignore other kinds of businesses offering foods/drinks. The current study assessed availability of select healthful and less-healthful foods/drinks from all storefront businesses in an urban environment and considered implications for food-environment research and community health. Cross-sectional assessment in 2013 of all storefront businesses (n=852) on all street segments (n=1,253) in 32 census tracts of the Bronx, New York. Investigators assessed for healthful items (produce, whole grains, nuts, water, milk) and less-healthful items (refined sweets, salty/fatty fare, sugar-added drinks, and alcohol), noting whether items were from food businesses (e.g., supermarkets and restaurants) or other storefront businesses (OSB, e.g., barber shops, gyms, hardware stores, laundromats). Data were analyzed in 2017. Half of all businesses offered food/drink items. More than one seventh of all street segments (more than one third in higher-poverty census tracts) had businesses selling food/drink. OSB accounted for almost one third of all businesses offering food/drink items (about one quarter of businesses offering any healthful items and more than two thirds of businesses offering only less-healthful options). Food environments include many businesses not primarily focused on selling foods/drinks. Studies that do not consider OSB may miss important food/drink sources, be incomplete and inaccurate, and potentially misguide interventions. OSB hold promise for improving food environments and community health by offering healthful items; some already do. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Is the density of alcohol establishments related to nonviolent crime?

PubMed

Toomey, Traci L; Erickson, Darin J; Carlin, Bradley P; Quick, Harrison S; Harwood, Eileen M; Lenk, Kathleen M; Ecklund, Alexandra M

2012-01-01

We examined the associations between the density of alcohol establishments and five types of nonviolent crime across urban neighborhoods. Data from the city of Minneapolis, MN, in 2009 were aggregated and analyzed at the neighborhood level. We examined the association between alcohol establishment density and five categories of nonviolent crime: vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, and underage alcohol possession/consumption. A Bayesian approach was used for model estimation accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density and then separately for off-premise establishments (e.g., liquor and convenience stores) and on-premise establishments (e.g., bars and restaurants). We found positive associations between density and each crime category. The association was strongest for public consumption and weakest for vandalism. We estimated that a 3.3%-10.9% increase across crime categories would result from a 20% increase in neighborhood establishment density. Similar results were seen for on- and off-premise establishments, although the strength of the associations was lower for off-premise density. Our results indicate that communities should consider the potential increase in nonviolent crime associated with an increase in the number of alcohol establishments within neighborhoods.

Are Barroom and Neighborhood Characteristics Independently Related to Local-Area Assaults?

PubMed

Morrison, Christopher; Mair, Christina F; Lee, Juliet P; Gruenewald, Paul J

2015-12-01

Two separate but complementary literatures examine bar-related violence: one has focused on barroom features, and the other has focused on features of neighborhoods near bars. This study unifies these 2 perspectives using a microenvironmental approach. In a purposive sample of 65 bars in 4 California cities, we used premise assessments to characterize the physical, social, and economic environments of barrooms (e.g., patron count, average pace of drinking, and restaurant service); and a combination of systematic social observation, census, and alcohol license data to characterize the neighborhoods in which they were located (e.g., physical disorder, alcohol outlet density, and median household income). Hierarchical Poisson models then assessed relationships between these features and counts of police-reported assaults within buffer areas around bars. Aspects of both barroom environments (more patrons, more dancing, and louder music) and neighborhood environments (greater bar density, greater physical disorder, lower population density, and lower income) were independently related to increased incidence of assaults. Preventive intervention to reduce bar-area violence may be directed at both bar environments (e.g., limiting the number of patrons) and neighborhood environments (e.g., limiting outlet density). Copyright © 2015 by the Research Society on Alcoholism.

Youth and Work: Restoring Teen and Young Adult Connections to Opportunity. KIDS COUNT Policy Report

ERIC Educational Resources Information Center

Annie E. Casey Foundation, 2012

2012-01-01

Forty years ago, a teenager leaving high school--with or without a diploma--could find a job in a local factory. Twenty years ago, even as manufacturing jobs moved offshore, young people could still gain a foothold in the workforce through neighborhood stores and restaurants. Amid the housing boom of the past decade, youth with some training could…

Objective assessment of obesogenic environments in youth: geographic information system methods and spatial findings from the Neighborhood Impact on Kids study.

PubMed

Frank, Lawrence D; Saelens, Brian E; Chapman, James; Sallis, James F; Kerr, Jacqueline; Glanz, Karen; Couch, Sarah C; Learnihan, Vincent; Zhou, Chuan; Colburn, Trina; Cain, Kelli L

2012-05-01

GIS-based walkability measures designed to explain active travel fail to capture "playability" and proximity to healthy food. These constructs should be considered when measuring potential child obesogenic environments. The aim of this study was to describe the development of GIS-based multicomponent physical activity and nutrition environment indicators of child obesogenic environments in the San Diego and Seattle regions. Block group-level walkability (street connectivity, residential density, land-use mix, and retail floor area ratio) measures were constructed in each region. Multiple sources were used to enumerate parks (∼900-1600 per region) and food establishments (∼10,000 per region). Physical activity environments were evaluated on the basis of walkability and presence and quality of parks. Nutrition environments were evaluated based on presence and density of fast-food restaurants and distance to supermarkets. Four neighborhood types were defined using high/low cut points for physical activity and nutrition environments defined through an iterative process dependent on regional counts of fast-food outlets and overall distance to parks and grocery stores from census block groups where youth live. To identify sufficient numbers of children aged 6-11 years, high physical activity environment block groups had at least one high-quality park within 0.25 miles and were above median walkability, whereas low physical activity environment groups had no parks and were below median walkability. High nutrition environment block groups had a supermarket within 0.5 miles, and fewer than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Low nutrition environments had either no supermarket, or a supermarket and more than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Income, educational attainment, and ethnicity varied across physical activity and nutrition environments. These approaches to defining neighborhood environments can be used to study physical activity, nutrition, and obesity outcomes. Findings presented in a companion paper validate these GIS methods for measuring obesogenic environments. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

Guess who's not coming to dinner? Evaluating online restaurant reservations for disease surveillance.

PubMed

Nsoesie, Elaine O; Buckeridge, David L; Brownstein, John S

2014-01-22

Alternative data sources are used increasingly to augment traditional public health surveillance systems. Examples include over-the-counter medication sales and school absenteeism. We sought to determine if an increase in restaurant table availabilities was associated with an increase in disease incidence, specifically influenza-like illness (ILI). Restaurant table availability was monitored using OpenTable, an online restaurant table reservation site. A daily search was performed for restaurants with available tables for 2 at the hour and at half past the hour for 22 distinct times: between 11:00 am-3:30 pm for lunch and between 6:00-11:30 PM for dinner. In the United States, we examined table availability for restaurants in Boston, Atlanta, Baltimore, and Miami. For Mexico, we studied table availabilities in Cancun, Mexico City, Puebla, Monterrey, and Guadalajara. Time series of restaurant use was compared with Google Flu Trends and ILI at the state and national levels for the United States and Mexico using the cross-correlation function. Differences in restaurant use were observed across sampling times and regions. We also noted similarities in time series trends between data on influenza activity and restaurant use. In some settings, significant correlations greater than 70% were noted between data on restaurant use and ILI trends. This study introduces and demonstrates the potential value of restaurant use data for event surveillance.

Changing the restaurant food environment to improve cardiovascular health in a rural community: implementation and evaluation of the Heart of New Ulm restaurant programme.

PubMed

Lindberg, Rebecca; Sidebottom, Abbey C; McCool, Brigitte; Pereira, Raquel F; Sillah, Arthur; Boucher, Jackie L

2018-04-01

The goals of the present study were to: (i) describe the implementation of a programme to improve the restaurant food environment in a rural community; and (ii) describe how practices changed in community restaurants. The intervention included a baseline assessment of all community restaurants (n 32) and a report on how they could increase the availability and promotion of healthful options. The assessment focused on sixteen healthy practices (HP) derived from the Nutrition Environment Measures Survey for Restaurants. Restaurants were invited to participate at gold, silver or bronze levels based on the number of HP attained. Participating restaurants received dietitian consultation, staff training and promotion of the restaurant. All community restaurants were reassessed 1·5 years after baseline. The restaurant programme was part of the Heart of New Ulm Project, a community-based CVD prevention programme in a rural community. All community restaurants (n 32) were included in the study. Over one-third (38 %) of community restaurants participated in the programme. At baseline, 22 % achieved at least a bronze level. This increased to 38 % at follow-up with most of the improvement among participating restaurants that were independently owned. Across all restaurants in the community, the HP showing the most improvement included availability of non-fried vegetables (63-84 %), fruits (41-53 %), smaller portions and whole grains. Findings demonstrate successes and challenges of improving healthful food availability and promotion in a community-wide restaurant programme.

Availability of nutrition information from chain restaurants in the United States.

PubMed

Wootan, Margo G; Osborn, Melissa

2006-03-01

Although obesity and poor dietary habits are complex multifactorial problems, away-from-home food has been identified as one likely and important contributor. Restaurants provide a growing and substantial portion of the average American's diet, yet the Nutrition Labeling and Education Act (NLEA), which went into effect in 1994, explicitly exempts restaurants from most labeling requirements. Thus, this study examined the availability of nutrition information from the largest chain restaurants in the United States. Between January and August 2004, we surveyed the 300 largest chain restaurants by telephone, e-mail, or examining company websites (response rate was 96%). The top chains, as ranked by revenue, were selected based on 2002 ratings in Restaurants and Institutions. Fifty-four percent of the 287 largest chain restaurants made some nutrition information available. Forty-four percent had nutrition information for the majority of their standard menu items. We found no significant differences in the availability of nutrition information based on the size of the restaurant chain. Of those restaurants with nutrition information, 86% provided information on the company website. The number of restaurants providing nutrition information has increased over the last 10 years. However, making informed and healthful food choices is hampered by the absence of nutrition information at many restaurants. Given the growing and significant role that away-from-home foods play in Americans' diets, the Surgeon General and the National Academies' Institute of Medicine recommend that nutrition information be available to customers at restaurants, and state legislatures and the U.S. Congress are beginning to address the issue.

Managerial modes of influence and counterproductivity in organizations: a longitudinal business-unit-level investigation.

PubMed

Detert, James R; Treviño, Linda K; Burris, Ethan R; Andiappan, Meena

2007-07-01

The authors studied the effect of 3 modes of managerial influence (managerial oversight, ethical leadership, and abusive supervision) on counterproductivity, which was conceptualized as a unit-level outcome that reflects the existence of a variety of intentional and unintentional harmful employee behaviors in the unit. Counterproductivity was represented by an objective measure of food loss in a longitudinal study of 265 restaurants. After prior food loss and alternative explanations (e.g., turnover, training, neighborhood income) were controlled for, results indicated that managerial oversight and abusive supervision significantly influenced counterproductivity in the following periods, whereas ethical leadership did not. Counterproductivity was also found to be negatively related to both restaurant profitability and customer satisfaction in the same period and to mediate indirect relationships between managerial influences and distal unit outcomes.

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015.

PubMed

Florian, Jana; Roy, Nicole M St Omer; Quintiliani, Lisa M; Truong, Ve; Feng, Yi; Bloch, Philippe P; Russinova, Zlatka L; Lasser, Karen E

2016-08-11

Diabetes self-management takes place within a complex social and environmental context.  This study's objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes "hot spots").  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants' reports in the photovoice group. We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes.

Modelling Psychological Needs for User-dependent Contextual Suggestion

DTIC Science & Technology

2014-11-01

neighborhood, night club, park, place of worship, restaurant, RV park, shopping mall, stadium, synagogue, university and zoo . The search ra- dius is set...them do not differ much from each other. For example, the desired description texts for zoos and aquariums may not differ signif- icantly, and similarly...district, place of worship, library as another group, and park, zoo , aquarium, natural reserve as yet another group. We have manually dis- tributed

Green neighborhoods, food retail and childhood overweight: differences by population density.

PubMed

Liu, Gilbert C; Wilson, Jeffrey S; Qi, Rong; Ying, Jun

2007-01-01

This study examines relationships between overweight in children and two environmentalfactors--amount of vegetation surrounding a child's place of residence and proximity of the child's residence to various types of food retail locations. We hypothesize that living in greener neighborhoods, farther from fast food restaurants, and closer to supermarkets would be associated with lower risk of overweight. Cross-sectional study. Network of primary care pediatric clinics in Marion County, Indiana. We acquired data for 7334 subjects, ages 3 to 18 years, presenting for routine well-child care. Neighborhood vegetation and proximity to food retail were calculated using geographic information systems for each subject using circular and network buffers. Child weight status was defined using body mass index percentiles. Analysis. We used cumulative logit models to examine associations between an index of overweight, neighborhood vegetation, and food retail environment. After controlling for individual socio-demographics and neighborhood socioeconomic status, measures of vegetation and food retail significantly predicted overweight in children. Increased neighborhood vegetation was associated with decreased risk for overweight, but only for subjects residing in higher population density regions. Increased distance between a subject's residence and the nearest large brand name supermarkets was associated with increased risk of overweight, but only for subjects residing in lower population density regions. This research suggests that aspects of the built environment are determinants of child weight status, ostensibly by influencing physical activity and dietary behaviors.

Multicollinearity in associations between multiple environmental features and body weight and abdominal fat: using matching techniques to assess whether the associations are separable.

PubMed

Leal, Cinira; Bean, Kathy; Thomas, Frédérique; Chaix, Basile

2012-06-01

Because of the strong correlations among neighborhoods' characteristics, it is not clear whether the associations of specific environmental exposures (e.g., densities of physical features and services) with obesity can be disentangled. Using data from the RECORD (Residential Environment and Coronary Heart Disease) Cohort Study (Paris, France, 2007-2008), the authors investigated whether neighborhood characteristics related to the sociodemographic, physical, service-related, and social-interactional environments were associated with body mass index and waist circumference. The authors developed an original neighborhood characteristic-matching technique (analyses within pairs of participants similarly exposed to an environmental variable) to assess whether or not these associations could be disentangled. After adjustment for individual/neighborhood socioeconomic variables, body mass index/waist circumference was negatively associated with characteristics of the physical/service environments reflecting higher densities (e.g., proportion of built surface, densities of shops selling fruits/vegetables, and restaurants). Multiple adjustment models and the neighborhood characteristic-matching technique were unable to identify which of these neighborhood variables were driving the associations because of high correlations between the environmental variables. Overall, beyond the socioeconomic environment, the physical and service environments may be associated with weight status, but it is difficult to disentangle the effects of strongly correlated environmental dimensions, even if they imply different causal mechanisms and interventions.

Uncertainty Can Increase Explanatory Credibility

DTIC Science & Technology

2013-08-01

example, that you ask a friend what she thinks of a new restaurant that has opened up in her neighborhood. If she says, “It’s good!” her intonation ... intonation . Figure 2 If James does regular aerobic exercises then he strengthens his heart. But, James did not strengthen his heart. What, if anything...variance from the different materials or the perception that the interaction was staged. General Discussion We used a novel experimental methodology

Geospatial Analysis of Food Environment Demonstrates Associations with Gestational Diabetes

PubMed Central

KAHR, Maike K.; SUTER, Melissa A.; BALLAS, Jerasimos; RAMIN, Susan M.; MONGA, Manju; LEE, Wesley; HU, Min; SHOPE, Cindy D.; CHESNOKOVA, Arina; KRANNICH, Laura; GRIFFIN, Emily N.; MASTROBATTISTA, Joan; DILDY, Gary A.; STREHLOW, Stacy L.; RAMPHUL, Ryan; HAMILTON, Winifred J; AAGAARD, Kjersti M.

2015-01-01

Background Gestational diabetes mellitus (GDM) is one of most common complications of pregnancy, with incidence rates varying by maternal age, race/ethnicity, obesity, parity, and family history. Given its increasing prevalence in recent decades, co-variant environmental and sociodemographic factors may be additional determinants of GDM occurrence. Objectives We hypothesized that environmental risk factors, in particular measures of the food environment, may be a diabetes contributor. We employed geospatial modeling in a populous U.S. county to characterize the association of the relative availability of fast food restaurants and supermarkets to GDM. Study Design Utilizing a perinatal database with over 4900 encoded antenatal and outcome variables inclusive of zip code data, 8912 consecutive pregnancies were analyzed for correlations between GDM and food environment based on county-wide food permit registration data. Linkage between pregnancies and food environment was achieved on the basis of validated 5 digit zip code data. The prevalence of supermarkets and fast food restaurants per 100,000 inhabitants for each zip code were gathered from publicly available food permit sources. In order to independently authenticate our findings with objective data, we measured hemoglobin A1c (HbA1c) levels as a function of geospatial distribution of food environment in a matched subset (n=80). Results Residence in neighborhoods with a high prevalence of fast food restaurants (fourth quartile) was significantly associated with an increased risk of developing GDM (relative to first quartile, aOR: 1.63 [95% CI 1.21–2.19]). In multivariate analysis, this association held true after controlling for potential confounders (p=0.002). Measurement of HbA1c levels in a matched subset were significantly increased in association with residence in a zip code with a higher fast food/supermarket ratio (n=80, r=0.251 p<0.05). Conclusions As demonstrated by geospatial analysis, a relationship of food environment and risk for gestational diabetes was identified. PMID:26319053

Geospatial analysis of food environment demonstrates associations with gestational diabetes.

PubMed

Kahr, Maike K; Suter, Melissa A; Ballas, Jerasimos; Ramin, Susan M; Monga, Manju; Lee, Wesley; Hu, Min; Shope, Cindy D; Chesnokova, Arina; Krannich, Laura; Griffin, Emily N; Mastrobattista, Joan; Dildy, Gary A; Strehlow, Stacy L; Ramphul, Ryan; Hamilton, Winifred J; Aagaard, Kjersti M

2016-01-01

Gestational diabetes mellitus (GDM) is one of most common complications of pregnancy, with incidence rates varying by maternal age, race/ethnicity, obesity, parity, and family history. Given its increasing prevalence in recent decades, covariant environmental and sociodemographic factors may be additional determinants of GDM occurrence. We hypothesized that environmental risk factors, in particular measures of the food environment, may be a diabetes contributor. We employed geospatial modeling in a populous US county to characterize the association of the relative availability of fast food restaurants and supermarkets to GDM. Utilizing a perinatal database with >4900 encoded antenatal and outcome variables inclusive of ZIP code data, 8912 consecutive pregnancies were analyzed for correlations between GDM and food environment based on countywide food permit registration data. Linkage between pregnancies and food environment was achieved on the basis of validated 5-digit ZIP code data. The prevalence of supermarkets and fast food restaurants per 100,000 inhabitants for each ZIP code were gathered from publicly available food permit sources. To independently authenticate our findings with objective data, we measured hemoglobin A1c levels as a function of geospatial distribution of food environment in a matched subset (n = 80). Residence in neighborhoods with a high prevalence of fast food restaurants (fourth quartile) was significantly associated with an increased risk of developing GDM (relative to first quartile: adjusted odds ratio, 1.63; 95% confidence interval, 1.21-2.19). In multivariate analysis, this association held true after controlling for potential confounders (P = .002). Measurement of hemoglobin A1c levels in a matched subset were significantly increased in association with residence in a ZIP code with a higher fast food/supermarket ratio (n = 80, r = 0.251 P < .05). As demonstrated by geospatial analysis, a relationship of food environment and risk for gestational diabetes was identified. Copyright © 2016 Elsevier Inc. All rights reserved.

The Neighborhood Energy Balance Equation: Does Neighborhood Food Retail Environment + Physical Activity Environment = Obesity? The CARDIA Study

PubMed Central

Boone-Heinonen, Janne; Diez-Roux, Ana V.; Goff, David C.; Loria, Catherine M.; Kiefe, Catarina I.; Popkin, Barry M.; Gordon-Larsen, Penny

2013-01-01

Background Recent obesity prevention initiatives focus on healthy neighborhood design, but most research examines neighborhood food retail and physical activity (PA) environments in isolation. We estimated joint, interactive, and cumulative impacts of neighborhood food retail and PA environment characteristics on body mass index (BMI) throughout early adulthood. Methods and Findings We used cohort data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study [n=4,092; Year 7 (24-42 years, 1992-1993) followed over 5 exams through Year 25 (2010-2011); 12,921 person-exam observations], with linked time-varying geographic information system-derived neighborhood environment measures. Using regression with fixed effects for individuals, we modeled time-lagged BMI as a function of food and PA resource density (counts per population) and neighborhood development intensity (a composite density score). We controlled for neighborhood poverty, individual-level sociodemographics, and BMI in the prior exam; and included significant interactions between neighborhood measures and by sex. Using model coefficients, we simulated BMI reductions in response to single and combined neighborhood improvements. Simulated increase in supermarket density (from 25th to 75th percentile) predicted inter-exam reduction in BMI of 0.09 kg/m2 [estimate (95% CI): -0.09 (-0.16, -0.02)]. Increasing commercial PA facility density predicted BMI reductions up to 0.22 kg/m2 in men, with variation across other neighborhood features [estimate (95% CI) range: -0.14 (-0.29, 0.01) to -0.22 (-0.37, -0.08)]. Simultaneous increases in supermarket and commercial PA facility density predicted inter-exam BMI reductions up to 0.31 kg/m2 in men [estimate (95% CI) range: -0.23 (-0.39, -0.06) to -0.31 (-0.47, -0.15)] but not women. Reduced fast food restaurant and convenience store density and increased public PA facility density and neighborhood development intensity did not predict reductions in BMI. Conclusions Findings suggest that improvements in neighborhood food retail or PA environments may accumulate to reduce BMI, but some neighborhood changes may be less beneficial to women. PMID:24386458

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015

PubMed Central

Roy, Nicole M. St. Omer; Quintiliani, Lisa M.; Truong, Ve; Feng, Yi; Bloch, Philippe P.; Russinova, Zlatka L.; Lasser, Karen E.

2016-01-01

Introduction Diabetes self-management takes place within a complex social and environmental context.  This study’s objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. Methods We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes “hot spots”).  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Results Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants’ reports in the photovoice group. Conclusion We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes. PMID:27513998

Neighborhood Immigrant Acculturation and Diet among Hispanic Female Residents of NYC

PubMed Central

Park, Yoosun; Neckerman, Kathryn; Quinn, James; Weiss, Christopher; Jacobson, Judith; Rundle, Andrew

2013-01-01

Objective To identify predominant dietary patterns among Hispanic women and to determine whether adherence to dietary patterns is predicted by neighborhood level factors: linguistic isolation, poverty rate and the retail food environment. Design Cross-sectional analyses of predictors of adherence to dietary patterns identified from principle component analyses of data collected using the Study of Women’s Health Across the Nation (SWAN) food frequency questionnaire. Census data were used to measure poverty rates and the percent of Spanish speaking families in the neighborhood in which no one ≥ 14 years old spoke English very well (linguistic isolation) and the retail food environment was measured using business listings data. Setting New York City. Subjects 345 Hispanic women. Results Two major dietary patterns were identified: a healthy diet pattern loading high for vegetable, legumes, potato, fish, and other seafood which explained 17% of the variance in the FFQ data and an energy dense diet pattern loading high for red meat, poultry, pizza, french fries, and high energy drink, which explained 9% of the variance in the FFQ data. Adherence to the healthy diet pattern was positively associated with neighborhood linguistic isolation and negatively associated with neighborhood poverty. More fast food restaurants per Km2 in the neighborhood was significantly associated with lower adherence to the healthy diet. Adherence to the energy dense diet pattern was inversely, but not significantly, associated with neighborhood linguistic isolation. Conclusions These results are consistent with the hypothesis that living in immigrant enclaves is associated with healthy diet patterns among Hispanics. PMID:21414245

CTC Sentinel. Volume 6, Issue 11-12, November 2013

DTIC Science & Technology

2013-11-01

Libyan government today seeks only to strengthen its existence and power through presenting loyalty to these belligerent countries and offering...opened fire at customs police in Port Said near the Suez Canal, killing one person. – Bloomberg October 8 October 8, 2013 (IRAQ): A car bomb exploded...in front of a restaurant in the mainly Shi`a neighborhood of Zafaraniyya, killing three people. – AP, October 8 NOvEMBER 2013 . VoL 6. IssUE 11-12

A national study of the association between food environments and county-level health outcomes.

PubMed

Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

2011-01-01

This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships between food availability and access variables (direct-to-consumer farm sales, per capita grocery stores, full-service restaurants, fast food restaurants, and convenience stores) with health outcomes. Controls include smoking, race/ethnicity, gender, age, education, poverty, primary care availability, recreational facility availability, and mobility/distance-from-grocery-store. Non-metro findings: Lower adjusted mortality rates were associated with more per capita full-service restaurants and grocery stores, and greater per capita direct farm sales. Lower adjusted diabetes rates were associated with a lower per capita supply of fast food restaurants and convenience stores, and more per capita full-service restaurants and grocery stores. Lower adjusted obesity rates were associated with more per capita full-service restaurants and grocery stores. Unexpectedly, obesity rates were positively associated with per capita grocery stores and negatively associated with fast food restaurants. Metro findings: More per capita full-service restaurants, grocery stores, and direct farm sales are associated with positive health outcomes; fast food restaurants and convenience stores are associated with negative health outcomes. The food access/availability environment is an important determinant of health outcomes in metro and non-metro areas. Future research should focus on more refined specifications that capture variability across non-metro settings. © 2011 National Rural Health Association.

Association between the neighborhood obesogenic environment and colorectal cancer risk in the Multiethnic Cohort.

PubMed

Canchola, Alison J; Shariff-Marco, Salma; Yang, Juan; Albright, Cheryl; Hertz, Andrew; Park, Song-Yi; Shvetsov, Yurii B; Monroe, Kristine R; Le Marchand, Loïc; Gomez, Scarlett Lin; Wilkens, Lynne R; Cheng, Iona

2017-10-01

Information on the role of the neighborhood environment and colorectal cancer risk is limited. We investigated the association between a comprehensive suite of possible obesogenic neighborhood attributes (socioeconomic status, population density, restaurant and retail food environments, numbers of recreational facilities and businesses, commute patterns, traffic density, and street connectivity) and colorectal cancer risk in the Multiethnic Cohort Study. Among 81,197 eligible participants living in California (35,397 males and 45,800 females), 1973 incident cases (981 males and 992 females) of invasive colorectal cancer were identified between 1993 and 2010. Separately for males and females, multivariable Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for colorectal cancer risk overall and by racial/ethnic group (African American, Japanese American, Latino, white). In males, higher traffic density was associated with an increased risk of colorectal cancer (HR=1.29, 95% CI: 1.03-1.61, p=0.03, for quintile 5 vs. quintile 1; p-trend=0.06). While this association may be due to chance, this pattern was seen (albeit non-statistically significant) in all racial/ethnic groups except whites. There were no other significant associations between other neighborhood obesogenic attributes and colorectal cancer risk. Findings from our large racial/ethnically diverse cohort suggest neighborhood obesogenic characteristics are not strongly associated with the risk of colorectal cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Availability of point-of-purchase nutrition information at a fast-food restaurant.

PubMed

Wootan, Margo G; Osborn, Melissa; Malloy, Claudia J

2006-12-01

Given the link between eating out, poor diets, and obesity, we assessed the availability of point-of-purchase nutrition information at the largest fast-food restaurant in the U.S., McDonald's. In August 2004, we visited 29 of 33 (88%) of the McDonald's outlets in Washington, DC and visually inspected the premises, as well as asked cashiers or restaurant managers whether they had nutrition information available in the restaurant. In Washington, DC, 59% of McDonald's outlets provided in-store nutrition information for the majority of their standard menu items. In 62% of the restaurants, it was necessary to ask two or more employees in order to obtain a copy of that information. We found that even at the largest chain restaurant in the country, nutrition information at the point of decision-making is often difficult to find or completely absent.

Availability of and Ease of Access to Calorie Information on Restaurant Websites

PubMed Central

Bennett, Gary G.; Steinberg, Dori M.; Lanpher, Michele G.; Askew, Sandy; Lane, Ilana B.; Levine, Erica L.; Goodman, Melody S.; Foley, Perry B.

2013-01-01

Objective Offering calories on restaurant websites might be particularly important for consumer meal planning, but the availability of and ease of accessing this information are unknown. Methods We assessed websites for the top 100 U.S. chain restaurants to determine the availability of and ease of access to calorie information as well as website design characteristics. We also examined potential predictors of calorie availability and ease of access. Results Eighty-two percent of restaurants provided calorie information on their websites; 25% presented calories on a mobile-formatted website. On average, calories could be accessed in 2.35±0.99 clicks. About half of sites (51.2%) linked to calorie information via the homepage. Fewer than half had a separate section identifying healthful options (46.3%), or utilized interactive meal planning tools (35.4%). Quick service/fast casual, larger restaurants, and those with less expensive entrées and lower revenue were more likely to make calorie information available. There were no predictors of ease of access. Conclusion Calorie information is both available and largely accessible on the websites of America’s leading restaurants. It is unclear whether consumer behavior is affected by the variability in the presentation of calorie information. PMID:23977193

Availability of and ease of access to calorie information on restaurant websites.

PubMed

Bennett, Gary G; Steinberg, Dori M; Lanpher, Michele G; Askew, Sandy; Lane, Ilana B; Levine, Erica L; Goodman, Melody S; Foley, Perry B

2013-01-01

Offering calories on restaurant websites might be particularly important for consumer meal planning, but the availability of and ease of accessing this information are unknown. We assessed websites for the top 100 U.S. chain restaurants to determine the availability of and ease of access to calorie information as well as website design characteristics. We also examined potential predictors of calorie availability and ease of access. Eighty-two percent of restaurants provided calorie information on their websites; 25% presented calories on a mobile-formatted website. On average, calories could be accessed in 2.35±0.99 clicks. About half of sites (51.2%) linked to calorie information via the homepage. Fewer than half had a separate section identifying healthful options (46.3%), or utilized interactive meal planning tools (35.4%). Quick service/fast casual, larger restaurants, and those with less expensive entrées and lower revenue were more likely to make calorie information available. There were no predictors of ease of access. Calorie information is both available and largely accessible on the websites of America's leading restaurants. It is unclear whether consumer behavior is affected by the variability in the presentation of calorie information.

Built Environment and Obesity by Urbanicity in the U.S

PubMed Central

Xu, Yanqing; Wang, Fahui

2015-01-01

Based on the data from the Behavioral Risk Factor Surveillance System 2012, this study examines the association of neighborhood built environments with individual physical inactivity and obesity in the U.S. Multilevel modeling is used to control for the effects of individual socio-demographic characteristics. Neighborhood variables include built environment, poverty level and urbanicity at the county level. Among the built environment variables, a poorer street connectivity and a more prominent presence of fast-food restaurants are associated with a higher obesity risk (especially for areas of certain urbanicity levels). Analysis of data subsets divided by areas of different urbanicity levels and by gender reveals the variability of effects of independent variables, more so for the neighborhood variables than individual variables. This implies that some obesity risk factors are geographically specific and vary between men and women. The results lend support to the role of built environment in influencing people’s health behavior and outcome, and promote public policies that need to be geographically adaptable and sensitive to the diversity of demographic groups. PMID:25864019

Do minority and poor neighborhoods have higher access to fast-food restaurants in the United States?

PubMed Central

James, Peter; Arcaya, Mariana C.; Parker, Devin M.; Tucker-Seeley, Reginald

2016-01-01

Background Disproportionate access to unhealthy foods in poor or minority neighborhoods may be a primary determinant of obesity disparities. We investigated whether fast-food access varies by Census block group (CBG) percent black and poverty. Methods We measured the average driving distance from each CBG population-weighted centroid to the five closest top ten fast-food chains and CBG percent black and percent below poverty Results Among 209,091 CBGs analyzed (95.1% of all US CBGs), CBG percent black was positively associated with fast-food access controlling for population density and percent poverty (average distance to fast food was 3.56 miles closer (95% CI: -3.64, -3.48) in CBGs with the highest versus lowest quartile of percentage of black residents). Poverty was not independently associated with fast-food access. The relationship between fast-food access and race was stronger in CBGs with higher levels of poverty (p for interaction <0.0001). Conclusions Predominantly black neighborhoods had higher access to fast-food while poverty was not an independent predictor of fast-food access. PMID:24945103

Built environment and obesity by urbanicity in the U.S.

PubMed

Xu, Yanqing; Wang, Fahui

2015-07-01

Based on the data from the Behavioral Risk Factor Surveillance System 2012, this study examines the association of neighborhood built environments with individual physical inactivity and obesity in the U.S. Multilevel modeling is used to control for the effects of individual socio-demographic characteristics. Neighborhood variables include built environment, poverty level and urbanicity at the county level. Among the built environment variables, a poorer street connectivity and a more prominent presence of fast-food restaurants are associated with a higher obesity risk (especially for areas of certain urbanicity levels). Analysis of data subsets divided by areas of different urbanicity levels and by gender reveals the variability of effects of independent variables, more so for the neighborhood variables than individual variables. This implies that some obesity risk factors are geographically specific and vary between men and women. The results lend support to the role of built environment in influencing people's health behavior and outcome, and promote public policies that need to be geographically adaptable and sensitive to the diversity of demographic groups. Copyright © 2015 Elsevier Ltd. All rights reserved.

Do minority and poor neighborhoods have higher access to fast-food restaurants in the United States?

PubMed

James, Peter; Arcaya, Mariana C; Parker, Devin M; Tucker-Seeley, Reginald D; Subramanian, S V

2014-09-01

Disproportionate access to unhealthy foods in poor or minority neighborhoods may be a primary determinant of obesity disparities. We investigated whether fast-food access varies by Census block group (CBG) percent black and poverty. We measured the average driving distance from each CBG population-weighted centroid to the five closest top ten fast-food chains and CBG percent black and percent below poverty. Among 209,091 CBGs analyzed (95.1% of all US CBGs), CBG percent black was positively associated with fast-food access controlling for population density and percent poverty (average distance to fast-food was 3.56 miles closer (95% CI: -3.64, -3.48) in CBGs with the highest versus lowest quartile of percentage of black residents). Poverty was not independently associated with fast-food access. The relationship between fast-food access and race was stronger in CBGs with higher levels of poverty (p for interaction <0.0001). Predominantly black neighborhoods had higher access to fast-food while poverty was not an independent predictor of fast-food access. Copyright © 2014 Elsevier Ltd. All rights reserved.

Nutrition-labeling regulation impacts on restaurant environments.

PubMed

Saelens, Brian E; Chan, Nadine L; Krieger, James; Nelson, Young; Boles, Myde; Colburn, Trina A; Glanz, Karen; Ta, Myduc L; Bruemmer, Barbara

2012-11-01

Recent attempts to improve the healthfulness of away-from-home eating include regulations requiring restaurants to post nutrition information. The impact of such regulations on restaurant environments is unknown. To examine changes in restaurant environments from before to after nutrition-labeling regulation in a newly regulated county versus a nonregulated county. Using the Nutrition Environment Measures Survey-Restaurant version audit, environments within the same quick-service chain restaurants were evaluated in King County (regulated) before and 6 and 18 months after regulation enforcement and in Multnomah County (nonregulated) restaurants over a 6-month period. Data were collected in 2008-2010 and analyses conducted in 2011. Overall availability of healthy options and facilitation of healthy eating did not increase differentially in King County versus Multnomah County restaurants aside from the substantial increase in onsite nutrition information posting in King County restaurants required by the new regulation. Barriers to healthful eating decreased in King County relative to Multnomah County restaurants, particularly in food-oriented establishments. King County restaurants demonstrated modest increases in signage that promotes healthy eating, although the frequency of such promotion remained low, and the availability of reduced portions decreased in these restaurants. The healthfulness of children's menus improved modestly over time, but not differentially by county. A restaurant nutrition-labeling regulation was accompanied by some, but not uniform, improvements in other aspects of restaurant environments in the regulated compared to the nonregulated county. Additional opportunities exist for improving the healthfulness of away-from-home eating beyond menu labeling. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Nutrition-Labeling Regulation Impacts on Restaurant Environments

PubMed Central

Saelens, Brian E.; Chan, Nadine; Krieger, James; Nelson, Young; Boles, Myde; Colburn, Trina; Glanz, Karen; Ta, Myduc; Bruemmer, Barbara

2012-01-01

Background Recent attempts to improve the healthfulness of away-from-home eating include regulations requiring restaurants to post nutrition information. The impact of such regulations on restaurant environments is unknown. Purpose To examine changes in restaurant environments from before to after nutrition-labeling regulation in a newly regulated county versus a nonregulated county. Methods Using the Nutrition Environment Measures Surveys–Restaurant version audit, environments within the same quick-service chain restaurants were evaluated in King County (regulated) before and 6 and 18 months after regulation enforcement and in Multnomah County (nonregulated) restaurants over a 6-month period. Data were collected in 2008–2010 and analyses conducted in 2011. Results Overall availability of healthy options and facilitation of healthy eating did not differentially increase in King County versus Multnomah County restaurants aside from the substantial increase in onsite nutrition information posting in King County restaurants required by the new regulation. Barriers to healthful eating decreased in King County relative to Multnomah County restaurants, particularly in food-oriented establishments. King County restaurants demonstrated modest increases in signage that promotes healthy eating, although the frequency of such promotion remained low, and the availability of reduced portions decreased in these restaurants. The healthfulness of children’s menus improved modestly over time, but not differentially by county. Conclusions A restaurant nutrition-labeling regulation was accompanied by some, but not uniform, improvements in other aspects of restaurant environments in the regulated compared to the nonregulated county. Additional opportunities exist for improving the healthfulness of awayfrom- home eating beyond menu labeling. PMID:23079173

Frequency of consumption at fast-food restaurants is associated with dietary intake in overweight and obese women recruited from financially disadvantaged neighborhoods

PubMed Central

Wilcox, Sara; Sharpe, Patricia A.; Turner-McGrievy, Gabrielle; Granner, Michelle; Baruth, Meghan

2013-01-01

Fast-food restaurants are more prevalent in lower income and predominately African American neighborhoods, where consumption of fast-food is also higher. In general populations, fast-food consumption is related to less healthy dietary intake. This cross-sectional study examined the hypotheses that greater fast-food consumption is associated with less healthy dietary intake and poorer diet quality in overweight and obese women (N=196, 25–51 years, 87% African American) recruited from financially disadvantaged Census tracts. Dietary intake and diet quality (Alternate Healthy Eating Index, AHEI) were assessed via three 24-hour dietary recalls. Linear regression models tested the association between fast-food consumption and each outcome (Model 1). Model 2 added sociodemographics and physical activity. Model 3 added total caloric intake. Fast-food consumption was significantly associated with total caloric intake; total intake of meat, grains, sweetened beverages, dairy, fiber, cholesterol, sodium, and added sugar; and percent of calories from total fat, saturated fat, and trans fatty acids. Statistically significant associations remained in Model 2 but most were not significant in Model 3. Fast-food consumption was not associated with diet quality (AHEI) in any model. In this at-risk sample, fast-food consumption was associated with more negative dietary practices. Significant associations generally disappeared when controlling for total caloric intake, suggesting that women who eat more fast-food have higher total caloric intakes as a result of increased consumption of unhealthy rather than healthy foods. PMID:23890353

Development and Reliability Testing of a Fast-Food Restaurant Observation Form.

PubMed

Rimkus, Leah; Ohri-Vachaspati, Punam; Powell, Lisa M; Zenk, Shannon N; Quinn, Christopher M; Barker, Dianne C; Pugach, Oksana; Resnick, Elissa A; Chaloupka, Frank J

2015-01-01

To develop a reliable observational data collection instrument to measure characteristics of the fast-food restaurant environment likely to influence consumer behaviors, including product availability, pricing, and promotion. The study used observational data collection. Restaurants were in the Chicago Metropolitan Statistical Area. A total of 131 chain fast-food restaurant outlets were included. Interrater reliability was measured for product availability, pricing, and promotion measures on a fast-food restaurant observational data collection instrument. Analysis was done with Cohen's κ coefficient and proportion of overall agreement for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. Interrater reliability, as measured by average κ coefficient, was .79 for menu characteristics, .84 for kids' menu characteristics, .92 for food availability and sizes, .85 for beverage availability and sizes, .78 for measures on the availability of nutrition information,.75 for characteristics of exterior advertisements, and .62 and .90 for exterior and interior characteristics measures, respectively. For continuous measures, average ICC was .88 for food pricing measures, .83 for beverage prices, and .65 for counts of exterior advertisements. Over 85% of measures demonstrated substantial or almost perfect agreement. Although some measures required revision or protocol clarification, results from this study suggest that the instrument may be used to reliably measure the fast-food restaurant environment.

Developing a mobile produce distribution system for low-income urban residents in food deserts.

PubMed

Widener, Michael J; Metcalf, Sara S; Bar-Yam, Yaneer

2012-10-01

Low-income households in the contemporary city often lack adequate access to healthy foods, like fresh produce, due to a variety of social and spatial barriers that result in neighborhoods being underserved by full-service supermarkets. Because of this, residents commonly resort to purchasing food at fast food restaurants or convenience stores with poor selections of produce. Research has shown that maintaining a healthy diet contributes to disease prevention and overall quality of life. This research seeks to increase low-income residents' access to healthy foods by addressing spatial constraints through the characterization of a mobile market distribution system model that serves in-need neighborhoods. The model optimally locates mobile markets based on the geographic distribution of these residents. Using data from the medium-sized city of Buffalo, New York, results show that, with relatively few resources, the model increases these residents' access to healthy foods, helping to create a healthier city.

Association between neighbourhood fast-food and full-service restaurant density and body mass index: a cross-sectional study of Canadian adults.

PubMed

Hollands, Simon; Campbell, M Karen; Gilliland, Jason; Sarma, Sisira

2014-05-07

Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents' forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p<0.001). These associations were primarily found in Canada's major urban jurisdictions. This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy.

Psychosocial factors influencing the frequency of fast-food consumption among urban and rural Costa Rican adolescents.

PubMed

Monge-Rojas, Rafael; Smith-Castro, Vanessa; Colón-Ramos, Uriyoán; Aragón, M Catalina; Herrera-Raven, Francisco

2013-01-01

The aim of this study was to identify psychosocial factors that influence fast-food consumption in urban and rural Costa Rican adolescents. A self-administered questionnaire designed for the study asked about sociodemographic information, frequency of fast-food consumption, meaning of "fast food," location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using principal components analysis with Varimax rotation method and eigenvalues. Descriptive statistics and a hierarchical linear regression model were used to predict the frequency of fast-food consumption. Responses from 400 adolescents (ages 12-17 y) reveal that daily consumption of fast food was 1.8 times more frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were found in the way adolescents classified fast foods (rural adolescents included more traditional foods like chips, sandwiches, and Casado-a dish consisting of rice, black beans, plantains, salad, and a meat), and in purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants). Living in rural areas, convenience and availability of foods, and the presence of external loci of control were predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower frequency. The development of interventions to reduce fast-food consumption in Costa Rican adolescents should consider not only convenience, but also the availability of these foods where adolescents are more exposed, particularly in rural areas. Interventions such as improving the convenience of healthy fast foods available in school canteens and neighborhood stores, policies to increase the price of unhealthy fast food, and activities to provide adolescents with the skills to increase self-efficacy and reduce the effect of external loci of control are recommended. Copyright © 2013 Elsevier Inc. All rights reserved.

Restaurant Inspection Scores and Foodborne Disease

PubMed Central

Pavlin, Boris I.; LaFleur, Bonnie J.; Ingram, L. Amanda; Schaffner, William

2004-01-01

Restaurants in the United States are regularly inspected by health departments, but few data exist regarding the effect of restaurant inspections on food safety. We examined statewide inspection records from January 1993 through April 2000. Data were available from 167,574 restaurant inspections. From 1993 to 2000, mean scores rose steadily from 80.2 to 83.8. Mean inspection scores of individual inspectors were 69–92. None of the 12 most commonly cited violations were critical food safety hazards. Establishments scoring <60 had a mean improvement of 16 points on subsequent inspections. Mean scores of restaurants experiencing foodborne disease outbreaks did not differ from restaurants with no reported outbreaks. A variety of factors influence the uniformity of restaurant inspections. The restaurant inspection system should be examined to identify ways to ensure food safety. PMID:15200861

Measurement of the local food environment: a comparison of existing data sources.

PubMed

Bader, Michael D M; Ailshire, Jennifer A; Morenoff, Jeffrey D; House, James S

2010-03-01

Studying the relation between the residential environment and health requires valid, reliable, and cost-effective methods to collect data on residential environments. This 2002 study compared the level of agreement between measures of the presence of neighborhood businesses drawn from 2 common sources of data used for research on the built environment and health: listings of businesses from commercial databases and direct observations of city blocks by raters. Kappa statistics were calculated for 6 types of businesses-drugstores, liquor stores, bars, convenience stores, restaurants, and grocers-located on 1,663 city blocks in Chicago, Illinois. Logistic regressions estimated whether disagreement between measurement methods was systematically correlated with the socioeconomic and demographic characteristics of neighborhoods. Levels of agreement between the 2 sources were relatively high, with significant (P < 0.001) kappa statistics for each business type ranging from 0.32 to 0.70. Most business types were more likely to be reported by direct observations than in the commercial database listings. Disagreement between the 2 sources was not significantly correlated with the socioeconomic and demographic characteristics of neighborhoods. Results suggest that researchers should have reasonable confidence using whichever method (or combination of methods) is most cost-effective and theoretically appropriate for their research design.

Impact of social and built environment factors on body size among breast cancer survivors: the Pathways Study

PubMed Central

Shariff-Marco, Salma; Von Behren, Julie; Reynolds, Peggy; Keegan, Theresa H. M.; Hertz, Andrew; Kwan, Marilyn L.; Roh, Janise M.; Thomsen, Catherine; Kroenke, Candyce H.; Ambrosone, Christine; Kushi, Lawrence H.; Gomez, Scarlett Lin

2017-01-01

Background As social and built environment factors have been shown to be associated with physical activity, dietary patterns, and obesity in the general population, they likely also influence these health behaviors among cancer survivors, and thereby impact survivorship outcomes. Methods Enhancing the rich, individual-level survey and medical record data from 4,505 breast cancer survivors in the Pathways Study, a prospective cohort drawn from Kaiser Permanente Northern California, we geocoded baseline residential addresses and appended social and built environment data. With multinomial logistic models, we examined associations between neighborhood characteristics and body mass index and whether neighborhood factors explained racial/ethnic/nativity disparities in overweight/obesity. Results Low neighborhood socioeconomic status, high minority composition, high traffic density, high prevalence of commuting by car, and a higher number of fast food restaurants were independently associated with higher odds of overweight or obesity. The higher odds of overweight among African Americans, US-born Asian Americans/Pacific Islanders and foreign-born Hispanics and the higher odds of obesity among African Americans and US-born Hispanics, compared to non-Hispanic Whites, remained significant though somewhat attenuated when accounting for social and built environment features. Conclusions Addressing aspects of neighborhood environments may help breast cancer survivors maintain a healthy body weight. Impact Further research in this area, such as incorporating data on individuals’ perceptions and use of their neighborhood environments, is needed to ultimately inform multilevel interventions that would ameliorate such disparities and improve outcomes for breast cancer survivors, regardless of their social status (e.g., race/ethnicity, socioeconomic status, nativity). PMID:28154107

Frequency of consumption at fast-food restaurants is associated with dietary intake in overweight and obese women recruited from financially disadvantaged neighborhoods.

PubMed

Wilcox, Sara; Sharpe, Patricia A; Turner-McGrievy, Gabrielle; Granner, Michelle; Baruth, Meghan

2013-08-01

Fast-food restaurants are more prevalent in lower-income and predominately African American neighborhoods, where consumption of fast food is also higher. In general populations, fast-food consumption is related to less healthy dietary intake. This cross-sectional study examined the hypotheses that greater fast-food consumption is associated with less healthy dietary intake and poorer diet quality in overweight and obese women (n = 196, 25-51 years, 87% African American) recruited from financially disadvantaged Census tracts. Dietary intake and diet quality (Alternate Healthy Eating Index) were assessed via three 24-hour dietary recalls. Linear regression models tested the association between fast-food consumption and each outcome (model 1). Model 2 added sociodemographics and physical activity. Model 3 added total caloric intake. Fast-food consumption was significantly associated with total caloric intake; total intake of meat, grains, sweetened beverages, dairy, fiber, cholesterol, sodium, and added sugar; and percent of calories from total fat, saturated fat, and trans-fatty acids. Statistically significant associations remained in model 2, but most were not significant in model 3. Fast-food consumption was not associated with diet quality (Alternate Healthy Eating Index) in any model. In this at-risk sample, fast-food consumption was associated with more negative dietary practices. Significant associations generally disappeared when controlling for total caloric intake, suggesting that women who eat more fast food have higher total caloric intakes as a result of increased consumption of unhealthy rather than healthy foods. Copyright © 2013 Elsevier Inc. All rights reserved.

Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience.

PubMed Central

Irwin, K; Ballard, J; Grendon, J; Kobayashi, J

1989-01-01

To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. PMID:2705592

Availability and Promotion of Healthful Foods in Stores and Restaurants - Guam, 2015.

PubMed

Lundeen, Elizabeth A; VanFrank, Brenna K; Jackson, Sandra L; Harmon, Brittani; Uncangco, Alyssa; Luces, Patrick; Dooyema, Carrie; Park, Sohyun

2017-07-13

Chronic disease, which is linked to unhealthy nutrition environments, is highly prevalent in Guam. The nutrition environment was assessed in 114 stores and 63 restaurants in Guam. Stores had limited availability of some healthier foods such as lean ground meat (7.5%) and 100% whole-wheat bread (11.4%), while fruits (81.0%) and vegetables (94.8%) were more commonly available; 43.7% of restaurants offered a healthy entrée or main dish salad, 4.1% provided calorie information, and 15.7% denoted healthier choices on menus. Improving the nutrition environment could help customers make healthier choices.

Multilevel Correlates of Satisfaction with Neighborhood Availability of Fresh Fruits and Vegetables

PubMed Central

Zenk, Shannon N.; Schulz, Amy J.; Lachance, Laurie L.; Mentz, Graciela; Kannan, Srimathi; Ridella, William; Galea, Sandro

2009-01-01

Background Little is known about influences on perceptions of neighborhood food environments, despite their relevance for food-shopping behaviors and food choices. Purpose This study examined relationships between multilevel factors (neighborhood structure, independently observed neighborhood food environment, individual socioeconomic position) and satisfaction with neighborhood availability of fruits and vegetables. Methods The multilevel regression analysis drew on data from a community survey of urban adults, in-person audit and mapping of food stores, and the 2000 Census. Results Satisfaction with neighborhood availability of fruits and vegetables was lower in neighborhoods that were further from a supermarket and that had proportionately more African-American residents. Neighborhood poverty and independently observed neighborhood fruit and vegetable characteristics (variety, prices, quality) were not associated with satisfaction. Individual education modified relationships between neighborhood availability of smaller food stores (small grocery stores, convenience stores, liquor stores) and satisfaction. Conclusions Individual-level and neighborhood-level factors affect perceptions of neighborhood food environments. PMID:19809859

Assessing the relationship between alcohol outlets and domestic violence: routine activities and the neighborhood environment.

PubMed

Roman, Caterina G; Reid, Shannon E

2012-01-01

Studies have consistently found a positive relationship between alcohol outlet density and assault, but only a handful of studies have examined whether outlet density has an influence on domestic violence. Using a framework based in crime opportunity theories, this study estimates spatial econometric regression models to test whether the density of alcohol outlets across neighborhoods is positively associated with police calls for service for domestic violence. Models also were developed to test whether the relationships found were consistent across time periods associated with the use of alcohol outlets (weeknights and weekends). The findings indicate that off-premise outlets were associated with a significant increase in domestic violence, but on-premise outlets (specifically restaurants and nightclubs) were associated with a decrease in domestic violence. The risk for domestic violence in areas of high densities of off-premise outlets was found to be high during the weekend but not during the weeknight, suggesting different routine activities for domestic violence offenders during the week.

Impact of Social and Built Environment Factors on Body Size among Breast Cancer Survivors: The Pathways Study.

PubMed

Shariff-Marco, Salma; Von Behren, Julie; Reynolds, Peggy; Keegan, Theresa H M; Hertz, Andrew; Kwan, Marilyn L; Roh, Janise M; Thomsen, Catherine; Kroenke, Candyce H; Ambrosone, Christine; Kushi, Lawrence H; Gomez, Scarlett Lin

2017-04-01

Background: As social and built environment factors have been shown to be associated with physical activity, dietary patterns, and obesity in the general population, they likely also influence these health behaviors among cancer survivors and thereby impact survivorship outcomes. Methods: Enhancing the rich, individual-level survey and medical record data from 4,505 breast cancer survivors in the Pathways Study, a prospective cohort drawn from Kaiser Permanente Northern California, we geocoded baseline residential addresses and appended social and built environment data. With multinomial logistic models, we examined associations between neighborhood characteristics and body mass index and whether neighborhood factors explained racial/ethnic/nativity disparities in overweight/obesity. Results: Low neighborhood socioeconomic status, high minority composition, high traffic density, high prevalence of commuting by car, and a higher number of fast food restaurants were independently associated with higher odds of overweight or obesity. The higher odds of overweight among African Americans, U.S.-born Asian Americans/Pacific Islanders, and foreign-born Hispanics and the higher odds of obesity among African Americans and U.S.-born Hispanics, compared with non-Hispanic whites, remained significant, although somewhat attenuated, when accounting for social and built environment features. Conclusions: Addressing aspects of neighborhood environments may help breast cancer survivors maintain a healthy body weight. Impact: Further research in this area, such as incorporating data on individuals' perceptions and use of their neighborhood environments, is needed to ultimately inform multilevel interventions that would ameliorate such disparities and improve outcomes for breast cancer survivors, regardless of their social status (e.g., race/ethnicity, socioeconomic status, nativity). Cancer Epidemiol Biomarkers Prev; 26(4); 505-15. ©2017 AACR See all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences." ©2017 American Association for Cancer Research.

Association between salt substitutes/enhancers and changes in sodium levels in fast-food restaurants: a cross-sectional analysis.

PubMed

Scourboutakos, Mary J; Murphy, Sarah A; L'Abbé, Mary R

2018-03-07

Restaurant foods have high sodium levels, and efforts have been made to promote reductions. The objective of this study was to understand if salt substitutes and enhancers are associated with changes in sodium levels in fast-food restaurants. A longitudinal database (MENU-FLIP) containing nutrition information for Canadian chain restaurants with 20 or more locations nationally was created in 2010 and updated in 2013 and 2016. In 2016, when available, ingredient lists were collected from restaurant websites and searched for the presence of salt substitutes/enhancers. Changes in sodium levels (per serving) and the prevalence of salt substitutes/enhancers in 222 foods from 12 of the leading fast-food restaurant chains were compared across 3 time points. Sixty-nine percent of foods contained a salt substitute/enhancer. Substitutes/enhancers were found in every restaurant chain ( n = 12) for which ingredient data were available. The most common substitutes/enhancers were yeast extracts (in 30% of foods), calcium chloride (28%), monosodium glutamate (14%) and potassium chloride (12%). Sodium levels in foods that contained substitutes/enhancers decreased significantly more (190 ± 42 mg/serving) over the study period than those in foods that did not contain a substitute/enhancer (40 ± 17 mg/serving, p < 0.001). Salt substitutes and enhancers are prevalent in restaurant foods and are one means by which restaurants may be lowering sodium levels in their foods. At this time, the potential consequences of these findings, if any, are uncertain. Copyright 2018, Joule Inc. or its licensors.

Availability and Promotion of Healthful Foods in Stores and Restaurants ― Guam, 2015

PubMed Central

VanFrank, Brenna K.; Jackson, Sandra L.; Harmon, Brittani; Uncangco, Alyssa; Luces, Patrick; Dooyema, Carrie; Park, Sohyun

2017-01-01

Chronic disease, which is linked to unhealthy nutrition environments, is highly prevalent in Guam. The nutrition environment was assessed in 114 stores and 63 restaurants in Guam. Stores had limited availability of some healthier foods such as lean ground meat (7.5%) and 100% whole-wheat bread (11.4%), while fruits (81.0%) and vegetables (94.8%) were more commonly available; 43.7% of restaurants offered a healthy entrée or main dish salad, 4.1% provided calorie information, and 15.7% denoted healthier choices on menus. Improving the nutrition environment could help customers make healthier choices. PMID:28704176

Measurement of the Local Food Environment: A Comparison of Existing Data Sources

PubMed Central

Bader, Michael D. M.; Ailshire, Jennifer A.; Morenoff, Jeffrey D.; House, James S.

2010-01-01

Studying the relation between the residential environment and health requires valid, reliable, and cost-effective methods to collect data on residential environments. This 2002 study compared the level of agreement between measures of the presence of neighborhood businesses drawn from 2 common sources of data used for research on the built environment and health: listings of businesses from commercial databases and direct observations of city blocks by raters. Kappa statistics were calculated for 6 types of businesses—drugstores, liquor stores, bars, convenience stores, restaurants, and grocers—located on 1,663 city blocks in Chicago, Illinois. Logistic regressions estimated whether disagreement between measurement methods was systematically correlated with the socioeconomic and demographic characteristics of neighborhoods. Levels of agreement between the 2 sources were relatively high, with significant (P < 0.001) kappa statistics for each business type ranging from 0.32 to 0.70. Most business types were more likely to be reported by direct observations than in the commercial database listings. Disagreement between the 2 sources was not significantly correlated with the socioeconomic and demographic characteristics of neighborhoods. Results suggest that researchers should have reasonable confidence using whichever method (or combination of methods) is most cost-effective and theoretically appropriate for their research design. PMID:20123688

Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting.

PubMed

Lee-Kwan, Seung Hee; Bleich, Sara N; Kim, Hyunju; Colantuoni, Elizabeth; Gittelsohn, Joel

2015-01-01

To investigate how a pilot environmental intervention changed food sales patterns in carryout restaurants. Quasi-experimental. Low-income neighborhoods of Baltimore, Maryland. Seven carryouts (three intervention, four comparison). Phase 1, menu board revision and healthy menu labeling; phase 2, increase of healthy sides and beverages; and phase 3, promotion of cheaper and healthier combination meals. Weekly handwritten menu orders collected to assess changes in the proportion of units sold and revenue of healthy items (entrée, sides and beverages, and combined). Logistic and Poisson regression models with generalized estimating equations. In the intervention group, odds for healthy entrée units and odds for healthy side and beverage units sold significantly increased in phases 2 and 3; odds for healthy entrée revenue significantly increased in phase 1 (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08-1.26), phase 2 (OR 1.32, 95% CI 1.25-1.41), and phase 3 (OR 1.39, 95% CI 1.14-1.70); and odds for healthy side and beverage revenues increased significantly in phase 2 (OR 1.62, 95% CI 1.33-1.97) and phase 3 (OR 2.73, 95% CI 2.15-3.47) compared to baseline. Total revenue in the intervention group was significantly higher in all phases than in the comparison group (p < .05). Environmental intervention changes such as menu revision, menu labeling, improved healthy food selection, and competitive pricing can increase availability and sales of healthy items in carryouts.

The Association between Density of Alcohol Establishments and Violent Crime within Urban Neighborhoods

PubMed Central

Toomey, Traci L.; Erickson, Darin J.; Carlin, Bradley P.; Lenk, Kathleen M.; Quick, Harrison S.; Jones, Alexis M.; Harwood, Eileen M.

2012-01-01

Background Numerous studies have found that areas with higher alcohol establishment density are more likely to have higher violent crime rates but many of these studies did not assess the differential effects of type of establishments or the effects on multiple categories of crime. In this study, we assess whether alcohol establishment density is associated with four categories of violent crime, and whether the strength of the associations varies by type of violent crime and by on-premise establishments (e.g., bars, restaurants) versus off-premise establishments (e.g., liquor and convenience stores). Methods Data come from the city of Minneapolis, Minnesota in 2009 and were aggregated and analyzed at the neighborhood level. Across the 83 neighborhoods in Minneapolis, we examined four categories of violent crime: assault, rape, robbery, and total violent crime. We used a Bayesian hierarchical inference approach to model the data, accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density as well as separately for on-premise establishments and off-premise establishments. Results Positive, statistically significant associations were observed for total alcohol establishment density and each of the violent crime outcomes. We estimate that a 3.9% to 4.3% increase across crime categories would result from a 20% increase in neighborhood establishment density. The associations between on-premise density and each of the individual violent crime outcomes were also all positive and significant and similar in strength as for total establishment density. The relationships between off-premise density and the crime outcomes were all positive but not significant for rape or total violent crime, and the strength of the associations was weaker than those for total and on-premise density. Conclusions Results of this study, combined with earlier findings, provide more evidence that community leaders should be cautious about increasing the density of alcohol establishments within their neighborhoods. PMID:22587231

Contextual Poverty, Nutrition and Chronic Kidney Disease

PubMed Central

Gutiérrez, Orlando M.

2014-01-01

Nutrition plays an important role in chronic kidney disease (CKD) outcomes. One of the strongest factors that impacts nutrition is socioeconomic status as evidenced by the large body of epidemiologic data showing that income and education are directly associated with diet quality. Apart from individual-level markers of socioeconomic status such as income and education, contextual factors such as availability of and transportation to food outlets that provide healthy food options and the density of fast food restaurants within particular regions markedly impact the ability of individuals to comply with nutrition recommendations. This is particularly true for nutrition guidelines most specific to individuals with CKD such as the consumption of protein, saturated fat, sodium and phosphorus, all of which have been shown to impact CKD health and are influenced by the availability of healthy food options within individual neighborhood food environments. Because of the strong association of contextual poverty with the diet quality, any serious attempt to improve the diet of CKD patients must include a discussion of the environmental barriers that each individual faces in trying to access healthy foods and health care providers should take account of these barriers when tailoring specific recommendations. PMID:25573510

Contextual poverty, nutrition, and chronic kidney disease.

PubMed

Gutiérrez, Orlando M

2015-01-01

Nutrition plays an important role in CKD outcomes. One of the strongest factors that affects nutrition is socioeconomic status as evidenced by the large body of epidemiologic data showing that income and education are directly associated with diet quality. Apart from individual-level markers of socioeconomic status such as income and education, contextual factors such as availability of and transportation to food outlets that provide healthy food options and the density of fast-food restaurants within particular regions markedly affect the ability of individuals to comply with nutrition recommendations. This is particularly true for nutrition guidelines most specific to individuals with CKD such as the consumption of protein, saturated fat, sodium, and phosphorus, all of which have been shown to affect CKD health and are influenced by the availability of healthy food options within individual neighborhood food environments. Because of the strong association of contextual poverty with the diet quality, any serious attempt to improve the diet of CKD patients must include a discussion of the environmental barriers that each individual faces in trying to access healthy foods, and health care providers should take account of these barriers when tailoring specific recommendations. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

A community-based restaurant initiative to increase availability of healthy menu options in Somerville, Massachusetts: Shape Up Somerville.

PubMed

Economos, Christina D; Folta, Sara C; Goldberg, Jeanne; Hudson, David; Collins, Jessica; Baker, Zachariah; Lawson, Eliza; Nelson, Miriam

2009-07-01

Environmental factors at the community level may play a role in the development and maintenance of obesity. Because many US families frequently eat meals outside of the home, restaurants are an environmental factor that can affect their health. The purpose of this project was to test the feasibility of a community-based restaurant initiative that targets families and young children. Somerville, Massachusetts, is an ethnically diverse, densely populated city. Approximately 44% of elementary school children in Somerville are overweight or obese. The restaurant initiative described here was conducted as part of a larger community-based environmental intervention, Shape Up Somerville: Eat Smart, Play Hard (SUS), designed to improve energy balance by making small changes in all aspects of a child's environment. Restaurant initiative activities were establishing criteria for approval as an SUS restaurant; conducting brief one-on-one interviews with 15 restaurant owners and managers; recruiting restaurants; and monitoring and evaluating restaurants' ability to adhere to the criteria, using questionnaires and site visits. Establishing approval criteria for restaurants required several iterations and ongoing flexibility. Barriers to participation included lack of time and interest and concerns about potential profit losses. The strategy of publicizing approved restaurants facilitated participation in the program. Twenty-eight percent of actively recruited restaurants participated in the initiative. Approximately one-half of restaurants fully complied with all approval criteria. Despite limited feasibility, the initiative provided valuable visibility and branding of the intervention within the community as well as lessons for working with restaurants to improve health.

Salud Tiene Sabor: a model for healthier restaurants in a Latino community.

PubMed

Nevarez, Carmen R; Lafleur, Mariah S; Schwarte, Liz U; Rodin, Beth; de Silva, Pri; Samuels, Sarah E

2013-03-01

The prevalence of overweight and obesity in children has risen nationally in recent decades, and is exceptionally high in low-income communities of color such as South Los Angeles CA. Independently owned restaurants participating in the Salud Tiene Sabor program at ethnic foods marketplace Mercado La Paloma in South Los Angeles are responding to the childhood obesity crisis by posting calories for menu items and providing nutrition information to patrons. To evaluate whether menu labeling and nutrition information at point of purchase have an influence on availability of healthy food options, patron awareness of calorie information, and restaurant owners' support of the program. A case-study design using mixed methods included restaurant owner and stakeholder interviews, patron surveys, and environmental assessments. Data were collected using originally designed tools, and analyzed in 2009-2011. Healthy eating options were available at the Mercado La Paloma; restaurant owners and the larger community supported the Salud Tiene Sabor program; 33% of patrons reported calorie information-influenced purchase decisions. Owners of independent restaurants have an important role in improving access to healthy foods in low-income, Latino communities. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A systematic review of calorie labeling and modified calorie labeling interventions: Impact on consumer and restaurant behavior

PubMed Central

Bleich, Sara N.; Economos, Christina D.; Spiker, Marie L.; Vercammen, Kelsey; VanEpps, Eric M.; Block, Jason P.; Elbel, Brian; Story, Mary; Roberto, Christina A.

2017-01-01

Background Evidence on the effects of restaurant calorie labeling on consumer and restaurant behavior is mixed. This paper examined: 1) consumer responses to calorie information alone or compared to modified calorie information, and 2) changes in restaurant offerings following or in advance of menu labeling implementation. Methods We searched PubMed, Web of Science, Policy File and PAIS International to identify restaurant calorie labeling studies through October 1, 2016, that measured calories ordered, consumed, or available for purchase on restaurant menus. We also searched reference lists of calorie labeling articles. Results Fifty-three studies were included: 18 in real-world restaurants, 9 in cafeterias, and 21 in laboratory or simulation settings. Five examined restaurant offerings. Conclusion Due to a lack of well-powered studies with strong designs, the degree to which menu labeling encourages lower calorie purchases and whether that translates to a healthier population is unclear. Although there is limited evidence that menu labeling affects calories purchased at fast-food restaurants, some evidence demonstrates that it lowers calories purchased at certain types of restaurants and in cafeteria settings. The limited data on modified calorie labels find that such labels can encourage lower-calorie purchases, but may not differ in effects relative to calorie labels alone. PMID:29045080

A Systematic Review of Calorie Labeling and Modified Calorie Labeling Interventions: Impact on Consumer and Restaurant Behavior.

PubMed

Bleich, Sara N; Economos, Christina D; Spiker, Marie L; Vercammen, Kelsey A; VanEpps, Eric M; Block, Jason P; Elbel, Brian; Story, Mary; Roberto, Christina A

2017-12-01

Evidence on the effects of restaurant calorie labeling on consumer and restaurant behavior is mixed. This paper examined: (1) consumer responses to calorie information alone or compared to modified calorie information and (2) changes in restaurant offerings following or in advance of menu labeling implementation. Searches were conducted in PubMed, Web of Science, Policy File, and PAIS International to identify restaurant calorie labeling studies through October 1, 2016, that measured calories ordered, consumed, or available for purchase on restaurant menus. The reference lists of calorie labeling articles were also searched. Fifty-three studies were included: 18 in real-world restaurants, 9 in cafeterias, and 21 in laboratory or simulation settings. Five examined restaurant offerings. Because of a lack of well-powered studies with strong designs, the degree to which menu labeling encourages lower-calorie purchases and whether that translates to a healthier population are unclear. Although there is limited evidence that menu labeling affects calories purchased at fast-food restaurants, some evidence demonstrates that it lowers calories purchased at certain types of restaurants and in cafeteria settings. The limited data on modified calorie labels find that such labels can encourage lower-calorie purchases but may not differ in effects relative to calorie labels alone. © 2017 The Obesity Society.

Relative and absolute availability of fast-food restaurants in relation to the development of diabetes: A population-based cohort study.

PubMed

Polsky, Jane Y; Moineddin, Rahim; Glazier, Richard H; Dunn, James R; Booth, Gillian L

2016-06-09

To determine whether residents living in areas with a high proportion of fast-food restaurants (FFR) relative to all restaurants are more likely to develop diabetes and whether the risk varies according to the volume of FFR. The study cohort consisted of adult respondents (20-84 years) to the Canadian Community Health Survey (cycles 2005, 2007/2008, 2009/2010) who resided within walking distance (720 m) of at least one restaurant in Toronto, Brampton, Mississauga or Hamilton, ON. The development of diabetes was established by linking participants to the Ontario Diabetes Database. Cox proportional hazards models were used to estimate hazard ratios (HRs) of incident diabetes associated with relative and absolute measures of restaurant availability. During a median follow-up of 5 years, 347 of 7,079 participants (4.6%) developed diabetes. Among younger adults (20-65 years, n = 5,806), a greater proportion of fast-food relative to all restaurants was significantly associated with incident diabetes after adjustment for a range of individual and area-level covariates, but only in areas with high volumes of fast-food retailers (3+ outlets) (HR = 1.79, 95% confidence interval: 1.03-3.12, across the interquartile range). Adjusting for body mass index rendered this association non-significant. No significant associations were observed in areas with low volumes of FFR or among older adults (65-84 years, n = 1,273). Absolute availability (number) of fast-food and other restaurants was generally unrelated to incident diabetes. Areas with the double burden of a high volume of FFR and few dining alternatives may represent an adverse environment for the development of diabetes.

Healthful food availability in stores and restaurants--American Samoa, 2014.

PubMed

Lee-Kwan, Seung Hee; Kumar, Gayathri; Ayscue, Patrick; Santos, Marjorie; McGuire, Lisa C; Blanck, Heidi M; Nua, Motusa Tuileama

2015-03-20

American Samoa, one of the U.S.-affiliated Pacific Islands, has documented the highest prevalence of adults with obesity (75%) in the world. The nutritionally poor food and beverage environment of food retail venues has been suspected to be a contributing factor, although an evaluation of these venues in American Samoa has not been conducted. In January 2014, American Samoa established an Obesity Task Force to develop policies and strategies to combat obesity. To inform the efforts of the task force, the American Samoa Department of Health and CDC conducted a baseline assessment of the availability, pricing, and promotion of healthful foods at retail food venues. Previously validated food environment assessment tools were modified to incorporate American Samoa foods and administered in a geographically representative sample of 70 stores (nine grocery stores and 61 convenience stores) and 20 restaurants. In convenience stores, healthful items were not found as available as less healthful counterparts, and some healthful items were more expensive than their less healthful counterparts. For restaurants, 70% offered at least one healthful entrée, whereas only 30% had healthful side dishes, such as vegetables. Actions to promote healthy eating, such as providing calorie information, were rare among restaurants. Improving availability, affordability, and the promotion of healthful foods in American Samoa stores and restaurants could support healthy eating among American Samoa residents.

What's on the menu? A review of the energy and nutritional content of US chain restaurant menus.

PubMed

Wu, Helen W; Sturm, Roland

2013-01-01

The present study aimed to (i) describe the availability of nutrition information in major chain restaurants, (ii) document the energy and nutrient levels of menu items, (iii) evaluate relationships with restaurant characteristics, menu labelling and trans fat laws, and nutrition information accessibility, and (iv) compare energy and nutrient levels against industry-sponsored and government-issued nutrition criteria. Descriptive statistics and multivariate regression analysis of the energy, total fat, saturated fat, trans fat, sodium, carbohydrate and protein levels of 29 531 regular and 1392 children's menu items [corrected]. Energy and nutrition information provided on restaurant websites or upon request, and secondary databases on restaurant characteristics. The top 400 US chain restaurants by sales, based on the 2009 list of the Restaurants & Institutions magazine. Complete nutrition information was reported for 245 (61 %) restaurants. Appetizers had more energy, fat and sodium than all other item types. Children's menu specialty beverages had more fat, saturated fat and carbohydrates than comparable regular menu beverages. The majority of main entrées fell below one-third of the US Department of Agriculture's estimated daily energy needs, but as few as 3 % were also within limits for sodium, fat and saturated fat. Main entrées had significantly more energy, fat and saturated fat in family-style restaurants than in fast-food restaurants. Restaurants that made nutrition information easily accessible on websites had significantly lower energy, fat and sodium contents across menu offerings than those providing information only upon request. The paper provides a comprehensive view of chain restaurant menu nutrition prior to nationwide labelling laws. It offers baseline data to evaluate how restaurants respond after laws are implemented.

Personal exposure to ultrafine particles.

PubMed

Wallace, Lance; Ott, Wayne

2011-01-01

Personal exposure to ultrafine particles (UFP) can occur while people are cooking, driving, smoking, operating small appliances such as hair dryers, or eating out in restaurants. These exposures can often be higher than outdoor concentrations. For 3 years, portable monitors were employed in homes, cars, and restaurants. More than 300 measurement periods in several homes were documented, along with 25 h of driving two cars, and 22 visits to restaurants. Cooking on gas or electric stoves and electric toaster ovens was a major source of UFP, with peak personal exposures often exceeding 100,000 particles/cm³ and estimated emission rates in the neighborhood of 10¹² particles/min. Other common sources of high UFP exposures were cigarettes, a vented gas clothes dryer, an air popcorn popper, candles, an electric mixer, a toaster, a hair dryer, a curling iron, and a steam iron. Relatively low indoor UFP emissions were noted for a fireplace, several space heaters, and a laser printer. Driving resulted in moderate exposures averaging about 30,000 particles/cm³ in each of two cars driven on 17 trips on major highways on the East and West Coasts. Most of the restaurants visited maintained consistently high levels of 50,000-200,000 particles/cm³ for the entire length of the meal. The indoor/outdoor ratios of size-resolved UFP were much lower than for PM₂.₅ or PM₁₀, suggesting that outdoor UFP have difficulty in penetrating a home. This in turn implies that outdoor concentrations of UFP have only a moderate effect on personal exposures if indoor sources are present. A time-weighted scenario suggests that for typical suburban nonsmoker lifestyles, indoor sources provide about 47% and outdoor sources about 36% of total daily UFP exposure and in-vehicle exposures add the remainder (17%). However, the effect of one smoker in the home results in an overwhelming increase in the importance of indoor sources (77% of the total).

Walk Score®

PubMed Central

Brown, Scott C.; Pantin, Hilda; Lombard, Joanna; Toro, Matthew; Huang, Shi; Plater-Zyberk, Elizabeth; Perrino, Tatiana; Perez-Gomez, Gianna; Barrera-Allen, Lloyd; Szapocznik, José

2013-01-01

Background Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the relationship of Walk Score to walking behavior. Purpose To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. Methods Participants were 391 recent healthy Cuban immigrants (M age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (M=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants’ addresses, walking and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant’s residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. Results For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. Conclusions Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities. PMID:23867028

75 FR 6025 - Environmental Impact Statements and Regulations; Availability of EPA Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-05

..., Vail Ski Area's 2007 Improvement Project, Proposed On-Mountain Restaurant from the top of Vail Mountain... Restaurant from the top of Vail Mountain to Mid Vail, Special-Use-Permit, Eagle/Holy Cross Ranger District...

Changes in the food environment over time: examining 40 years of data in the Framingham Heart Study.

PubMed

James, Peter; Seward, Michael W; James O'Malley, A; Subramanian, S V; Block, Jason P

2017-06-24

Research has explored associations between diet, body weight, and the food environment; however, few studies have examined historical trends in food environments. In the Framingham Heart Study Offspring (N = 3321) and Omni (N = 447) cohorts, we created food environment metrics in four Massachusetts towns utilizing geocoded residential, workplace, and food establishment addresses from 1971 to 2008. We created multilevel models adjusted for age, sex, education, and census tract poverty to examine trends in home, workplace, and commuting food environments. Proximity to and density of supermarkets, fast-food, full service restaurants, convenience stores, and bakeries increased over time for residential, workplace, and commuting environments; exposure to grocery stores decreased. The greatest increase in access was for supermarkets, with residential distance to the closest supermarket 1406 m closer (95% CI 1303 m, 1508 m) by 2005-2008 than in 1971-1975. Although poorer census tracts had higher access to fast-food restaurants consistently across follow-up, this disparity dissipated over time, due to larger increases in proximity to fast-food in wealthier neighborhoods. Access to most food establishment types increased over time, with similar trends across home, workplace, and commuter environments.

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.

PubMed

Kraak, Vivica; Englund, Tessa; Misyak, Sarah; Serrano, Elena

2017-07-12

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.

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

PubMed Central

Misyak, Sarah; Serrano, Elena

2017-01-01

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. PMID:28704965

Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants.

PubMed

D'Angelo, Heather; Ammerman, Alice; Gordon-Larsen, Penny; Linnan, Laura; Lytle, Leslie; Ribisl, Kurt M

2016-09-01

To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study. Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties. More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby. Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence youth smoking initiation and contribute to poor dietary intake.

Impact of individual and neighborhood factors on disparities in prostate cancer survival.

PubMed

DeRouen, Mindy C; Schupp, Clayton W; Koo, Jocelyn; Yang, Juan; Hertz, Andrew; Shariff-Marco, Salma; Cockburn, Myles; Nelson, David O; Ingles, Sue A; John, Esther M; Gomez, Scarlett L

2018-04-01

We addressed the hypothesis that individual-level factors act jointly with social and built environment factors to influence overall survival for men with prostate cancer and contribute to racial/ethnic and socioeconomic (SES) survival disparities. We analyzed multi-level data, combining (1) individual-level data from the California Collaborative Prostate Cancer Study, a population-based study of non-Hispanic White (NHW), Hispanic, and African American prostate cancer cases (N = 1800) diagnosed from 1997 to 2003, with (2) data on neighborhood SES (nSES) and social and built environment factors from the California Neighborhoods Data System, and (3) data on tumor characteristics, treatment and follow-up through 2009 from the California Cancer Registry. Multivariable, stage-stratified Cox proportional hazards regression models with cluster adjustments were used to assess education and nSES main and joint effects on overall survival, before and after adjustment for social and built environment factors. African American men had worse survival than NHW men, which was attenuated by nSES. Increased risk of death was associated with residence in lower SES neighborhoods (quintile 1 (lowest nSES) vs. 5: HR = 1.56, 95% CI: 1.11-2.19) and lower education (

The energy content of restaurant foods without stated calorie information.

PubMed

Urban, Lorien E; Lichtenstein, Alice H; Gary, Christine E; Fierstein, Jamie L; Equi, Ashley; Kussmaul, Carolyn; Dallal, Gerard E; Roberts, Susan B

2013-07-22

National recommendations for the prevention and treatment of obesity emphasize reducing energy intake through self-monitoring food consumption. However, little information is available on the energy content of foods offered by nonchain restaurants, which account for approximately 50% of restaurant locations in the United States. To measure the energy content of foods from independent and small-chain restaurants that do not provide stated information on energy content. We used bomb calorimetry to determine the dietary energy content of the 42 most frequently purchased meals from the 9 most common restaurant categories. Independent and small-chain restaurants were randomly selected, and 157 individual meals were analyzed. Area within 15 miles of downtown Boston. A random sample of independent and small-chain restaurants. Dietary energy. All meal categories provided excessive dietary energy. The mean energy content of individual meals was 1327 (95% CI, 1248-1406) kcal, equivalent to 66% of typical daily energy requirements. We found a significant effect of food category on meal energy (P ≤ .05), and 7.6% of meals provided more than 100% of typical daily energy requirements. Within-meal variability was large (average SD, 271 kcal), and we found no significant effect of restaurant establishment or size. In addition, meal energy content averaged 49% greater than those of popular meals from the largest national chain restaurants (P < .001) and in subset analyses contained 19% more energy than national food database information for directly equivalent items (P < .001). National chain restaurants have been criticized for offering meals with excess dietary energy. This study finds that independent and small-chain restaurants, which provide no nutrition information, also provide excessive dietary energy in amounts apparently greater than popular meals from chain restaurants or information in national food databases. A national requirement for accurate calorie labeling in all restaurants may discourage menus offering unhealthy portions and would allow consumers to make informed choices about ordering meals that promote weight gain and obesity.

Neighbourhood food environment and dietary intakes in adolescents: sex and perceived family affluence as moderators.

PubMed

Ho, Sai-Yin; Wong, Bonny Yee-Man; Lo, Wing-Sze; Mak, Kwok-Kei; Thomas, G Neil; Lam, Tai-Hing

2010-10-01

To examine the effects of perceived availability of fast-food shops, restaurants, and convenience stores on adolescent dietary intakes. Survey data from 34 369 students in 42 Hong Kong secondary schools were collected in 2006-7. Respondents reported the availability of fast-food shops, restaurants and convenience stores in the neighbourhood, and their intakes of fruit, vegetables, high-fat foods and junk food/soft drinks. For intakes of high-fat foods and junk food/ soft drinks, ≤ once a week was defined as low consumption and the rest moderate/high consumption. At least three servings of vegetables and two servings of fruit daily were defined as sufficient consumption. Logistic regression yielded adjusted odds ratios (OR) for each dietary intake in relation to the reported food shops. Potential effect modifications by socio-demographic factors were also examined. Perceived availability of fast-food shops and convenience stores were positively associated with moderate/high consumptions of high-fat foods (OR(fast) =1.10 and OR(con) =1.15) and junk food/soft drinks (OR(fast)=1.10 and OR(con) =1.10). Significant negative associations of the perceived availability of restaurants with intakes of vegetables and fruit were observed (OR(veg) =0.87 and OR(fruit) =0.83). The positive relationship between reporting fast-food shops with intake of junk food/soft drinks were observed only in boys and those with low perceived family affluence. The negative association of reporting restaurants with fruit consumption was found in those with low and middle perceived family affluence only. Perceived availability of neighbourhood fast-food shops, restaurants, and convenience stores may have a negative impact on adolescent dietary intakes particularly for those from poorer families.

Influenza vaccination status and attitudes among restaurant employees.

PubMed

Parrish, Amanda T; Graves, Meredith C; Harris, Jeffrey R; Hannon, Peggy A; Hammerback, Kristen; Allen, Claire L

2015-01-01

Restaurant employees represent a substantial portion of the US workforce, interact closely with the public, and are at risk for contracting influenza, yet their influenza vaccination rates and attitudes are unknown. Assess influenza vaccination rates and attitudes among Seattle restaurant employees, to identify factors that could enhance the success of a restaurant-based vaccination program. In 2012, we invited employees of Seattle restaurants to complete an anonymous paper survey assessing participant demographics, previous influenza vaccination status, and personal attitudes toward influenza vaccination (using a 5-point scale). Sit-down, full service restaurants in or near Seattle, Washington, were eligible if they had no previous history of offering worksite influenza vaccinations and had more than 20 employees who were older than 18 years and spoke either English or Spanish. We invited staff in all restaurant positions (servers, bussers, kitchen staff, chefs, managers, etc) to complete the survey, which was available in English and Spanish. Of 428 restaurant employees surveyed, 26% reported receiving the seasonal influenza vaccine in 2011-2012 (response rate = 74%). Across 8 attitude statements, participants were most likely to agree that the vaccine is not too expensive (89%), and least likely to agree that it is relevant for their age group (25%), or normative at their workplace (13%). Vaccinated participants reported significantly more positive attitudes than unvaccinated participants, and Hispanics reported significantly more positive attitudes than non-Hispanic whites. Increasing influenza vaccination rates among restaurant employees could protect a substantial portion of the US workforce, and the public, from influenza. Seattle restaurant employees have low vaccination rates against seasonal influenza. Interventions aimed at increasing vaccination among restaurant employees should highlight the vaccine's relevance and effectiveness for working-age adults.

Comparison of the nutrient content of children's menu items at US restaurant chains, 2010-2014.

PubMed

Deierlein, Andrea L; Peat, Kay; Claudio, Luz

2015-08-15

To determine changes in the nutritional content of children's menu items at U.S. restaurant chains between 2010 and 2014. The sample consisted of 13 sit down and 16 fast-food restaurant chains ranked within the top 50 US chains in 2009. Nutritional information was accessed in June-July 2010 and 2014. Descriptive statistics were calculated for nutrient content of main dishes and side dishes, as well as for those items that were added, removed, or unchanged during the study period. Nutrient content of main dishes did not change significantly between 2010 and 2014. Approximately one-third of main dishes at fast-food restaurant chains and half of main dishes at sit down restaurant chains exceeded the 2010 Dietary Guidelines for Americans recommended levels for sodium, fat, and saturated fat in 2014. Improvements in nutrient content were observed for side dishes. At sit down restaurant chains, added side dishes contained over 50% less calories, fat, saturated fat, and sodium, and were more likely to contain fruits/vegetables compared to removed sides (p < 0.05 for all comparisons). Added side dishes at fast-food restaurant chains contained less saturated fat (p < 0.05). The majority of menu items, especially main dishes, available to children still contain high amounts of calories, fat, saturated fat, and sodium. Efforts must be made by the restaurant industry and policy makers to improve the nutritional content of children's menu items at restaurant chains to align with the Dietary Guidelines for Americans. Additional efforts are necessary to help parents and children make informed choices when ordering at restaurant chains.

Musculoskeletal disorders in hotel restaurant workers.

PubMed

Chyuan, Jong-Yu Adol; Du, Chung-Li; Yeh, Wen-Yu; Li, Chung-Yi

2004-01-01

A variety of occupational groups have been shown to experience elevated risks of work-related musculoskeletal disorders (WMSD). Little information on WMSD is available in hotel restaurant workers. To document the profile of WMSD in a sample of hotel restaurant workers in Taiwan. A self-administered questionnaire was used to gather information regarding body site specific WMSD, pain intensity and strategies for pain relief amongst a sample of hotel restaurant workers. Among 905 restaurant workers, 785 (84%) reported experience of WMSD in the previous month, with the highest prevalence rate found for the shoulder (58%). The highest mean score for perceived pain intensity was found for the lower back/waist (2.50 points). Despite a high prevalence rate, only a small portion of those reporting WMSD (12%) considered their work capacity or activities of daily living to be affected by WMSD, and only <5% of workers with WMSD sought medical treatment. WMSD related pain is common among hotel restaurant workers in Taiwan, but it does not appear to interfere with job performance or daily living. Self-treatment and alternative therapies that have not been evaluated for effectiveness are commonly employed by hotel restaurant workers.

Location-based social networking media for restaurant promotion and food review using mobile application

NASA Astrophysics Data System (ADS)

Luhur, H. S.; Widjaja, N. D.

2014-03-01

This paper is focusing on the development of a mobile application for searching restaurants and promotions with location based and social networking features. The main function of the application is to search restaurant information. Other functions are also available in this application such as add restaurant, add promotion, add photo, add food review, and other features including social networking features. The restaurant and promotion searching application will be developed under Android platform. Upon completion of this paper, heuristic evaluation and usability testing have been conducted. The result of both testing shows that the application is highly usable. Even though there are some usability problems discovered, the problems can be eliminated immediately by implementing the recommendations from the expert evaluators and the users as the testers of the application. Further improvement made to the application will ensure that the application can really be beneficial for the users of the application.

Healthy Option Preferences of Rural Restaurant Customers

PubMed Central

Nothwehr, Faryle; Snetselaar, Linda; Dawson, Jeffrey D.; Hradek, Christine; Sepulveda, Marisol

2009-01-01

In preparation for an intervention study in three rural Iowa restaurants, 250 customers were surveyed regarding their interest in dietary change, perceptions of the restaurant, and interest in healthy options. Customers were ages 18 to 88, with a mean age of 52, and 53% were women. Most agreed that the restaurant offers healthy meals. Options customers stated they were most likely to order if available included meat that is baked or broiled, whole-wheat bread, fresh fruit or steamed vegetables, and regular salad dressing on the side. They were least interested in low-fat sour cream, low-fat salad dressing, low-fat milk, low-calorie dessert, and holding high-fat ingredients. Women were more likely to indicate interest in healthy options than were men. Interest in several options was also positively associated with age. Increasing the healthy options in restaurants may be especially effective in changing the dietary intake of women and older adults. PMID:19515859

Lack of healthy food options on children's menus of restaurants in the health-disparate Dan River region of Virginia and North Carolina, 2013.

PubMed

Hill, Jennie L; Olive, Nicole C; Waters, Clarice N; Estabrooks, Paul A; You, Wen; Zoellner, Jamie M

2015-03-26

Interest has increased in understanding the types and healthfulness of restaurant foods for children, particularly in disadvantaged areas. The purpose of this community-based participatory research study was to describe the quality of restaurant food offered to children in a health-disparate region in Virginia and North Carolina and to determine if the availability of healthy foods differed by location (rural, urban) or by the predominant race (black, white, mixed race) of an area's population. Restaurants offering a children's menu in the 3 counties in Virginia and North Carolina that make up the Dan River Region were identified by using state health department records. Research assistants reviewed menus using the Children's Menu Assessment (CMA), a tool consisting of 29 scored items (possible score range, -4 to 21). Scores were calculated for each restaurant. We obtained information on the predominant race of the population at the block group level for all counties from 2010 US Census data. For the 137 restaurants studied, mean CMA scores were low (mean, 1.6; standard deviation [SD], 2.7), ranging from -4 to 9 of 21 possible points. Scores were lowest for restaurants in the predominantly black block groups (mean, 0.2; SD, 0.4) and significantly different from the scores for restaurants in the predominantly white (mean, 1.4; SD, 1.6) and mixed-race block groups (mean, 2.6; SD, 2.4) (F = 4.3; P < .05). Children's menus available in the Dan River Region lack healthy food options, particularly in predominantly black block groups. These study findings can contribute to regional efforts in policy development or environmental interventions for children's food quality by the community-based participatory research partnership and help local stakeholders to determine possible strategies and solutions for improving local food options for children.

Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

PubMed Central

Olive, Nicole C.; Waters, Clarice N.; Estabrooks, Paul A.; You, Wen; Zoellner, Jamie M.

2015-01-01

Introduction Interest has increased in understanding the types and healthfulness of restaurant foods for children, particularly in disadvantaged areas. The purpose of this community-based participatory research study was to describe the quality of restaurant food offered to children in a health-disparate region in Virginia and North Carolina and to determine if the availability of healthy foods differed by location (rural, urban) or by the predominant race (black, white, mixed race) of an area’s population. Methods Restaurants offering a children’s menu in the 3 counties in Virginia and North Carolina that make up the Dan River Region were identified by using state health department records. Research assistants reviewed menus using the Children’s Menu Assessment (CMA), a tool consisting of 29 scored items (possible score range, −4 to 21). Scores were calculated for each restaurant. We obtained information on the predominant race of the population at the block group level for all counties from 2010 US Census data. Results For the 137 restaurants studied, mean CMA scores were low (mean, 1.6; standard deviation [SD], 2.7), ranging from −4 to 9 of 21 possible points. Scores were lowest for restaurants in the predominantly black block groups (mean, 0.2; SD, 0.4) and significantly different from the scores for restaurants in the predominantly white (mean, 1.4; SD, 1.6) and mixed-race block groups (mean, 2.6; SD, 2.4) (F = 4.3; P < .05). Conclusion Children’s menus available in the Dan River Region lack healthy food options, particularly in predominantly black block groups. These study findings can contribute to regional efforts in policy development or environmental interventions for children’s food quality by the community-based participatory research partnership and help local stakeholders to determine possible strategies and solutions for improving local food options for children. PMID:25811495

Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample.

PubMed

Zenk, Shannon N; Mentz, Graciela; Schulz, Amy J; Johnson-Lawrence, Vicki; Gaines, Causandra R

2017-02-01

Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. This longitudinal study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) in a predominately Black and Hispanic adult sample living in low- to moderate-income urban neighborhoods. This longitudinal study used two waves of data (2002, 2008), including interviewer-measured height and weight, from a community survey of adults ( n = 219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. Small grocery store availability was associated with 1.22-unit increase in BMI ( p = .047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI ( p = .055). BMI was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low- to moderate-income neighborhoods achieve healthier body weights over time.

Handling Practices of Fresh Leafy Greens in Restaurants: Receiving and Training†

PubMed Central

COLEMAN, ERIK; DELEA, KRISTIN; EVERSTINE, KAREN; REIMANN, DAVID; RIPLEY, DANNY

2015-01-01

Multiple foodborne illness outbreaks have been associated with the consumption of fresh produce. Investigations have indicated that microbial contamination throughout the farm-to-fork continuum often contributed to these outbreaks. Researchers have hypothesized that handling practices for leafy greens in restaurants may support contamination by and proliferation and amplification of pathogens that cause foodborne illness outbreaks. However, limited data are available on how workers handle leafy greens in restaurants. The purpose of this study was to collect descriptive data on handling practices of leafy greens in restaurants, including restaurant characteristics, types of leafy greens used, produce receipt, and food safety training and certification. As a federal collaborative partner with the Environmental Health Specialists Network (EHS-Net) of the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration (FDA) recommended that EHS-Net participants survey handling practices for leafy greens in restaurants. The recommendations in the FDA’s Guide to Minimize Microbial Food Safety Hazards of Leafy Greens are significant to this study for comparison of the results. The survey revealed that appropriate handling procedures assist in the mitigation of other unsafe handling practices for leafy greens. These results are significant because the FDA guidance for the safe handling of leafy greens was not available until 2009, after the survey had been completed. The information provided from this study can be used to promote additional efforts that will assist in developing interventions to prevent future foodborne illness outbreaks associated with leafy greens. PMID:24290691

Assessing the Availability of Healthier Children's Meals at Leading Quick-Service and Full-Service Restaurants.

PubMed

Sliwa, Sarah; Anzman-Frasca, Stephanie; Lynskey, Vanessa; Washburn, Kyle; Economos, Christina

2016-04-01

To compare the calorie, fat, saturated fat, and sodium content of available children's meal combinations in leading restaurants with national recommendations. Cross-sectional. Children's menu offerings and corresponding nutrition information were collected (May, 2014) from Web sites of the top 10 quick-service (QSR) and top 10 full-service (FSR) restaurant chains that offered a children's menu and provided nutrition information. Total calories (kcal), percent calories from fat and saturated fat, and total sodium (mg) were calculated for children's meal combinations (QSR N = 1,363; FSR N = 6,654). Combinations with ≤ 600 kcal, ≤ 35% kcal from fat, ≤ 10% kcal from saturated fat, ≤ 770 mg sodium, and those that met all 4 of these criteria were identified. Frequencies by restaurant segment. The majority of QSR (72%) and FSR (63%) meal combinations had ≤ 600 kcal. Only 31.9% of combinations at QSRs and 21.7% at FSRs met all 4 criteria. In both segments the calorie target was most frequently met, and the sodium target the least. Children's meal combinations with ≤ 600 kcal are available at leading restaurant chains, but many meals fail to meet current national recommendations for fat, saturated fat, and sodium. Menu labeling legislation may address caloric content but implications for other nutrients remain unclear. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Poor nutrition on the menu: children's meals at America's top chain restaurants.

PubMed

Batada, Ameena; Bruening, Meg; Marchlewicz, Elizabeth H; Story, Mary; Wootan, Margo G

2012-06-01

We evaluated the nutritional quality of children's meals at chain restaurants, because children obtain about a third of their daily calories from away-from-home foods and studies show that restaurant foods are often higher in calories and lower in nutritional value than foods prepared at home. We assessed the nutritional quality of children's meals at the 50 largest U.S. restaurant chains by visiting each chain's web site or calling the company. Eighteen of the chains did not have children's meals and 10 did not provide adequate nutrition information to be included in the study. The nutritional quality of each meal combination was evaluated against a set of nutrition standards based on key nutrition recommendations in the Dietary Guidelines for Americans. Of the 22 restaurants that had children's menus and available nutrition information, 99% of 1662 children's meal combinations were of poor nutritional quality. Restaurants should support healthier choices for children by reformulating existing menu items and adding new healthier items, posting calories on menus, and setting nutrition standards for marketing to children.

Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants

PubMed Central

Ammerman, Alice; Gordon-Larsen, Penny; Linnan, Laura; Lytle, Leslie; Ribisl, Kurt M.

2016-01-01

Objectives. To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study. Methods. Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties. Results. More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby. Conclusions. Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence youth smoking initiation and contribute to poor dietary intake. PMID:27459453

Sodium in Store and Restaurant Food Environments - Guam, 2015.

PubMed

Jackson, Sandra L; VanFrank, Brenna K; Lundeen, Elizabeth; Uncangco, Alyssa; Alam, Lawrence; King, Sallyann M Coleman; Cogswell, Mary E

2016-05-27

Compared with the United States overall, Guam has higher mortality rates from cardiovascular disease and stroke (1). Excess sodium intake can increase blood pressure and risk for cardiovascular disease (2,3). To determine the availability and promotion of lower-sodium options in the nutrition environment, the Guam Department of Public Health and Social Services (DPHSS) conducted an assessment in September 2015 using previously validated tools adapted to include sodium measures. Stores (N = 114) and restaurants (N = 63) were randomly sampled by region (north, central, and south). Data from 100 stores and 62 restaurants were analyzed and weighted to account for the sampling design. Across the nine product types assessed, lower-sodium products were offered less frequently than regular-sodium products (p<0.001) with <50% of stores offering lower-sodium canned vegetables, tuna, salad dressing, soy sauce, and hot dogs. Lower-sodium products were also less frequently offered in small stores than large (two or more cash registers) stores. Reduced-sodium soy sauce cost more than regular soy sauce (p<0.001) in stores offering both options in the same size bottle. Few restaurants engaged in promotion practices such as posting sodium information (3%) or identifying lower-sodium entrées (1%). Improving the availability and promotion of lower-sodium foods in stores and restaurants could help support healthier eating in Guam.

Availability of physical activity-related facilities and neighborhood demographic and socioeconomic characteristics: a national study.

PubMed

Powell, Lisa M; Slater, Sandy; Chaloupka, Frank J; Harper, Deborah

2006-09-01

We examined associations between neighborhood demographic characteristics and the availability of commercial physical activity-related outlets by zip code across the United States. Multivariate analyses were conducted to assess the availability of 4 types of outlets: (1) physical fitness facilities, (2) membership sports and recreation clubs, (3) dance facilities, and (4) public golf courses. Commercial outlet data were linked by zip code to US Census Bureau population and socioeconomic data. Results showed that commercial physical activity-related facilities were less likely to be present in lower-income neighborhoods and in neighborhoods with higher proportions of African American residents, residents with His-panic ethnicity, and residents of other racial minority backgrounds. In addition, these neighborhoods had fewer such facilities available. Lack of availability of facilities that enable and promote physical activity may, in part, underpin the lower levels of activity observed among populations of low socioeconomic status and minority backgrounds.

Frequency and correlation of some enteric indicator bacteria and Salmonella in ready-to-eat raw vegetable salads from Mexican restaurants.

PubMed

Gómez-Aldapa, Carlos A; Rangel-Vargas, Esmeralda; Castro-Rosas, Javier

2013-08-01

Data about Salmonella presence in ready-to-eat raw vegetable salads (REVS) consumed in restaurants or sold as REVS in México is not available. The objective of the study was to measure the frequency of coliform bacteria (CB), fecal coliform (FC), Escherichia coli, and Salmonella in REVS from different types of restaurants and determine the correlations of CB, FC, and E. coli versus Salmonella from frequencies and concentration data. The REVS were purchased from 3 types of restaurants: national chain restaurants (A1 , A2 ); local restaurants (B1 , B2 ); and small restaurants in local markets (C1 , C2 , C3 ). Two restaurants for each A and B, and 3 for C, were included. Forty REVS were purchased at each A and B restaurant, and 20 at each C restaurant. CB were tested by plate count using violet red bile agar, FC and E. coli were detected by the most probable number method and E. coli confirmed using IMViC test; conventional method of culture was used for Salmonella. Of 220 analyzed samples, 100% had CB, 95.5% had FC, 83.2% had E. coli, and 6.8% had Salmonella. E. coli frequency was equal to or exceeded 75% in all the cases: 75% (A1 , C1 , C2 ), 80% (B2 ), 85% (B1 , C3 ), and 100% (A2 ). Salmonella frequency was equal to or exceeded 2.5% in all cases: 2.5% (A1 ), 5% (B2 , C2 ), 7.5% (B1 ), and 10% (A2 , C1 , C3 ). No correlation was observed between FC or E. coli versus Salmonella in the analyzed salads. All the tested salads were of poor quality microbiologically, and microbiological quality did not differ between the restaurants types. © 2013 Institute of Food Technologists®

Using performance-based regulation to reduce childhood obesity.

PubMed

Sugarman, Stephen D; Sandman, Nirit

2008-11-18

Worldwide, the public health community has recognized the growing problem of childhood obesity. But, unlike tobacco control policy, there is little evidence about what public policies would work to substantially reduce childhood obesity. Public health leaders currently tend to support traditional "command and control" schemes that order private enterprises and governments to stop or start doing specific things that, is it hoped, will yield lower childhood obesity rates. These include measures such as 1) taking sweetened beverages out of schools, 2) posting calorie counts on fast-food menu boards, 3) labeling foods with a "red light" if they contain high levels of fat or sugar, 4) limiting the density of fast food restaurants in any neighborhood, 5) requiring chain restaurants to offer "healthy" alternatives, and 6) eliminating junk food ads on television shows aimed at children. Some advocates propose other regulatory interventions such as 1) influencing the relative prices of healthy and unhealthy foods through taxes and/or subsidies and 2) suing private industry for money damages as a way of blaming childhood obesity on certain practices of the food industry (such as its marketing, product composition, or portion size decisions). The food industry generally seeks to deflect blame for childhood obesity onto others, such as parents and schools.

Using performance-based regulation to reduce childhood obesity

PubMed Central

Sugarman, Stephen D; Sandman, Nirit

2008-01-01

Background Worldwide, the public health community has recognized the growing problem of childhood obesity. But, unlike tobacco control policy, there is little evidence about what public policies would work to substantially reduce childhood obesity. Public health leaders currently tend to support traditional "command and control" schemes that order private enterprises and governments to stop or start doing specific things that, is it hoped, will yield lower childhood obesity rates. These include measures such as 1) taking sweetened beverages out of schools, 2) posting calorie counts on fast-food menu boards, 3) labeling foods with a "red light" if they contain high levels of fat or sugar, 4) limiting the density of fast food restaurants in any neighborhood, 5) requiring chain restaurants to offer "healthy" alternatives, and 6) eliminating junk food ads on television shows aimed at children. Some advocates propose other regulatory interventions such as 1) influencing the relative prices of healthy and unhealthy foods through taxes and/or subsidies and 2) suing private industry for money damages as a way of blaming childhood obesity on certain practices of the food industry (such as its marketing, product composition, or portion size decisions). The food industry generally seeks to deflect blame for childhood obesity onto others, such as parents and schools. PMID:19017402

Economic Contextual Factors and Child Body Mass Index. NBER Working Paper No. 15046

ERIC Educational Resources Information Center

Powell, Lisa M.; Chaloupka, Frank J.

2009-01-01

This study examines the relationship between child weight and fast food and fruit and vegetable prices and the availability of fast food restaurants, full-service restaurants, supermarkets, grocery stores and convenience stores . We estimate cross-sectional and individual-level fixed effects (FE) models to account for unobserved individual-level…

Calorie Changes in Large Chain Restaurants

PubMed Central

Bleich, Sara N.; Wolfson, Julia A.; Jarlenski, Marian P.

2015-01-01

Introduction Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist. Methods Data (a census of items for included restaurants) were obtained from the MenuStat project. This analysis included 66 of the 100 largest U.S. restaurants that are available in all three 3 of the data (2012–2014; N=23,066 items). Generalized linear models were used to examine: (1) per-item calorie changes from 2012 to 2014 among items on the menu in all years; and (2) mean calories in new items in 2013 and 2014 compared with items on the menu in 2012 only. Data were analyzed in 2014. Results Overall, calories in newly introduced menu items declined by 71 (or 15%) from 2012 to 2013 (p=0.001) and by 69 (or 14%) from 2012 to 2014 (p=0.03). These declines were concentrated mainly in new main course items (85 fewer calories in 2013 and 55 fewer calories in 2014; p=0.01). Although average calories in newly introduced menu items are declining, they are higher than items common to the menu in all 3 years. No differences in mean calories among items on menus in 2012, 2013, or 2014 were found. Conclusions The previously observed declines in newly introduced menu items among large restaurant chains have been maintained, which suggests the beginning of a trend toward reducing calories. PMID:26163168

STRIVE, San Diego! Methodology of a Community-Based Participatory Intervention to Enhance Healthy Dining at Asian and Pacific Islander Restaurants.

PubMed

Oropeza, Sarah; Sadile, Mary Grace; Phung, Chantine Nguyen; Cabiles, Moana; Spackman, Sandy; Abuan, Myleen; Seligman, Fe; Araneta, Maria Rosario

2018-03-01

Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have elevated prevalence of dietary-related chronic conditions; however, culturally relevant dietary interventions are lacking. This article describes the methodology for a community-based participatory intervention. Strategies to Reach and Implement the Vision of Health Equity, San Diego! aims to increase access to healthy food in AANHPI restaurants, grocery stores, and farmers' markets. Time series quasi-experimental study design. Dietitians, health promotion specialists, and community partners collaborated with restaurant owners and chefs to develop culturally tailored approaches without compromising traditional flavors. AANHPI restaurants in San Diego County, CA. Twenty restaurants and 600 diners are anticipated and will be sampled at 3 intervals for a total of 1,800 diners. We describe the community-based interventions within restaurants, including (1) analyzing and modifying selected recipes to create and promote healthier dishes; (2) providing nutrition labels on selected food items; (3) marketing healthy menu items through food tastings, signage, and social media promotion; and (4) offering low-sodium soy sauce and other condiments. Temporal changes in availability of healthful options, and the frequency of healthy dining choices. Program evaluation consists of assessment of the nutritional environment in 20 participating restaurants and surveys of customers' opinions and behaviors at baseline and at 3 and 12 months postintervention. Fifteen restaurants have been recruited to date. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Are immigrant enclaves healthy places to live? The Multi-ethnic Study of Atherosclerosis.

PubMed

Osypuk, Theresa L; Diez Roux, Ana V; Hadley, Craig; Kandula, Namratha R

2009-07-01

The growing size and changing composition of the foreign-born population in the USA highlights the importance of examining the health consequences of living in neighborhoods with higher proportions of immigrants. Using data from the Multi-ethnic Study of Atherosclerosis in four US cities, we examined whether neighborhood immigrant composition was associated with health behaviors (diet, physical activity) among Hispanic and Chinese Americans (n=1902). Secondarily we tested whether neighborhoods with high proportions of immigrants exhibited better or worse neighborhood quality, and whether these dimensions of neighborhood quality were associated with healthy behaviors. Neighborhood immigrant composition was defined based on the Census 2000 tract percent of foreign-born from Latin-America, and separately, percent foreign-born from China. After adjustment for age, gender, income, education, neighborhood poverty, and acculturation, living in a tract with a higher proportion of immigrants was associated with lower consumption of high-fat foods among Hispanics and Chinese, but with being less physically active among Hispanics. Residents in neighborhoods with higher proportions of immigrants reported better healthy food availability, but also worse walkability, fewer recreational exercise resources, worse safety, lower social cohesion, and lower neighborhood-based civic engagement. Associations of neighborhood immigrant composition with diet persisted after adjustment for reported neighborhood characteristics, and associations with physical activity were attenuated. Respondent-reported neighborhood healthy food availability, walkability, availability of exercise facilities and civic participation remained associated with behaviors after adjusting for immigrant composition and other covariates. Results show that living in an immigrant enclave is not monolithically beneficial and may have different associations with different health behaviors.

DNA barcoding detected improper labelling and supersession of crab food served by restaurants in India.

PubMed

Vartak, Vivek Rohidas; Narasimmalu, Rajendran; Annam, Pavan Kumar; Singh, Dhirendra P; Lakra, Wazir S

2015-01-01

Detection of improper labelling of raw and processed seafood is of global importance for reducing commercial fraud and enhancing food safety. Crabs are crustaceans with intricate morphological as well as genetic divergence among species and are popular as seafood in restaurants. Owing to the high number of crab species available, it can be difficult to identify those included in particular food dishes, thus increasing the chance of supersession. DNA barcoding is an advanced technology for detecting improper food labelling and has been used successfully to authenticate seafood. This study identified 11 edible crab species from India by classical taxonomy and developed molecular barcodes with the cytochrome c oxidase I (COI) gene. These barcodes were used as reference barcodes for detecting any improper labelling of 50 restaurant crab samples. Neighbour-joining tree analysis with COI barcodes showed distinct clusters of restaurant samples with respective reference species. The study demonstrated 100% improper labelling of restaurant samples to cover up acts of inferior crab supersession. DNA barcoding successfully identified 11 edible crabs in accordance with classical taxonomy and discerned improper crab food labelling in restaurants of India. © 2014 Society of Chemical Industry.

Control of Fine Particulate (PM2.5) Emissions from Restaurant Operations.

PubMed

Whynot, Jill; Quinn, Gary; Perryman, Pamela; Votlucka, Peter

1999-09-01

This paper describes efforts to reduce particulate matter (PM) emissions from restaurant operations, including application of an existing control method to a new equipment type. Commercial charbroiling in the South Coast Air Basin results in emissions of approximately 10 tons/day of fine particulate matter ( PM 2.5) and 1.3 tons/day of volatile organic compounds (VOCs). Over a seven-year period, the South Coast Air Quality Management District worked with industry to develop test methods for measuring emissions from various cooking operations, evaluate control technologies, and develop a rule to reduce these emissions. Of the two basic types of charbroilers-chain-driven and underfired-underfired produce four times the emissions when equivalent amounts of product are cooked. Cost-effective control technology is currently available only for chain-driven charbroilers. The application of flameless catalytic oxidizers to chain-driven charbroilers was found to effectively reduce emissions by at least 83% and is cost-effective. The catalysts have been used worldwide at restaurants for several years. Research efforts are underway to identify control options for underfired charbroilers. Implementation of Rule 1138, Control of Emissions from Restaurant Operations, adopted November 14, 1997, will result in reductions of 0.5 tons/day of PM 2.5 and 0.2 tons/day of VOCs. Future rules will result in reductions from underfired charbroilers and possibly other restaurant equipment when cost-effective solutions are available.

Control of fine particulate (PM2.5) emissions from restaurant operations.

PubMed

Whynot, J; Quinn, G; Perryman, P; Votlucka, P

1999-09-01

This paper describes efforts to reduce particulate matter (PM) emissions from restaurant operations, including application of an existing control method to a new equipment type. Commercial charbroiling in the South Coast Air Basin results in emissions of approximately 10 tons/day of fine particulate matter (PM2.5) and 1.3 tons/day of volatile organic compounds (VOCs). Over a seven-year period, the South Coast Air Quality Management District worked with industry to develop test methods for measuring emissions from various cooking operations, evaluate control technologies, and develop a rule to reduce these emissions. Of the two basic types of charbroilers--chain-driven and underfired--underfired produce four times the emissions when equivalent amounts of product are cooked. Cost-effective control technology is currently available only for chain-driven charbroilers. The application of flameless catalytic oxidizers to chain-driven charbroilers was found to effectively reduce emissions by at least 83% and is cost-effective. The catalysts have been used worldwide at restaurants for several years. Research efforts are underway to identify control options for underfired charbroilers. Implementation of Rule 1138, Control of Emissions from Restaurant Operations, adopted November 14, 1997, will result in reductions of 0.5 tons/day of PM2.5 and 0.2 tons/day of VOCs. Future rules will result in reductions from underfired charbroilers and possibly other restaurant equipment when cost-effective solutions are available.

Reduced-portion entrées in a worksite and restaurant setting: impact on food consumption and waste.

PubMed

Berkowitz, Sarah; Marquart, Len; Mykerezi, Elton; Degeneffe, Dennis; Reicks, Marla

2016-11-01

Large portion sizes in restaurants have been identified as a public health risk. The purpose of the present study was to determine whether customers in two different food-service operator segments (non-commercial worksite cafeteria and commercial upscale restaurant) would select reduced-portion menu items and the impact of selecting reduced-portion menu items on energy and nutrient intakes and plate waste. Consumption and plate waste data were collected for 5 weeks before and 7 weeks after introduction of five reduced-size entrées in a worksite lunch cafeteria and for 3 weeks before and 4 weeks after introduction of five reduced-size dinner entrées in a restaurant setting. Full-size entrées were available throughout the entire study periods. A worksite cafeteria and a commercial upscale restaurant in a large US Midwestern metropolitan area. Adult worksite employees and restaurant patrons. Reduced-size entrées accounted for 5·3-12·8 % and 18·8-31·3 % of total entrées selected in the worksite and restaurant settings, respectively. Food waste, energy intake and intakes of total fat, saturated fat, cholesterol, Na, fibre, Ca, K and Fe were significantly lower when both full- and reduced-size entrées were served in the worksite setting and in the restaurant setting compared with when only full-size entrées were served. A relatively small proportion of reduced-size entrées were selected but still resulted in reductions in overall energy and nutrient intakes. These outcomes could serve as the foundation for future studies to determine strategies to enhance acceptance of reduced-portion menu items in restaurant settings.

Trends in Nutrient Content of Children's Menu Items in U.S. Chain Restaurants

PubMed Central

Moran, Alyssa J.; Block, Jason P.; Goshev, Simo G.; Bleich, Sara N.; Roberto, Christina A.

2017-01-01

Introduction Restaurant food is widely consumed by children and is associated with poor diet quality. Although many restaurants have made voluntary commitments to improve the nutritional quality of children's menus, it is unclear whether this has led to meaningful changes. Methods Nutrients in children's menu items (n=4,016) from 45 chain restaurants were extracted from the nutrition information database MenuStat. Bootstrapped mixed linear models estimated changes in mean calories, saturated fat, and sodium in children's menu items between 2012 and 2013, 2014, and 2015. Changes in nutrient content of these items over time were compared among restaurants participating in the Kids LiveWell initiative and non-participating restaurants. Types of available children's beverages were also examined. Data were analyzed in 2016. Results There was a significant increase in mean beverage calories from 2012 to 2013 (6, 95% CI=0.8, 10.6) and from 2012 to 2014 (11, 95% CI=3.7, 18.3), but no change between 2012 and 2015, and no differences in nutrient content of other items over time. Restaurants participating in Kids LiveWell reduced entrée calories between 2012 and 2013 (−24, 95% CI= −40.4, −7.2) and between 2012 and 2014 (−40, 95% CI= −68.1, −11.4) and increased side dish calories between 2012 and 2015 (49, 95% CI=4.6, 92.7) versus non-participating restaurants. Sugar-sweetened beverages consistently constituted 80% of children's beverages, with soda declining and flavored milks increasing between 2012 and 2015. Conclusions Results suggest little progress toward improving nutrition in children's menu items. Efforts are needed to engage restaurants in offering healthful children's meals. PMID:28089130

Trends in Nutrient Content of Children's Menu Items in U.S. Chain Restaurants.

PubMed

Moran, Alyssa J; Block, Jason P; Goshev, Simo G; Bleich, Sara N; Roberto, Christina A

2017-03-01

Restaurant food is widely consumed by children and is associated with poor diet quality. Although many restaurants have made voluntary commitments to improve the nutritional quality of children's menus, it is unclear whether this has led to meaningful changes. Nutrients in children's menu items (n=4,016) from 45 chain restaurants were extracted from the nutrition information database MenuStat. Bootstrapped mixed linear models estimated changes in mean calories, saturated fat, and sodium in children's menu items between 2012 and 2013, 2014, and 2015. Changes in nutrient content of these items over time were compared among restaurants participating in the Kids LiveWell initiative and non-participating restaurants. Types of available children's beverages were also examined. Data were analyzed in 2016. There was a significant increase in mean beverage calories from 2012 to 2013 (6, 95% CI=0.8, 10.6) and from 2012 to 2014 (11, 95% CI=3.7, 18.3), but no change between 2012 and 2015, and no differences in nutrient content of other items over time. Restaurants participating in Kids LiveWell reduced entrée calories between 2012 and 2013 (-24, 95% CI= -40.4, -7.2) and between 2012 and 2014 (-40, 95% CI= -68.1, -11.4) and increased side dish calories between 2012 and 2015 (49, 95% CI=4.6, 92.7) versus non-participating restaurants. Sugar-sweetened beverages consistently constituted 80% of children's beverages, with soda declining and flavored milks increasing between 2012 and 2015. Results suggest little progress toward improving nutrition in children's menu items. Efforts are needed to engage restaurants in offering healthful children's meals. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Managerial practices regarding workers working while ill.

PubMed

Norton, D M; Brown, L G; Frick, R; Carpenter, L R; Green, A L; Tobin-D'Angelo, M; Reimann, D W; Blade, H; Nicholas, D C; Egan, J S; Everstine, K

2015-01-01

Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants' policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or "stomach flu," possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non-food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill.

Are neighbourhood food resources distributed inequitably by income and race in the USA? Epidemiological findings across the urban spectrum

PubMed Central

Richardson, Andrea S; Boone-Heinonen, Janne; Popkin, Barry M

2012-01-01

Objective Many recent policies focus on socioeconomic inequities in availability of healthy food stores and restaurants. Yet understanding of how socioeconomic inequities vary across neighbourhood racial composition and across the range from rural to urban settings is limited, largely due to lack of large, geographically and socio-demographically diverse study populations. Using a national sample, the authors examined differences in neighbourhood food resource availability according to neighbourhood-level poverty and racial/ethnic population in non-urban, low-density urban and high-density urban areas. Design Cross-sectional data from an observational cohort study representative of the US middle and high school-aged population in 1994 followed into young adulthood. Participants Using neighbourhood characteristics of participants in the National Longitudinal Study of Adolescent Health (Wave III, 2001–2002; n=13 995 young adults aged 18–28 years representing 7588 US block groups), the authors examined associations between neighbourhood poverty and race/ethnicity with neighbourhood food resource availability in urbanicity-stratified multivariable linear regression. Primary and secondary outcome measures Neighbourhood availability of grocery/supermarkets, convenience stores and fast-food restaurants (measured as number of outlets per 100 km roadway). Results Neighbourhood race and income disparities were most pronounced in low-density urban areas, where high-poverty/high-minority areas had lower availability of grocery/supermarkets (β coefficient (β)=–1.91, 95% CI –2.73 to –1.09) and convenience stores (β=–2.38, 95% CI –3.62 to –1.14) and greater availability of fast-food restaurants (β=4.87, 95% CI 2.26 to 7.48) than low-poverty/low-minority areas. However, in high-density urban areas, high-poverty/low-minority neighbourhoods had comparatively greater availability of grocery/supermarkets (β=8.05, 95% CI 2.52 to 13.57), convenience stores (β=2.89, 95% CI 0.64 to 5.14) and fast-food restaurants (β=4.03, 95% CI 1.97 to 6.09), relative to low-poverty/low-minority areas. Conclusions In addition to targeting disproportionate fast-food availability in disadvantaged dense urban areas, our findings suggest that policies should also target disparities in grocery/supermarket and fast-food restaurant availability in low-density areas. PMID:22505308

Geographic variation in the relationship between body mass index and the built environment.

PubMed

Adachi-Mejia, Anna M; Lee, Chanam; Lee, Chunkuen; Carlos, Heather A; Saelens, Brian E; Berke, Ethan M; Doescher, Mark P

2017-07-01

Studies examining associations between weight status and neighborhood built environment (BE) have shown inconsistent results and have generally focused on urban settings. However, many Americans do not live in metropolitan areas and BE impacts may be different outside of metropolitan areas. We sought to examine whether the relationship between body mass index (BMI) and neighborhood BE exists and varies by geographic region across small towns in the United States. We conducted telephone surveys with 2156 adults and geographic information systems data in nine towns located within three geographic regions (Northeast, Texas, Washington) in 2011 and 2012. Multiple regression models examined the relationship between individual BMI and BE measures. Most physical activity variables were significantly associated with lower BMI in all geographic regions. We saw variation across geographic region in the relationship between characteristics of the BE variables and BMI. Some perceived and objectively-measured characteristics of the BE were significantly associated with adult BMI, but significant relationships varied by geographic region. For example, in the Northeast, perceived attractiveness of the neighborhood as a reason for why they chose to live there was associated with lower BMI; in Texas, the perceived presence of a fast food restaurant was negatively associated with BMI; in Washington, perceived presence of trees along the streets was associated with lower BMI. Our findings suggest that regional variation plays a role in the relationship between adult BMI and BE characteristics in small towns. Regardless of geographic location, interventions should encourage utilitarian walking and other forms of physical activity. Copyright © 2017 Elsevier Inc. All rights reserved.

Calorie changes in chain restaurant menu items: implications for obesity and evaluations of menu labeling.

PubMed

Bleich, Sara N; Wolfson, Julia A; Jarlenski, Marian P

2015-01-01

Supply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements. To describe trends in calories available in large U.S. restaurants. Data were obtained from the MenuStat project, a census of menu items in 66 of the 100 largest U.S. restaurant chains, for 2012 and 2013 (N=19,417 items). Generalized linear models were used to calculate (1) the mean change in calories from 2012 to 2013, among items on the menu in both years; and (2) the difference in mean calories, comparing newly introduced items to those on the menu in 2012 only (overall and between core versus non-core items). Data were analyzed in 2014. Mean calories among items on menus in both 2012 and 2013 did not change. Large restaurant chains in the U.S. have recently had overall declines in calories in newly introduced menu items (-56 calories, 12% decline). These declines were concentrated mainly in new main course items (-67 calories, 10% decline). New beverage (-26 calories, 8% decline) and children's (-46 calories, 20% decline) items also had fewer mean calories. Among chain restaurants with a specific focus (e.g., burgers), average calories in new menu items not core to the business declined more than calories in core menu items. Large chain restaurants significantly reduced the number of calories in newly introduced menu items. Supply-side changes to the calories in chain restaurants may have a significant impact on obesity prevention. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Calorie Changes in Chain Restaurant Menu Items: Implications for Obesity and Evaluations of Menu Labeling

PubMed Central

Bleich, Sara N.; Wolfson, Julia A.; Jarlenski, Marian P.

2014-01-01

Background Supply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements. Purpose To describe trends in calories available in large U.S. restaurants. Methods Data were obtained from the MenuStat project, a census of menu items in 66 of the 100 largest U.S. restaurant chains, for 2012 and 2013 (N=19,417 items). Generalized linear models were used to calculate: (1) the mean change in calories from 2012 to 2013, among items on the menu in both years; and (2) the difference in mean calories, comparing newly introduced items to those on the menu in 2012 only (overall and between core versus non-core items). Data were analyzed in 2014. Results Mean calories among items on menus in both 2012 and 2013 did not change. Large restaurant chains in the U.S. have recently had overall declines in calories in newly introduced menu items (−56 calories, 12% decline). These declines were concentrated mainly in new main course items (−67 calories, 10% decline). New beverage (−26 calories, 8% decline) and children’s (−46 calories, 20% decline) items also had fewer mean calories. Among chain restaurants with a specific focus (e.g., burgers), average calories in new menu items not core to the business declined more than calories in core menu items. Conclusions Large chain restaurants significantly reduced the number of calories in newly introduced menu items. Supply-side changes to the calories in chain restaurants may have a significant impact on obesity prevention. PMID:25306397

Calorie Changes in Large Chain Restaurants: Declines in New Menu Items but Room for Improvement.

PubMed

Bleich, Sara N; Wolfson, Julia A; Jarlenski, Marian P

2016-01-01

Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist. Data (a census of items for included restaurants) were obtained from the MenuStat project. This analysis included 66 of the 100 largest U.S. restaurants that are available in all three of the data years (2012-2014; N=23,066 items). Generalized linear models were used to examine: (1) per-item calorie changes from 2012 to 2014 among items on the menu in all years; and (2) mean calories in new items in 2013 and 2014 compared with items on the menu in 2012 only. Data were analyzed in 2014. Overall, calories in newly introduced menu items declined by 71 (or 15%) from 2012 to 2013 (p=0.001) and by 69 (or 14%) from 2012 to 2014 (p=0.03). These declines were concentrated mainly in new main course items (85 fewer calories in 2013 and 55 fewer calories in 2014; p=0.01). Although average calories in newly introduced menu items are declining, they are higher than items common to the menu in all 3 years. No differences in mean calories among items on menus in 2012, 2013, or 2014 were found. The previously observed declines in newly introduced menu items among large restaurant chains have been maintained, which suggests the beginning of a trend toward reducing calories. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The children's menu assessment: development, evaluation, and relevance of a tool for evaluating children's menus.

PubMed

Krukowski, Rebecca A; Eddings, Kenya; West, Delia Smith

2011-06-01

Restaurant foods represent a substantial portion of children's dietary intake, and consumption of foods away from home has been shown to contribute to excess adiposity. This descriptive study aimed to pilot-test and establish the reliability of a standardized and comprehensive assessment tool, the Children's Menu Assessment, for evaluating the restaurant food environment for children. The tool is an expansion of the Nutrition Environment Measures Survey-Restaurant. In 2009-2010, a randomly selected sample of 130 local and chain restaurants were chosen from within 20 miles of Little Rock, AR, to examine the availability of children's menus and to conduct initial calibration of the Children's Menu Assessment tool (final sample: n=46). Independent raters completed the Children's Menu Assessment in order to determine inter-rater reliability. Test-retest reliability was also examined. Inter-rater reliability was high: percent agreement was 97% and Spearman correlation was 0.90. Test-retest was also high: percent agreement was 91% and Spearman correlation was 0.96. Mean Children's Menu Assessment completion time was 14 minutes, 56 seconds ± 10 minutes, 21 seconds. Analysis of Children's Menu Assessment findings revealed that few healthier options were available on children's menus, and most menus did not provide parents with information for making healthy choices, including nutrition information or identification of healthier options. The Children's Menu Assessment tool allows for comprehensive, rapid measurement of the restaurant food environment for children with high inter-rater reliability. This tool has the potential to contribute to public health efforts to develop and evaluate targeted environmental interventions and/or policy changes regarding restaurant foods. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Spaces between home and school: The effect of eating location on adolescent nutrition.

PubMed

Williams, Jennifer L

2016-01-01

Using interview and self-administered survey data, this article examines how homes, schools, and the community spaces between these two locations affect adolescent nutrition in a low-income, urban setting. Results from this research show that eating location can play a significant role in the foods that adolescents consume. Food acquisition data provided by adolescents reveal that homes and schools provide spaces for the consumption of healthy foods while shops, restaurants, takeouts, and community centers contribute unhealthy snack foods to adolescent diets in a traditionally low-income, urban neighborhood in Northern Ireland. The results of this research show that eating location can provide a starting point for designing healthy eating interventions in low-income places to avoid overlap with spaces that already provide healthy foods to young people.

Racial/Ethnic and Income Disparities in Child and Adolescent Exposure to Food and Beverage Television Ads across U.S. Media Markets

PubMed Central

Powell, Lisa M.; Wada, Roy; Kumanyika, Shiriki K.

2015-01-01

Obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations. Targeted advertising may contribute to disparities. Designated market area (DMA) spot television ratings were used to assess geographic differences in child/adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics. Controlling for unobserved DMA-level factors and time trends, child/adolescent exposure to food-related ads, particularly for sugar-sweetened beverages and fast-food restaurants, was significantly higher in areas with higher proportions of black children/adolescents and lower-income households. Geographically targeted TV ads are important to consider when assessing obesity-promoting influences in black and low-income neighborhoods. PMID:25086271

Healthier side dishes at restaurants: an analysis of children's perspectives, menu content, and energy impacts.

PubMed

Anzman-Frasca, Stephanie; Dawes, Franciel; Sliwa, Sarah; Dolan, Peter R; Nelson, Miriam E; Washburn, Kyle; Economos, Christina D

2014-07-04

Children consume restaurant-prepared foods at high rates, suggesting that interventions and policies targeting consumption of these foods have the potential to improve diet quality and attenuate excess energy intake. One approach to encouraging healthier dietary intake in restaurants is to offer fruits and vegetables (FV) as side dishes, as opposed to traditional, energy-dense accompaniments like French fries. The aims of the current study were to examine: children's views about healthier side dishes at restaurants; current side dish offerings on children's menus at leading restaurants; and potential energy reductions when substituting FV side dishes in place of French fries. To investigate children's attitudes, a survey was administered to a nationally representative sample of U.S. 8- to 18-year-olds (n = 1178). To examine current side dish offerings, children's menus from leading quick service (QSR; n = 10) and full service restaurant chains (FSR; n = 10) were analyzed. Energy reductions that could result from substituting commonly-offered FV side dishes for French fries were estimated using nutrition information corresponding to the children's menu items. Two-thirds of children reported that they would not feel negatively about receiving FV sides instead of French fries with kids' meals. Liking/taste was the most common reason that children gave to explain their attitudes about FV side dishes. Nearly all restaurants offered at least 1 FV side dish option, but at most restaurants (60% of QSR; 70% of FSR), FV sides were never served by default. Substituting FV side dishes for French fries yielded an average estimated energy reduction of at least 170 calories. Results highlight some healthy trends in the restaurant context, including the majority of children reporting non-negative attitudes about FV side dishes and the consistent availability of FV side dish options at leading QSR and FSR. Yet the minority of restaurants offer these FV sides by default. Promoting creative, appealing FV side dishes can result in healthier, less energy-dense meals for children. Substituting or displacing energy-dense default side dishes with such FV dishes show promise as part of continued, comprehensive efforts to increase the healthfulness of meals consumed by children in restaurant settings.

Is the Physical Availability of Alcohol and Illicit Drugs Related to Neighborhood Rates of Child Maltreatment?

ERIC Educational Resources Information Center

Freisthler, Bridget; Needell, Barbara; Gruenewald, Paul J.

2005-01-01

Objective: This study examines how the availability of alcohol and illicit drugs (as measured by alcohol outlet density and police incidents of drug sales and possessions) is related to neighborhood rates of child abuse and neglect, controlling for other neighborhood demographic characteristics. Method: Data from substantiated reports of child…

Identifying risk profiles for childhood obesity using recursive partitioning based on individual, familial, and neighborhood environment factors.

PubMed

Van Hulst, Andraea; Roy-Gagnon, Marie-Hélène; Gauvin, Lise; Kestens, Yan; Henderson, Mélanie; Barnett, Tracie A

2015-02-15

Few studies consider how risk factors within multiple levels of influence operate synergistically to determine childhood obesity. We used recursive partitioning analysis to identify unique combinations of individual, familial, and neighborhood factors that best predict obesity in children, and tested whether these predict 2-year changes in body mass index (BMI). Data were collected in 2005-2008 and in 2008-2011 for 512 Quebec youth (8-10 years at baseline) with a history of parental obesity (QUALITY study). CDC age- and sex-specific BMI percentiles were computed and children were considered obese if their BMI was ≥95th percentile. Individual (physical activity and sugar-sweetened beverage intake), familial (household socioeconomic status and measures of parental obesity including both BMI and waist circumference), and neighborhood (disadvantage, prestige, and presence of parks, convenience stores, and fast food restaurants) factors were examined. Recursive partitioning, a method that generates a classification tree predicting obesity based on combined exposure to a series of variables, was used. Associations between resulting varying risk group membership and BMI percentile at baseline and 2-year follow up were examined using linear regression. Recursive partitioning yielded 7 subgroups with a prevalence of obesity equal to 8%, 11%, 26%, 28%, 41%, 60%, and 63%, respectively. The 2 highest risk subgroups comprised i) children not meeting physical activity guidelines, with at least one BMI-defined obese parent and 2 abdominally obese parents, living in disadvantaged neighborhoods without parks and, ii) children with these characteristics, except with access to ≥1 park and with access to ≥1 convenience store. Group membership was strongly associated with BMI at baseline, but did not systematically predict change in BMI. Findings support the notion that obesity is predicted by multiple factors in different settings and provide some indications of potentially obesogenic environments. Alternate group definitions as well as longer duration of follow up should be investigated to predict change in obesity.

Nutrition Labeling and Portion Size Information on Children's Menus in Fast-Food and Table-Service Chain Restaurants in London, UK

ERIC Educational Resources Information Center

Reeves, Sue; Wake, Yvonne; Zick, Andrea

2011-01-01

Objective: To investigate meals, price, nutritional content, and nutrition and portion size information available on children's menus in fast-food and table-service chain restaurants in London, since the United Kingdom does not currently require such information but may be initiating a voluntary guideline. Methods: Children's menus were assessed…

Long-haul truck drivers want healthful meal options at truck-stop restaurants.

PubMed

Whitfield Jacobson, Pamela J; Prawitz, Aimee D; Lukaszuk, Judith M

2007-12-01

Long-haul truckers are confined, by parking regulations and other constraints, to dining at truck-stop restaurants. Objectives were to (a) compare truckers' anthropometrics with recommended guidelines; and (b) assess eating/exercise habits, importance of healthful food choices, and attitudes about restaurants' provision of healthful options. Hypotheses were: (a) overweight/obese drivers will place less importance on healthful food choices than will drivers of optimal weight; (b) importance of healthful food choices and attitudes about their provision will be positively correlated. Questionnaires included Food Choices Index, Nutrition Attitude Survey, and demographic information; bioelectrical impedance assessed weight, body fat, and body mass index. Subjects (n=92) were truckers at a Midwestern truck-stop restaurant; 79 were overweight, 52 were obese. Mean rating of importance of healthful choices was above average. There was no difference in importance of healthful food choices for overweight/obese and optimal weight drivers, t(89)=-1.312; P=0.19. Drivers placing more importance on healthful food choices had more positive attitudes about restaurants' provision of such options, r(90)=0.74, P<0.001. Overall, drivers indicated they would choose healthful foods if available and appetizing. Registered dietitian-directed wellness programs that include education, support, and cooperation of truck-stop restaurants are critical to reduce obesity and risk of disease in this population.

Availability, Accessibility, and Price of Rapid HIV Self-Tests, New York City Pharmacies, Summer 2013.

PubMed

Myers, Julie E; El-Sadr Davis, Olivia Y; Weinstein, Elliott R; Remch, Molly; Edelstein, Amy; Khawja, Amina; Schillinger, Julia A

2017-02-01

We conducted an in-person survey of New York City (NYC) pharmacies to assess the availability, accessibility, and price of the over-the-counter, rapid HIV self-test kit. NYC pharmacies were stratified into high, moderate and low morbidity neighborhoods by the HIV diagnosis rate of the neighborhood in which the pharmacy was located. A random sample of 500 pharmacies was taken [250 from high morbidity neighborhoods (HighMN) and 250 from low morbidity neighborhoods (LowMN)]. Pharmacies were excluded if: closed during survey, non-retail, or >10 min walk from subway. Project staff visited pharmacies to determine kit availability (in pharmacy on day of survey), accessibility (not locked/behind counter), and price (marked on shelf/product). Of 361 pharmacies (161 LowMN; 200 HighMN), kits were available in 27 % and accessible in 10 %; there was no difference by neighborhood. Kits were most often kept behind the pharmacy counter; this was more common in HighMN than in LowMN. Kits were kept solely behind the pharmacy counter in 52 %. Median price was US $42.99 without variability across neighborhoods. The rapid HIV self-test had limited availability and access in retail pharmacies. The high median price measured suggests that cost remained a barrier.

Calorie changes in large chain restaurants from 2008 to 2015.

PubMed

Bleich, Sara N; Wolfson, Julia A; Jarlenski, Marian P

2017-07-01

No prior studies examining changes in the calorie content of chain restaurants have included national data before and after passage of federal menu labeling legislation, required by the 2010 Affordable Care Act. This paper describes trends in calories available in large U.S. chain restaurants in 2008 and 2012 to 2015 using data were obtained from the MenuStat project (2012 to 2015) and from the Center for Science in the Public Interest (2008). This analysis included 44 of the 100 largest U.S. restaurants which are available in all years of the data (2008 and 2012-2015) (N=19,391 items). Generalized linear models were used to examine 1) per-item calorie changes from 2008 to 2015 among items on the menu in all years and 2) mean calories in new items in 2012, 2013, 2014 and 2015 compared to items on the menu in 2008 only. We found that Among items common to the menu in all years, overall calories declined from 327kcal in 2008 to 318kcal in 2015 (p-value for trend=0.03). No differences in mean calories among menu items newly introduced in 2012, 2013, 2014, and 2015 relative to items only on the menu in 2008 were found. These results suggest that the federal menu labeling mandate (to be implemented in May 2017) appears to be influencing restaurant behavior towards lower average calories for menu items. Copyright © 2017 Elsevier Inc. All rights reserved.

Marketing little cigars and cigarillos: advertising, price, and associations with neighborhood demographics.

PubMed

Cantrell, Jennifer; Kreslake, Jennifer M; Ganz, Ollie; Pearson, Jennifer L; Vallone, Donna; Anesetti-Rothermel, Andrew; Xiao, Haijun; Kirchner, Thomas R

2013-10-01

We have documented little cigar and cigarillo (LCC) availability, advertising, and price in the point-of-sale environment and examined associations with neighborhood demographics. We used a multimodal real-time surveillance system to survey LCCs in 750 licensed tobacco retail outlets that sold tobacco products in Washington, DC. Using multivariate models, we examined the odds of LCC availability, the number of storefront exterior advertisements, and the price per cigarillo for Black & Mild packs in relation to neighborhood demographics. The odds of LCC availability and price per cigarillo decreased significantly in nearly a dose-response manner with each quartile increase in proportion of African Americans. Prices were also lower in some young adult neighborhoods. Having a higher proportion of African American and young adult residents was associated with more exterior LCC advertising. Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences.

Availability of commonly consumed and culturally specific fruits and vegetables in African-american and Latino neighborhoods.

PubMed

Grigsby-Toussaint, Diana S; Zenk, Shannon N; Odoms-Young, Angela; Ruggiero, Laurie; Moise, Imelda

2010-05-01

Although the importance of culture in shaping individual dietary behaviors is well-documented, cultural food preferences have received limited attention in research on the neighborhood food environment. The purpose of this study was to assess the availability of commonly consumed and culturally specific fruits and vegetables in retail food stores located in majority African-American and Latino neighborhoods in southwest Chicago, IL. A cross-sectional survey of 115 stores (15% grocery stores, 85% convenience/corner stores) in African-American neighborhoods and 110 stores (45% grocery stores, 55% convenience/corner stores) in Latino neighborhoods was conducted between May and August of 2006. chi(2) tests were used to assess differences in the availability (presence/absence) of commonly consumed (n=25) and culturally specific fruits and vegetables for African Americans (n=16 varieties) and Latinos (n=18 varieties). Stores located in neighborhoods in which the majority of residents were African American or Latino were more likely to carry fresh fruits and vegetables that were culturally relevant to the dominant group. For example, grocery stores located in Latino neighborhoods were more likely to carry chayote (82.0% vs 17.6%, P<0.05), whereas grocery stores located in African-American neighborhoods were more likely to carry black-eyed peas (52.9% vs 20%, P<0.05). Most stores, however, carried fewer than 50% of commonly consumed or culturally specific fruits and vegetables. Findings from this study highlight that limited availability of culturally specific as well as commonly consumed fruits and vegetables in the neighborhood may be a barrier to fruit and vegetable consumption among African Americans and Latinos. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Availability of commonly consumed and culturally specific fruits and vegetables in African-American and Latino neighborhoods

PubMed Central

Grigsby-Toussaint, Diana S.; Zenk, Shannon N.; Odoms-Young, Angela; Ruggiero, Laurie; Moise, Imelda

2010-01-01

Although the importance of culture in shaping individual dietary behaviors is well documented, cultural food preferences have received limited attention in research on the neighborhood food environment. The purpose of this study was to assess the availability of commonly consumed and culturally specific fruits and vegetables in retail food stores located in majority African-American and Latino neighborhoods in southwest Chicago. A cross-sectional survey of 115 stores (15% grocery stores, 85% convenience/corner stores) in African-American neighborhoods and 110 stores (45% grocery stores, 55% convenience/corner stores) in Latino neighborhoods was conducted between May and August 2006. Chi-square tests were used to test for differences in the availability (presence/absence) of commonly consumed (n=25) and culturally specific fruits and vegetables for African-Americans (n=16 varieties) and Latinos (n=18 varieties). Stores located in neighborhoods in which the majority of residents were African-American or Latino residents were more likely to carry fresh fruits and vegetables that were culturally relevant to the dominant group. For example, grocery stores located in Latino neighborhoods were more likely to carry chayote (82.0% vs. 17.6%, p <0.05), while grocery stores located in African-American neighborhoods were more likely to carry black-eyed peas (52.9% vs. 20%, p<0.05). Most stores, however, carried less than 50% of commonly consumed or culturally specific fruits and vegetables. Findings from this study highlight that limited availability of culturally specific as well as commonly consumed fruits and vegetables in the neighborhood may serve as a barrier to fruit and vegetable consumption among African-Americans and Latinos. PMID:20430136

Assessment of community food resources: A Latino neighborhood study in upstate New York

PubMed Central

Lopez-Class, Maria; Hosler, Akiko S.

2011-01-01

This study aims to assess availability, affordability, and accessibility of food items in a low-income Latino neighborhood within a small city using an on-site food store survey. Store locations were identified by on-site GPS. Results showed the Latino neighborhood had limited availability and above average cost of high-fiber bread. Fresh vegetables were more expensive compared to the non-Latino neighborhood, and more stores in the Latino neighborhood participated in Supplemental Nutrition Assistance Food Program. The lack of supermarkets, fewer stores with disability access, and the lack of public transportation left Latino residents without a vehicle or with physical disabilities with few food shopping options. PMID:22065468

Poverty, Sprawl, and Restaurant Types Influence Body Mass Index of Residents in California Counties

PubMed Central

Gregson, Jennifer

2011-01-01

Objectives. This article examines the relationships between structural poverty (the proportion of people in a county living at ≤130% of the federal poverty level [FPL]), urban sprawl, and three types of restaurants (grouped as fast food, chain full service, and independent full service) in explaining body mass index (BMI) of individuals. Methods. Relationships were tested with two-tiered hierarchical models. Individual-level data, including the outcome variable of calculated BMI, were from the 2005, 2006, and 2007 California Behavioral Risk Factor Surveillance Survey (n=14,205). County-level data (n=33) were compiled from three sources. The 2000 U.S. Census provided the proportion of county residents living at ≤130% of FPL and county demographic descriptors. The sprawl index used came from the Smart Growth America Project. Fast-food, full-service chain, and full-service independently owned restaurants as proportions of the total retail food environment were constructed from a commercially available market research database from 2004. Results. In the analysis, county-level demographic characteristics lost significance and poverty had a consistent, robust association on BMI (p<0.001). Sprawl demonstrated an additional, complementary association to county poverty (p<0.001). Independent restaurants had a large, negative association to BMI (p<0.001). The coefficients for chain and fast-food restaurants were large and positive (p≤0.001), indicating that as the proportion of these restaurants in a county increases, so does BMI. Conclusions. This study demonstrates the important role of county poverty and urban sprawl toward understanding environmental influences on BMI. Using three categories of restaurants demonstrates different associations of full-service chain and independent restaurants, which are often combined in other research. PMID:21563722

Energy contribution of sugar-sweetened beverage refills at fast-food restaurants.

PubMed

Breck, Andrew; Cantor, Jonathan H; Elbel, Brian

2017-09-01

To identify demographic and consumer characteristics associated with refilling a soft drink at fast-food restaurants and the estimated energy content and volume of those refills. Logistic and linear regression with cross-sectional survey data. Data include fast-food restaurant receipts and consumer surveys collected from restaurants in New York City (all boroughs except Staten Island), and Newark and Jersey City, New Jersey, during 2013 and 2014. Fast-food restaurant customers (n 11795) from ninety-eight restaurants. Thirty per cent of fast-food customers ordered a refillable soft drink. Nine per cent of fast-food customers with a refillable soft drink reported refilling their beverage (3 % of entire sample). Odds of having a beverage refill were higher among respondents with a refillable soft drink at restaurants with a self-serve refill kiosk (adjusted OR (aOR)=7·37, P<0·001) or who ate in the restaurant (aOR=4·45, P<0·001). KFC (aOR=2·18, P<0·001) and Wendy's (aOR=0·41, P<0·001) customers had higher and lower odds, respectively, of obtaining a refill, compared with Burger King customers. Respondents from New Jersey (aOR=1·47, P<0·001) also had higher odds of refilling their beverage than New York City customers. Customers who got a refill obtained on average 29 more 'beverage ounces' (858 ml) and 250 more 'beverage calories' (1046 kJ) than customers who did not get a refill. Refilling a beverage was associated with having obtained more beverage calories and beverage ounces. Environmental cues, such as the placement and availability of self-serve beverage refills, may influence consumer beverage choice.

Changes in sodium levels in chain restaurant foods in Canada (2010−2013): a longitudinal study

PubMed Central

Scourboutakos, Mary J.

2014-01-01

Background Several restaurant chains have committed to reducing sodium levels in their foods; however, how much sodium levels have changed over the past few years is unknown. The objective was to measure changes in sodium in restaurant foods from 2010 to 2013. Methods Data for the serving size, calorie and sodium level of 3878 foods were collected from the websites of 61 Canadian restaurant chains in 2010 and 2013. A longitudinal study of changes in sodium levels in foods available from the restaurants in 2010 and 2013 (n = 2198) was conducted. Levels in newly reported and discontinued foods were also investigated. Results Sodium levels (mg/serving) decreased in 30.1% of foods, increased in 16.3% and were unchanged in 53.6%. The average change in foods with a decrease in sodium was –220 (standard deviation [SD] ± 303) mg/serving (a decline of 19% [SD ± 17%]), whereas the average change in foods with an increase in sodium was 251 (SD ± 349) mg/serving (a 44% [SD ± 104%] increase). The prevalence and magnitude of change varied depending on the restaurant and food category. Overall, there was a small, yet significant, decrease in sodium per serving (–25 [SD ± 268] mg, p < 0.001); however, the percentage of foods exceeding the daily sodium adequate intake (1500 mg) and tolerable upper intake level (2300 mg) remained unchanged. Interpretation The observed increases and decreases in sodium show that industry efforts to voluntarily decrease sodium levels in Canadian restaurant foods have produced inconsistent results. Although the lower levels in some foods show that sodium reduction is possible, the simultaneous increase in other foods demonstrates the need for targets and timelines for sodium reduction in restaurants. PMID:25553327

Poverty, sprawl, and restaurant types influence body mass index of residents in California counties.

PubMed

Gregson, Jennifer

2011-01-01

This article examines the relationships between structural poverty (the proportion of people in a county living at < or =130% of the federal poverty level [FPL]), urban sprawl, and three types of restaurants (grouped as fast food, chain full service, and independent full service) in explaining body mass index (BMI) of individuals. Relationships were tested with two-tiered hierarchical models. Individual-level data, including the outcome variable of calculated BMI, were from the 2005, 2006, and 2007 California Behavioral Risk Factor Surveillance Survey (n = 14,205). County-level data (n = 33) were compiled from three sources. The 2000 U.S. Census provided the proportion of county residents living at < or = 130% of FPL and county demographic descriptors. The sprawl index used came from the Smart Growth America Project. Fast-food, full-service chain, and full-service independently owned restaurants as proportions of the total retail food environment were constructed from a commercially available market research database from 2004. In the analysis, county-level demographic characteristics lost significance and poverty had a consistent, robust association on BMI (p < 0.001). Sprawl demonstrated an additional, complementary association to county poverty (p < 0.001). Independent restaurants had a large, negative association to BMI (p < 0.001). The coefficients for chain and fast-food restaurants were large and positive (p < or = 0.001), indicating that as the proportion of these restaurants in a county increases, so does BMI. This study demonstrates the important role of county poverty and urban sprawl toward understanding environmental influences on BMI. Using three categories of restaurants demonstrates different associations of full-service chain and independent restaurants, which are often combined in other research.

Customer responses to mandatory menu labeling at full-service restaurants.

PubMed

Auchincloss, Amy H; Mallya, Giridhar G; Leonberg, Beth L; Ricchezza, Andrew; Glanz, Karen; Schwarz, Donald F

2013-12-01

In 2010, Philadelphia enacted a menu-labeling law requiring full-service restaurant chains to list values for calories, sodium, fat, and carbohydrates for each item on all printed menus. The goal of the study was to determine whether purchase decisions at full-service restaurants varied depending on the presence of labeling. In August 2011, this cross-sectional study collected 648 customer surveys and transaction receipts at seven restaurant outlets of one large full-service restaurant chain. Two outlets had menu labeling (case sites); five outlets did not (control sites). Outcomes included differences in calories and nutrients purchased and customers' reported use of nutrition information when ordering. Data were analyzed in 2012. Mean age was 37 years; 60% were female; 50% were black/African-American and reported incomes ≥$60,000. Customers purchased food with approximately 1600 kcal (food plus beverage, 1800 kcal); 3200 mg sodium; and 35 g saturated fat. After adjustment for confounders, customers at labeled restaurants purchased food with 151 fewer kilocalories (95% CI=-270, -33); 224 mg less sodium (95% CI=-457, +8); and 3.7 g less saturated fat (95% CI=-7.4, -0.1) compared to customers at unlabeled restaurants (or 155 less kilocalories from food plus beverage, 95% CI=-284, -27). Those reporting that nutrition information affected their order purchased 400 fewer food calories, 370 mg less sodium, and 10 g less saturated fat. Mandatory menu labeling was associated with better food choices among a segment of the public dining at full-service restaurants. Consumer education on the availability and use of nutrition information may extend the impact of menu labeling. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

Alcohol outlets and child physical abuse and neglect: applying routine activities theory to the study of child maltreatment.

PubMed

Freisthler, Bridget; Midanik, Lorraine T; Gruenewald, Paul J

2004-09-01

The purpose of this study is to examine whether or not alcohol access in neighborhood areas is differentially related to substantiated reports of child physical abuse and neglect. This cross-sectional ecological study uses spatial regression procedures to examine the relationship between the number of bars, restaurants and off-premise outlets per population and rates of child physical abuse and neglect in 940 census tracts in California, while controlling for levels of social disorganization, population density and county of residence. The number of off-premise outlets per population was positively associated with rates of child physical abuse (b = 3.34, SE = 1.14), and the number of bars per population was positively related to rates of child neglect (b = 1.89, SE = 0.59). These results suggest that alcohol access is differentially related to type of child maltreatment, with higher densities of bars being related to higher rates of child neglect, and higher rates of off-premise outlets related to higher rates of child physical abuse. The findings suggest there is a spatial dynamic of neighborhoods that can result in child maltreatment and underscore the importance of examining the alcohol environment when developing programs to prevent child maltreatment.

Commodification of Transitioning Ethnic Enclaves

PubMed Central

Terzano, Kathryn

2014-01-01

This literature review examines the changing roles of ethnic enclaves, the question of their authenticity, and their value as commodified spaces, giving special attention to Little Italy neighborhoods in the United States. Understanding the roles of ethnic enclaves requires some understanding about immigrants’ identities. For some theorists, immigrants become blended into society over the course of generations; for other theorists, descendants of immigrants sometimes retain their cultural heritage and traits, helping form a multicultural or pluralist society. In the traditional sense, ethnic enclaves consist of both ethnic residents and ethnic businesses (such as restaurants, shops, and grocers). One way that ethnic enclaves change is when the area experiences a demographic shift, and people from outside the ethnic group move their residences and businesses to the neighborhood, resulting in the area becoming diversified in people and businesses. A second way that an ethnic enclave changes is when the ethnic group shrinks, but the shops and other businesses remain, resulting in the area becoming diversified in residents but not businesses. This latter situation may encourage commodification of the neighborhood’s ethnic identity, where a municipality or business association seeks to preserve an enclave’s ethnic reputation for tourism purposes. This commodification has implications for many individuals and groups within the enclave as well as outside of it. PMID:25431441

Energy Expenditure associated with the use of neighborhood parks in 2 cities

Treesearch

Luis J. Suau; Myron F. Floyd; John O. Spengler; Jay E. Maddock; Paul H. Gobster

2012-01-01

Context: Availability of public neighborhood parks is associated with physical activity. Little is known about how parks contribute to population energy balance. Purpose: This study estimated energy expenditure associated with the use of neighborhood parks and compared energy expenditure by activity areas within parks and by neighborhood race/ethnicity and income....

Proximity to Food Establishments and Body Mass Index in the Framingham Heart Study Offspring Cohort Over 30 Years

PubMed Central

Block, Jason P.; Christakis, Nicholas A.; O’Malley, A. James; Subramanian, S. V.

2011-01-01

Existing evidence linking residential proximity to food establishments with body mass index (BMI; weight (kg)/height (m)2) has been inconclusive. In this study, the authors assessed the relation between BMI and proximity to food establishments over a 30-year period among 3,113 subjects in the Framingham Heart Study Offspring Cohort living in 4 Massachusetts towns during 1971–2001. The authors used novel data that included repeated measures of BMI and accounted for residential mobility and the appearance and disappearance of food establishments. They calculated proximity to food establishments as the driving distance between each subject’s residence and nearby food establishments, divided into 6 categories. The authors used cross-classified linear mixed models to account for time-varying attributes of individuals and residential neighborhoods. Each 1-km increase in distance to the closest fast-food restaurant was associated with a 0.11-unit decrease in BMI (95% credible interval: −0.20, −0.04). In sex-stratified analyses, this association was present only for women. Other aspects of the food environment were either inconsistently associated or not at all associated with BMI. Contrary to much prior research, the authors did not find a consistent relation between access to fast-food restaurants and individual BMI, necessitating a reevaluation of policy discussions on the anticipated impact of the food environment on weight gain. PMID:21965186

Spatial Variability of Sources and Mixing State of Atmospheric Particles in a Metropolitan Area.

PubMed

Ye, Qing; Gu, Peishi; Li, Hugh Z; Robinson, Ellis S; Lipsky, Eric; Kaltsonoudis, Christos; Lee, Alex K Y; Apte, Joshua S; Robinson, Allen L; Sullivan, Ryan C; Presto, Albert A; Donahue, Neil M

2018-05-30

Characterizing intracity variations of atmospheric particulate matter has mostly relied on fixed-site monitoring and quantifying variability in terms of different bulk aerosol species. In this study, we performed ground-based mobile measurements using a single-particle mass spectrometer to study spatial patterns of source-specific particles and the evolution of particle mixing state in 21 areas in the metropolitan area of Pittsburgh, PA. We selected sampling areas based on traffic density and restaurant density with each area ranging from 0.2 to 2 km 2 . Organics dominate particle composition in all of the areas we sampled while the sources of organics differ. The contribution of particles from traffic and restaurant cooking varies greatly on the neighborhood scale. We also investigate how primary and aged components in particles mix across the urban scale. Lastly we quantify and map the particle mixing state for all areas we sampled and discuss the overall pattern of mixing state evolution and its implications. We find that in the upwind and downwind of the urban areas, particles are more internally mixed while in the city center, particle mixing state shows large spatial heterogeneity that is mostly driven by emissions. This study is to our knowledge, the first study to perform fine spatial scale mapping of particle mixing state using ground-based mobile measurement and single-particle mass spectrometry.

Access to food outlets and children's nutritional intake in urban China: a difference-in-difference analysis.

PubMed

Wang, Rui; Shi, Lu

2012-06-30

In recent years supermarkets and fast food restaurants have been replacing those "wet markets" of independent vendors as the major food sources in urban China. Yet how these food outlets relate to children's nutritional intake remains largely unexplored. Using a longitudinal survey of households and communities in China, this study examines the effect of the urban built food environment (density of wet markets, density of supermarkets, and density of fast food restaurants) on children's nutritional intake (daily caloric intake, daily carbohydrate intake, daily protein intake, and daily fat intake). Children aged 6-18 (n = 185) living in cities were followed from 2004 to 2006, and difference-in-difference models are used to address the potential issue of omitted variable bias. Results suggest that the density of wet markets, rather than that of supermarkets, positively predicts children's four dimensions of nutritional intake. In the caloric intake model and the fat intake model, the positive effect of neighborhood wet market density on children's nutritional intake is stronger with children from households of lower income. With their cheaper prices and/or fresher food supply, wet markets are likely to contribute a substantial amount of nutritional intake for children living nearby, especially those in households with lower socioeconomic status. For health officials and urban planners, this study signals a sign of warning as wet markets are disappearing from urban China's food environment.

Residential Neighborhood Amenities and Physical Activity Among U.S. Children with Special Health Care Needs.

PubMed

An, Ruopeng; Yang, Yan; Li, Kaigang

2017-05-01

Objectives Children with special health care needs (SHCN) have or are at elevated risk for chronic physical, developmental, behavioral or emotional conditions and therefore require specialized health care services. This study examines the relationship between residential neighborhood amenities and physical activity among U.S. children with SHCN. Methods A nationally representative sample of 113,767 children aged 6-17 years was taken from National Survey of Children's Health (NSCH) 2007-2008 and 2011-2012. Residential neighborhood amenities were defined by parent-reported presence or absence of sidewalks, parks/playgrounds, and recreation center. Physical activity was measured by parent-reported number of physically active days (0-7), defined as 20 min or longer during the past week. Negative binomial regressions were performed to estimate the associations between residential neighborhood amenities and physical activity among U.S. children with and without SHCN, adjusting for various neighborhood (detracting condition and safety) and individual characteristics and NSCH sampling design. Results Approximately 23% of young children aged 6-11 years and adolescents aged 12-17 years had SHCN. Number of weekly physically active days was both 4.8 among young children with and without SHCN, and 3.7 and 4.1 among adolescents with and without SHCN, respectively. Among young children with SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.23; whereas among young children without SHCN, number of weekly physically active days was not associated with the availability of any amenity. Among adolescents with SHCN, neighborhood availability of parks/playgrounds was associated with increased weekly physically active days by 0.33, whereas neighborhood availability of sidewalks was associated with reduced weekly physically active days by 0.21. Conversely, among adolescents without SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.22. Conclusions for Practice Vulnerable health status and high dependence on health care may prevent children with SHCN from being physically active. Provision of adequate amenities in residential neighborhoods could be essential in promoting physical activity and preventing obesity among children/adolescents with SHCN.

Managerial Practices regarding Workers Working while III†

PubMed Central

Norton, D. M.; Brown, L. G.; Frick, R.; Carpenter, L. R.; Green, A. L.; Tobin-D’Angelo, M.; Reimann, D. W.; Blade, H.; Nicholas, D. C.; Egan, J. S.; Everstine, K.

2017-01-01

Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention’s Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants’ policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or “stomach flu,” possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non–food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill. PMID:25581195

Store type and demographic influence on the availability and price of healthful foods, Leon County, Florida, 2008.

PubMed

Leone, Angela F; Rigby, Samantha; Betterley, Connie; Park, Sohyun; Kurtz, Hilda; Johnson, Mary Ann; Lee, Jung Sun

2011-11-01

The availability of healthful foods varies by neighborhood. We examined the availability and price of more healthful foods by store type, neighborhood income level, and racial composition in a community with high rates of diet-related illness and death. We used the modified Nutrition Environment Measures Survey in Stores to conduct this cross-sectional study in 2008. We surveyed 73 stores (29% supermarkets, 11% grocery stores, and 60% convenience stores) in Leon County, Florida. We analyzed the price and availability of foods defined by the 2005 Dietary Guidelines for Americans as "food groups to encourage." We used descriptive statistics, t tests, analysis of variance, and χ(2) tests in the analysis. Measures of availability for all more healthful foods differed by store type (P < .001). Overall, supermarkets provided the lowest price for most fresh fruits and vegetables, low-fat milk, and whole-wheat bread. Availability of 10 of the 20 fruits and vegetables surveyed, shelf space devoted to low-fat milk, and varieties of whole-wheat bread differed by neighborhood income level (P < .05), but no trends were seen for the availability or price of more healthful foods by neighborhood racial composition. Store type affects the availability and price of more healthful foods. In particular, people without access to supermarkets may have limited ability to purchase healthful foods. Nutrition environment studies such as this one can be used to encourage improvements in neighborhoods that lack adequate access to affordable, healthful food, such as advocating for large retail stores, farmer's markets, and community gardens in disadvantaged neighborhoods.

Do GIS-derived measures of fast food retailers convey perceived fast food opportunities? Implications for food environment assessment

PubMed Central

Barnes, Timothy L.; Colabianchi, Natalie; Freedman, Darcy A.; Bell, Bethany A.; Liese, Angela D.

2018-01-01

Purpose Geographic information systems (GISs) have been used to define fast food availability, with higher availability perhaps promoting poorer quality diets. Alternative measures involve perceptions; however, few studies have examined associations between GIS-derived and perceived measures of the food environment. Methods Telephone surveys of 705 participants within an eight-county region in South Carolina were analyzed using logistic regression to examine relationships between geographic presence of and distance to various types of food retailers and perceived fast food availability. Results The mean distance to the nearest fast food restaurant was 6.1 miles, with 16% of participants having a fast food restaurant within 1 mile of home. The geographic presence of and distance to all food retailer types were significantly associated with perceived availability of fast food in unadjusted models. After adjustment, only the presence of a fast food restaurant or pharmacy was significantly associated with greater odds of higher perceived availability of fast food. Greater odds of lower perceived availability of fast food were observed with the presence of a dollar store and increasing distance to the nearest supermarket or pharmacy. Conclusions Measures of fast food availability, whether objective or perceived, may not be interchangeable. Researchers should carefully decide on the appropriate measurement tool—GIS-derived or perceived—in food environment studies. PMID:27617371

Do GIS-derived measures of fast food retailers convey perceived fast food opportunities? Implications for food environment assessment.

PubMed

Barnes, Timothy L; Colabianchi, Natalie; Freedman, Darcy A; Bell, Bethany A; Liese, Angela D

2017-01-01

Geographic information systems (GISs) have been used to define fast food availability, with higher availability perhaps promoting poorer quality diets. Alternative measures involve perceptions; however, few studies have examined associations between GIS-derived and perceived measures of the food environment. Telephone surveys of 705 participants within an eight-county region in South Carolina were analyzed using logistic regression to examine relationships between geographic presence of and distance to various types of food retailers and perceived fast food availability. The mean distance to the nearest fast food restaurant was 6.1 miles, with 16% of participants having a fast food restaurant within 1 mile of home. The geographic presence of and distance to all food retailer types were significantly associated with perceived availability of fast food in unadjusted models. After adjustment, only the presence of a fast food restaurant or pharmacy was significantly associated with greater odds of higher perceived availability of fast food. Greater odds of lower perceived availability of fast food were observed with the presence of a dollar store and increasing distance to the nearest supermarket or pharmacy. Measures of fast food availability, whether objective or perceived, may not be interchangeable. Researchers should carefully decide on the appropriate measurement tool-GIS-derived or perceived-in food environment studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Does opening a supermarket in a food desert change the food environment?

PubMed

Ghosh-Dastidar, Madhumita; Hunter, Gerald; Collins, Rebecca L; Zenk, Shannon N; Cummins, Steven; Beckman, Robin; Nugroho, Alvin K; Sloan, Jennifer C; Wagner, La'Vette; Dubowitz, Tamara

2017-07-01

Improving access to healthy foods in low-income neighborhoods is a national priority. Our study evaluated the impact of opening a supermarket in a 'food desert' on healthy food access, availability and prices in the local food environment. We conducted 30 comprehensive in-store audits collecting information on healthy and unhealthy food availability, food prices and store environment, as well as 746 household surveys in two low-income neighborhoods before and after one of the two neighborhoods received a new supermarket. We found positive and negative changes in food availability, and an even greater influence on food prices in neighborhood stores. The supermarket opening in a 'food desert' caused little improvement in net availability of healthy foods, challenging the underpinnings of policies such as the Healthy Food Financing Initiative. Copyright © 2017 Elsevier Ltd. All rights reserved.

Healthier side dishes at restaurants: an analysis of children’s perspectives, menu content, and energy impacts

PubMed Central

2014-01-01

Background Children consume restaurant-prepared foods at high rates, suggesting that interventions and policies targeting consumption of these foods have the potential to improve diet quality and attenuate excess energy intake. One approach to encouraging healthier dietary intake in restaurants is to offer fruits and vegetables (FV) as side dishes, as opposed to traditional, energy-dense accompaniments like French fries. The aims of the current study were to examine: children's views about healthier side dishes at restaurants; current side dish offerings on children's menus at leading restaurants; and potential energy reductions when substituting FV side dishes in place of French fries. Methods To investigate children’s attitudes, a survey was administered to a nationally representative sample of U.S. 8- to 18-year-olds (n = 1178). To examine current side dish offerings, children's menus from leading quick service (QSR; n = 10) and full service restaurant chains (FSR; n = 10) were analyzed. Energy reductions that could result from substituting commonly-offered FV side dishes for French fries were estimated using nutrition information corresponding to the children's menu items. Results Two-thirds of children reported that they would not feel negatively about receiving FV sides instead of French fries with kids' meals. Liking/taste was the most common reason that children gave to explain their attitudes about FV side dishes. Nearly all restaurants offered at least 1 FV side dish option, but at most restaurants (60% of QSR; 70% of FSR), FV sides were never served by default. Substituting FV side dishes for French fries yielded an average estimated energy reduction of at least 170 calories. Conclusions Results highlight some healthy trends in the restaurant context, including the majority of children reporting non-negative attitudes about FV side dishes and the consistent availability of FV side dish options at leading QSR and FSR. Yet the minority of restaurants offer these FV sides by default. Promoting creative, appealing FV side dishes can result in healthier, less energy-dense meals for children. Substituting or displacing energy-dense default side dishes with such FV dishes show promise as part of continued, comprehensive efforts to increase the healthfulness of meals consumed by children in restaurant settings. PMID:24996545

Use of calorie information at fast food and chain restaurants among US youth aged 9-18 years, 2010.

PubMed

Wethington, H; Maynard, L M; Blanck, H M

2013-09-01

To examine whether youth use calorie information when it is available at fast food/chain restaurants and what factors are associated with using this information to make their food selection. A cross-sectional analysis was conducted on a sample of 721 youth (9-18 years) using the 2010 YouthStyles and HealthStyles surveys. The outcome measure was reported use of calorie information at fast food/chain restaurants. Multivariable logistic regression was used to examine the associations between sociodemographic variables and the use of calorie information at fast food/chain restaurants. Of those who visited fast food/chain restaurants, 42.4% reported using calorie information at least sometimes. Girls were more likely than boys (adjusted odds ratio (aOR) = 1.8, 95% confidence interval (CI) = 1.2-2.5) and youth who were obese were more likely than those at a healthy weight (aOR = 1.7, 95% CI = 1.04-2.9) to use calorie information, and youth eating at a fast food/chain restaurant twice a week or more versus once a week or less were half as likely to report using calorie information (aOR = 0.5, 95% CI = 0.4-0.8). Public health education efforts can benefit from research to determine how to increase usage among youth so that their food choices are appropriate for their caloric needs.

Neighborhood availability of convenience stores and diet quality: findings from 20 years of follow-up in the coronary artery risk development in young adults study.

PubMed

Rummo, Pasquale E; Meyer, Katie A; Boone-Heinonen, Janne; Jacobs, David R; Kiefe, Catarina I; Lewis, Cora E; Steffen, Lyn M; Gordon-Larsen, Penny

2015-05-01

We examined the association between neighborhood convenience stores and diet outcomes for 20 years of the Coronary Artery Risk Development in Young Adults study. We used dietary data from the Coronary Artery Risk Development in Young Adults study years 1985-1986, 1992-1993, and 2005-2006 (n = 3299; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically and temporally matched neighborhood-level food resource and US Census data. We used random effects repeated measures regression to estimate associations between availability of neighborhood convenience stores with diet outcomes and whether these associations differed by individual-level income. In multivariable-adjusted analyses, greater availability of neighborhood convenience stores was associated with lower diet quality (mean score = 66.3; SD = 13.0) for participants with lower individual-level income (b = -2.40; 95% CI = -3.30, -1.51); associations at higher individual-level income were weaker. We observed similar associations with whole grain consumption across time but no statistically significant associations with consumption of sugar-sweetened beverages, artificially sweetened beverages, snacks, processed meats, fruits, or vegetables. The presence of neighborhood convenience stores may be associated with lower quality diets. Low-income individuals may be most sensitive to convenience store availability.

Fast-food consumption and obesity among Michigan adults.

PubMed

Anderson, Beth; Rafferty, Ann P; Lyon-Callo, Sarah; Fussman, Christopher; Imes, Gwendoline

2011-07-01

Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence. We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adults, using univariate and bivariate analyses and multivariate logistic regression, and compared these data with data on Michigan obesity prevalence. Approximately 80% of Michigan adults went to fast-food restaurants at least once per month and 28% went regularly (≥2 times/wk). Regular fast-food consumption was higher among younger adults (mostly men) but was not significantly associated with household income, education, race, or urbanicity (in a multivariate framework). The prevalence of obesity increased consistently with frequenting fast-food restaurants, from 24% of those going less than once a week to 33% of those going 3 or more times per week. The predominant reason for choosing fast food was convenience. Although hypothetically 68% of adults who go to fast-food restaurants would choose healthier fast-food items when available, only 16% said they ever use nutritional information when ordering. The prevalence of fast-food consumption is high in Michigan across education, income, and racial groups and is strongly associated with obesity. Making nutritional information at fast-food restaurants more readily available and easier to use may help consumers to order more healthful or lower-calorie items.

Marketing Little Cigars and Cigarillos: Advertising, Price, and Associations With Neighborhood Demographics

PubMed Central

Kreslake, Jennifer M.; Ganz, Ollie; Pearson, Jennifer L.; Vallone, Donna; Anesetti-Rothermel, Andrew; Xiao, Haijun; Kirchner, Thomas R.

2013-01-01

Objectives. We have documented little cigar and cigarillo (LCC) availability, advertising, and price in the point-of-sale environment and examined associations with neighborhood demographics. Methods. We used a multimodal real-time surveillance system to survey LCCs in 750 licensed tobacco retail outlets that sold tobacco products in Washington, DC. Using multivariate models, we examined the odds of LCC availability, the number of storefront exterior advertisements, and the price per cigarillo for Black & Mild packs in relation to neighborhood demographics. Results. The odds of LCC availability and price per cigarillo decreased significantly in nearly a dose-response manner with each quartile increase in proportion of African Americans. Prices were also lower in some young adult neighborhoods. Having a higher proportion of African American and young adult residents was associated with more exterior LCC advertising. Conclusions. Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences. PMID:23948008

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011

PubMed Central

Lightstone, Amy S.; Basurto-Davila, Ricardo; Morales, Douglas M.; Sturm, Roland

2015-01-01

Introduction The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. Methods We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents’ residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m2) or obese (BMI ≥30.0 kg/m2). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Results Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Discussion Little evidence was found for associations between proximity of respondents’ homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation. PMID:26334715

Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data

PubMed Central

Lee, David C; Gallagher, Mary Pat; Gopalan, Anjali; Osorio, Marcela; Vinson, Andrew J; Wall, Stephen P; Ravenell, Joseph E; Sevick, Mary Ann; Elbel, Brian

2018-01-01

Abstract Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency claims data from 2009 to 2013, we identified unique New York City residents with diabetes and geocoded their location using home addresses. Geospatial analysis was performed to estimate diabetes prevalence by New York City Census tract. We also used multivariable regression to identify neighborhood-level factors associated with higher diabetes prevalence. We estimated type 1 and type 2 diabetes prevalence at 0.23% and 10.5%, respectively, among adults and 0.20% and 0.11%, respectively, among children in New York City. Pediatric type 1 diabetes was associated with higher income (P = 0.001), whereas adult type 2 diabetes was associated with lower income (P < 0.001). Areas with a higher proportion of nearby restaurants categorized as fast food had a higher prevalence of all types of diabetes (P < 0.001) except for pediatric type 2 diabetes. Type 2 diabetes among children was only higher in neighborhoods with higher proportions of African American residents (P < 0.001). Our findings identify geographic disparities in diabetes prevalence that may require special attention to address the specific needs of adults and children living in these areas. Our results suggest that the food environment may be associated with higher type 1 diabetes prevalence. However, our analysis did not find a robust association with the food environment and pediatric type 2 diabetes, which was predominantly focused in African American neighborhoods. PMID:29719877

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011.

PubMed

Mejia, Nelly; Lightstone, Amy S; Basurto-Davila, Ricardo; Morales, Douglas M; Sturm, Roland

2015-09-03

The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents' residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m(2)) or obese (BMI ≥30.0 kg/m(2)). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Little evidence was found for associations between proximity of respondents' homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation.

Food labeling; nutrition labeling of standard menu items in restaurants and similar retail food establishments. Final rule.

PubMed

2014-12-01

To implement the nutrition labeling provisions of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act or ACA), the Food and Drug Administration (FDA or we) is requiring disclosure of certain nutrition information for standard menu items in certain restaurants and retail food establishments. The ACA, in part, amended the Federal Food, Drug, and Cosmetic Act (the FD&C Act), among other things, to require restaurants and similar retail food establishments that are part of a chain with 20 or more locations doing business under the same name and offering for sale substantially the same menu items to provide calorie and other nutrition information for standard menu items, including food on display and self-service food. Under provisions of the ACA, restaurants and similar retail food establishments not otherwise covered by the law may elect to become subject to these Federal requirements by registering every other year with FDA. Providing accurate, clear, and consistent nutrition information, including the calorie content of foods, in restaurants and similar retail food establishments will make such nutrition information available to consumers in a direct and accessible manner to enable consumers to make informed and healthful dietary choices.

Racial/ethnic and income disparities in child and adolescent exposure to food and beverage television ads across the U.S. media markets.

PubMed

Powell, Lisa M; Wada, Roy; Kumanyika, Shiriki K

2014-09-01

Obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations. Targeted advertising may contribute to disparities. Designated market area (DMA) spot television ratings were used to assess geographic differences in child/adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics. Controlling for unobserved DMA-level factors and time trends, child/adolescent exposure to food-related ads, particularly for sugar-sweetened beverages and fast-food restaurants, was significantly higher in areas with higher proportions of black children/adolescents and lower-income households. Geographically targeted TV ads are important to consider when assessing obesity-promoting influences in black and low-income neighborhoods. Copyright © 2014 Elsevier Ltd. All rights reserved.

Distribution and Neighborhood Correlates of Sober Living House Locations in Los Angeles.

PubMed

Mericle, Amy A; Karriker-Jaffe, Katherine J; Gupta, Shalika; Sheridan, David M; Polcin, Doug L

2016-09-01

Sober living houses (SLHs) are alcohol and drug-free living environments for individuals in recovery. The goal of this study was to map the distribution of SLHs in Los Angeles (LA) County, California (N = 260) and examine neighborhood correlates of SLH density. Locations of SLHs were geocoded and linked to tract-level Census data as well as to publicly available information on alcohol outlets and recovery resources. Neighborhoods with SLHs differed from neighborhoods without them on measures of socioeconomic disadvantage and accessibility of recovery resources. In multivariate, spatially lagged hurdle models stratified by monthly fees charged (less than $1400/month vs. $1400/month or greater), minority composition, and accessibility of treatment were associated with the presence of affordable SLHs. Accessibility of treatment was also associated with the number of affordable SLHs in those neighborhoods. Higher median housing value and accessibility of treatment were associated with whether a neighborhood had high-cost SLHs, and lower population density was associated with the number of high-cost SLHs in those neighborhoods. Neighborhood factors are associated with the availability of SLHs, and research is needed to better understand how these factors affect resident outcomes, as well as how SLHs may affect neighborhoods over time. © Society for Community Research and Action 2016.

Sociodemographic disparities among fast-food restaurant customers who notice and use calorie menu labels.

PubMed

Green, Jessie E; Brown, Alan G; Ohri-Vachaspati, Punam

2015-07-01

As part of the recently passed Patient Protection and Affordable Care Act, chain restaurants with 20 or more locations nationwide will soon be required to post calorie information on menus with the aim of helping customers make healthier food choices. To be effective, this policy must affect all customers, especially those most at risk for poor health and diet outcomes. To determine whether noticing or using calorie menu labels was associated with demographic characteristics of customers at a national fast-food chain currently implementing calorie menu labeling. Cross-sectional analysis. Customer receipts and survey data were collected from 329 participants using street-intercept survey methodology at 29 McDonald's restaurant locations in low- and high-income neighborhoods throughout the Phoenix, AZ, metropolitan area. Calorie menu labeling awareness and use were assessed. The total number of calories purchased was evaluated using participants' itemized receipts. Multivariate logistic regression analyses were used to calculate the odds of customers noticing or using calorie menu labels. Approximately 60% of participants noticed calorie menu labels, whereas only 16% reported using the information for food or beverage purchases. Higher-income individuals had twice the odds of noticing calorie labels (P=0.029) and three times the odds of using them (P=0.004). Significant positive associations were found between individuals with a bachelor's degree or higher and use of calorie menu labels (odds ratio 3.25; P=0.023). Noticing calorie menu labels was not associated with purchasing fewer calories; however, those who reported using calorie information purchased 146 fewer calories than those who did not (P=0.001). Using calorie menu labels is associated with purchasing fewer calories. However, there are significant socioeconomic disparities among customers who notice and use calorie menu labels. Targeted education campaigns are needed to improve the use of menu labeling across all sociodemographic groups. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Environmental influences on childhood obesity: ethnic and cultural influences in context.

PubMed

Kumanyika, Shiriki K

2008-04-22

Ethnicity is associated with differences in food-related beliefs, preferences, and behaviors, and cultural influences may contribute to the higher than average risk of obesity among children and youth in U.S. ethnic minority populations. However, cultural attitudes and beliefs are not the only potential source of ethnic variation in childhood obesity prevalence and should not be studied in isolation. Demographic, socio-structural, and environmental variables must also be considered. Available evidence indicates ethnic differences along several pathways that may increase risks of obesity development during gestation, infancy, childhood and adolescence. These include above-average prevalence of obesity in adult females and of maternal diabetes during pregnancy, parental attitudes and practices that may lead to overfeeding children, above-average levels of consumption of certain high calorie foods and beverages, and inadequate physical activity. Environments with lower than average neighborhood availability of healthful foods and higher than average availability of fast food restaurants, along with exposure to ethnically targeted food marketing may contribute to reliance on high calorie foods and beverages, and these foods may be socially and culturally valued. Attitudes about and environmental contexts for physical activity are also relevant. Increasingly, it is acknowledged that individual behaviors and lifestyles, e.g. food choices or child feeding practices, are responsive to the ecological contexts in which they are practiced. Focusing attention on the fluid interactions of cultural influences with contextual factors, of recognized importance for the study of childhood undernutrition, can also lead to further understanding of how to address ethnic disparities in childhood obesity.

A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing

PubMed Central

Henriksen, Lisa; Rose, Shyanika W.; Moreland-Russell, Sarah; Ribisl, Kurt M.

2015-01-01

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues. PMID:26180986

A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing.

PubMed

Lee, Joseph G L; Henriksen, Lisa; Rose, Shyanika W; Moreland-Russell, Sarah; Ribisl, Kurt M

2015-09-01

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.

Targeting the taqueria: implementing healthy food options at Mexican American restaurants.

PubMed

Hanni, Krista D; Garcia, Elan; Ellemberg, Cheryl; Winkleby, Marilyn

2009-04-01

As part of a 5-year community-based intervention in Salinas, California, the Steps to a Healthier Salinas team developed a taqueria intervention addressing obesity and diabetes among Mexican Americans. The authors present: (a) a comparison of service/entrée options for Salinas taquerias (n = 35) and fast-food restaurants ( n = 38) at baseline, (b) a case study of one taqueria, (c) a description of a healthy nutrition tool kit tailored to taquerias, and (d) an evaluation of the intervention at Year 3. It was found that traditional Mexican American-style menu offerings at taquerias tended to be healthier than American-style fast-food restaurant offerings. In addition, the initial response to the intervention has shown positive changes, which include the taqueria owners promoting available healthy menu items and modifying other menu offerings to reduce fats and increase fruit and vegetable availability. This, in turn, has led to a transition of the owners' perceptions of themselves as gatekeepers for a healthy community.

Price, promotion, and availability of nutrition information: a descriptive study of a popular fast food chain in New York City.

PubMed

Basch, Corey Hannah; Ethan, Danna; Rajan, Sonali

2013-08-25

Legislation in NYC requires chain restaurants to post calorie information on menu boards in an effort to help consumers make more informed decisions about food and beverage items they are purchasing. While this is a step in the right direction in light of the current obesity epidemic, there are other issues that warrant attention in a fast food setting, namely the pricing of healthy food options, promotional strategies, and access to comprehensive nutrition information. This study focused on a popular fast-food chain in NYC. The study's aims were threefold: (1) to determine the cost differential between the healthiest meal item on the chain's general menu and meal items available specifically on a reduced cost menu for one dollar (US$1.00); (2) to identify and describe the promotions advertised in the windows of these restaurants, as well as the nutrition content of promoted items; and (3) to ascertain availability of comprehensive nutrition information to consumers within the restaurants. We found the healthiest meal item to be significantly higher in price than less nutritious meal items available for $1.00 (t=146.9, p<.001), with the mean cost differential equal to $4.33 (95% CI: $4.27, $4.39). Window promotions generally advertised less healthful menu items, which may aid in priming customers to purchase these versus more healthful options. Comprehensive nutrition information beyond calorie counts was not readily accessible prior to purchasing. In addition to improving access to comprehensive nutrition information, advertising more of and lowering the prices of nutritious options may encourage consumers to purchase healthier foods in a fast food setting. Additional research in this area is needed in other geographic locations and restaurant chains. 

Price, Promotion, and Availability of Nutrition Information: A Descriptive Study of a Popular Fast Food Chain in New York City

PubMed Central

Basch, Corey Hannah; Ethan, Danna; Rajan, Sonali

2013-01-01

Legislation in NYC requires chain restaurants to post calorie information on menu boards in an effort to help consumers make more informed decisions about food and beverage items they are purchasing. While this is a step in the right direction in light of the current obesity epidemic, there are other issues that warrant attention in a fast food setting, namely the pricing of healthy food options, promotional strategies, and access to comprehensive nutrition information. This study focused on a popular fast-food chain in NYC. The study’s aims were threefold: (1) to determine the cost differential between the healthiest meal item on the chain’s general menu and meal items available specifically on a reduced cost menu for one dollar (US$1.00); (2) to identify and describe the promotions advertised in the windows of these restaurants, as well as the nutrition content of promoted items; and (3) to ascertain availability of comprehensive nutrition information to consumers within the restaurants. We found the healthiest meal item to be significantly higher in price than less nutritious meal items available for $1.00 (t = 146.9, p < .001), with the mean cost differential equal to $4.33 (95% CI $4.27, $4.39). Window promotions generally advertised less healthful menu items, which may aid in priming customers to purchase these versus more healthful options. Comprehensive nutrition information beyond calorie counts was not readily accessible prior to purchasing. In addition to improving access to comprehensive nutrition information, advertising more of and lowering the prices of nutritious options may encourage consumers to purchase healthier foods in a fast food setting. Additional research in this area is needed in other geographic locations and restaurant chains. PMID:24171876

Neighborhood Resources to Support Healthy Diets and Physical Activity Among US Military Veterans

PubMed Central

Zenk, Shannon N.; Matthews, Stephen A.; Powell, Lisa M.; Jones, Kelly K.; Slater, Sandy; Wing, Coady

2017-01-01

Introduction Among the nearly 21 million military veterans living in the United States, 64.0% of women and 76.1% of men are overweight or obese, higher rates than in the civilian population (56.9% of women and 69.9% of men). Attributes of the residential environment are linked to obesity. The objective of this study was to characterize the residential environments of the US veteran population with respect to availability of food and recreational venues. Methods We used American Community Survey data to determine the concentration of veterans (the percentage of veterans among the adult population) in all continental US census tracts in 2013, and we used proprietary data to construct measures of availability of food and recreational venues per census tract. Using descriptive statistics and ordinary least-squares regression, we examined associations between the concentration of veterans per census tract and those residential environmental features. Results In census tracts with high concentrations of veterans, residents had, on average, 0.5 (interquartile range, 0–0.8) supermarkets within a 1-mile radius, while residents in census tracts with low concentrations of veterans had 3.2 (interquartile range, 0.6–3.7) supermarkets. Patterns were similar for grocery and convenience stores, fast food restaurants, parks, and commercial fitness facilities. In adjusted analyses controlling for census-tract–level covariates, veteran concentration remained strongly negatively associated with availability of those food and recreational venues. In nonmetropolitan tracts, adjusted associations were greatly attenuated and even positive. Conclusion Where veterans live is strongly associated with availability of food outlets providing healthy (and unhealthy) foods and with recreational venues, raising questions about the contributions of veterans’ residential environments to their high obesity rates. Additional research is needed to address those questions. PMID:29120701

Is density of neighbourhood restaurants associated with BMI in rural Chinese adults? A longitudinal study from the China Health and Nutrition Survey.

PubMed

Du, Wenwen; Su, Chang; Wang, Huijun; Wang, Zhihong; Wang, Youfa; Zhang, Bing

2014-04-22

The neighbourhood availability of restaurants has been linked to the weight status. However, little is known regarding the relation between access to restaurant and obesity among the Chinese population. This study aims to explore the relationship between neighbourhood restaurant density and body mass index (BMI) in rural China. A longitudinal study using data from the China Health and Nutrition Survey (CHNS) was conducted. Participants aged 18 and older from the 2004, 2006, 2009 and 2011 CHNS were recruited Separate sex-stratified random intercept-slope growth models of repeated BMI observations were estimated in the study. The data were derived from rural communities in nine provinces in China. There were 11 835 male and 12 561 female person-years assessed in this study. The primary outcome of this study was weight status. It is defined as a BMI value, a continuous variable which is calculated by dividing weight (kg) by the square of height (m(2)). The study indicated that among men an increase of one indoor restaurant in the neighbourhood was associated with a 0.01 kg/m(2) increase in BMI, and an increase of one fixed outdoor food stall was associated with a 0.01 kg/m(2) decrease in BMI, whereas among women, an increase of one indoor restaurant in the neighbourhood was associated with a 0.005 kg/m(2) increase in BMI, and an increase of one fast-food restaurant and one fixed outdoor food stall was associated with a 0.02 and 0.004 kg/m(2) decline in BMI, respectively. The density of neighbourhood restaurants was found to be significantly related to BMI in rural China. The results indicated that providing healthy food choices and developing related public health policies are necessary to tackle obesity among rural Chinese adults.

Is density of neighbourhood restaurants associated with BMI in rural Chinese adults? A longitudinal study from the China Health and Nutrition Survey

PubMed Central

Du, Wenwen; Su, Chang; Wang, Huijun; Wang, Zhihong; Wang, Youfa; Zhang, Bing

2014-01-01

Objectives The neighbourhood availability of restaurants has been linked to the weight status. However, little is known regarding the relation between access to restaurant and obesity among the Chinese population. This study aims to explore the relationship between neighbourhood restaurant density and body mass index (BMI) in rural China. Design A longitudinal study using data from the China Health and Nutrition Survey (CHNS) was conducted. Participants aged 18 and older from the 2004, 2006, 2009 and 2011 CHNS were recruited Separate sex-stratified random intercept-slope growth models of repeated BMI observations were estimated in the study. Setting The data were derived from rural communities in nine provinces in China. Participants There were 11 835 male and 12 561 female person-years assessed in this study. Outcomes The primary outcome of this study was weight status. It is defined as a BMI value, a continuous variable which is calculated by dividing weight (kg) by the square of height (m2). Results The study indicated that among men an increase of one indoor restaurant in the neighbourhood was associated with a 0.01 kg/m2 increase in BMI, and an increase of one fixed outdoor food stall was associated with a 0.01 kg/m2 decrease in BMI, whereas among women, an increase of one indoor restaurant in the neighbourhood was associated with a 0.005 kg/m2 increase in BMI, and an increase of one fast-food restaurant and one fixed outdoor food stall was associated with a 0.02 and 0.004 kg/m2 decline in BMI, respectively. Conclusions The density of neighbourhood restaurants was found to be significantly related to BMI in rural China. The results indicated that providing healthy food choices and developing related public health policies are necessary to tackle obesity among rural Chinese adults. PMID:24755211

Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature

PubMed Central

Harnack, Lisa J; French, Simone A

2008-01-01

Background Eating away from home has increased in prevalence among US adults and now comprises about 50% of food expenditures. Calorie labeling on chain restaurant menus is one specific policy that has been proposed to help consumers make better food choices at restaurants. The present review evaluates the available empirical literature on the effects of calorie information on food choices in restaurant and cafeteria settings. Methods Computer-assisted searches were conducted using the PUBMED database and the Google Scholar world wide web search engine to identify studies published in peer-review journals that evaluated calorie labeling of cafeteria or restaurant menu items. Studies that evaluated labeling only some menu items (e.g. low calorie foods only) were excluded from the review since the influence of selective labeling may be different from that which may be expected from comprehensive labeling. Results Six studies were identified that met the selection criteria for this review. Results from five of these studies provide some evidence consistent with the hypothesis that calorie information may influence food choices in a cafeteria or restaurant setting. However, results from most of these studies suggest the effect may be weak or inconsistent. One study found no evidence of an effect of calorie labeling on food choices. Each of the studies had at least one major methodological shortcoming, pointing toward the need for better designed studies to more rigorously evaluate the influence of point-of-purchase calorie labeling on food choices. Conclusion More research is needed that meets minimum standards of methodological quality. Studies need to include behavioral outcomes such as food purchase and eating behaviors. Also, studies need to be implemented in realistic settings such as restaurants and cafeterias. PMID:18950529

Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults

PubMed Central

Xu, Hongwei; Short, Susan E; Liu, Tao

2013-01-01

Background Mixed findings have been reported on the association between Western fast-food restaurants and body weight status. Results vary across study contexts and are sensitive to the samples, measures and methods used. Most studies have failed to examine the temporally dynamic associations between community exposure to fast-food restaurants and weight changes. Methods Bayesian hierarchical regressions are used to model changes in body mass index, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR) as a function of changes in Western fast-food restaurants in 216 communities for more than 9000 Chinese adults followed up multiple times between 2000 and 2009. Results Number of Western fast-food restaurants is positively associated with subsequent increases in WHtR and WHpR among rural population. More fast-food restaurants are positively associated with a future increase in WHpR for urban women. Increased availability of fast food between two waves is related to increased WHtR for urban men over the same period. A past increase in number of fast-food restaurants is associated with subsequent increases in WHtR and WHpR for rural population. Conclusions The associations between community exposure to Western fast food and weight changes are temporally dynamic rather than static. Improved measures of exposure to community environment are needed to achieve more precise estimates and better understanding of these relationships. In light of the findings in this study and China’s rapid economic growth, further investigation and increased public health monitoring is warranted since Western fast food is likely to be more accessible and affordable in the near future. PMID:22923769

Ready for policy? Stakeholder attitudes toward menu labelling in Toronto, Canada.

PubMed

Mah, Catherine L; Vanderlinden, Loren; Mamatis, Dia; Ansara, Donna L; Levy, Jennifer; Swimmer, Lisa

2013-04-18

The purpose of this research was to assess key stakeholder attitudes regarding menu labelling in Toronto, the largest municipality in Canada. Menu labelling is a population health intervention where food-labelling principles are applied to the eating-out environment through disclosure of nutrient content of food items on restaurant menus at the point of sale. Menu-labelling legislation has been implemented in the United States, but has yet to be adopted in Canada. As provincial voluntary programs and federal analyses progress, municipal jurisdictions will need to assess the feasibility of moving forward with parallel interventions. Data were collected and analyzed in late 2011 to early 2012, including: a consumer eating-out module incorporated into a public health surveillance telephone survey (n=1,699); an online survey of independent restaurant operators (n=256); in-depth key informant interviews with executives and decision makers at chain restaurants (n=9); and a policy consultation with local restaurant associations. Toronto residents, particularly men, younger adults, and those with higher income or education, frequently eat out. A majority indicated that nutrition information is important to them; 69% note that they currently use it and 78% reported they would use it if it were readily available. Resistance to menu-labelling requirements at the municipal level was articulated by franchise/chain restaurant executives and industry associations. Despite overall low interest among independent restaurant operators, 57% reported feeling some responsibility to provide nutrition information and 50% believed it could be good for business. This research supports earlier literature that indicates strong public support for menu labelling alongside perceived barriers among the restaurant and foodservices sector. Leverage points for effective operator engagement for menu-labelling adoption were identified, nonetheless, highlighting the need for public health support.

Exploratory Analysis of Fast-Food Chain Restaurant Menus Before and After Implementation of Local Calorie-Labeling Policies, 2005–2011

PubMed Central

Namba, Alexa; Leonberg, Beth L.; Wootan, Margo G.

2013-01-01

Introduction Since 2008, several states and municipalities have implemented regulations requiring provision of nutrition information at chain restaurants to address obesity. Although early research into the effect of such labels on consumer decisions has shown mixed results, little information exists on the restaurant industry’s response to labeling. The objective of this exploratory study was to evaluate the effect of menu labeling on fast-food menu offerings over 7 years, from 2005 through 2011. Methods Menus from 5 fast-food chains that had outlets in jurisdictions subject to menu-labeling laws (cases) were compared with menus from 4 fast-food chains operating in jurisdictions not requiring labeling (controls). A trend analysis assessed whether case restaurants improved the healthfulness of their menus relative to the control restaurants. Results Although the overall prevalence of “healthier” food options remained low, a noteworthy increase was seen after 2008 in locations with menu-labeling laws relative to those without such laws. Healthier food options increased from 13% to 20% at case locations while remaining static at 8% at control locations (test for difference in the trend, P = .02). Since 2005, the average calories for an à la carte entrée remained moderately high (approximately 450 kilocalories), with less than 25% of all entrées and sides qualifying as healthier and no clear systematic differences in the trend between chain restaurants in case versus control areas (P ≥ .50). Conclusion These findings suggest that menu labeling has thus far not affected the average nutritional content of fast-food menu items, but it may motivate restaurants to increase the availability of healthier options. PMID:23786908

Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: a review of the literature.

PubMed

Harnack, Lisa J; French, Simone A

2008-10-26

Eating away from home has increased in prevalence among US adults and now comprises about 50% of food expenditures. Calorie labeling on chain restaurant menus is one specific policy that has been proposed to help consumers make better food choices at restaurants. The present review evaluates the available empirical literature on the effects of calorie information on food choices in restaurant and cafeteria settings. Computer-assisted searches were conducted using the PUBMED database and the Google Scholar world wide web search engine to identify studies published in peer-review journals that evaluated calorie labeling of cafeteria or restaurant menu items. Studies that evaluated labeling only some menu items (e.g. low calorie foods only) were excluded from the review since the influence of selective labeling may be different from that which may be expected from comprehensive labeling. Six studies were identified that met the selection criteria for this review. Results from five of these studies provide some evidence consistent with the hypothesis that calorie information may influence food choices in a cafeteria or restaurant setting. However, results from most of these studies suggest the effect may be weak or inconsistent. One study found no evidence of an effect of calorie labeling on food choices. Each of the studies had at least one major methodological shortcoming, pointing toward the need for better designed studies to more rigorously evaluate the influence of point-of-purchase calorie labeling on food choices. More research is needed that meets minimum standards of methodological quality. Studies need to include behavioral outcomes such as food purchase and eating behaviors. Also, studies need to be implemented in realistic settings such as restaurants and cafeterias.

Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults.

PubMed

Xu, Hongwei; Short, Susan E; Liu, Tao

2013-03-01

Mixed findings have been reported on the association between Western fast-food restaurants and body weight status. Results vary across study contexts and are sensitive to the samples, measures and methods used. Most studies have failed to examine the temporally dynamic associations between community exposure to fast-food restaurants and weight changes. Bayesian hierarchical regressions are used to model changes in body mass index, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR) as a function of changes in Western fast-food restaurants in 216 communities for more than 9000 Chinese adults followed up multiple times between 2000 and 2009. Number of Western fast-food restaurants is positively associated with subsequent increases in WHtR and WHpR among rural population. More fast-food restaurants are positively associated with a future increase in WHpR for urban women. Increased availability of fast food between two waves is related to increased WHtR for urban men over the same period. A past increase in number of fast-food restaurants is associated with subsequent increases in WHtR and WHpR for rural population. The associations between community exposure to Western fast food and weight changes are temporally dynamic rather than static. Improved measures of exposure to community environment are needed to achieve more precise estimates and better understanding of these relationships. In light of the findings in this study and China's rapid economic growth, further investigation and increased public health monitoring is warranted since Western fast food is likely to be more accessible and affordable in the near future.

Exploratory analysis of fast-food chain restaurant menus before and after implementation of local calorie-labeling policies, 2005-2011.

PubMed

Namba, Alexa; Auchincloss, Amy; Leonberg, Beth L; Wootan, Margo G

2013-06-20

Since 2008, several states and municipalities have implemented regulations requiring provision of nutrition information at chain restaurants to address obesity. Although early research into the effect of such labels on consumer decisions has shown mixed results, little information exists on the restaurant industry's response to labeling. The objective of this exploratory study was to evaluate the effect of menu labeling on fast-food menu offerings over 7 years, from 2005 through 2011. Menus from 5 fast-food chains that had outlets in jurisdictions subject to menu-labeling laws (cases) were compared with menus from 4 fast-food chains operating in jurisdictions not requiring labeling (controls). A trend analysis assessed whether case restaurants improved the healthfulness of their menus relative to the control restaurants. Although the overall prevalence of "healthier" food options remained low, a noteworthy increase was seen after 2008 in locations with menu-labeling laws relative to those without such laws. Healthier food options increased from 13% to 20% at case locations while remaining static at 8% at control locations (test for difference in the trend, P = .02). Since 2005, the average calories for an à la carte entrée remained moderately high (approximately 450 kilocalories), with less than 25% of all entrées and sides qualifying as healthier and no clear systematic differences in the trend between chain restaurants in case versus control areas (P ≥ .50). These findings suggest that menu labeling has thus far not affected the average nutritional content of fast-food menu items, but it may motivate restaurants to increase the availability of healthier options.

Neighborhood Availability of Convenience Stores and Diet Quality: Findings From 20 Years of Follow-Up in the Coronary Artery Risk Development in Young Adults Study

PubMed Central

Rummo, Pasquale E.; Meyer, Katie A.; Boone-Heinonen, Janne; Jacobs, David R.; Kiefe, Catarina I.; Lewis, Cora E.; Steffen, Lyn M.

2015-01-01

Objectives. We examined the association between neighborhood convenience stores and diet outcomes for 20 years of the Coronary Artery Risk Development in Young Adults study. Methods. We used dietary data from the Coronary Artery Risk Development in Young Adults study years 1985–1986, 1992–1993, and 2005–2006 (n = 3299; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically and temporally matched neighborhood-level food resource and US Census data. We used random effects repeated measures regression to estimate associations between availability of neighborhood convenience stores with diet outcomes and whether these associations differed by individual-level income. Results. In multivariable-adjusted analyses, greater availability of neighborhood convenience stores was associated with lower diet quality (mean score = 66.3; SD = 13.0) for participants with lower individual-level income (b = −2.40; 95% CI = −3.30, −1.51); associations at higher individual-level income were weaker. We observed similar associations with whole grain consumption across time but no statistically significant associations with consumption of sugar-sweetened beverages, artificially sweetened beverages, snacks, processed meats, fruits, or vegetables. Conclusions. The presence of neighborhood convenience stores may be associated with lower quality diets. Low-income individuals may be most sensitive to convenience store availability. PMID:25790410

75 FR 53324 - Notice of Availability: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2010...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5415-N-25] Notice of Availability... either a Choice Neighborhood Planning Grant or a Choice Neighborhood Implementation Grant application. Upon conclusion of its review of Planning Grant applications submitted in response to the Round 1 NOFA...

Disparities in Access to Over-the-Counter Nicotine Replacement Products in New York City Pharmacies

PubMed Central

Cabral, Lisa; Maantay, Juliana; Peprah, Dorothy; Lounsbury, David; Maroko, Andrew; Murphy, Mary; Shelley, Donna

2009-01-01

Objectives. We surveyed the availability of tobacco products and nonprescription nicotine replacement therapy (NRT) in pharmacies in New York City, stratified by the race, ethnicity, and socioeconomic status (SES) of the surrounding neighborhoods to determine whether disparities in availability existed. Methods. Surveyors visited a random sample of retail pharmacies to record the availability of tobacco products and nonprescription NRT. We used census data and geographic information systems analysis to determine the SES of each neighborhood. We used logistic modeling to explore relations between SES and the availability of NRT and tobacco products. Results. Of 646 pharmacies sampled, 90.8% sold NRT and 46.9% sold cigarettes. NRT and cigarettes were slightly more available in pharmacies in neighborhoods with a higher SES. NRT was more expensive in poorer neighborhoods. Conclusions. Small disparities existed in access to nonprescription NRT and cigarettes. The model did not adequately account for cigarette access, because of availability from other retail outlets. These results may explain some of the excess prevalence of cigarette use in low-SES areas. PMID:19638596

Community-based restaurant interventions to promote healthy eating: a systematic review.

PubMed

Valdivia Espino, Jennifer N; Guerrero, Natalie; Rhoads, Natalie; Simon, Norma-Jean; Escaron, Anne L; Meinen, Amy; Nieto, F Javier; Martinez-Donate, Ana P

2015-05-21

Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions. We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category. This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes. Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes.

Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review

PubMed Central

Valdivia Espino, Jennifer N.; Guerrero, Natalie; Rhoads, Natalie; Simon, Norma-Jean; Escaron, Anne L.; Meinen, Amy; Nieto, F. Javier

2015-01-01

Introduction Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions. Methods We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category. Results This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes. Conclusion Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes. PMID:25996986

Quality over Quantity: Contribution of Urban Green Space to Neighborhood Satisfaction

PubMed Central

Zhang, Yang; Van den Berg, Agnes E.; Van Dijk, Terry; Weitkamp, Gerd

2017-01-01

There is increasing evidence that the quality of green space significantly contributes to neighborhood satisfaction and well-being, independent of the mere amount of green space. In this paper, we examined residents’ perceptions of the quality and beneficial affordances of green space in relation to objectively assessed accessibility and usability. We used data from a survey in two neighborhoods (N = 223) of a medium-sized city in the Netherlands, which were similar in the amount of green space and other physical and socio-demographic characteristics, but differed in the availability of accessible and usable green spaces. Results show that residents of the neighborhood with a higher availability of accessible and usable green spaces were more satisfied with their neighborhood. This difference was statistically mediated by the higher level of perceived green space quality. Neighborhood satisfaction was significantly positively related to well-being. However, residents of the two neighborhoods did not differ in self-reported well-being and beneficial affordances of green space. These analyses contribute to a further understanding of how the accessibility and usability of green spaces may increase people’s neighborhood satisfaction. It highlights the importance of perceived quality in addition to the amount of green space when examining the beneficial effects of green space. PMID:28509879

Quality over Quantity: Contribution of Urban Green Space to Neighborhood Satisfaction.

PubMed

Zhang, Yang; Van den Berg, Agnes E; Van Dijk, Terry; Weitkamp, Gerd

2017-05-16

There is increasing evidence that the quality of green space significantly contributes to neighborhood satisfaction and well-being, independent of the mere amount of green space. In this paper, we examined residents' perceptions of the quality and beneficial affordances of green space in relation to objectively assessed accessibility and usability. We used data from a survey in two neighborhoods ( N = 223) of a medium-sized city in the Netherlands, which were similar in the amount of green space and other physical and socio-demographic characteristics, but differed in the availability of accessible and usable green spaces. Results show that residents of the neighborhood with a higher availability of accessible and usable green spaces were more satisfied with their neighborhood. This difference was statistically mediated by the higher level of perceived green space quality. Neighborhood satisfaction was significantly positively related to well-being. However, residents of the two neighborhoods did not differ in self-reported well-being and beneficial affordances of green space. These analyses contribute to a further understanding of how the accessibility and usability of green spaces may increase people's neighborhood satisfaction. It highlights the importance of perceived quality in addition to the amount of green space when examining the beneficial effects of green space.

Modelling impulsive factors for electronics and restaurant coupons’ e-store display

NASA Astrophysics Data System (ADS)

Ariningsih, P. K.; Nainggolan, M.; Sandy, I. A.

2018-04-01

In many times, the increment of e-store visitors does not followed by sales increment. Most purchases through e-commerce are impulsive buying, however only small amount of study is available to understand impulsive factors of e-store display. This paper suggests a preliminary concept on understanding the impulsive factors in Electronics and Restaurant Coupons e-store display, which are two among few popular group products sold through e-commerce. By conducting literature study and survey, 31 attributes were identified as impulsive factors in electronics e-store display and 20 attributes were identified as impulsive factors for restaurant coupon e-store. The attributes were then grouped into comprehensive impulsive factors by factor analysis. Each group of impulsive attributes were generated into 3 factors. Accessibility Factors and Trust Factors appeared for each group products. The other factors are Internal Factors for electronics e-store and Marketing factors for restaurant coupons e-store. Structural Equation Model of the impulsive factors was developed for each type of e-store, which stated the covariance between Trust Factors and Accessibility Factors. Based on preliminary model, Internal Factor and Trust Factor are influencing impulsive buying in electronics store. Special factor for electronics e-store is Internal Factor, while for restaurant coupons e-store is Marketing Factor.

Density and Proximity of Fast Food Restaurants and Body Mass Index Among African Americans

PubMed Central

Regan, Seann D.; Nguyen, Nga; Cromley, Ellen K.; Strong, Larkin L.; Wetter, David W.; McNeill, Lorna H.

2014-01-01

Objectives. The purpose of this study was to address current gaps in the literature by examining the associations of fast food restaurant (FFR) density around the home and FFR proximity to the home, respectively, with body mass index (BMI) among a large sample of African American adults from Houston, Texas. Methods. We used generalized linear models with generalized estimating equations to examine associations of FFR density at 0.5-, 1-, 2-, and 5-mile road network buffers around the home with BMI and associations of the closest FFR to the home with BMI. All models were adjusted for a range of individual-level covariates and neighborhood socioeconomic status. We additionally investigated the moderating effects of household income on these relations. Data were collected from December 2008 to July 2009. Results. FFR density was not associated with BMI in the main analyses. However, FFR density at 0.5, 1, and 2 miles was positively associated with BMI among participants with lower incomes (P ≤ .025). Closer FFR proximity was associated with higher BMI among all participants (P < .001), with stronger associations emerging among those of lower income (P < .013) relative to higher income (P < .014). Conclusions. Additional research with more diverse African American samples is needed, but results supported the potential for the fast food environment to affect BMI among African Americans, particularly among those of lower economic means. PMID:23678913

Is fast food addictive?

PubMed

Garber, Andrea K; Lustig, Robert H

2011-09-01

Studies of food addiction have focused on highly palatable foods. While fast food falls squarely into that category, it has several other attributes that may increase its salience. This review examines whether the nutrients present in fast food, the characteristics of fast food consumers or the presentation and packaging of fast food may encourage substance dependence, as defined by the American Psychiatric Association. The majority of fast food meals are accompanied by a soda, which increases the sugar content 10-fold. Sugar addiction, including tolerance and withdrawal, has been demonstrated in rodents but not humans. Caffeine is a "model" substance of dependence; coffee drinks are driving the recent increase in fast food sales. Limited evidence suggests that the high fat and salt content of fast food may increase addictive potential. Fast food restaurants cluster in poorer neighborhoods and obese adults eat more fast food than those who are normal weight. Obesity is characterized by resistance to insulin, leptin and other hormonal signals that would normally control appetite and limit reward. Neuroimaging studies in obese subjects provide evidence of altered reward and tolerance. Once obese, many individuals meet criteria for psychological dependence. Stress and dieting may sensitize an individual to reward. Finally, fast food advertisements, restaurants and menus all provide environmental cues that may trigger addictive overeating. While the concept of fast food addiction remains to be proven, these findings support the role of fast food as a potentially addictive substance that is most likely to create dependence in vulnerable populations.

Adolescents' Exposure to Community Violence: Are Neighborhood Youth Organizations Protective?

ERIC Educational Resources Information Center

Gardner, Margo; Brooks-Gunn, Jeanne

2009-01-01

Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), we identified a significant inverse association between the variety of youth organizations available at the neighborhood level and adolescents' exposure to community violence. We examined two non-competing explanations for this finding. First, at the individual…

Neighborhood fast food availability and fast food consumption.

PubMed

Oexle, Nathalie; Barnes, Timothy L; Blake, Christine E; Bell, Bethany A; Liese, Angela D

2015-09-01

Recent nutritional and public health research has focused on how the availability of various types of food in a person's immediate area or neighborhood influences his or her food choices and eating habits. It has been theorized that people living in areas with a wealth of unhealthy fast-food options may show higher levels of fast-food consumption, a factor that often coincides with being overweight or obese. However, measuring food availability in a particular area is difficult to achieve consistently: there may be differences in the strict physical locations of food options as compared to how individuals perceive their personal food availability, and various studies may use either one or both of these measures. The aim of this study was to evaluate the association between weekly fast-food consumption and both a person's perceived availability of fast-food and an objective measure of fast-food presence - Geographic Information Systems (GIS) - within that person's neighborhood. A randomly selected population-based sample of eight counties in South Carolina was used to conduct a cross-sectional telephone survey assessing self-report fast-food consumption and perceived availability of fast food. GIS was used to determine the actual number of fast-food outlets within each participant's neighborhood. Using multinomial logistic regression analyses, we found that neither perceived availability nor GIS-based presence of fast-food was significantly associated with weekly fast-food consumption. Our findings indicate that availability might not be the dominant factor influencing fast-food consumption. We recommend using subjective availability measures and considering individual characteristics that could influence both perceived availability of fast food and its impact on fast-food consumption. If replicated, our findings suggest that interventions aimed at reducing fast-food consumption by limiting neighborhood fast-food availability might not be completely effective. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neighborhood deprivation, supermarket availability, and BMI in low-income women: a multilevel analysis.

PubMed

Ford, Paula B; Dzewaltowski, David A

2011-10-01

High levels of neighborhood deprivation and lack of access to supermarkets have been associated with increased risk of obesity in women. This multilevel study used a statewide dataset (n = 21,166) of low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children to determine whether the association between neighborhood deprivation and BMI is mediated by the availability of retail food stores, and whether this relationship varied across the urban rural continuum. Residence in a high deprivation neighborhood was associated with a 0.94 unit increase in BMI among women in metropolitan areas. The relationship between tract deprivation and BMI was not linear among women in micropolitan areas, and no association was observed in rural areas. The presence of supermarkets or other retail food stores did not mediate the association between deprivation and BMI among women residing in any of the study areas. These results suggest that level of urbanity influences the effect of neighborhood condition on BMI among low-income women, and that the availability of supermarkets and other food stores does not directly influence BMI among low-income populations.

Hard Internet Truths: 34,748 Online Reviews Reveal What Patients Really Want from Doctors.

PubMed

King, Ron Harman; Stanley, Jonathan; Baum, Neil

2016-01-01

For all of us living in the Internet age, it's hard to underestimate the power of online reviews. Before booking a reservation at a new hotel or restaurant, who doesn't consult websites such as TripAdvisor and Open Table? Who would gamble $100 on a dinner out or $200 on a hotel stay before first seeing what other diners and patrons had to say about their experiences? Patients who are looking for a healthcare provider are no different than those customers looking for a restaurant or a hotel; they want opinions from others who have previously availed themselves of that restaurant or hotel. This article addresses the importance of online reputation management and offers ideas and suggestions for healthcare providers to control and protect their online reputations.

The effect of a smoke-free law on restaurant business in South Australia.

PubMed

Wakefield, Melanie; Siahpush, Mohammad; Scollo, Michelle; Lal, Anita; Hyland, Andrew; McCaul, Kieran; Miller, Caroline

2002-08-01

Despite evidence to the contrary from overseas research, the introduction of smoke-free legislation in South Australia (SA), which required all restaurants to go smoke-free in January 1999, sparked concerns among the hospitality industry about loss of restaurant business. This study aimed to determine whether the law had a detrimental impact on restaurant business in SA. Using time series analysis, we compared the ratio of monthly restaurant turnover from restaurants and cafés in SA to (a) total retail tumover in SA (minus restaurants) for the years 1991 to 2001 and (b) Australian restaurant tumover (minus SA, Westem Australia and the Australian Capital Territory) for the years 1991-2000. There was no decline in the ratio of (a) SA restaurant turnover to SA retail turnover or (b) SA restaurant tumover to Australian restaurant turnover. The introduction of a smoke-free law applying to restaurants in SA did not adversely affect restaurant business in SA.

Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods

PubMed Central

Zhang, Yang; van Dijk, Terry; Tang, Jianjun; van den Berg, Agnes E.

2015-01-01

The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces. PMID:26569280

Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods.

PubMed

Zhang, Yang; van Dijk, Terry; Tang, Jianjun; van den Berg, Agnes E

2015-11-12

The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents' emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces.

Neighborhood characteristics contribute to urban alcohol availability: Accounting for race/ethnicity and social disorganization.

PubMed

Snowden, Aleksandra J

2016-01-01

This study examined the role that race/ethnicity and social disorganization play in alcohol availability in Milwaukee, Wisconsin, census block groups. This study estimated negative binomial regression models to examine separately the relationship between neighborhood racial/ethnic composition and social disorganization levels for (1) total, (2) on-premise, and (3) off-premise alcohol outlets. Results of this study suggest that proportion Hispanic was positively associated with total and with off-premise alcohol outlets. Second, proportion African American was negatively associated with on-premise alcohol outlets and positively associated with off-premise alcohol outlets. Proportion Asian was not associated with total, on-premise, or off-premise alcohol outlets. However, the effects of race/ethnicity on alcohol availability were either unrelated or negatively related to alcohol outlet availability once neighborhood social disorganization levels were taken into account, and social disorganization was positively and significantly associated with all alcohol outlet types. Neighborhood characteristics contribute to alcohol availability and must be considered in any efforts aimed toward prevention of alcohol-related negative health and social outcomes.

ADOLESCENTS’ EXPOSURE TO COMMUNITY VIOLENCE: ARE NEIGHBORHOOD YOUTH ORGANIZATIONS PROTECTIVE?

PubMed Central

Gardner, Margo; Brooks-Gunn, Jeanne

2011-01-01

Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), we identified a significant inverse association between the variety of youth organizations available at the neighborhood level and adolescents’ exposure to community violence. We examined two non-competing explanations for this finding. First, at the individual level, we tested the hypothesis that access to a greater variety of neighborhood youth organizations predicts adolescents’ participation in organized community-based activities, which, in turn, protects against community violence exposure. Second, at the neighborhood level, we tested the hypothesis that lower violent crime rates explain the inverse relation between neighborhood youth organization variety and community violence exposure. Our findings supported the latter of these two mechanisms. PMID:21666761

ADOLESCENTS' EXPOSURE TO COMMUNITY VIOLENCE: ARE NEIGHBORHOOD YOUTH ORGANIZATIONS PROTECTIVE?

PubMed

Gardner, Margo; Brooks-Gunn, Jeanne

2009-05-01

Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), we identified a significant inverse association between the variety of youth organizations available at the neighborhood level and adolescents' exposure to community violence. We examined two non-competing explanations for this finding. First, at the individual level, we tested the hypothesis that access to a greater variety of neighborhood youth organizations predicts adolescents' participation in organized community-based activities, which, in turn, protects against community violence exposure. Second, at the neighborhood level, we tested the hypothesis that lower violent crime rates explain the inverse relation between neighborhood youth organization variety and community violence exposure. Our findings supported the latter of these two mechanisms.

IMET Feasibility Study and Implementation: Maximizing the Graduate School of Business and Public Policy Experience for International Students at the Naval Postgraduate School

DTIC Science & Technology

2006-06-01

commented: Most of materials will be available for only one country. Singaporeans do not understand German, I do not read French etc. Information...informed about restaurants and supermarkets offering international cuisine or even cuisine from their country in the Monterey area. The majority of the...restaurants and supermarkets offering international cuisine , or even cuisine from their country, in the Monterey area through the welcome package

Incorporating Neighborhood Choice in a Model of Neighborhood Effects on Income.

PubMed

van Ham, Maarten; Boschman, Sanne; Vogel, Matt

2018-05-09

Studies of neighborhood effects often attempt to identify causal effects of neighborhood characteristics on individual outcomes, such as income, education, employment, and health. However, selection looms large in this line of research, and it has been argued that estimates of neighborhood effects are biased because people nonrandomly select into neighborhoods based on their preferences, income, and the availability of alternative housing. We propose a two-step framework to disentangle selection processes in the relationship between neighborhood deprivation and earnings. We model neighborhood selection using a conditional logit model, from which we derive correction terms. Driven by the recognition that most households prefer certain types of neighborhoods rather than specific areas, we employ a principle components analysis to reduce these terms into eight correction components. We use these to adjust parameter estimates from a model of subsequent neighborhood effects on individual income for the unequal probability that a household chooses to live in a particular type of neighborhood. We apply this technique to administrative data from the Netherlands. After we adjust for the differential sorting of households into certain types of neighborhoods, the effect of neighborhood income on individual income diminishes but remains significant. These results further emphasize that researchers need to be attuned to the role of selection bias when assessing the role of neighborhood effects on individual outcomes. Perhaps more importantly, the persistent effect of neighborhood deprivation on subsequent earnings suggests that neighborhood effects reflect more than the shared characteristics of neighborhood residents: place of residence partially determines economic well-being.

An Examination of the Association of African American Mothers' Perceptions of Their Neighborhoods with Their Parenting and Adolescent Adjustment.

ERIC Educational Resources Information Center

Taylor, Ronald D.

2000-01-01

Investigated links between African American mothers' perceptions of their urban neighborhoods and adjustment of their adolescents. Interview data indicated that important features of neighborhoods (crime, physical deterioration, and resource availability) measured through mothers' reports related to adolescent functioning and mothers' parenting…

The food environment and adult obesity in US metropolitan areas.

PubMed

Michimi, Akihiko; Wimberly, Michael C

2015-11-26

This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

Impact of US smoke-free air laws on restaurants and bars by employer size: a panel study

PubMed Central

2017-01-01

Objectives Thirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina). Design Observational study using panel data. Setting 1) US, 2) North Carolina Interventions Smoke-free air laws. Outcome measures State-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce). Results There is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size. Conclusion The lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke. PMID:29175887

Chefs' opinions about reducing the calorie content of menu items in restaurants.

PubMed

Obbagy, Julie E; Condrasky, Margaret D; Roe, Liane S; Sharp, Julia L; Rolls, Barbara J

2011-02-01

Modifying the energy content of foods, particularly foods eaten away from home, is important in addressing the obesity epidemic. Chefs in the restaurant industry are uniquely placed to influence the provision of reduced-calorie foods, but little is known about their opinions on this issue. A survey was conducted among chefs attending US culinary meetings about strategies for creating reduced-calorie foods and opportunities for introducing such items on restaurant menus. The 432 respondents were from a wide variety of employment positions and the majority had been in the restaurant industry for ≥ 20 years. Nearly all chefs (93%) thought that the calories in menu items could be reduced by 10-25% without customers noticing. To decrease the calories in two specific foods, respondents were more likely to select strategies for reducing energy density than for reducing portion size (P < 0.004). Low consumer demand was identified as the greatest barrier to including reduced-calorie items on the menu by 38% of chefs, followed by the need for staff skills and training (24%), and high ingredient cost (18%). The majority of respondents (71%) ranked taste as the most influential factor in the success of reduced-calorie items (P < 0.0001). The results of this survey indicate that opportunities exist for reducing the energy content of restaurant items. Ongoing collaboration is needed between chefs and public health professionals to ensure that appealing reduced-calorie menu items are more widely available in restaurants and that research is directed toward effective ways to develop and promote these items.

Chefs’ opinions about reducing the calorie content of menu items in restaurants

PubMed Central

Obbagy, Julie E.; Condrasky, Margaret D.; Roe, Liane S.; Sharp, Julia L.; Rolls, Barbara J.

2011-01-01

Modifying the energy content of foods, particularly foods eaten away from home, is important in addressing the obesity epidemic. Chefs in the restaurant industry are uniquely placed to influence the provision of reduced-calorie foods, but little is known about their opinions on this issue. A survey was conducted among chefs attending U.S. culinary meetings about strategies for creating reduced-calorie foods and opportunities for introducing such items on restaurant menus. The 432 respondents were from a wide variety of employment positions and the majority had been in the restaurant industry for 20 years or more. Nearly all chefs (93%) thought that the calories in menu items could be reduced by 10 to 25% without customers noticing. To decrease the calories in two specific foods, respondents were more likely to select strategies for reducing energy density than for reducing portion size (p<0.004). Low consumer demand was identified as the greatest barrier to including reduced-calorie items on the menu by 38% of chefs, followed by the need for staff skills and training (24%), and high ingredient cost (18%). The majority of respondents (71%) ranked taste as the most influential factor in the success of reduced-calorie items (p<0.0001). The results of this survey indicate that opportunities exist for reducing the energy content of restaurant items. Ongoing collaboration is needed between chefs and public health professionals to ensure that appealing reduced-calorie menu items are more widely available in restaurants and that research is directed towards effective ways to develop and promote these items. PMID:20814414

Defining Neighborhood Boundaries for Urban Health Research

PubMed Central

Weiss, Linda; Ompad, Danielle; Galea, Sandro; Vlahov, David

2008-01-01

The body of literature exploring neighborhood effects on health has increased rapidly in recent years, yet a number of methodological concerns remain, including preferred methods for identification and delineation of study neighborhoods. In research combining census or other publicly available data with surveys of residents and/or street-level observations, questions regarding neighborhood definition take on added significance. Neighborhoods must be identified and delineated in such a way as to optimize quality and availability of data from each of these sources. IMPACT, a multi-level study examining associations between features of the urban environment and mental health, drug use, and sexual behavior, utilized a multi-step neighborhood definition process including development of census block group maps, review of land use and census tract data, and field visits and observation in each of the targeted communities. Field observations were guided by a pre-identified list of environmental features focused on the potential for recruitment (e.g. pedestrian volume); characteristics commonly used to define neighborhood boundaries (e.g. obstructions to pedestrian traffic, changes in land use), and characteristics that have been associated in the literature with health behaviors and health outcomes (such as housing type, maintenance and use of open spaces). This process, implemented in February through July 2005, proved feasible and offered the opportunity to identify neighborhoods appropriate to study objectives and to collect descriptive information that can be used as a context for understanding study results. PMID:17543706

Development and Deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to Measure Health-Related Neighborhood Conditions

PubMed Central

Bader, Michael D. M.; Mooney, Stephen J.; Lee, Yeon Jin; Sheehan, Daniel; Neckerman, Kathryn M.; Rundle, Andrew G.; Teitler, Julien O.

2014-01-01

Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies. PMID:25545769

Variations in the Availability and Quality of Early Childhood Education and Care by Socioeconomic Status of Neighborhoods

ERIC Educational Resources Information Center

Cloney, Dan; Cleveland, Gordon; Hattie, John; Tayler, Collette

2016-01-01

Research Findings: This article provides Australian evidence of the availability and quality of early childhood education and care (ECEC) services in low-socioeconomic status (SES) neighborhoods. There is less availability of ECEC in low-SES areas in Australia, and these programs provide a lower average quality of care than in more advantaged…

Food Melt in Consumer Food Environments in Low-income Urban Neighborhoods.

PubMed

Trapl, Erika S; Pike, Stephanie N; Borawski, Elaine; Flocke, Susan A; Freedman, Darcy A; Walsh, Colleen C; Schneider, Christine; Yoder, Laura

2017-11-01

We systematically evaluated changes in availability, price, and quality of perishable food items from the beginning to the end of the month in lowincome, urban neighborhoods. The sample included grocery stores or supermarkets in Cleveland, Ohio, within neighborhoods with >30% of population receiving food assistance. We collected data for 2 sequential months during the first and fourth weeks of each month. Two coders evaluated stores, collecting measures of availability, price, and quality for 50 items. We examined difference in number and proportion of items available at the beginning of the month (BOM) to items remaining available at the end of the month (EOM), as well as quality and price of those items. Across 48 stores, availability at EOM was lower than BOM; as store size increased, reduction in availability (ie, food melt) was significantly (p < .01) less pronounced. Overall, items became less expensive at the EOM whereas quality remained consistent; we noted no statistically significant differences by store type for price or quality. Food melt differentially affects individuals in neighborhoods without grocery stores. Findings reveal composition of food environments is dynamic rather than static, influencing food-purchasing choices among lowincome consumers.

No meaningful association of neighborhood food store availability with dietary intake, body mass index, or waist circumference in young Japanese women.

PubMed

Murakami, Kentaro; Sasaki, Satoshi; Takahashi, Yoshiko; Uenishi, Kazuhiro

2010-08-01

The affordability of food is considered as an important factor influencing people's diet and hence health status. The objective of this cross-sectional study was to test the hypothesis that neighborhood food store availability is associated with some aspects of dietary intake and thus possibly with body mass index (BMI) and waist circumference in young Japanese women. Subjects were 989 female Japanese dietetic students 18 to 22 years of age. Neighborhood food store availability was defined as the number of food stores within a 0.5-mile (0.8-km) radius of residence (meat stores, fish stores, fruit and vegetable stores, confectionery stores/bakeries, rice stores, convenience stores, and supermarkets/grocery stores). Dietary intake was estimated using a validated, comprehensive self-administered diet history questionnaire. No association was seen between any measure of neighborhood food store availability and dietary intake, except for a positive association between confectionery and bread availability (based on confectionery stores/bakeries, convenience stores, and supermarkets/grocery stores) and intake of these items (P for trend = .02). Further, no association was seen for BMI or waist circumference, except for an inverse relationship between availability of convenience stores and BMI and a positive relationship between store availability for meat (meat stores and supermarkets/grocery stores) and fish (fish stores and supermarkets/grocery stores) and waist circumference. In conclusion, this study of young Japanese women found no meaningful association between neighborhood food store availability and dietary intake, BMI, or waist circumference, with the exception of a positive relationship between availability and intake for confectionery and bread. Copyright © 2010 Elsevier Inc. All rights reserved.

76 FR 35234 - Notice of Web Availability: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

...' health, safety, employment, mobility, and education; and 3. Neighborhood: Transform distressed, high..., high quality public schools and education programs, high quality early learning programs and services..., communities must develop and implement a comprehensive neighborhood revitalization strategy, or Transformation...

The descriptive epidemiology of local restaurant smoking regulations in Massachusetts: an analysis of the protection of restaurant customers and workers.

PubMed

Skeer, M; Siegel, M

2003-06-01

To describe the range of restaurant smoking regulations in the 351 cities and towns in Massachusetts, and to analyse the level of protection from secondhand smoke exposure guaranteed by these regulations. We obtained the local restaurant smoking regulations for each town, analysing them in terms of the protection of restaurant workers, bar workers, and adult and youth restaurant customers. The percentage of restaurant patrons and workers and bar workers who are protected from secondhand smoke exposure by the current smoking regulations in Massachusetts. As of June 2002, 225 towns had local restaurant smoking regulations. Of these, 69 (30.7%) do not allow smoking in restaurants, 10 (4.4%) restrict smoking to adult only restaurants, 64 (28.4%) restrict smoking to enclosed, separately ventilated areas, and 82 (36.4%) restrict smoking to areas that need not be enclosed and separately ventilated. Of the 174 towns that, at a minimum, restrict smoking to bar areas or separately ventilated areas, 35 (20.1%) allow variances. Overall, 60 towns, covering only 17.7% of the population, completely ban smoking in restaurants. As a result, 81.3% of adult restaurant customers, 81.2% of youth customers, 82.3% of restaurant workers, and 87.0% of bar workers are not guaranteed protection from secondhand smoke in restaurants. Despite the widespread adoption of local restaurant smoking regulations in Massachusetts, the majority of restaurant customers and workers remain unprotected from secondhand smoke exposure. In light of this, public health practitioners must stop compromising the protection of customers and workers from secondhand smoke exposure in restaurants.

Is nonsmoking dangerous to the health of restaurants? The effect of California's indoor smoking ban on restaurant revenues.

PubMed

Stolzenberg, Lisa; D'Alessio, Stewart J

2007-02-01

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely because of the loss of patrons who smoked. Using an interrupted times-series autoregressive integrative moving average study design, the authors assess the effect of California's indoor smoking ban on revenue rates for all restaurants, for non-alcohol-serving restaurants, and for alcohol-serving restaurants. Results showed that revenues for alcohol-serving restaurants dropped by about 4% immediately following the establishment of the indoor smoking ban. However, this reduction was temporary because revenues for alcohol-serving restaurants quickly returned to normal levels. Findings also revealed that the indoor smoking ban had little observable impact on the revenue rate for restaurants overall and for non-alcohol-serving restaurants.

Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India.

PubMed

Patel, Opal; Shahulhameed, Safraj; Shivashankar, Roopa; Tayyab, Mohammad; Rahman, Atiqur; Prabhakaran, Dorairaj; Tandon, Nikhil; Jaacks, Lindsay M

2017-07-19

The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs). Geographic information system data were available for 131 CEBs (n = 5264) from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m 2 . The most common full service and fast food restaurants were Indian savory restaurants (57.2%) and Indian sweet shops (25.8%). Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p < 0.05). In unadjusted logistic regression models, participants in the highest versus lowest tertile of full service and fast food restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval), 1.44 (1.24, 1.67). After adjustment for age, household income, and education, the effect was attenuated: 1.08 (0.92, 1.26). Results were consistent with further adjustment for tobacco and alcohol use, moderate physical activity, and owning a bicycle or motorized vehicle. Most full service and fast food restaurants were Indian, suggesting that the nutrition transition in this megacity may be better characterized by the large number of unhealthy Indian food outlets rather than the Western food outlets. Full service and fast food restaurant density in the residence area of adults in Delhi, India, was associated with poor dietary intake. It was also positively associated with overweight/obesity, but this was largely explained by socioeconomic status. Further research is needed exploring these associations prospectively and in other LMICs.

Evaluation of a pilot healthy eating intervention in restaurants and food stores of a rural community: a randomized community trial.

PubMed

Martínez-Donate, Ana P; Riggall, Ann Josie; Meinen, Amy M; Malecki, Kristen; Escaron, Anne L; Hall, Bev; Menzies, Anne; Garske, Gary; Nieto, F Javier; Nitzke, Susan

2015-02-12

Research suggests that the food environment influences individual eating practices. To date, little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities. We tested "Waupaca Eating Smart " (WES), a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community. WES focused on labeling, promoting, and increasing the availability of healthy foods. We conducted a randomized community trial, with two Midwestern U.S. communities randomly assigned to serve as intervention or control site. We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods. The RE-AIM framework was used to guide the evaluation and organize the results. Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention. On a 0-4 scale, the average level of satisfaction with WES was 3.14 (SD=0.69) for restaurant managers and 3 (SD=0.0) for store managers. On average, 6.3 (SD=1.1) out of 10 possible intervention activities were implemented in restaurants and 9.0 (SD=0.0) out of 12 possible activities were implemented in food stores. One month after the end of the pilot implementation period, 5.4 (SD=1.6) and 7.5 (SD=0.7) activities were still in place at restaurants and food stores, respectively. The intervention reached 60% of customers in participating food outlets. Restaurant food environment scores improved from 13.4 to 24.1 (p < 0.01) in the intervention community and did not change significantly in the control community. Food environment scores decreased slightly in both communities. No or minimal changes in customer behaviors were observed after a 10-month implementation period. The intervention achieved high levels of reach, adoption, implementation, and maintenance, suggesting the feasibility and acceptability of restaurant-and food store-based interventions in rural communities. Pilot outcome data indicated very modest levels of effectiveness, but additional research adequately powered to test the impact of this intervention on food environment scores and customer behaviors needs to be conducted in order to identify its potential to promote healthy eating in rural community settings.

Smoke-free restaurants in Shanghai: should it be mandatory and is it acceptable?

PubMed

Zheng, Pinpin; Fu, Hua; Li, Guangyao

2009-02-01

This study aims to describe secondhand smoke (SHS) exposure in restaurants in Shanghai and to explore the impact on the health of restaurant workers. Attitude to smoke-free restaurants among restaurant workers and customers was also determined in this study. A random sample of 242 workers, 284 customers, and 46 restaurant owners participated in face-to-face questionnaire interviews. A total of 219 (90.7%) restaurant workers surveyed were found to be exposed to SHS during working hours with 24.2+/-18.6h of exposure on average per week. Exposure time each week was significantly associated with the symptoms of dyspnea and irritated eyes. Among the customers surveyed 73.9% supported the concept of a 100% smoke-free law in restaurants and 49.6% expressed that they would be more likely to eat in restaurants if smoking was banned in restaurants. And 58.6% of the restaurant owners surveyed regarded smoke-free laws banning smoking in restaurant as feasible and 56.5% estimated such bans would decrease the profit. Both restaurant workers and customers are substantially exposed to SHS. Although some restaurant owners are concerned about a decrease in profits, the fear of losing business is not supported by the response among customers. Therefore, introducing a law-banning smoking in restaurants appears to be feasible and acceptable in Shanghai.

75 FR 33772 - Polyethylene Retail Carrier Bags From Malaysia: Preliminary Results of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

..., specialty retail, discount stores, and restaurants, to their customers to package and carry their purchased.... Selection of Information Used as Facts Available Where the Department applies an adverse facts-available...

Reconsidering access: park facilities and neighborhood disamenities in New York City.

PubMed

Weiss, Christopher C; Purciel, Marnie; Bader, Michael; Quinn, James W; Lovasi, Gina; Neckerman, Kathryn M; Rundle, Andrew G

2011-04-01

With increasing concern about rising rates of obesity, public health researchers have begun to examine the availability of parks and other spaces for physical activity, particularly in cities, to assess whether access to parks reduces the risk of obesity. Much of the research in this field has shown that proximity to parks may support increased physical activity in urban environments; however, as yet, there has been limited consideration of environmental impediments or disamenities that might influence individuals' perceptions or usage of public recreation opportunities. Prior research suggests that neighborhood disamenities, for instance crime, pedestrian safety, and noxious land uses, might dissuade people from using parks or recreational facilities and vary by neighborhood composition. Motivated by such research, this study estimates the relationship between neighborhood compositional characteristics and measures of park facilities, controlling for variation in neighborhood disamenities, using geographic information systems (GIS) data for New York City parks and employing both kernel density estimation and distance measures. The central finding is that attention to neighborhood disamenities can appreciably alter the relationship between neighborhood composition and spatial access to parks. Policy efforts to enhance the recreational opportunities in urban areas should expand beyond a focus on availability to consider also the hazards and disincentives that may influence park usage.

Feasibility of increasing access to healthy foods in neighborhood corner stores.

PubMed

O'Malley, Keelia; Gustat, Jeanette; Rice, Janet; Johnson, Carolyn C

2013-08-01

The feasibility of working with neighborhood corner stores to increase the availability of fresh fruit and vegetables in low-income neighborhoods in New Orleans was assessed. Household interviews and 24-hour dietary recalls (n = 97), corner store customer intercept interviews (n = 60) and interviews with corner store operators (owners/managers) (n = 12) were conducted in three neighborhoods without supermarkets. Regional produce wholesalers were contacted by phone. Results indicated that the majority of neighborhood residents use supermarkets or super stores as their primary food source. Those who did shop at corner stores typically purchased prepared foods and/or beverages making up nearly one third of their daily energy intake. Most individuals would be likely to purchase fresh fruit and vegetables from the corner stores if these foods were offered. Store operators identified cost, infrastructure and lack of customer demand as major barriers to stocking more fresh produce. Produce wholesalers did not see much business opportunity in supplying fresh produce to neighborhood corner stores on a small scale. Increasing availability of fresh fruit and vegetables in corner stores may be more feasible with the addition of systems changes that provide incentives and make it easier for neighborhood corner stores to stock and sell fresh produce.

Accuracy of stated energy contents of restaurant foods.

PubMed

Urban, Lorien E; McCrory, Megan A; Dallal, Gerard E; Das, Sai Krupa; Saltzman, Edward; Weber, Judith L; Roberts, Susan B

2011-07-20

National recommendations for the prevention and treatment of obesity emphasize reducing energy intake. Foods purchased in restaurants provide approximately 35% of the daily energy intake in US individuals but the accuracy of the energy contents listed for these foods is unknown. To examine the accuracy of stated energy contents of foods purchased in restaurants. A validated bomb calorimetry technique was used to measure dietary energy in food from 42 restaurants, comprising 269 total food items and 242 unique foods. The restaurants and foods were randomly selected from quick-serve and sit-down restaurants in Massachusetts, Arkansas, and Indiana between January and June 2010. The difference between restaurant-stated and laboratory-measured energy contents, which were corrected for standard metabolizable energy conversion factors. The absolute stated energy contents were not significantly different from the absolute measured energy contents overall (difference of 10 kcal/portion; 95% confidence interval [CI], -15 to 34 kcal/portion; P = .52); however, the stated energy contents of individual foods were variable relative to the measured energy contents. Of the 269 food items, 50 (19%) contained measured energy contents of at least 100 kcal/portion more than the stated energy contents. Of the 10% of foods with the highest excess energy in the initial sampling, 13 of 17 were available for a second sampling. In the first analysis, these foods contained average measured energy contents of 289 kcal/portion (95% CI, 186 to 392 kcal/portion) more than the stated energy contents; in the second analysis, these foods contained average measured energy contents of 258 kcal/portion (95% CI, 154 to 361 kcal/portion) more than the stated energy contents (P <.001 for each vs 0 kcal/portion difference). In addition, foods with lower stated energy contents contained higher measured energy contents than stated, while foods with higher stated energy contents contained lower measured energy contents (P <.001). Stated energy contents of restaurant foods were accurate overall. However, there was substantial inaccuracy for some individual foods, with understated energy contents for those with lower energy contents.

Accuracy of Stated Energy Contents of Restaurant Foods

PubMed Central

Urban, Lorien E.; McCrory, Megan A.; Dallal, Gerard E.; Das, Sai Krupa; Saltzman, Edward; Weber, Judith L.; Roberts, Susan B.

2015-01-01

Context National recommendations for the prevention and treatment of obesity emphasize reducing energy intake. Foods purchased in restaurants provide approximately 35% of the daily energy intake in US individuals but the accuracy of the energy contents listed for these foods is unknown. Objective To examine the accuracy of stated energy contents of foods purchased in restaurants. Design and Setting A validated bomb calorimetry technique was used to measure dietary energy in food from 42 restaurants, comprising 269 total food items and 242 unique foods. The restaurants and foods were randomly selected from quick-serve and sit-down restaurants in Massachusetts, Arkansas, and Indiana between January and June 2010. Main Outcome Measure The difference between restaurant-stated and laboratory-measured energy contents, which were corrected for standard metabolizable energy conversion factors. Results The absolute stated energy contents were not significantly different from the absolute measured energy contents overall (difference of 10 kcal/portion; 95% confidence interval [CI], −15 to 34 kcal/portion; P=.52); however, the stated energy contents of individual foods were variable relative to the measured energy contents. Of the 269 food items, 50 (19%) contained measured energy contents of at least 100 kcal/portion more than the stated energy contents. Of the 10% of foods with the highest excess energy in the initial sampling, 13 of 17 were available for a second sampling. In the first analysis, these foods contained average measured energy contents of 289 kcal/portion (95% CI, 186 to 392 kcal/portion) more than the stated energy contents; in the second analysis, these foods contained average measured energy contents of 258 kcal/portion (95% CI, 154 to 361 kcal/portion) more than the stated energy contents (P<.001 for each vs 0 kcal/portion difference). In addition, foods with lower stated energy contents contained higher measured energy contents than stated, while foods with higher stated energy contents contained lower measured energy contents (P<.001). Conclusions Stated energy contents of restaurant foods were accurate overall. However, there was substantial inaccuracy for some individual foods, with understated energy contents for those with lower energy contents. PMID:21771989

Longitudinal Associations between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample

ERIC Educational Resources Information Center

Zenk, Shannon N.; Mentz, Graciela; Schulz, Amy J.; Johnson-Lawrence, Vicki; Gaines, Causandra R.

2017-01-01

Introduction: Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. Purpose: This longitudinal study examined whether multiple measures of neighborhood food…

Food for thought: obstacles to menu labelling in restaurants and cafeterias.

PubMed

Thomas, Erica

2016-08-01

Menu labelling is recommended as a policy intervention to reduce obesity and diet-related disease. The present commentary considers the many challenges the restaurant industry faces in providing nutrition information on its menus. Barriers include lack of nutrition expertise, time, cost, availability of nutrition information for exotic ingredients, ability to provide accurate nutrition information, libel risk, customer dissatisfaction, limited space on the menu, menu variations, loss of flexibility in changing the menu, staff training and resistance of employees to change current practice. Health promotion specialists and academics involved in fieldwork must help restaurateurs find solutions to these barriers for menu labelling interventions to be widely implemented and successful. Practical support for small independent restaurants such as free or subsidised nutrition analysis, nutrition training for staff and menu design may also be necessary to encourage voluntary participation.

Property Values as a Measure of Neighborhoods: An Application of Hedonic Price Theory.

PubMed

Leonard, Tammy; Powell-Wiley, Tiffany M; Ayers, Colby; Murdoch, James C; Yin, Wenyuan; Pruitt, Sandi L

2016-07-01

Researchers measuring relationships between neighborhoods and health have begun using property appraisal data as a source of information about neighborhoods. Economists have developed a rich tool kit to understand how neighborhood characteristics are quantified in appraisal values. This tool kit principally relies on hedonic (implicit) price models and has much to offer regarding the interpretation and operationalization of property appraisal data-derived neighborhood measures, which goes beyond the use of appraisal data as a measure of neighborhood socioeconomic status. We develop a theoretically informed hedonic-based neighborhood measure using residuals of a hedonic price regression applied to appraisal data in a single metropolitan area. We describe its characteristics, reliability in different types of neighborhoods, and correlation with other neighborhood measures (i.e., raw neighborhood appraisal values, census block group poverty, and observed property characteristics). We examine the association between all neighborhood measures and body mass index. The hedonic-based neighborhood measure was correlated in the expected direction with block group poverty rate and observed property characteristics. The neighborhood measure and average raw neighborhood appraisal value, but not census block group poverty, were associated with individual body mass index. We draw theoretically consistent methodology from the economics literature on hedonic price models to demonstrate how to leverage the implicit valuation of neighborhoods contained in publicly available appraisal data. Consistent measurement and application of the hedonic-based neighborhood measures in epidemiology will improve understanding of the relationships between neighborhoods and health. Researchers should proceed with a careful use of appraisal values utilizing theoretically informed methods such as this one.

The descriptive epidemiology of local restaurant smoking regulations in Massachusetts: an analysis of the protection of restaurant customers and workers

PubMed Central

Skeer, M; Siegel, M

2003-01-01

Objectives: To describe the range of restaurant smoking regulations in the 351 cities and towns in Massachusetts, and to analyse the level of protection from secondhand smoke exposure guaranteed by these regulations. Design: We obtained the local restaurant smoking regulations for each town, analysing them in terms of the protection of restaurant workers, bar workers, and adult and youth restaurant customers. Main outcome measure: The percentage of restaurant patrons and workers and bar workers who are protected from secondhand smoke exposure by the current smoking regulations in Massachusetts. Results: As of June 2002, 225 towns had local restaurant smoking regulations. Of these, 69 (30.7%) do not allow smoking in restaurants, 10 (4.4%) restrict smoking to adult only restaurants, 64 (28.4%) restrict smoking to enclosed, separately ventilated areas, and 82 (36.4%) restrict smoking to areas that need not be enclosed and separately ventilated. Of the 174 towns that, at a minimum, restrict smoking to bar areas or separately ventilated areas, 35 (20.1%) allow variances. Overall, 60 towns, covering only 17.7% of the population, completely ban smoking in restaurants. As a result, 81.3% of adult restaurant customers, 81.2% of youth customers, 82.3% of restaurant workers, and 87.0% of bar workers are not guaranteed protection from secondhand smoke in restaurants. Conclusions: Despite the widespread adoption of local restaurant smoking regulations in Massachusetts, the majority of restaurant customers and workers remain unprotected from secondhand smoke exposure. In light of this, public health practitioners must stop compromising the protection of customers and workers from secondhand smoke exposure in restaurants. PMID:12773735

Nicotine replacement therapy, tobacco products, and electronic cigarettes in pharmacies in St. Louis, Missouri.

PubMed

Barnoya, Joaquin; Jin, Linda; Hudmon, Karen Suchanek; Schootman, Mario

2015-01-01

To compare availability of nicotine replacement therapy (NRT), tobacco products, and electronic cigarettes (e-cigarettes) in pharmacies in St. Louis, MO. Cross-sectional study, on-site store audits of 322 pharmacies. St. Louis, MO. 242 eligible community pharmacies located in the study area. Pharmacies were visited by trained research assistants who conducted a 5- to 10-minute store audit using a paper-based data collection tool. Availability, accessibility, and pricing of NRT as a function of neighborhood poverty rate and proportion of black residents as well as availability of tobacco products and e-cigarettes. NRT availability decreased as neighborhood poverty rate increased (P = 0.02). Availability without pharmacy personnel assistance also decreased with increasing poverty rate (r = -0.19; 95% CI = -0.06, -0.31) and higher percentage of black residents (r = -0.18; 95% CI = -0.06, -0.31). Prices were lower in neighborhoods with higher poverty rates (P = 0.02) and a higher percentage of black residents (P = 0.03). E-cigarettes were available in 43% of pharmacies, and their availability and price did not differ by poverty rate or percentage of black residents. Low access to NRT might perpetuate smoking disparities in disadvantaged and racially diverse neighborhoods. Study data support policies to ensure equal NRT access to reduce disparities.

Economic effect of restaurant smoking restrictions on restaurant business in Massachusetts, 1992 to 1998.

PubMed

Bartosch, William J; Pope, G C

2002-06-01

To determine if restaurant business declines or improves after the implementation of restrictive restaurant smoking policies. Analysis used a pre/post-quasi-experimental design that compared town meals tax receipts before and after the imposition of highly restrictive restaurant smoking policies in adopting versus non-adopting communities. The effect of restaurant smoking policies was estimated using a fixed effects regression model, entering a panel of 84 months of data for the 239 towns in the study. A separate model estimated the effect of restaurant smoking policies on establishments that served alcohol. Change in the trend in meals tax revenue (adjusted for population) following the implementation of highly restrictive restaurant smoking policies. The local adoption of restrictive restaurant smoking policies did not lead to a measurable deviation from the strong positive trend in revenue between 1992 and 1998 that restaurants in Massachusetts experienced. Controlling for other less restrictive restaurant smoking policies did not change this finding. Similar results were found for only those establishments that served alcoholic beverages. Highly restrictive restaurant smoking policies do not have a significant effect on a community's level of meal receipts, indicating that claims of community wide restaurant business decline under such policies are unwarranted.

Are fast food restaurants an environmental risk factor for obesity?

PubMed Central

Jeffery, Robert W; Baxter, Judy; McGuire, Maureen; Linde, Jennifer

2006-01-01

Objective Eating at "fast food" restaurants has increased and is linked to obesity. This study examined whether living or working near "fast food" restaurants is associated with body weight. Methods A telephone survey of 1033 Minnesota residents assessed body height and weight, frequency of eating at restaurants, and work and home addresses. Proximity of home and work to restaurants was assessed by Global Index System (GIS) methodology. Results Eating at "fast food" restaurants was positively associated with having children, a high fat diet and Body Mass Index (BMI). It was negatively associated with vegetable consumption and physical activity. Proximity of "fast food" restaurants to home or work was not associated with eating at "fast food" restaurants or with BMI. Proximity of "non-fast food" restaurants was not associated with BMI, but was associated with frequency of eating at those restaurants. Conclusion Failure to find relationships between proximity to "fast food" restaurants and obesity may be due to methodological weaknesses, e.g. the operational definition of "fast food" or "proximity", or homogeneity of restaurant proximity. Alternatively, the proliferation of "fast food" restaurants may not be a strong unique cause of obesity. PMID:16436207

A prospective study of floor surface, shoes, floor cleaning and slipping in US limited-service restaurant workers.

PubMed

Verma, Santosh K; Chang, Wen Ruey; Courtney, Theodore K; Lombardi, David A; Huang, Yueng-Hsiang; Brennan, Melanye J; Mittleman, Murray A; Ware, James H; Perry, Melissa J

2011-04-01

Slips and falls are a leading cause of injury at work. Few studies, however, have systematically examined risk factors of slipping outside the laboratory environment. This study examined the association between floor surface characteristics, slip-resistant shoes, floor cleaning frequency and the risk of slipping in limited-service restaurant workers. 475 workers from 36 limited-service restaurants from three major chains in six states in the USA were recruited to participate in a prospective cohort study of workplace slipping. Kitchen floor surface roughness and coefficient of friction (COF) were measured in eight working areas and then averaged within each restaurant. The use of slip-resistant shoes was determined by examining the participant's shoes and noting the presence of a 'slip-resistant' marking on the sole. Restaurant managers reported the frequency of daily kitchen floor cleaning. Participants reported their slip experience and work hours weekly for up to 12 weeks. The survey materials were made available in three languages: English, Spanish and Portuguese. The associations between rate of slipping and risk factors were assessed using a multivariable negative binomial generalised estimating equation model. The mean of individual slipping rate varied among the restaurants from 0.02 to 2.49 slips per 40 work hours. After adjusting for age, gender, BMI, education, primary language, job tenure and restaurant chain, the use of slip-resistant shoes was associated with a 54% reduction in the reported rate of slipping (95% CI 37% to 64%), and the rate of slipping decreased by 21% (95% CI 5% to 34%) for each 0.1 increase in the mean kitchen COF. Increasing floor cleaning frequency was significantly associated with a decreasing rate of slipping when considered in isolation but not after statistical adjustment for other factors. These results provide support for the use of slip-resistant shoes and measures to increase COF as preventive interventions to reduce slips, falls and injuries.

Food deserts in Leon County, FL: disparate distribution of Supplemental Nutrition Assistance Program-accepting stores by neighborhood characteristics.

PubMed

Rigby, Samantha; Leone, Angela F; Kim, Hwahwan; Betterley, Connie; Johnson, Mary Ann; Kurtz, Hilda; Lee, Jung Sun

2012-01-01

Examine whether neighborhood characteristics of racial composition, income, and rurality were related to distribution of Supplemental Nutrition Assistance Program (SNAP)-accepting stores in Leon County, Florida. Cross-sectional; neighborhood and food store data collected in 2008. Forty-eight census tracts as proxy of neighborhoods in Leon County, Florida. All stores and SNAP-accepting stores were identified from a commercial business directory and a United States Department of Agriculture SNAP-accepting store list, respectively (n = 288). Proportion of SNAP-accepting stores across neighborhoods. Descriptive statistics to describe distribution of SNAP-accepting stores by neighborhood characteristics. Proportions of SNAP-accepting stores were compared by neighborhood characteristics with Wilcoxon-Mann-Whitney and Kruskal-Wallis tests. Of 288 available stores, 45.1% accepted SNAP benefits. Of the 48 neighborhoods, 16.7% had no SNAP-accepting stores. Proportions of SNAP-accepting grocery stores were significantly different by neighborhood racial composition and income. Primarily black neighborhoods did not have any supermarkets. Results were mixed with regard to distribution of food stores and SNAP-accepting stores by neighborhood racial composition, income, and rurality. This study suggests disparities in distribution of SNAP-accepting stores across neighborhood characteristics of racial composition, income, and rurality. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A risk-based restaurant inspection system in Los Angeles County.

PubMed

Buchholz, U; Run, G; Kool, J L; Fielding, J; Mascola, L

2002-02-01

The majority of local health departments perform routine restaurant inspections. In Los Angeles County (LAC), California, approximately $10 million/year is spent on restaurant inspections. However, data are limited as to whether or not certain characteristics of restaurants make them more likely to be associated with foodborne incident reports. We used data from the LAC Environmental Health Management Information System (EHMIS), which records the results of all routine restaurant inspections as well as data regarding all consumer-generated foodborne incidents that led to a special restaurant inspection by a sanitarian (investigated foodborne incidents [IFBIs]). We analyzed a cohort of 10,267 restaurants inspected from 1 July 1997 to 15 November 1997. We defined a "case restaurant" as any restaurant with a routine inspection from 1 July 1997 to 15 November 1997 and a subsequent IFBI from 1 July 1997 to 30 June 1998. Noncase restaurants did not have an IFBI from I July 1997 to 30 June 1998. We looked for specific characteristics of restaurants that might be associated with the restaurant subsequently having an IFBI, including the size of restaurant (assessed by number of seats), any previous IFBIs, the overall inspection score, and a set of 38 violation codes. We identified 158 case restaurants and 10,109 noncase restaurants. In univariate analysis, middle-sized restaurants (61 to 150 seats; n = 1,681) were 2.8 times (95% confidence interval [CI] = 2.0 to 4.0) and large restaurants (>150 seats; n = 621) were 4.6 times (95% CI = 3.0 to 7.0) more likely than small restaurants (< or =60 seats; n = 7,965) to become case restaurants. In addition, the likelihood of a restaurant becoming a case restaurant increased as the number of IFBIs in the prior year increased (chi2 for linear trend, P value = 0.0005). Other factors significantly associated with the occurrence of an IFBI included a lower overall inspection score, the incorrect storage of food, the reuse of food, the lack of employee hand washing, the lack of thermometers, and the presence of any food protection violation. In multivariate analysis, the size of restaurant, the incorrect storage of food, the reuse of food, and the presence of any food protection violation remained significant predictors for becoming a case restaurant. Our data suggest that routine restaurant inspections should concentrate on those establishments that have a large seating capacity or a poor inspection history. Evaluation of inspection data bases in individual local health departments and translation of those findings into inspection guidelines could lead to an increased efficiency and perhaps cost-effectiveness of local inspection programs.

Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.

PubMed

Gebremariam, Mekdes K; Vaqué-Crusellas, Cristina; Andersen, Lene F; Stok, F Marijn; Stelmach-Mardas, Marta; Brug, Johannes; Lien, Nanna

2017-02-14

Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.

Food availability as a determinant of weight gain among renal transplant recipients.

PubMed

Bloodworth, Robin F; Ward, Kenneth D; Relyea, George E; Cashion, Ann K

2014-06-01

Excessive weight gain is common after renal transplantation, but it is unknown whether environmental factors, such as food availability, contribute to this important clinical problem. We evaluated the effects of food availability (fast food restaurants, convenience stores, and grocery stores within 1, 2, and 3 mile buffers of transplant recipients' residences) on body mass index (BMI) change during the first year post-transplant. Participants (n = 299) resided in Memphis, Tennessee. BMI increased by 1.42 units (p < .001) corresponding to an average weight gain of 9.25 lbs (5.43%) during the first year post-transplant. The number of grocery stores within 1 mile of recipient's residence was associated with an increase in BMI (p < .05), but fast food restaurants and convenience stores were not significantly associated with BMI change. © 2014 Wiley Periodicals, Inc.

Does food vendor density mediate the association between neighborhood deprivation and BMI?: a G-computation mediation analysis.

PubMed

Zhang, Y Tara; Laraia, Barbara A; Mujahid, Mahasin S; Tamayo, Aracely; Blanchard, Samuel D; Warton, E Margaret; Kelly, N Maggi; Moffet, Howard H; Schillinger, Dean; Adler, Nancy; Karter, Andrew J

2015-05-01

In previous research, neighborhood deprivation was positively associated with body mass index (BMI) among adults with diabetes. We assessed whether the association between neighborhood deprivation and BMI is attributable, in part, to geographic variation in the availability of healthful and unhealthful food vendors. Subjects were 16,634 participants of the Diabetes Study of Northern California, a multiethnic cohort of adults living with diabetes. Neighborhood deprivation and healthful (supermarket and produce) and unhealthful (fast food outlets and convenience stores) food vendor kernel density were calculated at each participant's residential block centroid. We estimated the total effect, controlled direct effect, natural direct effect, and natural indirect effect of neighborhood deprivation on BMI. Mediation effects were estimated using G-computation, a maximum likelihood substitution estimator of the G-formula that allows for complex data relations such as multiple mediators and sequential causal pathways. We estimated that if neighborhood deprivation was reduced from the most deprived to the least deprived quartile, average BMI would change by -0.73 units (95% confidence interval: -1.05, -0.32); however, we did not detect evidence of mediation by food vendor density. In contrast to previous findings, a simulated reduction in neighborhood deprivation from the most deprived to the least deprived quartile was associated with dramatic declines in both healthful and unhealthful food vendor density. Availability of food vendors, both healthful and unhealthful, did not appear to explain the association between neighborhood deprivation and BMI in this population of adults with diabetes.

Walkable home neighbourhood food environment and children's overweight and obesity: Proximity, density or price?

PubMed

Le, Ha; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-06-09

To identify characteristics of the food environment associated with child overweight/obesity that could, if subjected to intervention, mitigate the risk of childhood overweight/obesity. We examined whether the proximity to or density of grocery and convenience stores or fast food restaurants, or the prices of healthy food options were more strongly associated with overweight/obesity risk in children. We collected geocoded data by residential addresses for 1,469 children aged 10-14 years and conducted a census of all food outlets in Saskatoon. The Nutrition Environment Measures Survey (NEMS)-Stores and the NEMS-Restaurants were used to measure availability, quality and relative price of healthy food items in stores and restaurants. Children's weight status was calculated on the basis of measured height and weight. Logistic regression was used to test the associations between overweight/obesity and food environment variables. Within an 800 m walking distance from home, 76% of children did not have access to a grocery store; 58% and 32% had access to at least one convenience store or one fast-food restaurant respectively. A significantly lower odds of overweight/obesity was associated with lower price of healthy food items/options in grocery stores (odds ratio [OR] = 0.87, 95% confidence interval [CI] 0.77-0.99) and fast-food restaurants (OR = 0.97, 95% CI 0.95-0.99) within walking distance of home. Neither the distance to the closest food outlet nor the density of food outlets around children's homes was associated with odds of overweight/obesity. Improving economic access to healthy food in food outlets or fast-food restaurants is one strategy to counter childhood overweight/ obesity.

Impact of US smoke-free air laws on restaurants and bars by employer size: a panel study.

PubMed

Shafer, Paul

2017-11-25

Thirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina). Observational study using panel data. 1) US, 2) North Carolina INTERVENTIONS: Smoke-free air laws. State-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce). There is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size. The lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

School vending machine use and fast-food restaurant use are associated with sugar-sweetened beverage intake in youth.

PubMed

Wiecha, Jean L; Finkelstein, Daniel; Troped, Philip J; Fragala, Maren; Peterson, Karen E

2006-10-01

To examine associations between use of school vending machines and fast-food restaurants and youth intake of sugar-sweetened beverages. A cross-sectional observational study. From a group randomized obesity intervention, we analyzed baseline data from 1,474 students in 10 Massachusetts middle schools with vending machines that sold soda and/or other sweetened drinks. Daily sugar-sweetened beverage consumption (regular soda, fruit drinks, and iced tea), purchases from school vending machines, and visits to fast-food restaurants in the preceding 7 days were estimated by self-report. Chi(2) and nonparametric tests were performed on unadjusted data; multivariable models adjusted for sex, grade, body mass index, and race/ethnicity, and accounted for clustering within schools. Among 646 students who reported using school vending machines, 456 (71%) reported purchasing sugar-sweetened beverages. Overall, 977 students (66%) reported eating at a fast-food restaurant. Sugar-sweetened beverage intakes averaged 1.2 servings per day. In adjusted models, relative to no vending machine purchases, servings per day increased by 0.21 for one to three purchases per week (P=0.0057), and 0.71 with four or more purchases (P<0.0001). Relative to no fast-food restaurant visits, sugar-sweetened beverage servings per day increased by 0.13 with one visit per week (P=0.07), 0.49 with two to three visits (P=0.0013), and by 1.64 with four or more visits (P=0.0016). Among students who use school vending machines, more report buying sugar-sweetened beverages than any other product category examined. Both school vending machine and fast-food restaurant use are associated with overall sugar-sweetened beverage intake. Reduction in added dietary sugars may be attainable by reducing use of these sources or changing product availability.

Ground Beef Handling and Cooking Practices in Restaurants in Eight States†

PubMed Central

Bogard, April K.; Fuller, Candace C.; Radke, Vincent; Selman, Carol A.; Smith, Kirk E.

2017-01-01

Eating in table-service restaurants has been implicated as a risk factor for Escherichia coli O157:H7 infection. To explore this association and learn about the prevalence of risky ground beef preparation practices in restaurants, the Environmental Health Specialists Network (EHS-Net) assessed ground beef handling policies and practices in restaurants in California, Colorado, Connecticut, Georgia, Minnesota, New York, Oregon, and Tennessee. Eligible restaurants prepared and served hamburgers. EHS-Net specialists interviewed a restaurant employee with authority over the kitchen (defined as the manager) using a standard questionnaire about food safety policies, hamburger preparation policies, and use of irradiated ground beef. Interviews were followed by observations of ground beef preparation. Data from 385 restaurants were analyzed: 67% of the restaurants were independently owned and 33% were chain restaurants; 75% of the restaurants were sit down, 19% were quick service or fast food, and 6% were cafeteria or buffet restaurants. Eighty-one percent of restaurants reported determining doneness of hamburgers by one or more subjective measures, and 49% reported that they never measure the final cook temperatures of hamburgers. At least two risky ground beef handling practices were observed in 53% of restaurants. Only 1% of restaurants reported purchasing irradiated ground beef, and 29% were unfamiliar with irradiated ground beef. Differences in risky ground beef handling policies and practices were noted for type of restaurant ownership (independently owned versus chain) and type of food service style (sit down versus quick service or fast food). This study revealed the pervasiveness of risky ground beef handling policies and practices in restaurants and the need for educational campaigns targeting food workers and managers. These results highlight the importance of continued efforts to reduce the prevalence of E. coli O157:H7 in ground beef. PMID:24290692

Ground beef handling and cooking practices in restaurants in eight States.

PubMed

Bogard, April K; Fuller, Candace C; Radke, Vincent; Selman, Carol A; Smith, Kirk E

2013-12-01

Eating in table-service restaurants has been implicated as a risk factor for Escherichia coli O157:H7 infection. To explore this association and learn about the prevalence of risky ground beef preparation practices in restaurants, the Environmental Health Specialists Network (EHS-Net) assessed ground beef handling policies and practices in restaurants in California, Colorado, Connecticut, Georgia, Minnesota, New York, Oregon, and Tennessee. Eligible restaurants prepared and served hamburgers. EHS-Net specialists interviewed a restaurant employee with authority over the kitchen (defined as the manager) using a standard questionnaire about food safety policies, hamburger preparation policies, and use of irradiated ground beef. Interviews were followed by observations of ground beef preparation. Data from 385 restaurants were analyzed: 67% of the restaurants were independently owned and 33% were chain restaurants; 75% of the restaurants were sit down, 19% were quick service or fast food, and 6% were cafeteria or buffet restaurants. Eighty-one percent of restaurants reported determining doneness of hamburgers by one or more subjective measures, and 49% reported that they never measure the final cook temperatures of hamburgers. At least two risky ground beef handling practices were observed in 53% of restaurants. Only 1% of restaurants reported purchasing irradiated ground beef, and 29% were unfamiliar with irradiated ground beef. Differences in risky ground beef handling policies and practices were noted for type of restaurant ownership (independently owned versus chain) and type of food service style (sit down versus quick service or fast food). This study revealed the pervasiveness of risky ground beef handling policies and practices in restaurants and the need for educational campaigns targeting food workers and managers. These results highlight the importance of continued efforts to reduce the prevalence of E. coli O157:H7 in ground beef.

Using community-based participatory research to design and initiate a study on immigrant worker health and safety in San Francisco's Chinatown restaurants.

PubMed

Minkler, Meredith; Lee, Pam Tau; Tom, Alex; Chang, Charlotte; Morales, Alvaro; Liu, Shaw San; Salvatore, Alicia; Baker, Robin; Chen, Feiyi; Bhatia, Rajiv; Krause, Niklas

2010-04-01

Restaurant workers have among the highest rates of work-related illness and injury in the US, but little is known about the working conditions and occupational health status of Chinese immigrant restaurant workers. Community-based participatory research (CBPR) was employed to study restaurant working conditions and worker health in San Francisco's Chinatown. A community/academic/health department collaborative was formed and 23 restaurant workers trained on research techniques and worker health and safety. A worker survey instrument and a restaurant observational checklist were collaboratively developed. The checklist was piloted in 71 Chinatown restaurants, and the questionnaire administered to 433 restaurant workers. Restaurant workers, together with other partners, made substantial contributions to construction of the survey and checklist tools and improved their cultural appropriateness. The utility of the checklist tool for restaurant-level data collection was demonstrated. CBPR holds promise for both studying worker health and safety among immigrant Chinese restaurant workers and developing culturally appropriate research tools. A new observational checklist also has potential for restaurant-level data collection on worker health and safety conditions. (c) 2010 Wiley-Liss, Inc.

A step-by-step approach to improve data quality when using commercial business lists to characterize retail food environments.

PubMed

Jones, Kelly K; Zenk, Shannon N; Tarlov, Elizabeth; Powell, Lisa M; Matthews, Stephen A; Horoi, Irina

2017-01-07

Food environment characterization in health studies often requires data on the location of food stores and restaurants. While commercial business lists are commonly used as data sources for such studies, current literature provides little guidance on how to use validation study results to make decisions on which commercial business list to use and how to maximize the accuracy of those lists. Using data from a retrospective cohort study [Weight And Veterans' Environments Study (WAVES)], we (a) explain how validity and bias information from existing validation studies (count accuracy, classification accuracy, locational accuracy, as well as potential bias by neighborhood racial/ethnic composition, economic characteristics, and urbanicity) were used to determine which commercial business listing to purchase for retail food outlet data and (b) describe the methods used to maximize the quality of the data and results of this approach. We developed data improvement methods based on existing validation studies. These methods included purchasing records from commercial business lists (InfoUSA and Dun and Bradstreet) based on store/restaurant names as well as standard industrial classification (SIC) codes, reclassifying records by store type, improving geographic accuracy of records, and deduplicating records. We examined the impact of these procedures on food outlet counts in US census tracts. After cleaning and deduplicating, our strategy resulted in a 17.5% reduction in the count of food stores that were valid from those purchased from InfoUSA and 5.6% reduction in valid counts of restaurants purchased from Dun and Bradstreet. Locational accuracy was improved for 7.5% of records by applying street addresses of subsequent years to records with post-office (PO) box addresses. In total, up to 83% of US census tracts annually experienced a change (either positive or negative) in the count of retail food outlets between the initial purchase and the final dataset. Our study provides a step-by-step approach to purchase and process business list data obtained from commercial vendors. The approach can be followed by studies of any size, including those with datasets too large to process each record by hand and will promote consistency in characterization of the retail food environment across studies.

Indoor air quality at restaurants with different styles of cooking in metropolitan Hong Kong.

PubMed

Lee, S C; Li, W M; Chan, L Y

2001-11-12

Indoor air quality (IAQ) of a restaurant has increasingly received a lot of public concerns in Hong Kong. Unfortunately, there is limited data about the IAQ of Hong Kong restaurants. In order to characterize the current IAQ of local restaurants, four restaurants in metropolitan Hong Kong including a Korean barbecue style restaurant, a Chinese hot pot restaurant, a Chinese dim sum restaurant and a Western canteen were selected for this study. The results of this study showed that the mean concentrations of CO2 at restaurants with gas stoves for food cooking in dining areas exceeded the range from 40 to 60% indoor CO2 concentrations at restaurants without gas stoves in dining areas. The average levels of PM10 and PM2.5 at the Korean barbecue style restaurant were as high as 1442 and 1167 microg/m3, respectively. At the Korean barbecue and Chinese hot pot restaurants, the levels of PM2.5 accounted for 80-93% of their respective PM10 concentrations. The 1-h average levels of CO observed at Korean barbecue style and hot pot restaurants were 15,100 and 8000 microg/m3, respectively. Relatively high concentrations of CO2, CO, PM10, PM2.5 benzene, toluene, methylene chloride and chloroform were measured in the dining areas of the Korean barbecue style and the Chinese hot pot restaurants. The operations of pan-frying food and boiling food with soup in a hot pot could generate considerable quantities of air pollutants.

Availability of tobacco products associated with use of marijuana cigars (blunts).

PubMed

Lipperman-Kreda, Sharon; Lee, Juliet P; Morrison, Chris; Freisthler, Bridget

2014-01-01

This study examines factors associated with availability of tobacco products for marijuana cigars (i.e., blunts) in 50 non-contiguous mid-sized California communities. The study is based on data collected in 943 tobacco outlets. Neighborhood demographics, community adult marijuana prevalence, medical marijuana policy and access to medical marijuana dispensaries and delivery services were included. Multilevel logistic regression analyses indicated that compared with small markets, availability of tobacco products associated with use of blunts was significantly higher in convenience stores, smoke/tobacco shops and liquor stores. None of the neighborhood demographics were associated with availability of blunt wrappers and only a small percent of Whites was positively associated with availability of blunt cigars, small cigars or cigarillos at the store. Controlling for outlet type and neighborhood demographics, higher city prevalence of adult marijuana use was associated with greater availability of blunt wrappers. Also, policy that permits medical marijuana dispensaries or private cultivation was positively associated with availability of tobacco products for blunts. Density of medical marijuana dispensaries and delivery services, however, was negatively associated with greater availability of these products at tobacco outlets. Results suggest that availability of tobacco products associated with blunts is similar in neighborhoods with different socioeconomic status and racial and ethnic composition. Results also suggest the important role that community norms that support marijuana use or legalization of medical marijuana and medical marijuana policy may play in increasing availability of tobacco products associated with blunts. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Availability of Tobacco Products Associated with Use of Marijuana Cigars (Blunts)

PubMed Central

Juliet, P. Lee; Morrison, Chris; Bridget, Freisthler

2013-01-01

Objectives This study examines factors associated with availability of tobacco products for marijuana cigars (i.e., blunts) in 50 non-contiguous mid-sized California communities. Methods The study is based on data collected in 943 tobacco outlets. Neighborhood demographics, community adult marijuana prevalence, medical marijuana policy and access to medical marijuana dispensaries and delivery services were included. Results Multilevel logistic regression analyses indicated that compared with small markets, availability of tobacco products associated with use of blunts was significantly higher in convenience stores, smoke/tobacco shops and liquor stores. None of the neighborhood demographics were associated with availability of blunt wrappers and only a small percent of Whites was positively associated with availability of blunt cigars, small cigars or cigarillos at the store. Controlling for outlet type and neighborhood demographics, higher city prevalence of adult marijuana use was associated with greater availability of blunt wrappers. Also, policy that permits medical marijuana dispensaries or private cultivation was positively associated with availability of tobacco products for blunts. Density of medical marijuana dispensaries and delivery services, however, was negatively associated with greater availability of these products at tobacco outlets. Conclusions Results suggest that availability of tobacco products associated with blunts is similar in neighborhoods with different socioeconomic status and racial and ethnic composition. Results also suggest the important role that community norms that support marijuana use or legalization of medical marijuana and medical marijuana policy may play in increasing availability of tobacco products associated with blunts. PMID:24290366

The effect of ordinances requiring smoke-free restaurants on restaurant sales.

PubMed Central

Glantz, S A; Smith, L R

1994-01-01

OBJECTIVES: The effect on restaurant revenues of local ordinances requiring smoke-free restaurants is an important consideration for restauranteurs themselves and the cities that depend on sales tax revenues to provide services. METHODS: Data were obtained from the California State Board of Equalization and Colorado State Department of Revenue on taxable restaurant sales from 1986 (1982 for Aspen) through 1993 for all 15 cities where ordinances were in force, as well as for 15 similar control communities without smoke-free ordinances during this period. These data were analyzed using multiple regression, including time and a dummy variable for whether an ordinance was in force. Total restaurant sales were analyzed as a fraction of total retail sales and restaurant sales in smoke-free cities vs the comparison cities similar in population, median income, and other factors. RESULTS. Ordinances had no significant effect on the fraction of total retail sales that went to restaurants or on the ratio of restaurant sales in communities with ordinances compared with those in the matched control communities. CONCLUSIONS. Smoke-free restaurant ordinances do not adversely affect restaurant sales. PMID:8017529

Mixed Messages, Mixed Outcomes: Exposure to Direct-to-Consumer Advertising for Statin Drugs is Associated with More Frequent Visits to Fast Food Restaurants and Exercise.

PubMed

Niederdeppe, Jeff; Avery, Rosemary J; Kellogg, Maxwell D; Mathios, Alan

2017-07-01

This study examines whether exposure to direct-to-consumer advertising (DTCAs) for statin drugs is associated with non-pharmaceutical behaviors to prevent cardiovascular disease. We focus on the relationship between statin drug DTCA exposure and the frequency of (a) visits to fast-food restaurants and (b) exercise. We combine data on the televised broadcast availability of statin drug DTCAs in large media markets in the United States with 18 waves of the Simmons National Consumer Survey (NCS; n = 120, 229) from 2001 to 2009. We find that statin drug DTCA exposure is associated, in a dose-response pattern, with modest increases in the frequency of exercise and large increases in the frequency of fast-food-restaurant visits. The relationship between statin DTCA exposure and fast-food-restaurant visits were largely consistent in direction but differed in magnitude between those without a previous diagnosis of high cholesterol and those treating high cholesterol with a statin. We conclude with a discussion of the implications of these results for future research on pharmaceutical DTCA and population health.

Persistent disparities in obesity risk among public schoolchildren from childhood through adolescence.

PubMed

Chen, Danhong; Thomsen, Michael R; Nayga, Rodolfo M; Bennett, Judy L

2016-08-01

Arkansas is among the poorest states and has high rates of childhood obesity. In 2003, it became the first state to systematically screen public schoolchildren for unhealthy weight status. This study aims to examine the socioeconomic disparities in Body Mass Index (BMI) growth and the risk of the onset of obesity from childhood through adolescence. This study analyzed (in 2015) the data for a large cohort of Arkansas public schoolchildren for whom BMIs were measured from school years 2003/2004 through 2009/2010. A linear growth curve model was used to assess how child-level sociodemographics and neighborhood characteristics were associated with growth in BMI z-scores. Cox regression was subsequently used to investigate how these factors were associated with the onset of obesity. Because children might be classified as obese in multiple years, sensitivity analysis was conducted using recurrent event Cox regression. Survival analysis indicated that the risk of onset of obesity rose sharply between ages of 5 and 10 and then again after age 15. The socioeconomic disparities in obesity risk persisted from kindergarten through adolescence. While better access to full service restaurants was associated with lower risk of the onset of obesity (Hazard Ratio (HR)=0.98, 95% CI=0.97-0.99), proximity to fast food restaurants was related to increased risk of the onset of obesity (HR=1.01, 95% CI=1.00-1.01). This analysis stresses the need for policies to narrow the socioeconomic gradient and identifies important time periods for preventative interventions in childhood obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Restaurant eating in nonpurge binge-eating women.

PubMed

Timmerman, Gayle M

2006-11-01

This study describes restaurant-eating behaviors for nonpurge binge-eating women in comparison to dieters. Restaurant-eating behaviors were determined from a content analysis of 14-day food diaries using a convenience sample of 71 women who reported binging without purging and 46 dieters without a recent binge history. Comparing bingers to dieters, there were no significant differences in frequency of eating out, dessert consumption at restaurants, or fast food eating. Bingers more often perceived restaurant eating to be uncontrolled and excessive. Both bingers and dieters consumed significantly more calories (226-253 kcal) and fat (10.4-16.0 gm) on restaurant days. Extra calories consumed on restaurant-eating days may contribute to weight gain over time, especially with frequent restaurant eating. Restaurants may present a high-risk food environment for bingers and dieters, contributing to loss of control and excess consumption.

[Neighborhood environment quality, individual-level social capital, and depressive symptoms among adolescents].

PubMed

Asakura, Takashi

2011-09-01

We aimed to develop measures to assess features of neighborhood quality and individual social capital, as well as their associations with depressive symptoms among early adolescents. To determine whether relations of depressive symptoms with neighborhood quality might be contingent upon the level of individual cognitive social capital, neighborhood-by-cognitive social capital interaction terms were examined. A qualitative study was conducted to elicit the perceptions of early adolescents about their neighborhood environment. Subsequently, we recruited 2,002 eighth graders and asked for responses to a self-administered questionnaire. The variables analyzed in this study were the Center for Epidemiologic Studies-Depression scale (10 items), features of neighborhood quality, cognitive and structural individual social capital, and demographics. We adopted a generalized estimating equation regression model for the multivariate analysis. The analytic sample was 1,786 with no missing variable in the models. Seven subscales were devised to assess quality features of neighborhood environments with an examination of validity and reliability: "availability of services," "good neighborhood relations," "spaces for recreation," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," "civic communities," and "aesthetic look." We also developed a scale of individual cognitive social capital, which consisted of three constructs: "social trust," "reciprocity," and "social norms." Additionally, the number of social activities in which subjects participated was counted as an indicator of the structural aspect of individual social capital. On examination with the generalized estimating equation regression model, "availability of services," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," and cognitive social capital were significantly associated with the CES-D scores controlling for demographics. We also found a significant interplay between "dirty-looking, squalid, unclean" and the cognitive social capital for estimating scores of depressive symptoms. Improvement in features of neighborhood quality such as availability of services, cleanliness, and security and social order in terms of public policy as well as civic activities could contribute to promotion of mental health in adolescents. Individual cognitive social capital accumulated through experiencs of good social relationshisp in a community could also play important roles in maximizing mental health.

Comparison of sunscreen availability in Chicago Hispanic and non-Hispanic neighborhoods.

PubMed

Hernandez, Claudia; Calero, Diana; Robinson, Gina; Mermelstein, Robin; Robinson, June K

2012-10-01

Poorer survival rates from melanoma among Hispanics have been previously reported. There is little information regarding sunscreen acquisition behaviors or availability/access to products that may help reduce the risk of skin cancer in Hispanic communities. This study sought to understand perceptions regarding sun protection and skin cancer risk and whether the availability of over-the-counter sunscreen products differed in three Chicago neighborhoods with different ethnic compositions. We drew on interviews with 65 adult Spanish speaking Hispanics (23-72 years) recruited from faith-based institutions to better understand sunscreen use perceptions. Commercial establishments open to the general public were physically canvassed to determine whether there were any differences in sunscreen products availability. Stores carrying sun protection products are nearly twice as common in non Hispanic White neighborhoods versus Hispanic. In addition, when sunscreens are available for sale, Hispanics have fewer sunscreens to choose from. Emergent themes that were elicited during the interviews revealed that barriers to increased sunscreen use include economic and erroneous perceptions regarding skin cancer incidence and risk. Environmental factors that may reinforce these beliefs include lower availability and variety of sun protection products in Hispanic neighborhoods. These findings indicate that providing culturally appropriate public health information encouraging the use of sunscreen and improving its availability in Hispanic communities are potential points of intervention in attempts to improve morbidity from skin cancer. © 2012 John Wiley & Sons A/S.

Food sanitation practices in restaurants of Ramallah and Al-Bireh district of Palestine.

PubMed

Al-Khatib, I A; Al-Mitwalli, S M

2009-01-01

Safe handling of food in restaurants is a basic element in the reduction of foodborne illness. We investigated knowledge and practices about food safety by food-handlers in restaurants in Ramallah and Al-Bireh district of Palestine. A high proportion of workers in the restaurants had no previous experience in other restaurants and 63.4% had received no training on food sanitation and safety. Most of the restaurants in the refugee camps, villages and towns had only 1 worker. Restaurants lacked basic conditions for food sanitation and safety, such as hot water in most and cleaning materials in some. Many workers had poor personal hygiene practices. Training is needed for restaurant owners and staff to improve food handling practices and standards.

Ecology and phylogeny of birds foraging at outdoor restaurants in Sweden

PubMed Central

Sjöstedt de Luna, Sara; Blank, Henrick; Lundqvist, Henrik

2015-01-01

Abstract Background Birds frequently visit the outdoor serving areas of restaurants to feed on scraps of food and leftovers. Although this feeding association between humans and birds is widespread and could have significant effects, both positive and negative, for all taxa involved, the authors know of no published studies that have investigated restaurant bird communities. To lay the foundation for future research, the authors conducted a basic study of birds at 80 outdoor restaurants in Sweden, identifying which species and taxonomic clades of birds visited the restaurants and comparing restaurant birds in urban and rural environments. New information Thirteen species of birds visited the outdoor restaurants. Eight of these species were predominant, i.e. accounting for 51% or more of bird presence (sum of minutes of all individual birds) at one or more restaurants. Every restaurant studied had a predominant species, but species often differed from each other in frequency of predominance in different landscapes. No endangered species were seen visiting restaurants. However, three farmland bird species (House Sparrow Passer domesticus, White Wagtail Motacilla alba, Eurasian Tree Sparrow Passer montanus), whose numbers are reported to be declining in the countryside, were predominant at the majority of restaurants in rural areas, suggesting that rural restaurants might be able to contribute to the conservation of these species. The thirteen species of restaurant-visiting birds belonged to five monophyletic clades. Ninety percent of all restaurants had, as their predominant species, birds from either Clade A (Passeridae, Motacillidae, Fringillidae) or Clade C (Corvidae). Statistical testing revealed that Clade A and Clade C were distributed differently in environments along the urban-rural gradient. At all spatial scales measured, birds of Clade C were predominant at the majority of restaurants in urban areas, while birds of Clade A were the predominant clade at the majority of restaurants in rural areas. The authors use this evidence, and observations of birds foraging in association with other primates, to hypothesize that the outdoor serving areas of modern restaurants may be helping to preserve and nurture ancient human-bird symbioses that have been part of human ecology since antiquity. PMID:26491395

Local concentration of fast-food outlets is associated with poor nutrition and obesity.

PubMed

Kruger, Daniel J; Greenberg, Emily; Murphy, Jillian B; DiFazio, Lindsay A; Youra, Kathryn R

2014-01-01

We investigated the relationship of the local availability of fast-food restaurant locations with diet and obesity. We geocoded addresses of survey respondents and fast-food restaurant locations to assess the association between the local concentration of fast-food outlets, BMI, and fruit and vegetable consumption. The survey was conducted in Genesee County, Michigan. There were 1345 individuals included in this analysis, and the response rate was 25%. The Speak to Your Health! Community Survey included fruit and vegetable consumption items from the Behavioral Risk Factor Surveillance System, height, weight, and demographics. We used ArcGIS to map fast-food outlets and survey respondents. Stepwise linear regressions identified unique predictors of body mass index (BMI) and fruit and vegetable consumption. Survey respondents had 8 ± 7 fast-food outlets within 2 miles of their home. Individuals living in close proximity to fast-food restaurants had higher BMIs t(1342) = 3.21, p < .001, and lower fruit and vegetable consumption, t(1342) = 2.67, p = .008. Individuals may be at greater risk for adverse consequences of poor nutrition because of the patterns in local food availability, which may constrain the success of nutrition promotion efforts. Efforts to decrease the local availability of unhealthy foods as well as programs to help consumers identify strategies for obtaining healthy meals at fast-food outlets may improve health outcomes.

The influence of neighborhood food stores on change in young girls' body mass index.

PubMed

Leung, Cindy W; Laraia, Barbara A; Kelly, Maggi; Nickleach, Dana; Adler, Nancy E; Kushi, Lawrence H; Yen, Irene H

2011-07-01

As the prevalence of childhood obesity has risen in past decades, more attention has been given to how the neighborhood food environment affects children's health outcomes. This exploratory study examined the relationship between the presence of neighborhood food stores within a girl's neighborhood and 3-year risk of overweight/obesity and change in BMI, in girls aged 6 or 7 years at baseline. A longitudinal analysis of participants in the Cohort Study of Young Girls' Nutrition, Environment and Transitions (CYGNET) was conducted from 2005 to 2008. Neighborhood food stores were identified from a commercial database and classified according to industry codes in 2006. Generalized linear and logistic models were used to examine how availability of food stores within 0.25-mile and 1.0-mile network buffers of a girl's residence were associated with BMI z-score change and risk of overweight or obesity, adjusting for baseline BMI/weight and family sociodemographic characteristics. Data were analyzed in 2010. Availability of convenience stores within a 0.25-mile network buffer of a girl's residence was associated with greater risk of overweight/obesity (OR=3.38, 95% CI=1.07, 10.68) and an increase in BMI z-score (β=0.13, 95% CI=0.00, 0.25). Availability of produce vendors/farmer's markets within a 1.0-mile network buffer of a girl's residence was inversely associated with overweight/obesity (OR=0.22, 95% CI=0.05, 1.06). A significant trend was observed between availability of produce vendors/farmer's markets and lower risk of overweight/obesity after 3 years. Although food store inventories were not assessed and food store indices were not created, the availability of neighborhood food stores may affect a young girl's weight trajectory over time. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Influence of Neighborhood Food Stores on Change in Young Girls’ Body Mass Index

PubMed Central

Leung, Cindy W.; Laraia, Barbara A.; Kelly, Maggi; Nickleach, Dana; Adler, Nancy E.; Kushi, Lawrence H.; Yen, Irene H.

2011-01-01

Background As the prevalence of childhood obesity has risen in past decades, more attention has been given to how the neighborhood food environment affects children’s health outcomes. Purpose This exploratory study examined the relationship between the presence of neighborhood food stores within a girl’s neighborhood and 3-year risk of overweight/obesity and change in BMI, in girls aged 6 or 7 years at baseline. Methods A longitudinal analysis of participants in the Cohort Study of Young Girls’ Nutrition, Environment and Transitions (CYGNET) was conducted from 2005–2008. Neighborhood food stores were identified from a commercial database and classified according to industry codes in 2006. Generalized linear and logistic models were used to examine how availability of food stores within 0.25-mile and 1.0-mile network buffers of a girl’s residence were associated with BMI z-score change and risk of overweight or obesity, adjusting for baseline BMI/weight and family sociodemographic characteristics. Data were analyzed in 2010. Results Availability of convenience stores within a 0.25-mile network buffer of a girl’s residence was associated with greater risk of overweight/obesity (OR 3.38, 95% CI 1.07, 10.68) and an increase in BMI z-score (β=0.13, 95% CI 0.00, 0.25). Availability of produce vendors/farmer’s markets within a 1.0-mile network buffer of a girl’s residence was inversely associated with overweight/ obesity (OR 0.22, 95% CI 0.05, 1.06). A significant trend was observed between availability of produce vendors/farmer’s markets and lower risk of overweight/obesity after 3 years. Conclusions Although food store inventories were not assessed and food store indices were not created, the availability of neighborhood food stores may affect a young girl’s weight trajectory over time. PMID:21665062

Views about secondhand smoke and smoke-free policies among North Carolina restaurant owners before passage of a law to prohibit smoking.

PubMed

Linnan, Laura A; Weiner, Bryan J; Bowling, J Michael; Bunger, Erin M

2010-01-01

This study examined the knowledge, attitudes, and beliefs about secondhand smoke and smoke-free policies among North Carolina restaurant owners and managers before passage of House Bill 2, which prohibited smoking in most restaurants and bars. A random sample of North Carolina restaurants was selected to participate. A 15-minute telephone survey was completed by 523 restaurant owners and managers (one per participating restaurant) who spoke English and operated a restaurant that had seating for guests and was not a corporate headquarters for a restaurant chain (response rate, 36.7%). Bivariable analyses using chi2 tests of association were conducted. Multivariable modeling with logistic regression was used to examine relationships among several predictor variables and current smoking policies at participating restaurants, support among owners and managers for a statewide ban on smoking in restaurants, and beliefs among owners and managers about the economic impact of smoke-free policies. Restaurant owners and managers were aware that secondhand smoke causes cancer and asthma (79% and 73% or respondents, respectively) but were less aware that it causes heart attacks (56%). Sixty-six percent of restaurants did not permit any smoking indoors. Sixty percent of owners and managers supported a statewide smoke-free law. Owners and managers who were current smokers, those who worked at a restaurant with an employee smoking prevalence of more than 25%, and those who worked in a restaurant without a 700% smoke-free policy were significantly less likely to support a statewide law requiring smoke-free public places. Only owner and manager smoking status and no current smoke-free indoor policy were significant independent predictors of the belief that instituting a smoke-free policy would have negative economic consequences for the restaurant. Although participating establishments were a representative sample of North Carolina restaurants, an overall survey response rate of 36.7% limits the generalizability of these findings. Most North Carolina restaurant owners and managers in our sample had a smoke-free indoor policy and supported a law to make public places smoke-free. Results were used to strengthen interventions that create a safe and healthy environment for restaurant employees and customers, in anticipation of passage of House Bill 2.

Succession, climate, and neighborhood dynamics influence tree growth over time: an 87-year record of change in a Pinus resinosa (Aiton)-dominated forest, Minnesota, USA

Treesearch

Miranda T. Curzon; Anthony W. D' Amato; Shawn Fraver; Emily S. Huff; Brian J. Palik

2016-01-01

Resource availability and its influence on tree-to-tree interactions are expected to change over the course of forest stand development, but the rarity of long-term datasets has limited examinations of neighborhood crowding over extended time periods. How do a history of neighborhood interactions and population-level dynamics, including demographic transition, impact...

Mean wind speed below building height in residential neighborhoods with different tree densities

Treesearch

G.M. Heisler

1990-01-01

There is little available knowledge of the absolute or relative effects of trees and buildings on wind at or below building height in residential neighborhoods. In this study, mean wind speed was measured at a height of 6.6 ft (2 m) in neighborhoods of single-family houses. BuIlding densities ranged between 6% and 12% of the land ares, and tree-cover densities were...

Restaurant volatility and the Iowa City, Iowa, smoke-free restaurant ordinance.

PubMed

Sheffer, Megan A; Squier, Christopher A; Gilmore, Gary D

2013-01-01

To determine the economic impact of the Iowa City, Iowa, smoke-free restaurant ordinance (IC-SFRO) using an immediate and novel approach. In this retrospective study, food permit licensure served as the measure to assess the IC-SFRO impact. The Iowa City experience provided an excellent experimental setting, as the ordinance was enacted March 1, 2002, and repealed May 7, 2003, because of preemption. The city of Coralville served as a natural control, as it is contiguous to Iowa City, has similar population demographics, and has never enacted a smoke-free restaurant ordinance. Food permit licensure data for all Iowa City and Coralville restaurants were obtained from the Johnson County Health Department. Differences in restaurant volatility were assessed using Fisher's exact probability test. The number of restaurants increased in both Iowa City and Coralville throughout the ordinance period. The ratio of the total number of restaurants in Iowa City to the total number of restaurants in the Iowa City-Coralville metropolitan area remained stable. The proportion of restaurants for each city did not differ significantly during the preordinance, ordinance, and postordinance periods. The IC-SFRO did not adversely impact the restaurant industry in terms of restaurant closures. The Iowa legislature was urged to draft evidence-based legislation, such as amending preemption of the IC-SFRO, to protect and promote the health of its communities.

What menu changes do restaurants make after joining a voluntary restaurant recognition program?

PubMed

Gase, Lauren N; Kaur, Mandip; Dunning, Lauren; Montes, Christine; Kuo, Tony

2015-06-01

Programs that recognize restaurants for offering healthful options have emerged as a popular strategy to address the obesity epidemic; however, program fidelity and business responses to such programs are rarely assessed. This study sought to examine how retail restaurants in Los Angeles County chose to comply with participation criteria required by the Choose Health LA Restaurants initiative in the region; the program recognizes restaurants for offering reduced-size portions and healthy children's meals. Menus of all restaurants that joined within 1 year of program launch (n = 17 restaurant brands) were assessed for changes. Nine of the 17 brands made changes to their menus to meet participation criteria for reduced-size portions while 8 of the 10 restaurant brands that offered children's menus made changes to improve the healthfulness of children's meals. Results of this comparative assessment lend support to restaurant compliance with program criteria and menu improvements, even though they are voluntary, representing an important step toward implementing this strategy in the retail environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

From Menu to Mouth: Opportunities for Sodium Reduction in Restaurants

PubMed Central

Gunn, Janelle Peralez

2014-01-01

Restaurant foods can be a substantial source of sodium in the American diet. According to the Institute of Medicine, the significant contribution made by restaurants and food service menu items to Americans’ sodium intake warrants targeted attention. Public health practitioners are uniquely poised to support sodium-reduction efforts in restaurants and help drive demand for lower-sodium products through communication and collaboration with restaurant and food service professionals and through incentives for restaurants. This article discusses the role of the public health practitioner in restaurant sodium reduction and highlights select strategies that have been taken by state and local jurisdictions to support this effort. PMID:24456646

Gaseous and particulate polycyclic aromatic hydrocarbons (PAHs) emissions from commercial restaurants in Hong Kong.

PubMed

Chen, Yi; Ho, Kin Fai; Ho, Steven Sai Hang; Ho, Wing Kei; Lee, Shun Cheng; Yu, Jian Zhen; Sit, Elber Hoi Leung

2007-12-01

Commercial cooking emissions are important air pollution sources in a heavily urbanized city. Exhaust samples were collected in six representative commercial kitchens including Chinese restaurants, Western restaurants, and Western fast-food restaurants in Hong Kong during peak lunch hours. Both gaseous and particulate emissions were evaluated. Eight gaseous and twenty-two particulate polycyclic aromatic hydrocarbons (PAHs) were quantified in this study. In the gaseous phase, naphthalene (67-89%) was the most abundant PAH in all of the exhaust samples. The contribution of acenaphthylene in the gaseous phase was significantly higher in emissions from the Chinese restaurants, whereas fluorene was higher in emissions from the Western cooking style restaurants (i.e., Western restaurants and Western fast-food restaurants). Pyrene is the most abundant particulate PAH in the Chinese restaurants (14-49%) while its contribution was much lower in the Western cooking style restaurants (10-22%). Controlled cooking conditions were monitored in a staff canteen to compare the emissions from several different local cooking styles, including deep frying, steaming, and mixed cooking styles (combination of steaming and frying). Deep frying produced the highest amount of total gaseous PAHs, 6 times higher than the steaming. However, steaming produced the highest particulate emissions. The estimated annual gaseous PAH emissions for the Chinese restaurants, Western restaurants, and Western fast-food restaurants were 255, 173, and 20.2 t y(-1) whereas 252, 1.9, and 0.4 t y(-1) were estimated for particulate phase PAH emissions. The study provides useful information and estimates for PAH emissions from commercial cooking exhaust in Hong Kong.

Impact of a Neighborhood-Based Curriculum on the Helpfulness of Pediatric Residents' Anticipatory Guidance to Impoverished Families.

PubMed

Real, Francis J; Beck, Andrew F; Spaulding, Jeanne R; Sucharew, Heidi; Klein, Melissa D

2016-11-01

Introduction Neighborhood location has been shown to impact childhood health and well-being. It follows that neighborhood context-the risks and assets present within a patient's neighborhood-may be an important consideration during provision of primary care. Pediatric residents often serve as the primary care physicians for high risk populations though are often unfamiliar with local neighborhoods. As such, education interventions that deepen residents' understanding of a patient's neighborhood context may allow for targeted care provision. A neighborhood-based curriculum was therefore created to improve residents' familiarity with local neighborhoods. Methods The neighborhood-based curriculum utilized a shared interactive presentation to address the topics of housing, nutrition, safe play, pharmacies, and transportation. Education modules included introduction to readily available on-line resources. A pre-post survey assessed resident self-perceived competence on the curricular topics of interest. Caregivers were interviewed in the post-curriculum period to rate the helpfulness of resident-administered advice. Results Following the curriculum, residents reported improved competence on the topics of safe play and transportation (p < 0.05). When addressed in the clinical setting, the large majority of families felt that residents' advice on curricular topics was helpful; however, individual curricular topics were not consistently addressed during clinical encounters. Discussion A neighborhood-based education curriculum can be effective in teaching pediatric residents about the social determinants of health and local neighborhood resources. As research increasingly demonstrates the impact of neighborhood on health, we expect further educational focus on neighborhood as a means from which to educate residents who often care for an impoverished population.

Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan.

PubMed

Wang, Jin; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-03-01

To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments. Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels. Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and "Healthy Entrées" sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as "Facilitators" and "Barriers") significantly differed by neighbourhood distress level. The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.

Economic Impact of Smoke-Free Air Laws in North Dakota on Restaurants and Bars.

PubMed

Shafer, Paul R; Loomis, Brett R

2016-08-01

In late 2012, North Dakota expanded its statewide smoke-free air law to cover all restaurants and bars in the state. Several North Dakota communities also had local ordinances that prohibited smoking in restaurants and bars prior to the statewide law. Previous work found no effect of the initial statewide law or several local laws on restaurant and bar sales. Using quarterly county-level employment data from 1990 to 2014, we examined whether the expanded statewide law or pre-existing local laws were associated with significant changes in employment in restaurants and bars in North Dakota. Separate models were estimated for restaurant and bar employment using two methods of controlling for smoke-free air law coverage. We found no evidence of a significant association between employment in restaurants and bars in North Dakota and the expanded statewide law or pre-existing local laws. Prior employment levels in restaurants and bars and prevailing economic conditions were the main drivers of restaurant and bar employment, not smoke-free air laws. This study examines the economic impact of smoke-free air laws in North Dakota on restaurant and bar employment following the expansion of the statewide law in late 2012 to cover all restaurants and bars. We find no significant adverse effect of smoke-free air laws on restaurants and bars, consistent with results from previous studies conducted in North Dakota and throughout the United States. This study is the first to analyze the economic impact of smoke-free air laws in North Dakota on restaurant and bar employment following the 2012 expansion of the statewide law to cover all restaurants and bars. We find no evidence of a significant adverse effect of smoke-free air laws on restaurants and bars, consistent with results from previous studies conducted in North Dakota and throughout the United States. Prior employment levels and prevailing economic conditions proved to be the main drivers of restaurant and bar employment, not smoke-free air laws. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items

ERIC Educational Resources Information Center

Thayer, Linden M.; Pimentel, Daniela C.; Smith, Janice C.; Garcia, Beverly A.; Sylvester, Laura Lee; Kelly, Tammy; Johnston, Larry F.; Ammerman, Alice S.; Keyserling, Thomas C.

2017-01-01

Background: Because Americans commonly consume restaurant foods with poor dietary quality, effective interventions are needed to improve food choices at restaurants. Purpose: The purpose of this study was to design and evaluate a restaurant-based intervention to help customers select and restaurants promote heart healthy menu items with healthful…

29 CFR 779.386 - Restaurants may qualify as exempt 13(a)(2) establishments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Restaurants may qualify as exempt 13(a)(2) establishments... Service Establishments Restaurants and Establishments Providing Food and Beverage Service § 779.386 Restaurants may qualify as exempt 13(a)(2) establishments. (a) A restaurant may qualify as an exempt retail or...

Insufficient smoking restrictions in restaurants around junior high schools in Japan.

PubMed

Kotani, Kazuhiko; Osaki, Yoneatsu; Kurozawa, Youichi; Kishimoto, Takuji

2006-12-01

Controls for second hand smoke (SHS) and adolescent smoking have been still sociomedical concerns in Japan. Restaurant smoking restrictions are associated with community social norms affecting adolescent smoking behavior, and the status in areas around Junior high schools (JHSs) in the community could be a sign of community practices on regulating SHS for adolescents. To examine whether restaurant smoking restrictions are seen especially in areas around JHSs in Japan, a survey using the direct inspection of a total of 163 restaurants (64 restaurants within and 99 outside a 1-km radius from the nearest JHSs) was conducted in May 2003 in Yonago city, Japan. We assessed smoking restriction status in each restaurant and classified them into 2 groups according to the distance from the nearest JHSs. There were only 2 (3.1%) restaurants with 100% non-smoking and 11 (17.2%) with some partial restrictions among the restaurants within a 1-km radius of JHSs. There were 1 (1.0%) restaurant with 100% non-smoking, 3 (3.0%) with complete non-smoking sections and 17 (17.2%) with some partial restrictions among the restaurants outside a 1-km radius of JHSs. Among restaurants with some partial restrictions, restriction methods were considered insufficient. The smoking restriction status was not significantly different between the restaurant groups within and outside a 1-km radius of JHSs. These results suggest that the public awareness of and attitude toward adolescent smoking problems remains low in Japan. Further SHS control actions for adolescents are needed in Japan.

Associations between Body Mass Index and Park Proximity, Size, Cleanliness and Recreational Facilities

PubMed Central

Quinn, James; Lovasi, Gina; Bader, Michael; Yousefzadeh, Paulette; Weiss, Christopher; Neckerman, Kathryn

2013-01-01

Purpose To determine whether body mass index (BMI) is associated with proximity to neighborhood parks, the size of the parks, their cleanliness and the availability of recreational facilities in the parks. Design Cross-sectional. Setting New York City. Subjects 13,102 adults (median age 45 years, 36% male) recruited from 2000–2002. Measures Anthropometric and socio-demographic data from study subjects were linked to Department of Parks & Recreation data on park space, cleanliness, and facilities. Neighborhood level socio-demographic and park proximity metrics were created for half-mile radius circular buffers around each subject’s residence. Proximity to park space was measured as the proportion of the subject’s neighborhood buffer area that was total park space, large park space (a park > 6 acres) and small park space (a park <=6 acres). Analysis Hierarchical linear models were used to determine whether neighborhood park metrics were associated with BMI. Results Higher proximity to large park space was significantly associated with lower BMI (beta = −1.69 95% CI = −2.76, −0.63). Across the population distribution of proximity to large park space, compared to subjects living in neighborhoods at the 10th percentile of the distribution, the covariate adjusted average BMI was estimated to be 0.35 kg/m2 lower for those living in neighborhoods at the 90th percentile. The proportion of neighborhood area that was small park space was not associated with BMI, nor was park cleanliness or the availability of recreational facilities. Conclusions Neighborhood proximity to large park spaces is modestly associated with lower BMI in a diverse urban population. PMID:23448416

Demarcation of local neighborhoods to study relations between contextual factors and health

PubMed Central

2010-01-01

Background Several studies have highlighted the importance of collective social factors for population health. One of the major challenges is an adequate definition of the spatial units of analysis which present properties potentially related to the target outcomes. Political and administrative divisions of urban areas are the most commonly used definition, although they suffer limitations in their ability to fully express the neighborhoods as social and spatial units. Objective This study presents a proposal for defining the boundaries of local neighborhoods in Rio de Janeiro city. Local neighborhoods are constructed by means of aggregation of contiguous census tracts which are homogeneous regarding socioeconomic indicators. Methodology Local neighborhoods were created using the SKATER method (TerraView software). Criteria used for socioeconomic homogeneity were based on four census tract indicators (income, education, persons per household, and percentage of population in the 0-4-year age bracket) considering a minimum population of 5,000 people living in each local neighborhood. The process took into account the geographic boundaries between administrative neighborhoods (a political-administrative division larger than a local neighborhood, but smaller than a borough) and natural geographic barriers. Results The original 8,145 census tracts were collapsed into 794 local neighborhoods, distributed along 158 administrative neighborhoods. Local neighborhoods contained a mean of 10 census tracts, and there were an average of five local neighborhoods per administrative neighborhood. The local neighborhood units demarcated in this study are less socioeconomically heterogeneous than the administrative neighborhoods and provide a means for decreasing the well-known statistical variability of indicators based on census tracts. The local neighborhoods were able to distinguish between different areas within administrative neighborhoods, particularly in relation to squatter settlements. Conclusion Although the literature on neighborhood and health is increasing, little attention has been paid to criteria for demarcating neighborhoods. The proposed method is well-structured, available in open-access software, and easily reproducible, so we expect that new experiments will be conducted to evaluate its potential use in other settings. The method is thus a potentially important contribution to research on intra-urban differentials, particularly concerning contextual factors and their implications for different health outcomes. PMID:20587046

Demarcation of local neighborhoods to study relations between contextual factors and health.

PubMed

Santos, Simone M; Chor, Dora; Werneck, Guilherme Loureiro

2010-06-29

Several studies have highlighted the importance of collective social factors for population health. One of the major challenges is an adequate definition of the spatial units of analysis which present properties potentially related to the target outcomes. Political and administrative divisions of urban areas are the most commonly used definition, although they suffer limitations in their ability to fully express the neighborhoods as social and spatial units. This study presents a proposal for defining the boundaries of local neighborhoods in Rio de Janeiro city. Local neighborhoods are constructed by means of aggregation of contiguous census tracts which are homogeneous regarding socioeconomic indicators. Local neighborhoods were created using the SKATER method (TerraView software). Criteria used for socioeconomic homogeneity were based on four census tract indicators (income, education, persons per household, and percentage of population in the 0-4-year age bracket) considering a minimum population of 5,000 people living in each local neighborhood. The process took into account the geographic boundaries between administrative neighborhoods (a political-administrative division larger than a local neighborhood, but smaller than a borough) and natural geographic barriers. The original 8,145 census tracts were collapsed into 794 local neighborhoods, distributed along 158 administrative neighborhoods. Local neighborhoods contained a mean of 10 census tracts, and there were an average of five local neighborhoods per administrative neighborhood.The local neighborhood units demarcated in this study are less socioeconomically heterogeneous than the administrative neighborhoods and provide a means for decreasing the well-known statistical variability of indicators based on census tracts. The local neighborhoods were able to distinguish between different areas within administrative neighborhoods, particularly in relation to squatter settlements. Although the literature on neighborhood and health is increasing, little attention has been paid to criteria for demarcating neighborhoods. The proposed method is well-structured, available in open-access software, and easily reproducible, so we expect that new experiments will be conducted to evaluate its potential use in other settings. The method is thus a potentially important contribution to research on intra-urban differentials, particularly concerning contextual factors and their implications for different health outcomes.

Is Nonsmoking Dangerous to the Health of Restaurants? The Effect of California's Indoor Smoking Ban on Restaurant Revenues

ERIC Educational Resources Information Center

Stolzenberg, Lisa; D'Alessio, Stewart J.

2007-01-01

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely…

Predicted Impact of the Food and Drug Administration's Menu-Labeling Regulations on Restaurants in 4 New Jersey Cities.

PubMed

Gruner, Jessie; DeWeese, Robin S; Lorts, Cori; Yedidia, Michael J; Ohri-Vachaspati, Punam

2018-02-01

To determine the proportion of restaurants that will be required to post calorie information under the Food and Drug Administration's menu-labeling regulations in 4 New Jersey cities. We classified geocoded 2014 data on 1753 restaurant outlets in accordance with the Food and Drug Administration's guidelines, which will require restaurants with 20 or more locations nationwide to post calorie information. We used multivariate logistic regression analyses to assess the association between menu-labeling requirements and census tract characteristics. Only 17.6% of restaurants will be affected by menu labeling; restaurants in higher-income tracts have higher odds than do restaurants in lower-income tracts (odds ratio [OR] = 1.55; P = .02). Restaurants in non-Hispanic Black (OR = 1.62; P = .02) and mixed race/ethnicity (OR = 1.44; P = .05) tracts have higher odds than do restaurants in non-Hispanic White tracts of being affected. Additional strategies are needed to help consumers make healthy choices at restaurants not affected by the menu-labeling law. These findings have implications for designing implementation strategies for the law and for evaluating its impact.

Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea.

PubMed

Park, Sohyun; Lee, Heeseung; Seo, Dong-Il; Oh, Kwang-Hwan; Hwang, Taik Gun; Choi, Bo Youl

2016-12-01

This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies.

Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea

PubMed Central

Lee, Heeseung; Seo, Dong-il; Oh, Kwang-hwan; Hwang, Taik Gun; Choi, Bo Youl

2016-01-01

BACKGROUND/OBJECTIVES This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. SUBJECTS/METHODS The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. RESULTS The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. CONCLUSIONS This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies. PMID:27909562

Out to eat: the emergence and evolution of the restaurant in nineteenth-century New York City.

PubMed

Lobel, Cindy R

2010-01-01

Unheard of in the eighteenth century, restaurants became an integral part of New York City's public culture in the antebellum period. This article examines the emergence and development of New York's restaurant sector in the nineteenth century, focusing on three aspects in particular: the close ties between urbanization and the rise of New York's restaurants, the role restaurants played in enforcing the city's class structure and gender mores, and the role of restaurants in shaping the public culture of the growing metropolis.

Does access to fast food lead to super-sized pregnant women and whopper babies?

PubMed

Lhila, Aparna

2011-12-01

Rise in the availability of fast-food restaurants has been blamed, at least partly, for the increasing obesity in the U.S. The existing studies of obesity have focused primarily on children, adolescents, and adults, and this paper extends the literature by raising a little-studied question and using nationally representative data to answer it. It examines the relationship between the supply of fast-food restaurants and weight gain of pregnant women and their newborns. I study prenatal weight gain because excessive weight gain has been linked to postpartum overweight/obesity and I study both tails of the birthweight distribution because the origin of obesity may be traced to the prenatal period and both tail outcomes have been associated with obesity later in life. I merge the 1998 and 2004 Natality Detail Files with the Area Resource File, and County Business Patterns, which provide data on the number of fast-food restaurants in the metropolitan area where the mother resides. The empirical model includes an extensive list of MSA characteristics and MSA fixed effects to control for factors that may be correlated with both health outcomes and restaurants' location decision. Results reveal that the fast-food and weight gain relationship is robust to the inclusion of these controls but these controls greatly mitigate the fast food-infant health relationship. Greater access to fast-food restaurants is positively related to mothers' probability of excessive weight gain but it does not share a statistically significant relationship with birthweight. These relationships hold in all the socioeconomic and demographic subgroups studied. 2011 Elsevier B.V. All rights reserved.

Characteristics of Prepared Food Sources in Low-Income Neighborhoods of Baltimore City

PubMed Central

LEE, SEUNG HEE; ROWAN, MEGAN T.; POWELL, LISA M.; NEWMAN, SARA; KLASSEN, ANN CARROLL; FRICK, KEVIN D.; ANDERSON, JENNIFER; GITTELSOHN, JOEL

2011-01-01

The food environment is associated with obesity risk and diet-related chronic diseases. Despite extensive research conducted on retail food stores, little is known about prepared food sources (PFSs). We conducted an observational assessment of all PFSs (N = 92) in low-income neighborhoods in Baltimore. The most common PFSs were carry-outs, which had the lowest availability of healthy food choices. Only a small proportion of these carry-outs offered healthy sides, whole wheat bread, or entrée salads (21.4%, 7.1%, and 33.9%, respectively). These findings suggest that carry-out-specific interventions are necessary to increase healthy food availability in low-income urban neighborhoods. PMID:21359162

Exploring data availability for the Environmental Quality Index to assess environmental health disparities

EPA Science Inventory

The interaction between environmental insults and human health is complex. Environmental exposures tend to cluster, with disamenities (e.g., landfills, industrial plants) often located in high-minority and largely poor neighborhoods, while wealthier neighborhoods contain amenitie...

Assessing the food environment of a rural community: baseline findings from the heart of New Ulm project, Minnesota, 2010-2011.

PubMed

Pereira, Raquel F; Sidebottom, Abbey C; Boucher, Jackie L; Lindberg, Rebecca; Werner, Rebecca

2014-03-06

Changes in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program. We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota. At least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for "healthy." Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores. Baseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China.

PubMed

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. The findings suggested food environment disparities did exist in different cities of China.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China

PubMed Central

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

Objective The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. Methods The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Results Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. Conclusions The findings suggested food environment disparities did exist in different cities of China. PMID:26938866

Effects of the Tobacco Products Control Amendment Act of 1999 on restaurant revenues in South Africa--a survey approach.

PubMed

van Walbeek, Corné; Blecher, Evan; van Graan, Madalet

2007-03-01

To investigate the impact of the restrictions on smoking in indoor public places on the financial situation of the hospitality industry. A telephone survey was undertaken of 1011 restaurants, selected by searching public-access Internet databases. Fifty per cent of surveyed restaurants spent an average of R67 000 (median of R25 000) to comply with the clean indoor air legislation. The capital cost for the remaining 50% of restaurants was zero. The impact on restaurant revenues was limited: 59% of restaurants reported no change in revenue, 22% an increase and 19% a decrease as a result of the legislation. Franchised restaurants experienced a net gain in revenue (34% reporting an increase, 16% reporting a decrease, and 50% reporting no change), although on average they incurred more costs to comply with the legislation than independent restaurants. On average, independent restaurants reported a decrease in their revenues as a result of the legislation (21% reporting a decrease, 13% reporting an increase, and 66% reporting no change). Ninety-two per cent of respondents believed that their restaurants complied with the legislation. The new smoking policies have been well accepted by nonsmokers (nearly 100%) and smokers (87%) alike. Despite the hospitality and tobacco industries' claim that the law restricting smoking in restaurants would have very detrimental financial consequences, the retrospective evidence does not support this.

Sodium monitoring in commercially processed and restaurant foods.

PubMed

Ahuja, Jaspreet K C; Pehrsson, Pamela R; Haytowitz, David B; Wasswa-Kintu, Shirley; Nickle, Melissa; Showell, Bethany; Thomas, Robin; Roseland, Janet; Williams, Juhi; Khan, Mona; Nguyen, Quynhanh; Hoy, Kathy; Martin, Carrie; Rhodes, Donna; Moshfegh, Alanna; Gillespie, Cathleen; Gunn, Janelle; Merritt, Robert; Cogswell, Mary

2015-03-01

Most sodium in the US diet comes from commercially processed and restaurant foods. Sodium reduction in these foods is key to several recent public health efforts. The objective was to provide an overview of a program led by the USDA, in partnership with other government agencies, to monitor sodium contents in commercially processed and restaurant foods in the United States. We also present comparisons of nutrients generated under the program to older data. We track ∼125 commercially processed and restaurant food items ("sentinel foods") annually using information from food manufacturers and periodically by nationwide sampling and laboratory analyses. In addition, we monitor >1100 other commercially processed and restaurant food items, termed "priority-2 foods" (P2Fs) biennially by using information from food manufacturers. These foods serve as indicators for assessing changes in the sodium content of commercially processed and restaurant foods in the United States. We sampled all sentinel foods nationwide and reviewed all P2Fs in 2010-2013 to determine baseline sodium concentrations. We updated sodium values for 73 sentinel foods and 551 P2Fs in the USDA's National Nutrient Database for Standard Reference (releases 23-26). Sodium values changed by at least 10% for 43 of the sentinel foods, which, for 31 foods, including commonly consumed foods such as bread, tomato catsup, and potato chips, the newer sodium values were lower. Changes in the concentrations of related nutrients (total and saturated fat, total sugar, potassium, or dietary fiber) that were recommended by the 2010 Dietary Guidelines for Americans for reduced or increased consumption accompanied sodium reduction. The results of sodium reduction efforts, based on resampling of the sentinel foods or re-review of P2Fs, will become available beginning in 2015. This monitoring program tracks sodium reduction efforts, improves food composition databases, and strengthens national nutrition monitoring. © 2015 American Society for Nutrition.

Sodium monitoring in commercially processed and restaurant foods

PubMed Central

Ahuja, Jaspreet KC; Pehrsson, Pamela R; Haytowitz, David B; Wasswa-Kintu, Shirley; Nickle, Melissa; Showell, Bethany; Thomas, Robin; Roseland, Janet; Williams, Juhi; Khan, Mona; Nguyen, Quynhanh; Hoy, Kathy; Martin, Carrie; Rhodes, Donna; Moshfegh, Alanna; Gillespie, Cathleen; Gunn, Janelle; Merritt, Robert; Cogswell, Mary

2015-01-01

Background Most sodium in the US diet comes from commercially processed and restaurant foods. Sodium reduction in these foods is key to several recent public health efforts. Objective The objective was to provide an overview of a program led by the USDA, in partnership with other government agencies, to monitor sodium contents in commercially processed and restaurant foods in the United States. We also present comparisons of nutrients generated under the program to older data. Design We track ∼125 commercially processed and restaurant food items (“sentinel foods”) annually using information from food manufacturers and periodically by nationwide sampling and laboratory analyses. In addition, we monitor >1100 other commercially processed and restaurant food items, termed “priority-2 foods” (P2Fs) biennially by using information from food manufacturers. These foods serve as indicators for assessing changes in the sodium content of commercially processed and restaurant foods in the United States. We sampled all sentinel foods nationwide and reviewed all P2Fs in 2010–2013 to determine baseline sodium concentrations. Results We updated sodium values for 73 sentinel foods and 551 P2Fs in the USDA’s National Nutrient Database for Standard Reference (releases 23–26). Sodium values changed by at least 10% for 43 of the sentinel foods, which, for 31 foods, including commonly consumed foods such as bread, tomato catsup, and potato chips, the newer sodium values were lower. Changes in the concentrations of related nutrients (total and saturated fat, total sugar, potassium, or dietary fiber) that were recommended by the 2010 Dietary Guidelines for Americans for reduced or increased consumption accompanied sodium reduction. The results of sodium reduction efforts, based on resampling of the sentinel foods or re-review of P2Fs, will become available beginning in 2015. Conclusion This monitoring program tracks sodium reduction efforts, improves food composition databases, and strengthens national nutrition monitoring. PMID:25733648

75 FR 26188 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

..., restaurant advertising, labeling, etc.); advertising, administrative, and operational expenses for trade... CFR part 1486 for additional evaluation criteria. 2. Review and Selection Process: All applications...

Total prohibition of smoking but not partial restriction effectively reduced exposure to tobacco smoke among restaurant workers in Finland.

PubMed

Reijula, Jere; Johnsson, Tom; Kaleva, Simo; Tuomi, Tapani; Reijula, Kari

2013-10-01

To assess work-related exposure to tobacco smoke in Finnish restaurants, a series of nationwide questionnaire surveys were conducted among restaurant workers and the levels of indoor air nicotine concentrations were measured in restaurants. The survey aimed to evaluate the impact of the smoke-free legislation in general and in particular after the total smoking ban launched in 2007. In 2003-2010, four national questionnaire surveys were conducted among restaurant workers and the concentration of nicotine in indoor air was measured in different types of restaurants, bars and nightclubs. Between 2003 and 2010, the proportion of restaurant workers reporting occupational exposure to tobacco smoke dropped from 59% to 11%. Among pub workers, the decrease was from 97% to 18% and in workers of dining restaurants from 49% to 10%, respectively. The median concentration of nicotine in indoor air of all restaurants decreased from 11.7 μg/m(3) to 0.1 μg/m(3). The most significant decrease was detected in pubs where the decrease was from 16.1 μg/m(3) to 0.1 μg/m(3). Among all restaurant workers, in 2003-2010 the prevalence of daily smokers was reduced from 39% to 31% in men and from 35% to 25% in women. Total prohibition of smoking but not partial restriction in restaurants was effective in reducing work-related exposure to tobacco smoke. Strict tobacco legislation may partly be associated with the significant decrease of daily smoking prevalence among restaurant workers.

Segregation as a multi-scalar phenomenon and its implications for neighborhood-scale research: the case of South Seattle 1990–2010

PubMed Central

Fowler, Christopher S.

2015-01-01

Neighborhoods and neighborhood change are often at least implicitly understood in relation to processes taking place at scales both smaller than and larger than the neighborhood itself. Until recently our capacity to represent these multi-scalar processes with quantitative measures has been limited. Recent work on “segregation profiles” by Reardon and collaborators (Reardon et al., 2008, 2009) expands our capacity to explore the relationship between population measures and scale. With the methodological tools now available, we need a conceptual shift in how we view population measures in order to bring our theories and measures of neighborhoods into alignment. I argue that segregation can be beneficially viewed as multi-scalar; not a value calculable at some ‘correct’ scale, but a continuous function with respect to scale. This shift requires new ways of thinking about and analyzing segregation with respect to scale that engage with the complexity of the multi-scalar measure. Using block level data for eight neighborhoods in Seattle, Washington I explore the implications of a multi-scalar segregation measure for understanding neighborhoods and neighborhood change from 1990 to 2010. PMID:27041785

Segregation as a multi-scalar phenomenon and its implications for neighborhood-scale research: the case of South Seattle 1990-2010.

PubMed

Fowler, Christopher S

Neighborhoods and neighborhood change are often at least implicitly understood in relation to processes taking place at scales both smaller than and larger than the neighborhood itself. Until recently our capacity to represent these multi-scalar processes with quantitative measures has been limited. Recent work on "segregation profiles" by Reardon and collaborators (Reardon et al., 2008, 2009) expands our capacity to explore the relationship between population measures and scale. With the methodological tools now available, we need a conceptual shift in how we view population measures in order to bring our theories and measures of neighborhoods into alignment. I argue that segregation can be beneficially viewed as multi-scalar ; not a value calculable at some 'correct' scale, but a continuous function with respect to scale. This shift requires new ways of thinking about and analyzing segregation with respect to scale that engage with the complexity of the multi-scalar measure. Using block level data for eight neighborhoods in Seattle, Washington I explore the implications of a multi-scalar segregation measure for understanding neighborhoods and neighborhood change from 1990 to 2010.

Neighborhood impact on healthy food availability and pricing in food stores.

PubMed

Krukowski, Rebecca A; West, Delia Smith; Harvey-Berino, Jean; Elaine Prewitt, T

2010-06-01

Availability and price of healthy foods in food stores has the potential to influence purchasing patterns, dietary intake, and weight status of individuals. This study examined whether demographic factors of the store neighborhood or store size have an impact on the availability and price of healthy foods in sample of grocery stores and supermarkets. The Nutrition Environment Measures Study-Store (NEMS-S) instrument, a standardized observational survey, was utilized to evaluate food stores (N = 42) in a multi-site (Vermont and Arkansas) study in 2008. Census data associated with store census tract (median household income and proportion African-American) were used to characterize store neighborhood and number of cash registers was used to quantify store size. Median household income was significantly associated with the NEMS healthy food availability score (r = 0.36, P < 0.05); neither racial composition (r = -0.23, P = 0.14) nor store size (r = 0.27, P = 0.09) were significantly related to the Availability score. Larger store size (r = 0.40, P < 0.01) was significantly associated with the NEMS-S Price scores, indicating more favorable prices for healthier items; neither racial composition nor median household income were significantly related to the Price score (P's > 0.05). Even among supermarkets, healthier foods are less available in certain neighborhoods, although, when available, the quality of healthier options did not differ, suggesting that targeting availability may offer promise for policy initiatives. Furthermore, increasing access to larger stores that can offer lower prices for healthier foods may provide another avenue for enhancing food environments to lower disease risk.

Survey of restaurants regarding smoking policies.

PubMed

Williams, Alcia; Peterson, Elizabeth; Knight, Susan; Hiller, Marc; Pelletier, Andrew

2004-01-01

The New Hampshire Indoor Smoking Act was implemented in 1994 to protect the public's health by regulating smoking in enclosed places. A survey was conducted of New Hampshire restaurants to determine smoking policies, to determine restaurant characteristics associated with smoking policies, and to evaluate compliance with the Indoor Smoking Act. A list of New Hampshire restaurants was obtained from a marketing firm. Establishments were selected randomly until 400 had completed a 22-question telephone survey. Forty-four percent of restaurants permitted smoking. Characteristics positively associated with permitting smoking were being a non-fast-food restaurant, selling alcohol, selling tobacco, and having greater than the median number of seats. Of restaurants permitting smoking, 96.1% had a designated smoking area, 87.0% had a ventilation system to minimize secondhand smoke, 83.6% had a physical barrier between smoking and nonsmoking areas, and 53.1% exhibited signs marking the smoking area. Forty percent of restaurants permitting smoking met all four requirements of the Indoor Smoking Act. Smoking policies differ, by type of restaurant. Compliance with the Indoor Smoking Act is low.

Promoting Influenza Vaccination to Restaurant Employees.

PubMed

Graves, Meredith C; Harris, Jeffrey R; Hannon, Peggy A; Hammerback, Kristen; Parrish, Amanda T; Ahmed, Faruque; Zhou, Chuan; Allen, Claire L

2016-09-01

To evaluate an evidence-based workplace approach to increasing adult influenza vaccination levels applied in the restaurant setting We implemented an intervention and conducted a pre/post analysis to determine effect on vaccination. Eleven Seattle-area restaurants. Restaurants with 25+ employees speaking English or Spanish and over 18 years. Restaurants received influenza vaccination promotion materials, assistance arranging on-site vaccination events, and free influenza vaccinations for employees. Pre/post employee surveys of vaccination status with direct observation and employer interviews to evaluate implementation. We conducted descriptive analysis of employee survey data and performed qualitative analysis of implementation data. To assess intervention effect, we used a mixed-effects logistic regression model with a restaurant-specific random effect. Vaccination levels increased from 26% to 46% (adjusted odds ratio 2.33, 95% confidence interval 1.69, 3.22), with 428 employees surveyed preintervention, 305 surveyed postintervention, and response rates of 73% and 55%, respectively. The intervention was effective across subgroups, but there were restaurant-level differences. An access-based workplace intervention can increase influenza vaccination levels in restaurant employees, but restaurant-level factors may influence success. © 2016 by American Journal of Health Promotion, Inc.

Strategies and willingness of rural restaurateurs to promote healthy foods.

PubMed

Benson, W

1995-01-01

Nutritionists need to understand the willingness of restaurateurs to prepare and sell healthy foods, as Canadians frequently eat meals at food services. The lunch trade restaurants under the jurisdiction of a rural and semi-rural Alberta health unit were surveyed by telephone. Two thirds of the restaurants were family-style and had 100 seats or fewer. Five of 20 healthy foods were rated as difficult to serve, due to: lack of customer demand; lack of food availability; and the need to maintain the quality of fresh vegetables, fruits and milk products. Many restaurateurs are willing to change internally by training staff (88%) and by trying new recipes (84%). Staff education materials perceived to be helpful by 80% of restaurateurs included video/audio tapes, information sheets and posters. Restaurateurs were most willing to use menu inserts (76%), table tents (68%) and door decals (72%) to promote healthy foods. Nutrition services should focus on how restaurants can make changes to include healthy foods through food preparation and menu items.

Restaurant owners' perspectives on a voluntary program to recognize restaurants for offering reduced-size portions, Los Angeles County, 2012.

PubMed

Gase, Lauren; Dunning, Lauren; Kuo, Tony; Simon, Paul; Fielding, Jonathan E

2014-03-20

Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized. In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions. Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). Analyses of qualitative data revealed 6 themes related to portion size: 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders. A program to recognize restaurants for offering reduced-size portions may be a feasible approach in Los Angeles County. These findings may have applications for jurisdictions interested in engaging restaurants as partners in reducing the obesity epidemic.

Restaurant Owners’ Perspectives on a Voluntary Program to Recognize Restaurants for Offering Reduced-Size Portions, Los Angeles County, 2012

PubMed Central

Dunning, Lauren; Kuo, Tony; Simon, Paul; Fielding, Jonathan E.

2014-01-01

Introduction Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized. Methods In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions. Results Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). Analyses of qualitative data revealed 6 themes related to portion size: 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders. Conclusion A program to recognize restaurants for offering reduced-size portions may be a feasible approach in Los Angeles County. These findings may have applications for jurisdictions interested in engaging restaurants as partners in reducing the obesity epidemic. PMID:24650622

Reducing sodium across the board: a pilot program in Schenectady County independent restaurants.

PubMed

Schuldt, June; Levings, Jessica Lee; Kahn-Marshall, Jennifer; Hunt, Glynnis; Mugavero, Kristy; Gunn, Janelle Peralez

2014-01-01

Excess sodium intake can lead to increased blood pressure. Restaurant foods contribute nearly a quarter of the sodium consumed in the American diet. The objective of the pilot project was to develop and implement in collaboration with independent restaurants a tool, the Restaurant Assessment Tool and Evaluation (RATE), to assess efforts to reduce sodium in independent restaurants and measure changes over time in food preparation categories, including menu, cooking techniques, and products. Twelve independent restaurants in Schenectady County, New York, voluntarily participated. From initial assessment to a 6-month follow-up assessment using the RATE, 11 restaurants showed improvement in the cooking category, 9 showed improvement in the menu category, and 7 showed improvement in the product category. Menu analysis conducted by the Schenectady County Health Department staff suggested that reported sodium-reduction strategies might have affected approximately 25% of the restaurant menu items. The findings from this project suggest that a facilitated assessment, such as the RATE, can provide a useful platform for independent restaurant owners and public health practitioners to discuss and encourage sodium reduction. The RATE also provides opportunities to build and strengthen relationships between public health care practitioners and independent restaurant owners, which may help sustain the positive changes made.

77 FR 24173 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... promotions (e.g., in-store, restaurant advertising, labeling, etc.); advertising, administrative, and... additional evaluation criteria. 2. Review and Selection Process: All applications undergo a multi- phase...

78 FR 23890 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... promotions (e.g., in-store, restaurant advertising, labeling, etc.); advertising, administrative, and... and Selection Process: All applications undergo a multi- phase review within FAS, by appropriate FAS...

Food Safety for People with Cancer

MedlinePlus

... became ill from food you ate in a restaurant or other food establishment. The health department staff ... to 4 p.m. Eastern Time. An extensive selection of timely food safety messages is also available ...

76 FR 21320 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... promotions (in-store, restaurant advertising, labeling, etc.); advertising, administrative, and operational... and Selection Process: All applications undergo a multi- phase review within FAS, by appropriate FAS...

Statistical Validation of a Web-Based GIS Application and Its Applicability to Cardiovascular-Related Studies.

PubMed

Lee, Jae Eun; Sung, Jung Hye; Malouhi, Mohamad

2015-12-22

There is abundant evidence that neighborhood characteristics are significantly linked to the health of the inhabitants of a given space within a given time frame. This study is to statistically validate a web-based GIS application designed to support cardiovascular-related research developed by the NIH funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) and discuss its applicability to cardiovascular studies. Geo-referencing, geocoding and geospatial analyses were conducted for 500 randomly selected home addresses in a U.S. southeastern Metropolitan area. The correlation coefficient, factor analysis and Cronbach's alpha (α) were estimated to quantify measures of the internal consistency, reliability and construct/criterion/discriminant validity of the cardiovascular-related geospatial variables (walk score, number of hospitals, fast food restaurants, parks and sidewalks). Cronbach's α for CVD GEOSPATIAL variables was 95.5%, implying successful internal consistency. Walk scores were significantly correlated with number of hospitals (r = 0.715; p < 0.0001), fast food restaurants (r = 0.729; p < 0.0001), parks (r = 0.773; p < 0.0001) and sidewalks (r = 0.648; p < 0.0001) within a mile from homes. It was also significantly associated with diversity index (r = 0.138, p = 0.0023), median household incomes (r = -0.181; p < 0.0001), and owner occupied rates (r = -0.440; p < 0.0001). However, its non-significant correlation was found with median age, vulnerability, unemployment rate, labor force, and population growth rate. Our data demonstrates that geospatial data generated by the web-based application were internally consistent and demonstrated satisfactory validity. Therefore, the GIS application may be useful to apply to cardiovascular-related studies aimed to investigate potential impact of geospatial factors on diseases and/or the long-term effect of clinical trials.

What's Cooking at the Restaurant School

ERIC Educational Resources Information Center

Binzen, Peter

1975-01-01

Describes the operation and program of the Restaurant School in Philadelphia, which in a one-year course of formal instruction and on-the-job training teaches students how to own and operate small restaurants and invests in the restaurants of some of its graduates. (JT)

Associations of Fast Food Restaurant Availability With Dietary Intake and Weight Among African Americans in the Jackson Heart Study, 2000–2004

PubMed Central

Diez Roux, Ana V.; Smith, Adam E.; Tucker, Katherine L.; Gore, Larry D.; Zhang, Lei; Wyatt, Sharon B.

2011-01-01

Objectives. We examined the associations of fast food restaurant (FFR) availability with dietary intake and weight among African Americans in the southeastern United States. Methods. We investigated cross-sectional associations of FFR availability with dietary intake and body mass index (BMI) and waist circumference in 4740 African American Jackson Heart Study participants (55.2 ±12.6 years, 63.3% women). We estimated FFR availability using circular buffers with differing radii centered at each participant's geocoded residential location. Results. We observed no consistent associations between FFR availability and BMI or waist circumference. Greater FFR availability was associated with higher energy intake among men and women younger than 55 years, even after adjustment for individual socioeconomic status. For each standard deviation increase in 5-mile FFR availability, the energy intake increased by 138 kilocalories (confidence interval [CI] = 70.53, 204.75) for men and 58 kilocalories (CI = 8.55, 105.97) for women. We observed similar associations for the 2-mile FFR availability, especially in men. FFR availability was also unexpectedly positively associated with total fiber intake. Conclusions. FFR availability may contribute to greater energy intake in younger African Americans who are also more likely to consume fast food. PMID:21551382

Spatial access to restaurants and grocery stores in relation to frequency of home cooking.

PubMed

Pinho, Maria Gabriela M; Mackenbach, Joreintje D; Charreire, Hélène; Oppert, Jean-Michel; Bárdos, Helga; Rutter, Harry; Compernolle, Sofie; Beulens, Joline W J; Brug, Johannes; Lakerveld, Jeroen

2018-01-16

Little is known about the relation between the neighbourhood food environment and home cooking. We explored the independent and combined associations between residential neighbourhood spatial access to restaurants and grocery stores with home cooking in European adults. Data of 5076 participants of the SPOTLIGHT study were collected across five European countries in 2014. Food retailers were classified into grocery stores (supermarkets and local food shops) and restaurants (full-service restaurants, fast food and take-away restaurants, café/bars). We used multinomial logistic regression models to test the associations between tertiles of spatial access to restaurants and spatial to access grocery stores and the outcome 'frequency of home cooking' categorized into 0-3; 4-5; and 6-7 days/week. Additive interaction analysis was used to test the combined association between access to grocery stores and to restaurants with home cooking. Mean age was 52.3 years; most participants were women (55.5%) and completed higher education (53.8%). Residents with highest access to restaurants had a reduced likelihood of home cooking 6-7 days/week (vs. 0-3 days/week) (relative risk ratio (RRR) 0.42; 95%CI = 0.23-0.76) when compared with lowest access to restaurants. No association was found for spatial access to grocery stores. Additive interaction analysis showed that individuals with medium access to grocery stores and highest access to restaurants had the lowest likelihood (RRR = 0.29, 95%CI = 0.10-0.84) of cooking 6-7 days/week when compared to individuals with lowest access to restaurants and highest access to grocery stores. Greater neighbourhood spatial access to restaurants was associated with lower frequency of home cooking, largely independent of access to grocery stores.

Support for smoke-free policy among restaurant owners and managers in Ulaanbaatar, Mongolia

PubMed Central

Chang, S-H; Delgermaa, V; Mungun-Ulzii, K; Erdenekhuu, N; Odkhuu, E; Huang, S-L

2009-01-01

Objectives: Exposure to second-hand smoke (SHS) is widespread in restaurants in Ulaanbaatar, the capital city of Mongolia. While a smoke-free policy is the most effective way of protecting restaurant workers and customers from SHS, this has not been well accepted in Mongolia. Furthermore, little is known about restaurants’ attitude toward the smoke-free policy. Methods: A cross-sectional survey directed to restaurant owners or managers was conducted in 475 representative restaurants in Ulaanbaatar. Face-to-face interviews using a questionnaire and on-site observation were performed. Results: Only 29.3% of the restaurants claimed to prohibit smoking; none of the remaining had any protection toward SHS, and half of the restaurants estimated that more than 20% of customers would smoke inside. None of them had visible “no smoking” signs and the majority never received complaints about SHS. Despite the generally high level of knowledge of the health effects of SHS, of the 336 restaurants that were not smoke free, only 25.9% expressed that they planned to take action in the near future. By contrast, 87.8% of restaurants would support the government if it asked all restaurants to ban smoking. Multivariate analysis identified that restaurants having menus in foreign languages, selling cigarettes and predicting business decline were less likely to support the government smoke-free policy. Conclusions: This survey demonstrates that restaurants owners and managers were reluctant to take action on their own, but would support government policy. The government can assume a stronger role first by revising the law on tobacco control following the Framework Convention on Tobacco Control guideline. PMID:19797533

Development of an Environmental Quality Index to assess environmental public health disparities - What data are available?

EPA Science Inventory

Assessing exposure to environmental insults and human health outcomes is complex. Environmental exposures tend to cluster spatially, with disamenities (e.g., landfills, industrial plants) often located in high-minority and largely poor neighborhoods, while wealthier neighborhoods...

Restaurant Policies and Practices for Serving Raw Fish in Minnesota.

PubMed

Hedeen, Nicole

2016-10-01

The number of restaurants serving sushi within Minnesota is continuously increasing. The practices and protocols of serving raw fish are complex and require detailed planning to ensure that food served to patrons will not cause illness. Although the popularity of sushi is increasing, there is a lack of research on food safety issues pertaining to preparation of raw fish and sushi rice. To address this gap, the Minnesota Department of Health Environmental Health Specialists Network Food program collected descriptive data on restaurant practices and policies concerning the service of raw fish and sushi rice in 40 Minnesota restaurants. At each restaurant, a specialist interviewed a restaurant manager, conducted an observation of the sushi prep areas in the restaurant kitchen, and reviewed parasite destruction letters and invoices from fish supplier(s). Over half of the restaurants (59%) were missing one or more of the parasite destruction letters from their fish supplier(s) guaranteeing that fish had been properly frozen to the time and temperature requirements in the Minnesota Food Code. A total of 42 parasite destruction letters from suppliers were observed; 10% were considered "adequate" letters. The majority of the letters were missing details pertaining to the types of fish frozen, the length of time fish were frozen, or details on what temperatures fish were held frozen or a combination of all three. Most restaurants were using time as a public health control for their sushi rice. For those restaurants using time as a public health control, 26% had a written procedure on-site, and approximately 53% were keeping track of time. Bare hand contact during sushi prep was observed in 17% of restaurants, and in more than 40% of the restaurants, at least one fish was mislabeled on the menu. Findings from this study indicate that many Minnesota restaurants are not complying with the Food Code requirements pertaining to parasite destruction for the service of raw fish or the use of time as a public health control for sushi rice.

Public opinion on smoke-free policies in restaurants and predicted effect on patronage in Hong Kong.

PubMed

Lam, T H; Janghorbani, M; Hedley, A J; Ho, S Y; McGhee, S M; Chan, B

2002-09-01

The Hong Kong government has proposed legislation for smoke-free policies in all restaurants and bars. This is opposed by certain sections of the catering industry. To assess public opinion on smoke-free restaurants and to estimate changes in patronage. A population based, cross sectional random digit dialling telephone survey conducted from November 1999 to January 2000. 1077 randomly selected subjects age 15 years or over (response fraction of 81.6%). 68.9% (95% confidence interval (CI) 66.2% to 71.7%) supported a totally smoke-free policy in restaurants. Experiences of discomfort or symptoms from second hand smoke in restaurants were common. The majority (77.2%, 95% CI 74.7% to 79.7%) anticipated no change in their frequency of use of restaurants after a smoke-free policy. Increased use was predicted by 19.7% (95% CI 17.3% to 22.1%) of respondents, whereas 3.2% (95% CI 2.2% to 4.4%) stated that they would dine out less often. In multivariate analyses, non-smokers (adjusted odds ratio (OR) 4.9), people who ate three times or less per week in restaurants as compared to those who ate >10 times per week (OR 2.1), those who had previous experience of discomfort from exposure to passive smoking in restaurants (OR 2.8), or who had avoided restaurants in the past because of smoking (OR 1.9), were more likely to support a totally smoke-free policy in restaurants. Smoke-free policies do not appear to have an adverse effect on restaurants, and may increase business by a considerable margin. This comprehensive survey-the first in Asia-shows strong community support for smoke-free dining and predicts an overall increase in the patronage of restaurants after the introduction of legislation for totally smoke-free restaurants.

Association of Individual and Neighborhood Factors with Home Food Availability: Evidence from the National Health and Nutrition Examination Survey.

PubMed

Chai, Weiwen; Fan, Jessie X; Wen, Ming

2018-05-01

Accumulating evidence suggests the important role of the home food environment in an individual's dietary intake. This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. The analysis included 8,975 participants aged 19 to 65 years. Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES' complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability. The results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

75 FR 68361 - Agency Information Collection Activities; Proposed Collection; Comment Request; Restaurant Menu...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

...] Agency Information Collection Activities; Proposed Collection; Comment Request; Restaurant Menu and... appropriate, and other forms of information technology. Restaurant Menu and Vending Machine Labeling... restaurants and similar retail food establishments (SRFE) with 20 or more locations doing business under the...

77 FR 65555 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... the initial data collection for select restaurant facility types, followed by the initial data... period data collection survey measurement) period Restaurants Full Service 2013 2016 2019 Restaurants. Fast Food Restaurants. Institutional Foodservice........ Hospitals 2014 2017 2020 Nursing Homes...

76 FR 4574 - Drawbridge Operation Regulations; Oakland Inner Harbor Tidal Canal, Oakland/Alameda, CA, Schedule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... Chance, Aroma Restaurant, Eskelund Marine, Bocanova, Vortex Marine Construction, British Marine, The Outboard Motor Shop, Waterfront Hotel-Miss Pearl's Restaurant, Encinal Yacht Club, Marina Village Inn, Kincaid's Restaurant, Scott's Seafood Restaurant, Captain Ed Payne Technical Services, Il Pescatore...

75 FR 20314 - Federal Employees Health Benefits Program; Miscellaneous Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... continuation of Federal Employees Health Benefits (FEHB) coverage for certain former Senate Restaurant[email protected] . SUPPLEMENTARY INFORMATION: Background Senate Restaurants Employees Public Law 110-279... employees of the Senate Restaurants after the operations of the Senate Restaurants are contracted to be...

Smoking control in restaurants: the effectiveness of self-regulation in Australia.

PubMed Central

Schofield, M J; Considine, R; Boyle, C A; Sanson-Fisher, R

1993-01-01

OBJECTIVES. The provision of smoke-free areas in restaurants has been a controversial issue; the restaurant industry largely opts for a self-regulation approach. This study aimed to examine the effectiveness of self-regulation as a strategy in meeting the industry's and customers' perceived needs. METHODS. Restaurateur and customer perspectives on the provision of smoke-free areas in restaurants were examined by survey among 365 restaurateurs and 1327 customers in New South Wales, Australia. RESULTS. Less than 2% of restaurants were totally smoke-free; 22% provided some smoke-free areas. Customers were much more likely than owners to think that smoke-free areas should be provided. Owners appeared to be unaware of customers' views about smoke-free areas in restaurants. CONCLUSIONS. Little evidence was found to support the effectiveness of the self-regulation policy adopted by the restaurant industry. Characteristics of restaurants and owners associated with the provision of smoke-free areas are presented and implications of the findings are discussed. PMID:8363005

Attitudes towards a smoking ban in restaurants of managers, employees and customers in Kunming City, China.

PubMed

Jiang, Li; Sriplung, Hutcha; Chongsuvivatwong, Virasakdi; Li, Tao; Xiao, Yize

2010-09-01

The objective of this study was to investigate the attitudes of restaurant managers, employees and customers towards a total smoking ban policy in restaurants. A restaurant based survey in an urban area of Kunming City, China, was carried out from May to August 2009. One hundred managers, 1,055 employees and 5,213 customers aged 15 years or above were interviewed using a structured questionnaire. The percentage of respondents supporting a total smoking ban in restaurants was 17% among managers, 13.4% among employees, and 16.6% among customers. Multilevel analysis confirmed respondents who did not smoke, who were educated, and who worked or dined at a restaurant with fewer than 200 seats were more likely to support a total smoking ban. A total smoking ban in restaurants is unlikely to be supported by people involved in the restaurant business in the study area. This coincides with poor awareness of the harms of smoking.

Salmonella enteritidis outbreak in a restaurant chain: the continuing challenges of prevention.

PubMed Central

Vugia, D. J.; Mishu, B.; Smith, M.; Tavris, D. R.; Hickman-Brenner, F. W.; Tauxe, R. V.

1993-01-01

In 1990, a Salmonella enteritidis (SE) outbreak occurred in a restaurant chain in Pennsylvania. To determine its cause(s), we conducted a case-control study and a cohort study at one restaurant, and a survey of restaurants. Egg dishes were associated with illness (P = 0.03). Guests from one hotel eating at the restaurant had a diarrhoeal attack rate of 14%, 4.7-fold higher than among those not eating there (P = 0.04). There were no differences in egg handling between affected and unaffected restaurants. Eggs supplied to affected restaurants were medium grade AA eggs from a single farm, and were reportedly refrigerated during distribution. Human and hen SE isolates were phage type 8 and had similar plasmid profiles and antibiograms. We estimate the prevalence of infected eggs during the outbreak to be as high as 1 in 12. Typical restaurant egg-handling practices and refrigeration during distribution appear to be insufficient by themselves to prevent similar outbreaks. PMID:8432323

Energy Contents of Frequently Ordered Restaurant Meals and Comparison with Human Energy Requirements and US Department of Agriculture Database Information: A Multisite Randomized Study

PubMed Central

Urban, Lorien E.; Weber, Judith L.; Heyman, Melvin B.; Schichtl, Rachel L.; Verstraete, Sofia; Lowery, Nina S.; Das, Sai Krupa; Schleicher, Molly M.; Rogers, Gail; Economos, Christina; Masters, William A.; Roberts, Susan B.

2017-01-01

Background Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ~50% of US restaurants are individual or small-chain (non–chain) establishments that do not provide nutrition information. Objective To measure the energy content of frequently ordered meals in non–chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. Design A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non–chain restaurants, together with equivalent meals from large-chain restaurants. Setting Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. Main outcome measures Meal energy content determined by bomb calorimetry. Statistical analysis performed Regional and cuisine differences were assessed using a mixed model with restaurant nested within region×cuisine as the random factor. Paired t tests were used to evaluate differences between non–chain and chain meals, human energy requirements, and food database values. Results Meals from non–chain restaurants contained 1,205±465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P=0.41). There was a significant effect of cuisine on non–chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. Conclusions Non–chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy. Restaurants in general, rather than specific categories of restaurant, expose patrons to excessive portions that induce overeating through established biological mechanisms. PMID:26803805

Energy Contents of Frequently Ordered Restaurant Meals and Comparison with Human Energy Requirements and U.S. Department of Agriculture Database Information: A Multisite Randomized Study.

PubMed

Urban, Lorien E; Weber, Judith L; Heyman, Melvin B; Schichtl, Rachel L; Verstraete, Sofia; Lowery, Nina S; Das, Sai Krupa; Schleicher, Molly M; Rogers, Gail; Economos, Christina; Masters, William A; Roberts, Susan B

2016-04-01

Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ∼50% of US restaurants are individual or small-chain (non-chain) establishments that do not provide nutrition information. To measure the energy content of frequently ordered meals in non-chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non-chain restaurants, together with equivalent meals from large-chain restaurants. Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. Meal energy content determined by bomb calorimetry. Regional and cuisine differences were assessed using a mixed model with restaurant nested within region×cuisine as the random factor. Paired t tests were used to evaluate differences between non-chain and chain meals, human energy requirements, and food database values. Meals from non-chain restaurants contained 1,205±465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P=0.41). There was a significant effect of cuisine on non-chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. Non-chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy. Restaurants in general, rather than specific categories of restaurant, expose patrons to excessive portions that induce overeating through established biological mechanisms. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Are perceived neighborhood hazards a barrier to physical activity in children?

PubMed

Romero, A J; Robinson, T N; Kraemer, H C; Erickson, S J; Haydel, K F; Mendoza, F; Killen, J D

2001-10-01

We hypothesized that children's perceptions of more neighborhood hazards would be associated with less physical activity, less aerobic fitness, and a higher body mass index. To examine the association between a hazardous neighborhood context and physical activity in children. Fourth-grade students (n = 796) of diverse ethnic and economic backgrounds completed measures of neighborhood hazards, self-reported physical activity, physical fitness, height, and weight. Parents (n = 518) completed telephone interviews and provided data on their education level and occupation. As expected, children from families of lower socioeconomic status perceived significantly more neighborhood hazards. Contrary to our hypothesis, the perception of more hazards was significantly associated with more reported physical activity. This finding was not explained by school heterogeneity, alteration of the hazards measure, or differences in socioeconomic status. To further examine the relationship between neighborhood hazards and physical activity, we suggest that future studies include assessments of sedentary behavior, parental fear of violence, parental regulation of children's leisure activities, and cost and quality of available play areas and organized sports.

Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Use and Diagnoses.

PubMed

Kersten, Ellen E; Adler, Nancy E; Gottlieb, Laura; Jutte, Douglas P; Robinson, Sarah; Roundfield, Katrina; LeWinn, Kaja Z

2018-05-01

: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011. Hot-spot analysis was used to compare the spatial distribution of neighborhood child opportunity and income. Generalized estimating equation logistic regression models were used to examine independent associations between neighborhood child opportunity and frequent acute care use (≥4 visits per year) and diagnosis group after adjusting for neighborhood income and patient age, sex, race and/or ethnicity, payer, and health system. Neighborhood child opportunity and income had distinct spatial distributions, and we identified different clusters of high- and low-risk neighborhoods. Children living in the lowest opportunity neighborhoods had significantly greater odds of ≥4 acute care visits per year (odds ratio 1.33; 95% confidence interval 1.03-1.73) compared with those in the highest opportunity neighborhoods. Neighborhood child opportunity was negatively associated with visits for respiratory conditions, asthma, assault, and ambulatory care-sensitive conditions but positively associated with injury-related visits. The Child Opportunity Index could be an effective tool for identifying neighborhood factors beyond income related to child health. Copyright © 2018 by the American Academy of Pediatrics.

Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas

PubMed Central

Adu-Brimpong, Joel; Coffey, Nathan; Ayers, Colby; Berrigan, David; Yingling, Leah R.; Thomas, Samantha; Mitchell, Valerie; Ahuja, Chaarushi; Rivers, Joshua; Hartz, Jacob; Powell-Wiley, Tiffany M.

2017-01-01

Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist), a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783) participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions). Twelve street segments per home address were assessed for (1) Land-Use Type; (2) Public Transportation Availability; (3) Street Characteristics; (4) Environment Quality and (5) Sidewalks/Walking/Biking features. Checklist items were scored 0–2 points/question. A combinations algorithm was developed to assess street segments’ representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score®, a validated neighborhood walkability measure. Street segment quality scores ranged 10–47 (Mean = 29.4 ± 6.9) and overall neighborhood quality scores, 172–475 (Mean = 352.3 ± 63.6). Walk scores® ranged 0–91 (Mean = 46.7 ± 26.3). Street segment combinations’ correlation coefficients ranged 0.75–1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores® (r = 0.62, p < 0.001). This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes. PMID:28282878

Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas.

PubMed

Adu-Brimpong, Joel; Coffey, Nathan; Ayers, Colby; Berrigan, David; Yingling, Leah R; Thomas, Samantha; Mitchell, Valerie; Ahuja, Chaarushi; Rivers, Joshua; Hartz, Jacob; Powell-Wiley, Tiffany M

2017-03-08

Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist), a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783) participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions). Twelve street segments per home address were assessed for (1) Land-Use Type; (2) Public Transportation Availability; (3) Street Characteristics; (4) Environment Quality and (5) Sidewalks/Walking/Biking features. Checklist items were scored 0-2 points/question. A combinations algorithm was developed to assess street segments' representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score ® , a validated neighborhood walkability measure. Street segment quality scores ranged 10-47 (Mean = 29.4 ± 6.9) and overall neighborhood quality scores, 172-475 (Mean = 352.3 ± 63.6). Walk scores ® ranged 0-91 (Mean = 46.7 ± 26.3). Street segment combinations' correlation coefficients ranged 0.75-1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores ® ( r = 0.62, p < 0.001). This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes.

SMOKE-FREE ORDINANCES INCREASE RESTAURANT PROFIT AND VALUE

PubMed Central

Alamar, Benjamin C.

2011-01-01

This study estimates the economic value added to a restaurant by a smoke-free policy using regression analysis of the purchase price of restaurants, as a function of the presence of a smoke-free law and other control variables. There was a median increase of 16% (interquartile range 11% to 25%) in the sale price of a restaurant in a jurisdiction with a smoke-free law compared to a comparable restaurant in a community without such a law. This result indicates that, contrary to claims made by the tobacco industry and other opponents of smoke-free laws, these laws are associated with an increase in restaurant profitability. PMID:21637722

Outdoor ultrafine particle concentrations in front of fast food restaurants.

PubMed

Vert, Cristina; Meliefste, Kees; Hoek, Gerard

2016-01-01

Ultrafine particles (UFPs) have been associated with negative effects on human health. Emissions from motor vehicles are the principal source of UFPs in urban air. A study in Vancouver suggested that UFP concentrations were related to density of fast food restaurants near the monitoring sites. A previous monitoring campaign could not separate the contribution of restaurants from road traffic. The main goal of this study has been the quantification of fast food restaurants' contribution to outdoor UFP concentrations. A portable particle number counter (DiscMini) has been used to carry out mobile monitoring in a largely pedestrianized area in the city center of Utrecht. A fixed route passing 17 fast food restaurants was followed on 8 days. UFP concentrations in front of the restaurants were 1.61 times higher than in a nearby square without any local sources used as control area and 1.22 times higher compared with all measurements conducted in between the restaurants. Adjustment for other sources such as passing mopeds, smokers or candles did not explain the increase. In conclusion, fast food restaurants result in significant increases in outdoor UFP concentrations in front of the restaurant.

The Fast-Casual Conundrum: Fast-Casual Restaurant Entrées Are Higher in Calories than Fast Food.

PubMed

Schoffman, Danielle E; Davidson, Charis R; Hales, Sarah B; Crimarco, Anthony E; Dahl, Alicia A; Turner-McGrievy, Gabrielle M

2016-10-01

Frequently eating fast food has been associated with consuming a diet high in calories, and there is a public perception that fast-casual restaurants (eg, Chipotle) are healthier than traditional fast food (eg, McDonald's). However, research has not examined whether fast-food entrées and fast-casual entrées differ in calorie content. The purpose of this study was to determine whether the caloric content of entrées at fast-food restaurants differed from that found at fast-casual restaurants. This study was a cross-sectional analysis of secondary data. Calorie information from 2014 for lunch and dinner entrées for fast-food and fast-casual restaurants was downloaded from the MenuStat database. Mean calories per entrée between fast-food restaurants and fast-casual restaurants and the proportion of restaurant entrées that fell into different calorie ranges were assessed. A t test was conducted to test the hypothesis that there was no difference between the average calories per entrée at fast-food and fast-casual restaurants. To examine the difference in distribution of entrées in different calorie ranges between fast-food and fast-casual restaurants, χ(2) tests were used. There were 34 fast-food and 28 fast-casual restaurants included in the analysis (n=3,193 entrées). Fast-casual entrées had significantly more calories per entrée (760±301 kcal) than fast-food entrées (561±268; P<0.0001). A greater proportion of fast-casual entrées compared with fast-food entrées exceeded the median of 640 kcal per entrée (P<0.0001). Although fast-casual entrées contained more calories than fast-food entrées in the study sample, future studies should compare actual purchasing patterns from these restaurants to determine whether the energy content or nutrient density of full meals (ie, entrées with sides and drinks) differs between fast-casual restaurants and fast-food restaurants. Calorie-conscious consumers should consider the calorie content of entrée items before purchase, regardless of restaurant type. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

CLEARPOND: Cross-Linguistic Easy-Access Resource for Phonological and Orthographic Neighborhood Densities

PubMed Central

Marian, Viorica; Bartolotti, James; Chabal, Sarah; Shook, Anthony

2012-01-01

Past research has demonstrated cross-linguistic, cross-modal, and task-dependent differences in neighborhood density effects, indicating a need to control for neighborhood variables when developing and interpreting research on language processing. The goals of the present paper are two-fold: (1) to introduce CLEARPOND (Cross-Linguistic Easy-Access Resource for Phonological and Orthographic Neighborhood Densities), a centralized database of phonological and orthographic neighborhood information, both within and between languages, for five commonly-studied languages: Dutch, English, French, German, and Spanish; and (2) to show how CLEARPOND can be used to compare general properties of phonological and orthographic neighborhoods across languages. CLEARPOND allows researchers to input a word or list of words and obtain phonological and orthographic neighbors, neighborhood densities, mean neighborhood frequencies, word lengths by number of phonemes and graphemes, and spoken-word frequencies. Neighbors can be defined by substitution, deletion, and/or addition, and the database can be queried separately along each metric or summed across all three. Neighborhood values can be obtained both within and across languages, and outputs can optionally be restricted to neighbors of higher frequency. To enable researchers to more quickly and easily develop stimuli, CLEARPOND can also be searched by features, generating lists of words that meet precise criteria, such as a specific range of neighborhood sizes, lexical frequencies, and/or word lengths. CLEARPOND is freely-available to researchers and the public as a searchable, online database and for download at http://clearpond.northwestern.edu. PMID:22916227

A Multilevel Assessment of Barriers to Adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of Low Socioeconomic Status

PubMed Central

Bertoni, Alain G.; Foy, Capri G.; Hunter, Jaimie C.; Quandt, Sara A.; Vitolins, Mara Z.; Whitt-Glover, Melicia C.

2013-01-01

Background We examined perceptions of Dietary Approaches to Stop Hypertension (DASH) and the food environment among African Americans (AA) with high blood pressure living in two low-income communities and objectively assessed local food outlets. Methods Focus groups were conducted with 30 AAs; participants discussed DASH and the availability of healthy foods in their community. Sessions were transcribed and themes identified. Fifty-four stores and 114 restaurants were assessed using the Nutrition Environment Measures Survey (NEMS). Results Common themes included poor availability, quality, and cost of healthy foods; tension between following DASH and feeding other family members; and lack of congruity between their preferred foods and DASH. Food outlets in majority AA census tracts had lower NEMS scores (stores: −11.7, p=.01, restaurants: −8.3, p=.001) compared with majority White areas. Conclusions Interventions promoting DASH among lower income AAs should reflect the food customs, economic concerns, and food available in communities. PMID:22080704

75 FR 67978 - Agency Information Collection Activities; Proposed Collection; Comment Request; Restaurant Menu...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

...] Agency Information Collection Activities; Proposed Collection; Comment Request; Restaurant Menu Labeling... appropriate, and other forms of information technology. Restaurant Menu Labeling: Registration for Small... restaurants and similar retail food establishments (SRFE) with 20 or more locations, as well as operators of...

75 FR 76615 - Federal Employees Health Benefits Program Miscellaneous Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-09

... continuation of Federal Employees Health Benefits (FEHB) coverage for certain former Senate Restaurant... to permit this change by revised ruling. Background Senate Restaurants Employees Public Law 110-279... employees of the Senate Restaurants after the operations of the Senate Restaurants are contracted to be...

Restaurant menu labeling: impact of nutrition information on entree sales and patron attitudes.

PubMed

Albright, C L; Flora, J A; Fortmann, S P

1990-01-01

This study examined changes in sales of low fat/low cholesterol foods targeted in a restaurant menu labeling program. Sales of labeled items were tracked before and after the program was introduced, and a subsample of patrons were surveyed for information on visibility and comprehension of the menu labels. Two of the four restaurants had significant increases in the sales of targeted foods following labeling. Comparisons between patrons dining in restaurants which had an increase in sales (I--increase restaurants) to those dining in restaurants which had no overall shift in sales (NI--no increase restaurants) revealed no differences in patron awareness or comprehension of the menu labels. There were age and gender differences between I and NI restaurants, with I restaurants having proportionally more males, and a younger clientele. Taste was the primary reason given by patrons for their entree choice, regardless of whether or not it was labeled. In all four restaurants women and older patrons were more aware of the program and more responsive to its recommendations. These findings suggest that environmental strategies may be an effective method of encouraging dietary changes in the general population, but patron characteristics such as age and gender may influence receptivity to this type of intervention. Future studies aimed at developing effective point of purchase education programs should evaluate these patron characteristics and include more powerful behavior change strategies.

Parents' meal choices for their children at fast food and family restaurants with different menu labeling presentations.

PubMed

Lee, Kiwon; Lee, Youngmi

2018-06-01

This study examined the effect of nutrition labeling formats on parents' food choices for their children at different restaurant types. An online survey was conducted with 1,980 parents of children aged 3-12 years. Participants were randomly assigned to fast food or family restaurant scenarios, and one of four menu stimuli conditions: no labeling, low-calorie symbol (symbol), numeric value (numeric), and both low-calorie symbol and numeric value (symbol + numeric). Participants selected menu items for their children. Menu choices and total calories were compared by nutrition labeling formats in each type of the restaurant. Low-calorie item selections were scored and a two-way analysis of variance (ANOVA) was conducted for an interaction effect between restaurant and labeling type. In the fast food restaurant group, parents presented with low-calorie symbols selected the lowest calorie items more often than those not presented with the format. Parents in the symbol + numeric condition selected significantly fewer calories (653 kcal) than those in the no labeling (677 kcal) or numeric conditions (674 kcal) ( P = 0.006). In the family restaurant group, no significant difference were observed among different labeling conditions. A significant interaction between restaurant and labeling type on low-calorie selection score (F = 6.03, P < 0.01) suggests that the effect of nutrition labeling format interplays with restaurant type to jointly affect parents' food choices for their children. The provision of easily interpretable nutritional information format at fast food restaurants may encourage healthier food choices of parents for their children; however, the effects were negligible at family restaurants.

Noise in restaurants: levels and mathematical model.

PubMed

To, Wai Ming; Chung, Andy

2014-01-01

Noise affects the dining atmosphere and is an occupational hazard to restaurant service employees worldwide. This paper examines the levels of noise in dining areas during peak hours in different types of restaurants in Hong Kong SAR, China. A mathematical model that describes the noise level in a restaurant is presented. The 1-h equivalent continuous noise level (L(eq,1-h)) was measured using a Type-1 precision integral sound level meter while the occupancy density, the floor area of the dining area, and the ceiling height of each of the surveyed restaurants were recorded. It was found that the measured noise levels using Leq,1-h ranged from 67.6 to 79.3 dBA in Chinese restaurants, from 69.1 to 79.1 dBA in fast food restaurants, and from 66.7 to 82.6 dBA in Western restaurants. Results of the analysis of variance show that there were no significant differences between means of the measured noise levels among different types of restaurants. A stepwise multiple regression analysis was employed to determine the relationships between geometrical and operational parameters and the measured noise levels. Results of the regression analysis show that the measured noise levels depended on the levels of occupancy density only. By reconciling the measured noise levels and the mathematical model, it was found that people in restaurants increased their voice levels when the occupancy density increased. Nevertheless, the maximum measured hourly noise level indicated that the noise exposure experienced by restaurant service employees was below the regulated daily noise exposure value level of 85 dBA.

27 CFR 31.42 - Restaurants serving liquors with meals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Restaurants serving... Part Certain Organizations, Agencies, and Persons § 31.42 Restaurants serving liquors with meals. Proprietors of restaurants and other persons who serve liquors with meals to paying customers, even if no...

76 FR 30050 - Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... Restaurants and Similar Retail Food Establishments; Correction AGENCY: Food and Drug Administration, HHS... restaurants and similar retail food establishments. The document published with several errors in cross...)(2) that an authorized official may register an individual restaurant or similar retail food...

Local Geographic Variation of Public Services Inequality: Does the Neighborhood Scale Matter?

PubMed Central

Wei, Chunzhu; Cabrera-Barona, Pablo; Blaschke, Thomas

2016-01-01

This study aims to explore the effect of the neighborhood scale when estimating public services inequality based on the aggregation of social, environmental, and health-related indicators. Inequality analyses were carried out at three neighborhood scales: the original census blocks and two aggregated neighborhood units generated by the spatial “k”luster analysis by the tree edge removal (SKATER) algorithm and the self-organizing map (SOM) algorithm. Then, we combined a set of health-related public services indicators with the geographically weighted principal components analyses (GWPCA) and the principal components analyses (PCA) to measure the public services inequality across all multi-scale neighborhood units. Finally, a statistical test was applied to evaluate the scale effects in inequality measurements by combining all available field survey data. We chose Quito as the case study area. All of the aggregated neighborhood units performed better than the original census blocks in terms of the social indicators extracted from a field survey. The SKATER and SOM algorithms can help to define the neighborhoods in inequality analyses. Moreover, GWPCA performs better than PCA in multivariate spatial inequality estimation. Understanding the scale effects is essential to sustain a social neighborhood organization, which, in turn, positively affects social determinants of public health and public quality of life. PMID:27706072

You are where you shop: grocery store locations, weight, and neighborhoods.

PubMed

Inagami, Sanae; Cohen, Deborah A; Finch, Brian Karl; Asch, Steven M

2006-07-01

Residents in poor neighborhoods have higher body mass index (BMI) and eat less healthfully. One possible reason might be the quality of available foods in their area. Location of grocery stores where individuals shop and its association with BMI were examined. The 2000 U.S. Census data were linked with the Los Angeles Family and Neighborhood Study (L.A.FANS) database, which consists of 2620 adults sampled from 65 neighborhoods in Los Angeles County between 2000 and 2002. In 2005, multilevel linear regressions were used to estimate the associations between BMI and socioeconomic characteristics of grocery store locations after adjustment for individual-level factors and socioeconomic characteristics of residential neighborhoods. Individuals have higher BMI if they reside in disadvantaged areas and in areas where the average person frequents grocery stores located in more disadvantaged neighborhoods. Those who own cars and travel farther to their grocery stores also have higher BMI. When controlling for grocery store census tract socioeconomic status (SES), the association between residential census tract SES and BMI becomes stronger. Where people shop for groceries and distance traveled to grocery stores are independently associated with BMI. Exposure to grocery store mediates and suppresses the association of residential neighborhoods with BMI and could explain why previous studies may not have found robust associations between residential neighborhood predictors and BMI.

Assessing the Food Environment of a Rural Community: Baseline Findings From the Heart of New Ulm Project, Minnesota, 2010–2011

PubMed Central

Sidebottom, Abbey C.; Boucher, Jackie L.; Lindberg, Rebecca; Werner, Rebecca

2014-01-01

Introduction Changes in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program. Methods We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota. Results At least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for “healthy.” Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores. Conclusion Baseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions. PMID:24602590

Race and food store availability in an inner-city neighbourhood.

PubMed

Galvez, Maida P; Morland, Kimberly; Raines, Cherita; Kobil, Jessica; Siskind, Jodi; Godbold, James; Brenner, Barbara

2008-06-01

A growing body of research has shown that disparities in resources, including food stores, exist at the neighbourhood level and the greatest disparities are seen in minority neighbourhoods, the same neighbourhoods at increased risk of obesity and diabetes. Less is known about whether differences in availability of resources by African American or Latino race/ethnicity exist within a single minority community. The present study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York. A cross-sectional study utilising a walking survey of East Harlem was performed. Food stores were classified into: supermarkets, grocery stores, convenience stores, specialty stores, full-service restaurants and fast-food stores. One hundred and sixty-five East Harlem census blocks were examined; 17 were AA, 34 were L and 114 were RM. Of AA census blocks, 100% had neither supermarkets nor grocery stores. AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. We found that inequities in food store availability exist by race/ethnicity in East Harlem, New York. This has implications for racial/ethnic differences in dietary quality, obesity and obesity-related disorders.

Supervisor vs. employee safety perceptions and association with future injury in US limited-service restaurant workers.

PubMed

Huang, Yueng-Hsiang; Verma, Santosh K; Chang, Wen-Ruey; Courtney, Theodore K; Lombardi, David A; Brennan, Melanye J; Perry, Melissa J

2012-07-01

Many studies have found management commitment to safety to be an important construct of safety climate. This study examined the association between supervisor and employee (shared and individual) perceptions of management commitment to safety and the rate of future injuries in limited-service restaurant workers. A total of 453 participants (34 supervisors/managers and 419 employees) from 34 limited-service restaurants participated in a prospective cohort study. Employees' and managers' perceptions of management commitment to safety and demographic variables were collected at the baseline. The survey questions were made available in three languages: English, Spanish, and Portuguese. For the following 12 weeks, participants reported their injury experience and weekly work hours. A multivariate negative binomial generalized estimating equation model with compound symmetry covariance structure was used to assess the association between the rate of self-reported injuries and measures of safety perceptions. There were no significant relationships between supervisor and either individual or shared employee perceptions of management commitment to safety. Only individual employee perceptions were significantly associated with future employee injury experience but not supervisor safety perceptions or shared employee perceptions. Individual employee perception of management commitment to safety is a significant predictor for future injuries in restaurant environments. A study focusing on employee perceptions would be more predictive of injury outcomes than supervisor/manager perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Neighborhood walkability moderates the association between low back pain and physical activity: A co-twin control study.

PubMed

Zadro, J R; Shirley, D; Pinheiro, M B; Bauman, A; Duncan, G E; Ferreira, P H

2017-06-01

The aim of this study was to investigate whether neighborhood walkability moderates the association between low back pain (LBP) and physical activity (PA), using a co-twin design to control for genetics and shared environmental factors. A cross-sectional analysis was performed on 10,228 twins from the Washington State Twin Registry with available data on LBP from recruitment surveys between 2009 and 2013. LBP within the past 3months was our exposure variable. Our outcome variables were sufficient moderate or vigorous-intensity PA (MVPA, defined as at least 75min of vigorous-intensity PA, or 150min of moderate-intensity PA per week), and walking (≥150min per week). Neighborhood walkability, estimated using the commercially available Walk Score®, was our moderator variable. After controlling for the influence of genetics and shared environment, individuals reporting LBP were significantly less likely to engage in sufficient MVPA if they lived in a neighborhood with high walkability (OR=0.59, 95%CI: 0.36-0.96). There was no association between LBP and sufficient MVPA for individuals living in a neighborhood with low walkability (OR=1.27, 95%CI: 0.93-1.72), demonstrating that walkability is a significant moderator of the association between LBP and PA (interaction p=0.013). These findings were similar for the association between LBP and walking (high walkability OR=0.42, 95%CI: 0.22-0.78; low walkability OR=0.71, 95%CI: 0.46-1.12), although the interaction was not significant (p=0.700). Neighborhood walkability moderates the association between LBP and PA. Our results highlight the importance of targeting interventions promoting PA towards individuals with LBP living in a neighborhood with good walkable access to amenities. Copyright © 2017 Elsevier Inc. All rights reserved.

Health Implications of Adults' Eating at and Living near Fast Food or Quick Service Restaurants.

PubMed

Jiao, J; Moudon, A V; Kim, S Y; Hurvitz, P M; Drewnowski, A

2015-07-20

This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home. Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obese, having a cardiovascular disease or diabetes, as binary health outcomes. In all, 2001 participants in the 2008-2009 Seattle Obesity Study survey were included in the analyses. Results showed eating ⩾2 times a week at a fast food or quick service restaurant was associated with perceived poor health status, overweight and obese. However, living close to such restaurants was not related to negative health outcomes. Frequent eating at a fast food or quick service restaurant was associated with perceived poor health status and higher body mass index, but living close to such facilities was not.

Support for smoke-free restaurants among Massachusetts adults, 1992-1999.

PubMed Central

Brooks, D R; Mucci, L A

2001-01-01

OBJECTIVES: The authors examined trends and predictors of public support for smoke-free restaurants in Massachusetts. METHODS: Since 1992, the Massachusetts Behavioral Risk Factor Surveillance System has asked survey respondents about their attitudes toward smoking in restaurants. Analyses using data from 1992 to 1999 characterized changes over time in support for smoke-free restaurants and the role of demographic and smoking-related factors in predicting support. RESULTS: During 1992 to 1999, the rate of support for smoke-free restaurants increased from 37.5% to 59.8%, with similar increases among current, former, and never smokers. After adjustment for smoking status, support was associated with socioeconomic characteristics, race/ethnicity, and household smoking rules. Among current smokers, lighter smokers and those who were trying to quit were more likely to endorse smoke-free restaurants. CONCLUSIONS: There has been a substantial increase in support for smoke-free restaurants among both smokers and nonsmokers in Massachusetts. PMID:11211644

78 FR 36635 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

...) (individual) [SDNTK] (Linked To: RESTAURANT BAR LOS ANDARIEGOS, S.A. DE C.V.). 2. BUENROSTRO VILLA, Denisse... (Mexico) (individual) [SDNTK] (Linked To: RESTAURANT BAR LOS ANDARIEGOS, S.A. DE C.V.). 8. CORTES...]. 15. RESTAURANT BAR LOS ANDARIEGOS, S.A. DE C.V. (a.k.a. BARBARESCO RESTAURANT), [[Page 36638

Relationships among grocery nutrition label users and consumers' attitudes and behavior toward restaurant menu labeling.

PubMed

Roseman, Mary G; Mathe-Soulek, Kimberly; Higgins, Joseph A

2013-12-01

In the United States (US), based on the 2010 Affordable Care Act, restaurant chains and similar retail food establishments with 20 or more locations are required to begin implementing calorie information on their menus. As enacting of the law begins, it is important to understand its potential for improving consumers' healthful behaviors. Therefore, the objective of this study was to explore relationships among users of grocery nutrition labels and attitudes toward restaurant menu labeling, along with the caloric content of their restaurant menu selection. Study participants were surveyed and then provided identical mock restaurant menus with or without calories. Results found that participants who used grocery nutrition labels and believed they would make healthy menu selections with nutrition labels on restaurant menus made healthier menu selections, regardless of whether the menu displayed calories or not. Consumers' nutrition knowledge and behaviors gained from using grocery nutrition labels and consumers' desire for restaurants to provide nutrition menu labels have a positive effect on their choosing healthful restaurant menu items. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of personal values, urban form, and auto availability in the analysis of walking for transportation.

PubMed

Coogan, Matthew A; Karash, Karla H; Adler, Thomas; Sallis, James

2007-01-01

To examine the association of personal values, the built environment, and auto availability with walking for transportation. Participants were drawn from 11 U.S. metropolitan areas with good transit services. 865 adults who had recently made or were contemplating making a residential move. Respondents reported if walking was their primary mode for nine trip purposes. "Personal values" reflected ratings of 15 variables assessing attitudes about urban and environmental attributes, with high reliability (ot = 0.85). Neighborhood form was indicated by a three-item scale. Three binary variables were created to reflect (1) personal values, (2) neighborhood form, and (3) auto availability. The association with walking was reported for each of the three variables, each combination of two variables, and the combination of three variables. An analysis of covariance was applied, and a hierarchic linear regression model was developed. All three variables were associated with walking, and all three variables interacted. The standardized coefficients were 0.23for neighborhood form, 0.21 for autos per person, and 0.18 for personal values. Positive attitudes about urban attributes, living in a supportive neighborhood, and low automobile availability significantly predicted more walking for transportation. A framework for further research is proposed in which a factor representing the role of the automobile is examined explicitly in addition to personal values and urban form.

Food marketing to children through toys: response of restaurants to the first U.S. toy ordinance.

PubMed

Otten, Jennifer J; Hekler, Eric B; Krukowski, Rebecca A; Buman, Matthew P; Saelens, Brian E; Gardner, Christopher D; King, Abby C

2012-01-01

On August 9, 2010, Santa Clara County CA became the first U.S. jurisdiction to implement an ordinance that prohibits the distribution of toys and other incentives to children in conjunction with meals, foods, or beverages that do not meet minimal nutritional criteria. Restaurants had many different options for complying with this ordinance, such as introducing more healthful menu options, reformulating current menu items, or changing marketing or toy distribution practices. To assess how ordinance-affected restaurants changed their child menus, marketing, and toy distribution practices relative to non-affected restaurants. Children's menu items and child-directed marketing and toy distribution practices were examined before and at two time points after ordinance implementation (from July through November 2010) at ordinance-affected fast-food restaurants compared with demographically matched unaffected same-chain restaurants using the Children's Menu Assessment tool. Affected restaurants showed a 2.8- to 3.4-fold improvement in Children's Menu Assessment scores from pre- to post-ordinance with minimal changes at unaffected restaurants. Response to the ordinance varied by restaurant. Improvements were seen in on-site nutritional guidance; promotion of healthy meals, beverages, and side items; and toy marketing and distribution activities. The ordinance appears to have positively influenced marketing of healthful menu items and toys as well as toy distribution practices at ordinance-affected restaurants, but did not affect the number of healthful food items offered. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Understanding the ecology of child maltreatment: a review of the literature and directions for future research.

PubMed

Freisthler, Bridget; Merritt, Darcey H; LaScala, Elizabeth A

2006-08-01

Studies examining neighborhood characteristics in relation to social problems, including child maltreatment, have proliferated in the past 25 years. This article reviews the current state of knowledge of ecological studies of child maltreatment. Taken as a whole, these 18 studies document a stable ecological relationship among neighborhood impoverishment, housing stress, and rates of child maltreatment, as well as some evidence that unemployment, child care burden, and alcohol availability may contribute to child abuse and neglect. The authors include a discussion of methodological difficulties in conducting research at the neighborhood level and present a set of recommendations for future research that emphasizes movement from a simple examination of neighborhood-level characteristics toward a theoretically driven explication of processes and mechanisms supported by appropriate multilevel modeling techniques. The final goal of such efforts would be to enable practitioners to develop evidence-based neighborhood interventions that would prevent and reduce child abuse and neglect.

Neighborhood Age Structure and its Implications for Health

PubMed Central

2006-01-01

Age structure at the neighborhood level is rarely considered in contextual studies of health. However, age structure can play a critical role in shaping community life, the availability of resources, and the opportunities for social engagement—all factors that, research suggests, have direct and indirect effects on health. Age structure can be theorized as a compositional effect and as a contextual effect. In addition, the dynamic nature of age structure and the utility of a life course perspective as applied to neighborhood effects research merits attention. Four Chicago neighborhoods are summarized to illustrate how age structure varies across small space, suggesting that neighborhood age structure should be considered a key structural covariate in contextual research on health. Considering age structure implies incorporating not only meaningful cut points for important age groups (e.g., proportion 65 years and over) but attention to the shape of the distribution as well. PMID:16865558

National outbreak of Salmonella serotype saintpaul infections: importance of Texas restaurant investigations in implicating jalapeño peppers.

PubMed

Mody, Rajal K; Greene, Sharon A; Gaul, Linda; Sever, Adrianne; Pichette, Sarah; Zambrana, Ingrid; Dang, Thi; Gass, Angie; Wood, René; Herman, Karen; Cantwell, Laura B; Falkenhorst, Gerhard; Wannemuehler, Kathleen; Hoekstra, Robert M; McCullum, Isaac; Cone, Amy; Franklin, Lou; Austin, Jana; Delea, Kristin; Behravesh, Casey Barton; Sodha, Samir V; Yee, J Christopher; Emanuel, Brian; Al-Khaldi, Sufian F; Jefferson, Val; Williams, Ian T; Griffin, Patricia M; Swerdlow, David L

2011-02-23

In May 2008, PulseNet detected a multistate outbreak of Salmonella enterica serotype Saintpaul infections. Initial investigations identified an epidemiologic association between illness and consumption of raw tomatoes, yet cases continued. In mid-June, we investigated two clusters of outbreak strain infections in Texas among patrons of Restaurant A and two establishments of Restaurant Chain B to determine the outbreak's source. We conducted independent case-control studies of Restaurant A and B patrons. Patients were matched to well controls by meal date. We conducted restaurant environmental investigations and traced the origin of implicated products. Forty-seven case-patients and 40 controls were enrolled in the Restaurant A study. Thirty case-patients and 31 controls were enrolled in the Restaurant Chain B study. In both studies, illness was independently associated with only one menu item, fresh salsa (Restaurant A: matched odds ratio [mOR], 37; 95% confidence interval [CI], 7.2-386; Restaurant B: mOR, 13; 95% CI 1.3-infinity). The only ingredient in common between the two salsas was raw jalapeño peppers. Cultures of jalapeño peppers collected from an importer that supplied Restaurant Chain B and serrano peppers and irrigation water from a Mexican farm that supplied that importer with jalapeño and serrano peppers grew the outbreak strain. Jalapeño peppers, contaminated before arrival at the restaurants and served in uncooked fresh salsas, were the source of these infections. Our investigations, critical in understanding the broader multistate outbreak, exemplify an effective approach to investigating large foodborne outbreaks. Additional measures are needed to reduce produce contamination.

National Outbreak of Salmonella Serotype Saintpaul Infections: Importance of Texas Restaurant Investigations in Implicating Jalapeño Peppers

PubMed Central

Mody, Rajal K.; Greene, Sharon A.; Gaul, Linda; Sever, Adrianne; Pichette, Sarah; Zambrana, Ingrid; Dang, Thi; Gass, Angie; Wood, René; Herman, Karen; Cantwell, Laura B.; Falkenhorst, Gerhard; Wannemuehler, Kathleen; Hoekstra, Robert M.; McCullum, Isaac; Cone, Amy; Franklin, Lou; Austin, Jana; Delea, Kristin; Behravesh, Casey Barton; Sodha, Samir V.; Yee, J. Christopher; Emanuel, Brian; Al-Khaldi, Sufian F.; Jefferson, Val; Williams, Ian T.; Griffin, Patricia M.; Swerdlow, David L.

2011-01-01

Background In May 2008, PulseNet detected a multistate outbreak of Salmonella enterica serotype Saintpaul infections. Initial investigations identified an epidemiologic association between illness and consumption of raw tomatoes, yet cases continued. In mid-June, we investigated two clusters of outbreak strain infections in Texas among patrons of Restaurant A and two establishments of Restaurant Chain B to determine the outbreak's source. Methodology/Principal Findings We conducted independent case-control studies of Restaurant A and B patrons. Patients were matched to well controls by meal date. We conducted restaurant environmental investigations and traced the origin of implicated products. Forty-seven case-patients and 40 controls were enrolled in the Restaurant A study. Thirty case-patients and 31 controls were enrolled in the Restaurant Chain B study. In both studies, illness was independently associated with only one menu item, fresh salsa (Restaurant A: matched odds ratio [mOR], 37; 95% confidence interval [CI], 7.2–386; Restaurant B: mOR, 13; 95% CI 1.3–infinity). The only ingredient in common between the two salsas was raw jalapeño peppers. Cultures of jalapeño peppers collected from an importer that supplied Restaurant Chain B and serrano peppers and irrigation water from a Mexican farm that supplied that importer with jalapeño and serrano peppers grew the outbreak strain. Conclusions/Significance Jalapeño peppers, contaminated before arrival at the restaurants and served in uncooked fresh salsas, were the source of these infections. Our investigations, critical in understanding the broader multistate outbreak, exemplify an effective approach to investigating large foodborne outbreaks. Additional measures are needed to reduce produce contamination. PMID:21373185

Parents' meal choices for their children at fast food and family restaurants with different menu labeling presentations

PubMed Central

2018-01-01

BACKGROUND/OBJECTIVES This study examined the effect of nutrition labeling formats on parents' food choices for their children at different restaurant types. SUBJECTS/METHODS An online survey was conducted with 1,980 parents of children aged 3–12 years. Participants were randomly assigned to fast food or family restaurant scenarios, and one of four menu stimuli conditions: no labeling, low-calorie symbol (symbol), numeric value (numeric), and both low-calorie symbol and numeric value (symbol + numeric). Participants selected menu items for their children. Menu choices and total calories were compared by nutrition labeling formats in each type of the restaurant. RESULTS Low-calorie item selections were scored and a two-way analysis of variance (ANOVA) was conducted for an interaction effect between restaurant and labeling type. In the fast food restaurant group, parents presented with low-calorie symbols selected the lowest calorie items more often than those not presented with the format. Parents in the symbol + numeric condition selected significantly fewer calories (653 kcal) than those in the no labeling (677 kcal) or numeric conditions (674 kcal) (P = 0.006). In the family restaurant group, no significant difference were observed among different labeling conditions. A significant interaction between restaurant and labeling type on low-calorie selection score (F = 6.03, P < 0.01) suggests that the effect of nutrition labeling format interplays with restaurant type to jointly affect parents' food choices for their children. CONCLUSIONS The provision of easily interpretable nutritional information format at fast food restaurants may encourage healthier food choices of parents for their children; however, the effects were negligible at family restaurants. PMID:29854330

Frequency of indicator bacteria, Salmonella and diarrhoeagenic Escherichia coli pathotypes on ready-to-eat cooked vegetable salads from Mexican restaurants.

PubMed

Bautista-De León, H; Gómez-Aldapa, C A; Rangel-Vargas, E; Vázquez-Barrios, E; Castro-Rosas, J

2013-06-01

The presence of coliform bacteria, faecal coliforms, Escherichia coli, diarrhoeagenic E. coli pathotypes (DEP) and Salmonella were determined in ready-to-eat cooked vegetable salads (RECS) from restaurants in Pachuca city, Mexico. The RECS were purchased from three types of restaurants: national chain restaurants (A), local restaurants (B) and small restaurants (C). Two restaurants for each A and B, and three for C, were included. Forty RECS samples were purchased at each A and B restaurant and 20 at each C restaurant. Of the overall total of 220 analysed samples, 100, 98·2, 72·3, 4·1 and 4·1% had coliform bacteria, faecal coliforms, E. coli, DEP and Salmonella, respectively. Identified DEP included enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC) and Shiga toxin-producing E. coli (STEC). The EPEC, ETEC and STEC were isolated each from 1·4% of samples. No E. coli O157:H7 were detected in any STEC-positive samples. The analysis of Kruskal-Wallis anova and median test of microbiological data showed that the microbiological quality of RECS did not differ between the different restaurants (P > 0·05). This is the first report regarding microbiological quality and Salmonella, enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC) and Shiga toxin-producing E. coli (STEC) isolation from ready-to-eat cooked vegetable salads from Mexican restaurants. Ready-to-eat cooked vegetable salads could be an important factor contributing to the endemicity of EPEC, ETEC and STEC, and Salmonella caused gastroenteritis in Mexico. © 2013 The Society for Applied Microbiology.

Individual, Social, and Environmental Correlates of Healthy and Unhealthy Eating.

PubMed

Trapp, Georgina S A; Hickling, Siobhan; Christian, Hayley E; Bull, Fiona; Timperio, Anna F; Boruff, Bryan; Shrestha, Damber; Giles-Corti, Billie

2015-12-01

Few studies use comprehensive ecological approaches considering multilevel factors to understand correlates of healthy (and unhealthy) dietary intake. The aim of this study was to examine the association between individual, social, and environmental factors on composite measures of healthy and unhealthy dietary intake in adults. Participants (n = 565) of the Australian RESIDential Environments (RESIDE) project self-reported dietary intake, home food availability, and behavioral and perceived social and physical environmental influences on food choices. A geographic information system measured proximity of supermarkets from each participant's home. "Healthy" and "unhealthy" eating scores were computed based on adherence to dietary guidelines. Univariate and multivariate models were constructed using linear regression. After full adjustment, "healthy" eating (mean = 6.25, standard deviation [SD] = 1.95) was significantly associated with having confidence to prepare healthy meals (β = 0.34; 95% confidence interval [CI] = [0.13, 0.55]); having more healthy (β = 0.13; 95% CI = [0.09-0.16]) and fewer unhealthy (β = -0.04; 95% CI = [-0.06, -0.02]) foods available at home; and having a supermarket within 800 meters of home (β = 1.39; 95% CI = [0.37, 2.404]). "Unhealthy" eating (mean = 3.53, SD = 2.06) was associated with being male (β = 0.39; 95% CI = [0.02, 0.75]), frequently eating takeaway (β = 0.33; 95% CI = [0.21, 0.46]) and cafe or restaurant meals (β = 0.20; 95% CI = [0.06, 0.33]) and having fewer healthy (β = -0.07; 95% CI = [-0.10, -0.03]) and more unhealthy (β = 0.09; 95% CI = [0.07, 0.10]) foods available within the home. Initiatives to improve adherence to dietary guidelines and reduce the consumption of unhealthy foods needs to be multifaceted; addressing individual factors and access to healthy food choices in both the home and neighborhood food environment. Ensuring proximity to local supermarkets, particularly in new suburban developments, appears to be an important strategy for facilitating healthy eating. © 2015 Society for Public Health Education.

Supplementing Public Health Inspection via Social Media.

PubMed

Schomberg, John P; Haimson, Oliver L; Hayes, Gillian R; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions.

Validation of walk score for estimating neighborhood walkability: an analysis of four US metropolitan areas.

PubMed

Duncan, Dustin T; Aldstadt, Jared; Whalen, John; Melly, Steven J; Gortmaker, Steven L

2011-11-01

Neighborhood walkability can influence physical activity. We evaluated the validity of Walk Score(®) for assessing neighborhood walkability based on GIS (objective) indicators of neighborhood walkability with addresses from four US metropolitan areas with several street network buffer distances (i.e., 400-, 800-, and 1,600-meters). Address data come from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5-11 years and their families participating in YMCA-administered, after-school programs located in four geographically diverse metropolitan areas in the US (n = 733). GIS data were used to measure multiple objective indicators of neighborhood walkability. Walk Scores were also obtained for the participant's residential addresses. Spearman correlations between Walk Scores and the GIS neighborhood walkability indicators were calculated as well as Spearman correlations accounting for spatial autocorrelation. There were many significant moderate correlations between Walk Scores and the GIS neighborhood walkability indicators such as density of retail destinations and intersection density (p < 0.05). The magnitude varied by the GIS indicator of neighborhood walkability. Correlations generally became stronger with a larger spatial scale, and there were some geographic differences. Walk Score(®) is free and publicly available for public health researchers and practitioners. Results from our study suggest that Walk Score(®) is a valid measure of estimating certain aspects of neighborhood walkability, particularly at the 1600-meter buffer. As such, our study confirms and extends the generalizability of previous findings demonstrating that Walk Score is a valid measure of estimating neighborhood walkability in multiple geographic locations and at multiple spatial scales.

76 FR 30051 - Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... Restaurants and Similar Retail Food Establishments; Extension of Comment Period AGENCY: Food and Drug... for providing nutrition information for standard menu items in certain chain restaurants and similar... restaurants and similar retail food establishments that are a part of a chain with 20 or more locations doing...

75 FR 20513 - Changes in the Federal Employees Dental and Vision Insurance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... positions in 5 U.S.C. 8901(1). We are also including in the regulations certain former Senate restaurant... for certain employees of the Senate Restaurants after the operations of the Senate Restaurants are contracted to be performed by a private business concern. The law provides that a Senate Restaurants employee...

21 CFR 101.10 - Nutrition labeling of restaurant foods.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Nutrition labeling of restaurant foods. 101.10... restaurant foods. Nutrition labeling in accordance with § 101.9 shall be provided upon request for any restaurant food or meal for which a nutrient content claim (as defined in § 101.13 or in subpart D of this...

Factors That Lead to Environmentally Sustainable Practices in the Restaurant Industry: A Qualitative Analysis of Two Green Restaurant Innovators

ERIC Educational Resources Information Center

Nyheim, Peter

2012-01-01

In recent years, more organizations, including restaurants, have concerned themselves with sustainability. As with any new endeavor, guidance is needed. The purpose of this study was to investigate factors that lead to environmentally sustainable practices in the restaurant industry. Using Rogers' Diffusion of Innovation Theory as a…

Destinations matter: The association between where older adults live and their travel behavior.

PubMed

Chudyk, Anna M; Winters, Meghan; Moniruzzaman, Md; Ashe, Maureen C; Gould, Joanie Sims; McKay, Heather

2015-03-01

The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted. Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts -physical activity and mobility - are closely linked and together contribute to older adults living healthy, independent lives. Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity. We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk. As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to: (1) describe the types of destinations older adults with low income most commonly travel to in one week; and (2) determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day). We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We also assessed participants' sociodemographic characteristics and mobility (physical function, car access, confidence walking). We used a negative binomial model to determine the association between Street Smart Walk Score and number of transportation walking trips (average per day). Our sample was comprised of 150 participants (median age 74 years; 51 men) from who we acquired at least one day of travel diary data (range = 1-7 days). Participants made three trips per day (2, 5; median P 25 , P 75 ) and travelled to six different destination types per week (5, 9; median P 25 , P 75 ). Destinations most relevant to older adults were grocery stores, malls, and restaurants/cafés. Each 10-point increase in Street Smart Walk Score was associated with a 20% increase in the number of transportation walking trips (average per day, incidence rate ratio = 1.20, 95% CI = 1.12, 1.29). Our findings provide preliminary evidence regarding destinations that may be most relevant to older adults. They also suggest that the prevalence of these neighborhood destinations may encourage walking. As we approach a new era of healthy city benchmarks, our findings guide policy makers and developers to retrofit and develop communities that support the mobility, health, and independence of older adults.

Destinations matter: The association between where older adults live and their travel behavior

PubMed Central

Chudyk, Anna M.; Winters, Meghan; Moniruzzaman, Md; Ashe, Maureen C.; Gould, Joanie Sims; McKay, Heather

2016-01-01

The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted. Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts –physical activity and mobility – are closely linked and together contribute to older adults living healthy, independent lives. Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity. We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk. As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to: (1) describe the types of destinations older adults with low income most commonly travel to in one week; and (2) determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day). We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We also assessed participants’ sociodemographic characteristics and mobility (physical function, car access, confidence walking). We used a negative binomial model to determine the association between Street Smart Walk Score and number of transportation walking trips (average per day). Our sample was comprised of 150 participants (median age 74 years; 51 men) from who we acquired at least one day of travel diary data (range = 1–7 days). Participants made three trips per day (2, 5; median P25, P75) and travelled to six different destination types per week (5, 9; median P25, P75). Destinations most relevant to older adults were grocery stores, malls, and restaurants/cafés. Each 10-point increase in Street Smart Walk Score was associated with a 20% increase in the number of transportation walking trips (average per day, incidence rate ratio = 1.20, 95% CI = 1.12, 1.29). Our findings provide preliminary evidence regarding destinations that may be most relevant to older adults. They also suggest that the prevalence of these neighborhood destinations may encourage walking. As we approach a new era of healthy city benchmarks, our findings guide policy makers and developers to retrofit and develop communities that support the mobility, health, and independence of older adults. PMID:27104147

Successful customer intercept interview recruitment outside small and midsize urban food retailers.

PubMed

Pelletier, Jennifer E; Caspi, Caitlin E; Schreiber, Liana R N; Erickson, Darin J; Harnack, Lisa; Laska, Melissa N

2016-10-05

Customer intercept interviews are increasingly used to characterize food purchases at retail food outlets and restaurants; however, methodological procedures, logistical issues and response rates using intercept methods are not well described in the food environment literature. The aims of this manuscript were to 1) describe the development and implementation of a customer intercept interview protocol in a large, NIH-funded study assessing food purchases in small and midsize food retailers in Minneapolis and St. Paul, Minnesota, 2) describe intercept interview response rates by store type and environmental factors (e.g., neighborhood socioeconomic status, day/time, weather), and 3) compare demographic characteristics (e.g., gender, race/ethnicity) of participants versus non-participants. After a pilot phase involving 28 stores, a total of 616 interviews were collected from customers exiting 128 stores in fall 2014. The number of eligible customers encountered per hour (a measure of store traffic), participants successfully recruited per hour, and response rates were calculated overall and by store type, neighborhood socio-economic status, day and time of data collection, and weather. Response rates by store type, neighborhood socio-economic status, time and day of data collection, and weather, and characteristics of participants and non-participants were compared using chi-square tests. The overall response rate was 35 %, with significantly higher response rates at corner/small grocery stores (47 %) and dollar stores (46 %) compared to food-gas marts (32 %) and pharmacies (26 %), and for data collection between 4:00-6:00 pm on weekdays (40 %) compared to weekends (32 %). The distribution of race/ethnicity, but not gender, differed between participants and non-participants (p < 0.01), with greater participation rates among those identified as Black versus White. Customer intercept interviews can be successfully used to recruit diverse samples of customers at small and midsize food retailers. Future community-based studies using customer intercept interviews should collect data sufficient to report response rates and consider potential differences between the racial/ethnic composition of the recruited sample and the target population.

Complex Deployed Responsive Service

NASA Astrophysics Data System (ADS)

Parry, Glenn; McLening, Marc; Caldwell, Nigel; Thompson, Rob

A pizza restaurant must provide product, in the form of the food and drink, and service in the way this is delivered to the customer. Providing this has distinct operational challenges, but what if the restaurant also provides a home delivery service? The service becomes deployed as the customer is no-longer co-located with the production area. The business challenge is complicated as service needs to be delivered within a geographic region, to time or the pizza will be cold, and within a cost that is not ­prohibitive. It must also be responsive to short term demand; needing to balance the number of staff it has available to undertake deliveries against a forecast of demand.

Mitigating the Health Risks of Dining Out: The Need for Standardized Portion Sizes in Restaurants

PubMed Central

Story, Mary

2014-01-01

Because restaurants routinely serve food with more calories than people need, dining out represents a risk factor for overweight, obesity, and other diet-related chronic diseases. Most people lack the capacity to judge the caloric content of food and there is limited evidence that people make use of calorie-labeling information when it is available. Standardized portion sizes would not preclude people from eating as much as they want, but would make the amount they are getting fully transparent. We describe the potential benefits and means of implementing a system of standardized portion sizes that might facilitate a healthier diet among the US population. PMID:24524513

Sodium levels in Canadian fast-food and sit-down restaurants.

PubMed

Scourboutakos, Mary J; L'Abbé, Mary R

2013-01-31

To evaluate the sodium levels in Canadian restaurant and fast-food chain menu items. Nutrition information was collected from the websites of major sit-down (n=20) and fast-food (n=65) restaurants across Canada in 2010 and a database was constructed. Four thousand and forty-four meal items, baked goods, side dishes and children's items were analyzed. Sodium levels were compared to the recommended adequate intake level (AI), tolerable upper intake level (UL) and the US National Sodium Reduction Initiative (NSRI) targets. On average, individual sit-down restaurant menu items contained 1455 mg sodium/serving (or 97% of the AI level of 1500 mg/day). Forty percent of all sit-down restaurant items exceeded the AI for sodium and more than 22% of sit-down restaurant stir fry entrées, sandwiches/wraps, ribs, and pasta entrées with meat/seafood exceeded the daily UL for sodium (2300 mg). Fast-food restaurant meal items contained, on average, 1011 mg sodium (68% of the daily AI), while side dishes (from sit-down and fast-food restaurants) contained 736 mg (49%). Children's meal items contained, on average, 790 mg/serving (66% of the sodium AI for children of 1200 mg/day); a small number of children's items exceeded the children's daily UL. On average, 52% of establishments exceeded the 2012 NSRI density targets and 69% exceeded the 2014 targets. The sodium content in Canadian restaurant foods is alarmingly high. A population-wide sodium reduction strategy needs to address the high levels of sodium in restaurant foods.

Smoking reduced in urban restaurants: the effect of Beijing Smoking Control Regulation.

PubMed

Xiao, Lin; Jiang, Yuan; Liu, Xiurong; Li, Yuqin; Gan, Quan; Liu, Fan

2017-03-01

To evaluate the effectiveness of Beijing Smoking Control Regulation, occurrence of smoking in restaurants was compared before and after the law took effect. A cohort study design was used in a randomly selected sample of 176 restaurants in two districts of Beijing. Undercover visits were paid by investigators to the same restaurants at lunch or dinner time 5 months before the law took effect and 1-month after. The occurrence of smoking and presence of no-smoking signs were observed. Much less smoking was observed (14.8%) in restaurants compared to that before the law took effect (40.3%). The drop in smoking occurrence was more evident in open dining areas (from 32.4% to 5.1%) compared to the men's restrooms of the restaurants (23.8% to 18.8%). No intervention from restaurant staff was observed whenever smoking occurred. Posting of no-smoking signage increased considerably after the law came into effect (from 52.6% to 82.4%), but very few no-smoking signs included the symptom hotline number (38.5%) or the amount of penalty (5.6%). The Beijing Smoking Control Regulation achieved one of its intended goals of reducing smoking occurrences in restaurants, but further effort of strengthening implementation is still needed and should focus on boosting compliance with no-smoking sign requirements, reducing smoking in restrooms of the restaurants and mobilising the restaurant staff to intervene in case of violations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Fine and ultrafine particle exposures on 73 trips by car to 65 non-smoking restaurants in the San Francisco Bay Area.

PubMed

Ott, W R; Wallace, L A; McAteer, J M; Hildemann, L M

2017-01-01

A number of studies indicate cooking is a major source of exposure to particulate matter, but few studies have measured indoor air pollution in restaurants, where cooking predominates. We made 73 visits by car to 65 different non-smoking restaurants in 10 Northern California towns while carrying portable continuous monitors that unobtrusively measured ultrafine (down to 10 nm) and fine (PM 2.5 ) particles to characterize indoor restaurant exposures, comparing them with exposures in the car. The mean ultrafine number concentrations in the restaurants on dinner visits averaging 1.4 h was 71 600 particles/cm 3 , or 4.3 times the mean concentration on car trips, and 12.3 times the mean background concentration in the residence. Restaurants that cooked dinner in the same room as the patrons had higher ultrafine concentrations than restaurants with separate kitchens. Restaurant PM 2.5 mass concentrations averaged 36.3 μg/m 3 , ranging from 1.5 to 454 μg/m 3 , but were relatively low on most visits: 43% of the indoor means were below 10 μg/m 3 and 66% were below 20 μg/m 3 , with 5.5% above 100 μg/m 3 . Exposure to fine and ultrafine particles when visiting a restaurant exceeded the exposure a person received while traveling by car to and from the restaurant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using Geographic Information Systems and Local Food Store Data in California's Low-Income Neighborhoods to Inform Community Initiatives and Resources

PubMed Central

Quinn, Valerie; Foerster, Susan B.

2010-01-01

Objectives. We examined conditions in California low-income neighborhoods that affect obesity to inform program planning, nutrition education, community participation, investment of resources, and involvement of stakeholders. Methods. Staff members in 18 local health departments were trained to use an online geographic information system (GIS) and conduct field surveys. GIS data were aggregated from 68 low-income neighborhoods of 1 or more census tracts. Data were collected in 2007 to 2009 from 473 grocery stores in 62 neighborhoods. Results. Thirty-one percent of neighborhoods mapped had no supermarket within any of their census tract boundaries, but health department staff members estimated that 74.2% of residents had access to a large grocery store within 1 mile. Eighty-one percent of small markets sold produce, and 67.6% offered 4 or more types of fresh vegetables. Conclusions. Small markets and corner stores in California's low-income neighborhoods often have fresh produce available for sale. Stores providing healthy options in typically underserved areas can be part of community efforts to promote healthy eating behaviors. PMID:20864701

Using geographic information systems and local food store data in California's low-income neighborhoods to inform community initiatives and resources.

PubMed

Ghirardelli, Alyssa; Quinn, Valerie; Foerster, Susan B

2010-11-01

We examined conditions in California low-income neighborhoods that affect obesity to inform program planning, nutrition education, community participation, investment of resources, and involvement of stakeholders. Staff members in 18 local health departments were trained to use an online geographic information system (GIS) and conduct field surveys. GIS data were aggregated from 68 low-income neighborhoods of 1 or more census tracts. Data were collected in 2007 to 2009 from 473 grocery stores in 62 neighborhoods. Thirty-one percent of neighborhoods mapped had no supermarket within any of their census tract boundaries, but health department staff members estimated that 74.2% of residents had access to a large grocery store within 1 mile. Eighty-one percent of small markets sold produce, and 67.6% offered 4 or more types of fresh vegetables. Small markets and corner stores in California's low-income neighborhoods often have fresh produce available for sale. Stores providing healthy options in typically underserved areas can be part of community efforts to promote healthy eating behaviors.

Validity of Walk Score® as a measure of neighborhood walkability in Japan.

PubMed

Koohsari, Mohammad Javad; Sugiyama, Takemi; Hanibuchi, Tomoya; Shibata, Ai; Ishii, Kaori; Liao, Yung; Oka, Koichiro

2018-03-01

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan. Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017). Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density ( r  = 0.82) and with the number of local destinations ( r  = 0.77). Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data.

Restaurant challenge offers healthful meal options and builds diabetes awareness.

PubMed

Blair, Angela M; Drass, Janice A; Stone, Marylou; Rhoades, Deborah; Baldwin, Susan A; Russ, Kelsey M

2011-01-01

The Frederick Restaurant Challenge is an innovative project based on a collaborative effort among community organizations and partners designed to offer delicious healthful meal options at local restaurants during the month of November for American Diabetes Month. Local restaurants were challenged to participate and submitted recipes for healthful meals to the Frederick County Diabetes Coalition for review by registered dietitians. Diners voted on meals to determine the challenge winner(s), and were eligible to win prizes as well. Publicity prior to and during the month was effective in creating positive news about healthful meals when eating out, raised awareness about diabetes, and provided restaurants with desirable advertising opportunities. Feedback from restaurants and diners was overwhelmingly positive. The purpose of this article is to describe this successful low-budget project to encourage its replication in local communities. The Frederick Restaurant Challenge proved to be a very successful, innovative, low-budget project that met its intended goals: to develop healthful meal options for people with diabetes (or for anyone wishing to eat healthier); to demonstrate that healthful food can taste delicious; and to encourage restaurants to continue offering healthful options on their menus beyond the challenge month. Community interventions such as the Frederick Restaurant Challenge offer unique and important strategies for affecting change and raising awareness not only for people with diabetes but also for the entire community.

Healthier Children's Meals in Restaurants: An Exploratory Study to Inform Approaches That Are Acceptable Across Stakeholders.

PubMed

Anzman-Frasca, Stephanie; Folta, Sara C; Glenn, Meaghan E; Jones-Mueller, Anita; Lynskey, Vanessa M; Patel, Anjali A; Tse, Lisa L; Lopez, Nanette V

2017-04-01

Assess parents', children's, and restaurant executives' perspectives on children's meals in restaurants. Cross-sectional. Parents and children completed predominantly quantitative surveys at 4 quick- and full-service restaurant locations. Telephone interviews were conducted with executives representing additional restaurants. Parents (n = 59) and their first- through fourth-grade children (n = 58); executives (n = 4). Parent/child perspectives on child meal selection and toy incentives in restaurants; executives' views on kids' meals and barriers to supplying healthier kids' meals. Frequencies, thematic analysis. A total of 63% of children ordered from children's menus, 8% of whom ordered healthier kids' meals. Half of parents reported that children determined their own orders. Taste was the most common reason for children's meal choices. Most (76%) children reported visiting the restaurant previously; 64% of them placed their usual order. Parents' views on toy incentives were mixed. Themes from executive interviews highlighted factors driving children's menu offerings, including children's habits and preferences and the need to use preexisting pantry items. Executives described menu changes as driven by profitability, consumer demand, regulation, and corporate social responsibility. Findings can inform the development of restaurant interventions that are effective in promoting healthier eating and are acceptable to parents, children, and restaurant personnel. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

Plain Water and Sugar-Sweetened Beverage Consumption in Relation to Energy and Nutrient Intake at Full-Service Restaurants

PubMed Central

An, Ruopeng

2016-01-01

Background: Drinking plain water, such as tap or bottled water, provides hydration and satiety without adding calories. We examined plain water and sugar-sweetened beverage (SSB) consumption in relation to energy and nutrient intake at full-service restaurants. Methods: Data came from the 2005–2012 National Health and Nutrition Examination Survey, comprising a nationally-representative sample of 2900 adults who reported full-service restaurant consumption in 24-h dietary recalls. Linear regressions were performed to examine the differences in daily energy and nutrient intake at full-service restaurants by plain water and SSB consumption status, adjusting for individual characteristics and sampling design. Results: Over 18% of U.S. adults had full-service restaurant consumption on any given day. Among full-service restaurant consumers, 16.7% consumed SSBs, 2.6% consumed plain water but no SSBs, and the remaining 80.7% consumed neither beverage at the restaurant. Compared to onsite SSB consumption, plain water but no SSB consumption was associated with reduced daily total energy intake at full-service restaurants by 443.4 kcal, added sugar intake by 58.2 g, saturated fat intake by 4.4 g, and sodium intake by 616.8 mg, respectively. Conclusion: Replacing SSBs with plain water consumption could be an effective strategy to balance energy/nutrient intake and prevent overconsumption at full-service restaurant setting. PMID:27153083

Plain Water and Sugar-Sweetened Beverage Consumption in Relation to Energy and Nutrient Intake at Full-Service Restaurants.

PubMed

An, Ruopeng

2016-05-04

Drinking plain water, such as tap or bottled water, provides hydration and satiety without adding calories. We examined plain water and sugar-sweetened beverage (SSB) consumption in relation to energy and nutrient intake at full-service restaurants. Data came from the 2005-2012 National Health and Nutrition Examination Survey, comprising a nationally-representative sample of 2900 adults who reported full-service restaurant consumption in 24-h dietary recalls. Linear regressions were performed to examine the differences in daily energy and nutrient intake at full-service restaurants by plain water and SSB consumption status, adjusting for individual characteristics and sampling design. Over 18% of U.S. adults had full-service restaurant consumption on any given day. Among full-service restaurant consumers, 16.7% consumed SSBs, 2.6% consumed plain water but no SSBs, and the remaining 80.7% consumed neither beverage at the restaurant. Compared to onsite SSB consumption, plain water but no SSB consumption was associated with reduced daily total energy intake at full-service restaurants by 443.4 kcal, added sugar intake by 58.2 g, saturated fat intake by 4.4 g, and sodium intake by 616.8 mg, respectively. Replacing SSBs with plain water consumption could be an effective strategy to balance energy/nutrient intake and prevent overconsumption at full-service restaurant setting.

School Vouchers and Student Neighborhoods: Evidence from the Milwaukee Parental Choice Program

ERIC Educational Resources Information Center

Carlson, Deven E.; Cowen, Joshua M.

2015-01-01

In this paper we explore the relationship between students' residential location and participation in Milwaukee's large, widely available private school voucher program. We are interested in one overarching question: do voucher schools disproportionately draw students from better public schools and city neighborhoods, or do they draw students most…

76 FR 74804 - Federal Housing Administration (FHA) First Look Sales Method Under the Neighborhood Stabilization...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-01

... participate in the First Look Sales Method. This notice announces the availability of a universal NAID to aid... universal NAID to aid eligible NSP purchasers in the purchase of properties under First Look Sales Method... Administration (FHA) First Look Sales Method Under the Neighborhood Stabilization Programs (NSP) Technical...

Secondhand Tobacco Smoke and Municipal Smokefree Ordinances: Attitudes of Restaurant and Bar Owners and Managers

ERIC Educational Resources Information Center

Hays, Scott P.

2006-01-01

Understanding the attitudes of restaurant and bar owners and managers toward a smokefree city ordinance can contribute greatly to the success of a smokefree policy campaign. While local opposition to a smokefree policy always arises from restaurant and bar owners, this study of restaurant and bar owners and managers in two Midwestern cities…

Lazy collaborative filtering for data sets with missing values.

PubMed

Ren, Yongli; Li, Gang; Zhang, Jun; Zhou, Wanlei

2013-12-01

As one of the biggest challenges in research on recommender systems, the data sparsity issue is mainly caused by the fact that users tend to rate a small proportion of items from the huge number of available items. This issue becomes even more problematic for the neighborhood-based collaborative filtering (CF) methods, as there are even lower numbers of ratings available in the neighborhood of the query item. In this paper, we aim to address the data sparsity issue in the context of neighborhood-based CF. For a given query (user, item), a set of key ratings is first identified by taking the historical information of both the user and the item into account. Then, an auto-adaptive imputation (AutAI) method is proposed to impute the missing values in the set of key ratings. We present a theoretical analysis to show that the proposed imputation method effectively improves the performance of the conventional neighborhood-based CF methods. The experimental results show that our new method of CF with AutAI outperforms six existing recommendation methods in terms of accuracy.

K-SPAN: A lexical database of Korean surface phonetic forms and phonological neighborhood density statistics.

PubMed

Holliday, Jeffrey J; Turnbull, Rory; Eychenne, Julien

2017-10-01

This article presents K-SPAN (Korean Surface Phonetics and Neighborhoods), a database of surface phonetic forms and several measures of phonological neighborhood density for 63,836 Korean words. Currently publicly available Korean corpora are limited by the fact that they only provide orthographic representations in Hangeul, which is problematic since phonetic forms in Korean cannot be reliably predicted from orthographic forms. We describe the method used to derive the surface phonetic forms from a publicly available orthographic corpus of Korean, and report on several statistics calculated using this database; namely, segment unigram frequencies, which are compared to previously reported results, along with segment-based and syllable-based neighborhood density statistics for three types of representation: an "orthographic" form, which is a quasi-phonological representation, a "conservative" form, which maintains all known contrasts, and a "modern" form, which represents the pronunciation of contemporary Seoul Korean. These representations are rendered in an ASCII-encoded scheme, which allows users to query the corpus without having to read Korean orthography, and permits the calculation of a wide range of phonological measures.

Determinants of children's use of and time spent in fast-food and full-service restaurants.

PubMed

McIntosh, Alex; Kubena, Karen S; Tolle, Glen; Dean, Wesley; Kim, Mi-Jeong; Jan, Jie-Sheng; Anding, Jenna

2011-01-01

Identify parental and children's determinants of children's use of and time spent in fast-food (FF) and full-service (FS) restaurants. Analysis of cross-sectional data. Parents were interviewed by phone; children were interviewed in their homes. Parents and children ages 9-11 or 13-15 from 312 families were obtained via random-digit dialing. Dependent variables were the use of and the time spent in FF and FS restaurants by children. Determinants included parental work schedules, parenting style, and family meal ritual perceptions. Logistic regression was used for multivariate analysis of use of restaurants. Least squares regression was used for multivariate analysis of time spent in restaurants. Significance set at P < .05. Factors related to use of and time spent in FF and FS restaurants included parental work schedules, fathers' use of such restaurants, and children's time spent in the family automobile. Parenting style, parental work, parental eating habits and perceptions of family meals, and children's other uses of their time influence children's use of and time spent in FF and FS restaurants. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Restaurants With Calories Displayed On Menus Had Lower Calorie Counts Compared To Restaurants Without Such Labels

PubMed Central

Bleich, Sara N.; Wolfson, Julia A.; Jarlenski, Marian P.; Block, Jason P.

2016-01-01

Beginning in December 2016, calorie labeling on menus will be mandatory for US chain restaurants and many other establishments that serve food, such as ice cream shops and movie theaters. But before the federal mandate kicks in, several large chain restaurants have begun to voluntarily display information about the calories in the items on their menus. This increased transparency may be associated with lower overall calorie content of offered items. This study used data for the period 2012–14 from the MenuStat project, a data set of menu items at sixty-six of the largest US restaurant chains. We compared differences in calorie counts of food items between restaurants that voluntarily implemented national menu labeling and those that did not. We found that the mean per item calorie content in all years was lower for restaurants that voluntarily posted information about calories (the differences were 139 calories in 2012, 136 in 2013, and 139 in 2014). New menu items introduced in 2013 and 2014 showed a similar pattern. Calorie labeling may have important effects on the food served in restaurants by compelling the introduction of lower-calorie items. PMID:26526245

Restaurants With Calories Displayed On Menus Had Lower Calorie Counts Compared To Restaurants Without Such Labels.

PubMed

Bleich, Sara N; Wolfson, Julia A; Jarlenski, Marian P; Block, Jason P

2015-11-01

Beginning in December 2016, calorie labeling on menus will be mandatory for US chain restaurants and many other establishments that serve food, such as ice cream shops and movie theaters. But before the federal mandate kicks in, several large chain restaurants have begun to voluntarily display information about the calories in the items on their menus. This increased transparency may be associated with lower overall calorie content of offered items. This study used data for the period 2012-14 from the MenuStat project, a data set of menu items at sixty-six of the largest US restaurant chains. We compared differences in calorie counts of food items between restaurants that voluntarily implemented national menu labeling and those that did not. We found that the mean per item calorie content in all years was lower for restaurants that voluntarily posted information about calories (the differences were 139 calories in 2012, 136 in 2013, and 139 in 2014). New menu items introduced in 2013 and 2014 showed a similar pattern. Calorie labeling may have important effects on the food served in restaurants by compelling the introduction of lower-calorie items. Project HOPE—The People-to-People Health Foundation, Inc.

Actual and perceived impacts of tobacco regulation on restaurants and firms.

PubMed

Crémieux, P Y; Ouellette, P

2001-03-01

To examine the actual and anticipated costs of a law regulating workplace smoking and smoking in restaurants, taking into consideration observed and anticipated infrastructure costs, lost productivity, increased absenteeism, and loss of clientele. A survey of 401 Québec restaurants and 600 Québec firms conducted by the Québec Ministry of Health before the enactment of the law was used to derive costs incurred by those who had already complied and anticipated by those that did not. Direct and indirect costs associated with tobacco regulation at work and in restaurants were minimal. Annualised infrastructure costs amounted to less than 0.0002% of firm revenues and 0.15% of restaurant revenues. Anticipated costs were larger and amounted to 0.0004% of firm revenues and 0.41% of restaurant revenues. Impacts on productivity, absenteeism, and restaurant patronage were widely anticipated but not observed in currently compliant establishments. Firms and restaurants expected high costs to result from strict tobacco regulation because of infrastructure costs, decreased productivity, and decreased patronage. That none of these were actually observed suggests that policy makers should discount industry claims that smoking regulations impose undue economic hardship.

Why eat at fast-food restaurants: reported reasons among frequent consumers.

PubMed

Rydell, Sarah A; Harnack, Lisa J; Oakes, J Michael; Story, Mary; Jeffery, Robert W; French, Simone A

2008-12-01

A convenience sample of adolescents and adults who regularly eat at fast-food restaurants were recruited to participate in an experimental trial to examine the effect of nutrition labeling on meal choices. As part of this study, participants were asked to indicate how strongly they agreed or disagreed with 11 statements to assess reasons for eating at fast-food restaurants. Logistic regression was conducted to examine whether responses differed by demographic factors. The most frequently reported reasons for eating at fast-food restaurants were: fast food is quick (92%), restaurants are easy to get to (80%), and food tastes good (69%). The least frequently reported reasons were: eating fast food is a way of socializing with family and friends (33%), restaurants have nutritious foods to offer (21%), and restaurants are fun and entertaining (12%). Some differences were found with respect to the demographic factors examined. It appears that in order to reduce fast-food consumption, food and nutrition professionals need to identify alternative quick and convenient food sources. As motivation for eating at fast-food restaurants appears to differ somewhat by age, sex, education, employment status, and household size, tailored interventions could be considered.

Investigation of an outbreak of Salmonella enteritidis gastroenteritis associated with consumption of eggs in a restaurant chain in Maryland.

PubMed

Lin, F Y; Morris, J G; Trump, D; Tilghman, D; Wood, P K; Jackman, N; Israel, E; Libonati, J P

1988-10-01

Salmonella enteritidis ser. enteritidis was isolated from patrons and employees of three restaurants in a restaurant chain in Maryland during August and September 1985. Isolates from all three restaurants had identical plasmid profiles; this profile was present in 13 of 40 randomly selected S. enteritidis isolates received by the Maryland state health department laboratory during a comparable time period. The outbreak in one restaurant resulted in at least 71 illnesses, with 17 persons known to have been hospitalized. Scrambled eggs served on a "breakfast bar" were implicated as the vehicle of transmission in this restaurant, with eggs a possible vehicle in another of the three restaurants. The data point out the risks associated with improper handling of eggs in food service establishments, provide further evidence for the observed association between S. enteritidis and eggs in the northeastern United States, and demonstrate the utility of plasmid analysis in investigation of outbreaks involving common Salmonella serotypes.

Health Implications of Adults' Eating at and Living near Fast Food or Quick Service Restaurants

PubMed Central

Jiao, J; Moudon, A V; Kim, S Y; Hurvitz, P M; Drewnowski, A

2015-01-01

Background: This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home. Methods: Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obese, having a cardiovascular disease or diabetes, as binary health outcomes. In all, 2001 participants in the 2008–2009 Seattle Obesity Study survey were included in the analyses. Results: Results showed eating ⩾2 times a week at a fast food or quick service restaurant was associated with perceived poor health status, overweight and obese. However, living close to such restaurants was not related to negative health outcomes. Conclusions: Frequent eating at a fast food or quick service restaurant was associated with perceived poor health status and higher body mass index, but living close to such facilities was not. PMID:26192449

Nutrition labeling and value size pricing at fast-food restaurants: a consumer perspective.

PubMed

O'Dougherty, Maureen; Harnack, Lisa J; French, Simone A; Story, Mary; Oakes, J Michael; Jeffery, Robert W

2006-01-01

This pilot study examined nutrition-related attitudes that may affect food choices at fast-food restaurants, including consumer attitudes toward nutrition labeling of fast foods and elimination of value size pricing. A convenience sample of 79 fast-food restaurant patrons aged 16 and above (78.5% white, 55% female, mean age 41.2 [17.1]) selected meals from fast-food restaurant menus that varied as to whether nutrition information was provided and value pricing included and completed a survey and interview on nutrition-related attitudes. Only 57.9% of participants rated nutrition as important when buying fast food. Almost two thirds (62%) supported a law requiring nutrition labeling on restaurant menus. One third (34%) supported a law requiring restaurants to offer lower prices on smaller instead of bigger-sized portions. This convenience sample of fast-food patrons supported nutrition labels on menus. More research is needed with larger samples on whether point-of-purchase nutrition labeling at fast-food restaurants raises perceived importance of nutrition when eating out.

The changing distribution and determinants of obesity in the neighborhoods of New York City, 2003-2007.

PubMed

Black, Jennifer L; Macinko, James

2010-04-01

Obesity (body mass index >or=30 kg/m(2)) is a growing urban health concern, but few studies have examined whether, how, or why obesity prevalence has changed over time within cities. This study characterized the individual- and neighborhood-level determinants and distribution of obesity in New York City from 2003 to 2007. Individual-level data from the Community Health Survey (n = 48,506 adults, 34 neighborhoods) were combined with neighborhood measures. Multilevel regression assessed changes in obesity over time and associations with neighborhood-level income and food and physical activity amenities, controlling for age, racial/ethnic identity, education, employment, US nativity, and marital status, stratified by gender. Obesity rates increased by 1.6% (P < 0.05) each year, but changes over time differed significantly between neighborhoods and by gender. Obesity prevalence increased for women, even after controlling for individual- and neighborhood-level factors (prevalence ratio = 1.021, P < 0.05), whereas no significant changes were reported for men. Neighborhood factors including increased area income (prevalence ratio = 0.932) and availability of local food and fitness amenities (prevalence ratio = 0.889) were significantly associated with reduced obesity (P < 0.001). Findings suggest that policies to reduce obesity in urban environments must be informed by up-to-date surveillance data and may require a variety of initiatives that respond to both individual and contextual determinants of obesity.

Invited Commentary: Observing Neighborhood Physical Disorder in an Age of Technological Innovation.

PubMed

Hwang, Jackelyn

2017-08-01

Researchers across several disciplines have argued that the characteristics of neighborhood environments can affect a variety of individual- and neighborhood-level outcomes. Physical disorder is one feature of neighborhoods that scholars have argued is important, but data that capture physical disorder have been limited because of the time and resources required for in-person audits. The advent of Google Street View, which provides publicly available street-level imagery with nearly complete coverage of the United States, opens new possibilities for researchers. In this issue of the Journal, Mooney et al. (Am J Epidemiol. 2017;186(3):265-273) compare in-person and virtual audits in Detroit, Michigan, and demonstrate that virtual audits offer key advantages to measuring neighborhood physical disorder over in-person audits, including substantial reductions in time and resources with little to no loss of measurement precision. In this invited commentary, I welcome the use of virtual audits for advancing the study of neighborhoods and outline areas in which they can advance understanding of neighborhood effects. I also describe areas of caution in their implementation and outline how new innovations can advance the use of virtual audits for furthering understanding of neighborhood environments. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community adaptations to an impending food desert in rural Appalachia, USA.

PubMed

Miller, Wayne C; Rogalla, Denver; Spencer, Dustin; Zia, Nida; Griffith, Brian N; Heinsberg, Haylee B

2016-01-01

The United States Department of Agriculture (USDA) describes a food desert as an urban neighborhood or rural town without ready access to fresh, healthy, and affordable food. An estimated 2.3 million rural Americans live in food deserts. One goal of the USDA is to eliminate food deserts. However, at a time when some food deserts are being eliminated, hundreds of grocery stores are closing, causing other food deserts to arise. The literature is scarce on how a community adapts to an impending food desert. Alderson, West Virginia, USA (population 1184) rallied to face an impending food desert when the only grocery store in town closed in December 2014. This study investigated how this small rural community adapted to its oncoming food desert. A community member survey was administered to 155 Alderson families (49%) to determine how the new food desert affected family food acquisition and storage behaviors. A restaurant survey was given to the town's four restaurants to determine how the food desert affected their businesses. Sales data for a new food hub (Green Grocer) was obtained to see if this new initiative offset the negative effects of the food desert. ANOVA and t-tests were used to compare group numerical data. Two group response rates were compared by testing the equality of two proportions. Categorical data were analyzed with the χ2 or frequency distribution analysis. Group averages are reported as mean ± standard error of the mean. Significance for all analyses was set at p<0.05. Even though 86% of the population shopped at the new Green Grocer, 77% did most of their shopping at a store at least 17.7 km (11 miles) from home. The number of long-distance monthly shopping trips made after the food desert (3.3±0.4) did not change significantly (p=0.16) from the number before the food desert (2.8±0.3). Price comparisons among the Green Grocer and three distant supermarkets showed a 30% savings by traveling to distant supermarkets. Frequency of monthly restaurant visits did not change after the emergence of the food desert (2.98±0.54 vs 3.05±0.51, p=0.85). However, restaurant patrons requested to buy fresh produce and dairy from the restaurants to use for their own home cooking. Food pantry use increased by 43%, with community members requesting more fresh produce, meat, and dairy. The food desert triggered a 21% increase in home gardening and an 11% increase in home food preservation. Opening a Green Grocer offset only some of the effects of the food desert, because community members use it as a convenience store to purchase fresh produce and dairy products that families may lack before their next long-distance trip to a supermarket. Alderson's low-income residents now rely more heavily on food pantry assistance, while a small number of other residents have started gardening and food preservation. The first factor governing food acquisition behavior in rural Appalachia is food pricing, with the proximity of food access coming in second. How to overcome these two major barriers to food security in the midst of current economics and marketing remains to be answered.

Supplementing Public Health Inspection via Social Media

PubMed Central

Schomberg, John P.; Haimson, Oliver L.; Hayes, Gillian R.; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions. PMID:27023681

Eating out

MedlinePlus

... your meal. Healthy Eating at All Types of Restaurants Sandwich restaurants or deli counters allow you to better manage ... be grilled or toasted without added butter. Chinese restaurants offer healthy choices if you are careful: Most ...

Small food stores and availability of nutritious foods: a comparison of database and in-store measures, Northern California, 2009.

PubMed

Kersten, Ellen; Laraia, Barbara; Kelly, Maggi; Adler, Nancy; Yen, Irene H

2012-01-01

Small food stores are prevalent in urban neighborhoods, but the availability of nutritious food at such stores is not well known. The objective of this study was to determine whether data from 3 sources would yield a single, homogenous, healthful food store category that can be used to accurately characterize community nutrition environments for public health research. We conducted in-store surveys in 2009 on store type and the availability of nutritious food in a sample of nonchain food stores (n = 102) in 6 predominantly urban counties in Northern California (Alameda, Contra Costa, Marin, Sacramento, San Francisco, and Santa Clara). We compared survey results with commercial database information and neighborhood sociodemographic data by using independent sample t tests and classification and regression trees. Sampled small food stores yielded a heterogeneous group of stores in terms of store type and nutritious food options. Most stores were identified as convenience (54%) or specialty stores (22%); others were small grocery stores (19%) and large grocery stores (5%). Convenience and specialty stores were smaller and carried fewer nutritious and fresh food items. The availability of nutritious food and produce was better in stores in neighborhoods that had a higher percentage of white residents and a lower population density but did not differ significantly by neighborhood income. Commercial databases alone may not adequately categorize small food stores and the availability of nutritious foods. Alternative measures are needed to more accurately inform research and policies that seek to address disparities in diet-related health conditions.

Small Food Stores and Availability of Nutritious Foods: A Comparison of Database and In-Store Measures, Northern California, 2009

PubMed Central

Laraia, Barbara; Kelly, Maggi; Adler, Nancy; Yen, Irene H.

2012-01-01

Introduction Small food stores are prevalent in urban neighborhoods, but the availability of nutritious food at such stores is not well known. The objective of this study was to determine whether data from 3 sources would yield a single, homogenous, healthful food store category that can be used to accurately characterize community nutrition environments for public health research. Methods We conducted in-store surveys in 2009 on store type and the availability of nutritious food in a sample of nonchain food stores (n = 102) in 6 predominantly urban counties in Northern California (Alameda, Contra Costa, Marin, Sacramento, San Francisco, and Santa Clara). We compared survey results with commercial database information and neighborhood sociodemographic data by using independent sample t tests and classification and regression trees. Results Sampled small food stores yielded a heterogeneous group of stores in terms of store type and nutritious food options. Most stores were identified as convenience (54%) or specialty stores (22%); others were small grocery stores (19%) and large grocery stores (5%). Convenience and specialty stores were smaller and carried fewer nutritious and fresh food items. The availability of nutritious food and produce was better in stores in neighborhoods that had a higher percentage of white residents and a lower population density but did not differ significantly by neighborhood income. Conclusion Commercial databases alone may not adequately categorize small food stores and the availability of nutritious foods. Alternative measures are needed to more accurately inform research and policies that seek to address disparities in diet-related health conditions. PMID:22789445

Young adults and eating away from home: associations with dietary intake patterns and weight status differ by choice of restaurant

PubMed Central

Neumark-Sztainer, Dianne; Laska, Melissa Nelson; Story, Mary

2011-01-01

Background Young adults report frequent away-from-home eating; however, little is known regarding what types of restaurants are patronized or if associations with dietary intake and weight status differ according to restaurant type. Objective This cross-sectional study in a diverse sample of young adults examines sociodemographic differences in the frequency of eating at different types of fast-food and full-service (server brings food to table) restaurants. Additionally, this study examines whether associations between away-from-home eating, dietary intake, and weight status differ according to restaurant type. Design There were 1030 men and 1257 women (mean age=25.3) who participated in Project EAT-III. Participants were members of a longitudinal cohort who completed baseline surveys at schools in Minneapolis/St. Paul, Minnesota and completed the EAT-III surveys online or by mail in 2008–2009. Main outcome measures Height, weight, and usual dietary intake were self-reported. Statistical analyses performed Regression models adjusted for sociodemographic characteristics were used to examine associations between frequency of restaurant use, dietary intake, and weight status. Results More frequent use of fast-food restaurants that primarily served burgers and fries was associated with higher risk for overweight/obesity; higher intake of total energy, sugar-sweetened beverages, and fat; and with lower intake of healthful foods and key nutrients. For example, those who reported burger-and-fries restaurant use on three or more occasions/week consumed nearly one additional sugar-sweetened beverage per day compared to those who reported burger-and-fries restaurant use on less than one occasion/week. More frequent use of fast-food restaurants that primarily served sandwiches/subs was related to a few markers of poorer diet quality, but unrelated to weight status. More frequent use of full-service restaurants was also unrelated to weight status and to higher intake of vegetables. Conclusions There may be a need for interventions to promote healthier food choices among young adults who report frequent burger-and-fries restaurant use. PMID:22027052

Young adults and eating away from home: associations with dietary intake patterns and weight status differ by choice of restaurant.

PubMed

Larson, Nicole; Neumark-Sztainer, Dianne; Laska, Melissa Nelson; Story, Mary

2011-11-01

Young adults report frequent away-from-home eating; however, little is known regarding what types of restaurants are patronized or whether associations with dietary intake and weight status differ according to restaurant type. This cross-sectional study in a diverse sample of young adults examines sociodemographic differences in the frequency of eating at different types of fast-food and full-service (server brings food to table) restaurants. In addition, this study examines whether associations between away-from-home eating, dietary intake, and weight status differ according to restaurant type. There were 1,030 men and 1,257 women (mean age=25.3 years) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults). Participants were members of a longitudinal cohort who completed baseline surveys at schools in Minneapolis/St Paul, MN, and completed the EAT-III surveys online or by mail in 2008-2009. Height, weight, and usual dietary intake were self-reported. Regression models adjusted for sociodemographic characteristics were used to examine associations between frequency of restaurant use, dietary intake, and weight status. More frequent use of fast-food restaurants that primarily served burgers and french fries was associated with higher risk for overweight/obesity; higher intake of total energy, sugar-sweetened beverages, and fat; and with lower intake of healthful foods and key nutrients. For example, those who reported burger-and-fries restaurant use on three or more occasions per week consumed nearly one additional sugar-sweetened beverage per day compared to those who reported burger-and-fries restaurant use on less than one occasion per week. More frequent use of fast-food restaurants that primarily served sandwiches/subs was related to a few markers of poorer diet quality, but unrelated to weight status. More frequent use of full-service restaurants was also unrelated to weight status and related to higher intake of vegetables. There may be a need for interventions to promote healthier food choices among young adults who report frequent burger-and-fries restaurant use. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Are food and drink retailers within NHS venues adhering to NICE Quality standard 94 guidance on childhood obesity? A cross-sectional study of two large secondary care NHS hospitals in England

PubMed Central

James, Alice; Birch, Laura; Fletcher, Peter; Pearson, Sally; Boyce, Catherine; Ness, Andy R; Hamilton-Shield, Julian P; Lithander, Fiona E

2017-01-01

Objective To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1–3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94. Design Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals. Main outcome measures Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM). Compliance with quality statements 2 and 3 was assessed through the measurement of how clearly the shops, cafes and restaurants displayed nutrition information on menus, and the availability and prominent display of healthy food and drink options in retail outlets, respectively. Results Adherence to quality statement 1 was poor. Of the 18 vending machines assessed, only 7 (39%) served both a healthy food and a healthy drink option. Neither hospital was compliant with quality statement 2 wherein nutritional information was not available on menus of food providers in either hospital. There was inconsistent compliance with quality standard 3 whereby healthy food and drink options were prominently displayed in the two main hospital restaurants, but all shops and cafes prioritised the display of unhealthy items. Conclusions Neither hospital was consistently compliant with quality statements 1–3 of the NICE quality standard 94. Improving the availability of healthy foods and drinks while reducing the display and accessibility to less healthy options in NHS venues may improve family awareness of healthy alternatives. Making it easier for parents to direct their children to healthier choices is an ostensibly central component of our healthcare system. PMID:29150472

Hydrothermal carbonization of food waste for nutrient recovery and resuse

USDA-ARS?s Scientific Manuscript database

Food waste represents a rather large and currently underutilized source of potentially available and reusable nutrients. Laboratory-scale experiments evaluating the hydrothermal carbonization of food wastes collected from restaurants were conducted to understand how changes in feedstock composition ...

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study

PubMed Central

Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

2015-01-01

Objectives To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. Setting Prelaw and postlaw design study. Participants 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. Methods We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. Primary and secondary outcome measures Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. Results Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having ‘unhealthy’ air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to ‘good’. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had ‘unhealthy’ air both before and after the law. Conclusions The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods. PMID:26185176

Validation of Walk Score® for Estimating Neighborhood Walkability: An Analysis of Four US Metropolitan Areas

PubMed Central

Duncan, Dustin T.; Aldstadt, Jared; Whalen, John; Melly, Steven J.; Gortmaker, Steven L.

2011-01-01

Neighborhood walkability can influence physical activity. We evaluated the validity of Walk Score® for assessing neighborhood walkability based on GIS (objective) indicators of neighborhood walkability with addresses from four US metropolitan areas with several street network buffer distances (i.e., 400-, 800-, and 1,600-meters). Address data come from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5–11 years and their families participating in YMCA-administered, after-school programs located in four geographically diverse metropolitan areas in the US (n = 733). GIS data were used to measure multiple objective indicators of neighborhood walkability. Walk Scores were also obtained for the participant’s residential addresses. Spearman correlations between Walk Scores and the GIS neighborhood walkability indicators were calculated as well as Spearman correlations accounting for spatial autocorrelation. There were many significant moderate correlations between Walk Scores and the GIS neighborhood walkability indicators such as density of retail destinations and intersection density (p < 0.05). The magnitude varied by the GIS indicator of neighborhood walkability. Correlations generally became stronger with a larger spatial scale, and there were some geographic differences. Walk Score® is free and publicly available for public health researchers and practitioners. Results from our study suggest that Walk Score® is a valid measure of estimating certain aspects of neighborhood walkability, particularly at the 1600-meter buffer. As such, our study confirms and extends the generalizability of previous findings demonstrating that Walk Score is a valid measure of estimating neighborhood walkability in multiple geographic locations and at multiple spatial scales. PMID:22163200

Smart Substitutions for Healthy Cooking

MedlinePlus

... slice of toast. For High-Fat Items at Restaurant You can eat sensibly when you eat out ... yogurt, sherbet or fruit ice. For Fast-Food Restaurants You can eat sensibly at fast-food restaurants ...

Estimated Cost to a Restaurant of a Foodborne Illness Outbreak.

PubMed

Bartsch, Sarah M; Asti, Lindsey; Nyathi, Sindiso; Spiker, Marie L; Lee, Bruce Y

Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances. We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases. We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), and a high amount of lawsuits and legal fees ($1 656 569) and fines ($100 000). This cost amounts to 10% to 5790% of a restaurant's annual marketing costs and 0.3% to 101% of annual profits and revenue. The biggest cost drivers were lawsuits and legal fees, outbreak size, and lost revenue. Pathogen type affected the cost by a maximum of $337 000, the difference between a Bacillus cereus outbreak (least costly) and a listeria outbreak (most costly). The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures. Our study can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.

Effect of a Manager Training and Certification Program on Food Safety and Hygiene in Food Service Operations

PubMed Central

Kassa, Hailu; Silverman, Gary S.; Baroudi, Karim

2010-01-01

Food safety is an important public health issue in the U.S. Eating at restaurants and other food service facilities increasingly has been associated with food borne disease outbreaks. Food safety training and certification of food mangers has been used as a method for reducing food safety violations at food service facilities. However, the literature is inconclusive about the effectiveness of such training programs for improving food safety and protecting consumer health. The purpose of this study was to examine the effect of food manger training on reducing food safety violations. We examined food inspection reports from the Toledo/Lucas County Health Department (Ohio) from March 2005 through February 2006 and compared food hygiene violations between food service facilities with certified and without certified food managers. We also examined the impact on food safety of a food service facility being part of a larger group of facilities. Restaurants with trained and certified food managers had significantly fewer critical food safety violations but more non-critical violations than restaurants without certified personnel. Institutional food service facilities had significantly fewer violations than restaurants, and the number of violations did not differ as a function of certification. Similarly, restaurants with many outlets had significantly fewer violations than restaurants with fewer outlets, and training was not associated with lower numbers of violations from restaurants with many outlets. The value of having certified personnel was only observed in independent restaurants and those with few branches. This information may be useful in indicating where food safety problems are most likely to occur. Furthermore, we recommend that those characteristics of institutional and chain restaurants that result in fewer violations should be identified in future research, and efforts made to apply this knowledge at the level of individual restaurants. PMID:20523880

Energy Intake from Restaurants

PubMed Central

Powell, Lisa M.; Nguyen, Binh T.; Han, Euna

2012-01-01

Background Eating food away from home and restaurant consumption have increased over the past few decades. Purpose To examine recent changes in calories from fast-food and full-service restaurant consumption and to assess characteristics associated with consumption. Methods Analyses of 24-hour dietary recalls from children, adolescents, and adults using nationally representative data from the 2003–2004 through 2007–2008 National Health and Nutrition Examination Surveys, including analysis by gender, ethnicity, income and location of consumption. Multivariate regression analyses of associations between demographic and socioeconomic characteristics and consumption prevalence and average daily caloric intake from fast-food and full-service restaurants. Results In 2007–2008, 33%, 41% and 36% of children, adolescents and adults, respectively, consumed foods and/or beverages from fast-food restaurant sources and 12%, 18% and 27% consumed from full-service restaurants. Their respective mean caloric intake from fast food was 191 kcal, 404 kcal, and 315 kcal, down by 25% (p≤0.05), 3% and 9% from 2003–2004; and among consumers, intake was 576 kcal, 988 kcal, and 877 kcal, respectively, down by 12% (p≤0.05), 2% and 7%. There were no changes in daily calories consumed from full-service restaurants. Consumption prevalence and average daily caloric intake from fast-food (adults only) and full-service restaurants (all age groups) were higher when consumed away from home versus at home. There were some demographic and socioeconomic associations with the likelihood of fast-food consumption, but characteristics were generally not associated with the extent of caloric intake among those who consumed from fast-food or from full-service restaurants. Conclusions In 2007–2008, fast-food and full-service restaurant consumption remained prevalent and a source of substantial energy intake. PMID:23079172

Effect of a manager training and certification program on food safety and hygiene in food service operations.

PubMed

Kassa, Hailu; Silverman, Gary S; Baroudi, Karim

2010-05-06

Food safety is an important public health issue in the U.S. Eating at restaurants and other food service facilities increasingly has been associated with food borne disease outbreaks. Food safety training and certification of food mangers has been used as a method for reducing food safety violations at food service facilities. However, the literature is inconclusive about the effectiveness of such training programs for improving food safety and protecting consumer health. The purpose of this study was to examine the effect of food manger training on reducing food safety violations. We examined food inspection reports from the Toledo/Lucas County Health Department (Ohio) from March 2005 through February 2006 and compared food hygiene violations between food service facilities with certified and without certified food managers. We also examined the impact on food safety of a food service facility being part of a larger group of facilities.Restaurants with trained and certified food managers had significantly fewer critical food safety violations but more non-critical violations than restaurants without certified personnel. Institutional food service facilities had significantly fewer violations than restaurants, and the number of violations did not differ as a function of certification. Similarly, restaurants with many outlets had significantly fewer violations than restaurants with fewer outlets, and training was not associated with lower numbers of violations from restaurants with many outlets. The value of having certified personnel was only observed in independent restaurants and those with few branches. This information may be useful in indicating where food safety problems are most likely to occur. Furthermore, we recommend that those characteristics of institutional and chain restaurants that result in fewer violations should be identified in future research, and efforts made to apply this knowledge at the level of individual restaurants.

The economic impact of smoke-free laws on restaurants and bars in 9 States.

PubMed

Loomis, Brett R; Shafer, Paul R; van Hasselt, Martijn

2013-08-01

Smoke-free air laws in restaurants and bars protect patrons and workers from involuntary exposure to secondhand smoke, but owners often express concern that such laws will harm their businesses. The primary objective of this study was to estimate the association between local smoke-free air laws and economic outcomes in restaurants and bars in 8 states without statewide smoke-free air laws: Alabama, Indiana, Kentucky, Mississippi, Missouri, South Carolina, Texas, and West Virginia. A secondary objective was to examine the economic impact of a 2010 statewide smoke-free restaurant and bar law in North Carolina. Using quarterly data from 2000 through 2010, we estimated dynamic panel data models for employment and sales in restaurants and bars. The models controlled for smoke-free laws, general economic activity, cigarette sales, and seasonality. We included data from 216 smoke-free cities and counties in the analysis. During the study period, only North Carolina had a statewide law banning smoking in restaurants or bars. Separate models were estimated for each state. In West Virginia, smoke-free laws were associated with a significant increase of approximately 1% in restaurant employment. In the remaining 8 states, we found no significant association between smoke-free laws and employment or sales in restaurants and bars. Results suggest that smoke-free laws did not have an adverse economic impact on restaurants or bars in any of the states studied; they provided a small economic benefit in 1 state. On the basis of these findings, we would not expect a statewide smoke-free law in Alabama, Indiana, Kentucky, Missouri, Mississippi, South Carolina, Texas, or West Virginia to have an adverse economic impact on restaurants or bars in those states.

The Economic Impact of Smoke-Free Laws on Restaurants and Bars in 9 States

PubMed Central

Shafer, Paul R.; van Hasselt, Martijn

2013-01-01

Introduction Smoke-free air laws in restaurants and bars protect patrons and workers from involuntary exposure to secondhand smoke, but owners often express concern that such laws will harm their businesses. The primary objective of this study was to estimate the association between local smoke-free air laws and economic outcomes in restaurants and bars in 8 states without statewide smoke-free air laws: Alabama, Indiana, Kentucky, Mississippi, Missouri, South Carolina, Texas, and West Virginia. A secondary objective was to examine the economic impact of a 2010 statewide smoke-free restaurant and bar law in North Carolina. Methods Using quarterly data from 2000 through 2010, we estimated dynamic panel data models for employment and sales in restaurants and bars. The models controlled for smoke-free laws, general economic activity, cigarette sales, and seasonality. We included data from 216 smoke-free cities and counties in the analysis. During the study period, only North Carolina had a statewide law banning smoking in restaurants or bars. Separate models were estimated for each state. Results In West Virginia, smoke-free laws were associated with a significant increase of approximately 1% in restaurant employment. In the remaining 8 states, we found no significant association between smoke-free laws and employment or sales in restaurants and bars. Conclusion Results suggest that smoke-free laws did not have an adverse economic impact on restaurants or bars in any of the states studied; they provided a small economic benefit in 1 state. On the basis of these findings, we would not expect a statewide smoke-free law in Alabama, Indiana, Kentucky, Missouri, Mississippi, South Carolina, Texas, or West Virginia to have an adverse economic impact on restaurants or bars in those states. PMID:23906328

A voluntary nutrition labeling program in restaurants: Consumer awareness, use of nutrition information, and food selection.

PubMed

White, Christine M; Lillico, Heather G; Vanderlee, Lana; Hammond, David

2016-12-01

Health Check (HC) was a voluntary nutrition labeling program developed by the Heart and Stroke Foundation of Canada as a guide to help consumers choose healthy foods. Items meeting nutrient criteria were identified with a HC symbol. This study examined the impact of the program on differences in consumer awareness and use of nutritional information in restaurants. Exit surveys were conducted with 1126 patrons outside four HC and four comparison restaurants in Ontario, Canada (2013). Surveys assessed participant noticing of nutrition information, influence of nutrition information on menu selection, and nutrient intake. Significantly more patrons at HC restaurants noticed nutrition information than at comparison restaurants (34.2% vs. 28.1%; OR = 1.39; p = 0.019); however, only 5% of HC restaurant patrons recalled seeing the HC symbol. HC restaurant patrons were more likely to say that their order was influenced by nutrition information (10.9% vs. 4.5%; OR = 2.96, p < 0.001); and consumed less saturated fat and carbohydrates, and more protein and fibre (p < 0.05). Approximately 15% of HC restaurant patrons ordered HC approved items; however, only 1% ordered a HC item and mentioned seeing the symbol in the restaurant in an unprompted recall task, and only 4% ordered a HC item and reported seeing the symbol on the item when asked directly. The HC program was associated with greater levels of noticing and influence of nutrition information, and more favourable nutrient intake; however, awareness of the HC program was very low and differences most likely reflect the type of restaurants that "self-selected" into the program.

Consumer underestimation of sodium in fast food restaurant meals: Results from a cross-sectional observational study.

PubMed

Moran, Alyssa J; Ramirez, Maricelle; Block, Jason P

2017-06-01

Restaurants are key venues for reducing sodium intake in the U.S. but little is known about consumer perceptions of sodium in restaurant foods. This study quantifies the difference between estimated and actual sodium content of restaurant meals and examines predictors of underestimation in adult and adolescent diners at fast food restaurants. In 2013 and 2014, meal receipts and questionnaires were collected from adults and adolescents dining at six restaurant chains in four New England cities. The sample included 993 adults surveyed during 229 dinnertime visits to 44 restaurants and 794 adolescents surveyed during 298 visits to 49 restaurants after school or at lunchtime. Diners were asked to estimate the amount of sodium (mg) in the meal they had just purchased. Sodium estimates were compared with actual sodium in the meal, calculated by matching all items that the respondent purchased for personal consumption to sodium information on chain restaurant websites. Mean (SD) actual sodium (mg) content of meals was 1292 (970) for adults and 1128 (891) for adolescents. One-quarter of diners (176 (23%) adults, 155 (25%) adolescents) were unable or unwilling to provide estimates of the sodium content of their meals. Of those who provided estimates, 90% of adults and 88% of adolescents underestimated sodium in their meals, with adults underestimating sodium by a mean (SD) of 1013 mg (1,055) and adolescents underestimating by 876 mg (1,021). Respondents underestimated sodium content more for meals with greater sodium content. Education about sodium at point-of-purchase, such as provision of sodium information on restaurant menu boards, may help correct consumer underestimation, particularly for meals of high sodium content. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 278.2 - Participation of retail food stores.

Code of Federal Regulations, 2010 CFR

2010-01-01

... restaurants. A restaurant operating under a State contract shall require a household purchasing meals to show... personnel of the restaurant know that the program participant tendering coupons is eligible to use coupons...

Chinese restaurant syndrome

MedlinePlus

Chinese restaurant syndrome is a set of symptoms that some people have after eating Chinese food. A food additive ... Chinese restaurant syndrome is most often diagnosed based on the symptoms. The health care provider may ask the following ...

Eating Well While Eating Out

MedlinePlus

... stuff, like caffeine. Tips for Eating at a Restaurant Most restaurant portions are way larger than the average serving ... of your dish home. Here are some other restaurant survival tips: Ask for sauces and salad dressings ...

Dangerous dining: health and safety in the New York City restaurant industry.

PubMed

Jayaraman, Saru; Dropkin, Jonathan; Siby, Sekou; Alston, Laine Romero; Markowitz, Steven

2011-12-01

We characterized the health and safety conditions of New York City restaurant workers, a population comprising largely of immigrants and people of color. We conducted an anonymous questionnaire survey of 502 New York City restaurant workers, addressing working conditions, benefits, demographic factors, psychosocial exposures, and medical symptoms and conditions. Restaurant workers reported fast-paced, repetitive, and physically demanding jobs that sometimes involve chemical exposures. Despite their youth, they experience a high prevalence of musculoskeletal and traumatic injuries. Few receive job benefits despite significant symptoms. Job-related injuries are positively associated with practices that pose a danger to consumers. New York City restaurant workers have stressful jobs, experience significant injury, and illness but receive few job benefits. A healthier work organization and greater access to benefits for restaurant workers would improve their health and public health.

Restaurant Food Cooling Practices†

PubMed Central

BROWN, LAURA GREEN; RIPLEY, DANNY; BLADE, HENRY; REIMANN, DAVE; EVERSTINE, KAREN; NICHOLAS, DAVE; EGAN, JESSICA; KOKTAVY, NICOLE; QUILLIAM, DANIELA N.

2017-01-01

Improper food cooling practices are a significant cause of foodborne illness, yet little is known about restaurant food cooling practices. This study was conducted to examine food cooling practices in restaurants. Specifically, the study assesses the frequency with which restaurants meet U.S. Food and Drug Administration (FDA) recommendations aimed at reducing pathogen proliferation during food cooling. Members of the Centers for Disease Control and Prevention’s Environmental Health Specialists Network collected data on food cooling practices in 420 restaurants. The data collected indicate that many restaurants are not meeting FDA recommendations concerning cooling. Although most restaurant kitchen managers report that they have formal cooling processes (86%) and provide training to food workers on proper cooling (91%), many managers said that they do not have tested and verified cooling processes (39%), do not monitor time or temperature during cooling processes (41%), or do not calibrate thermometers used for monitoring temperatures (15%). Indeed, 86% of managers reported cooling processes that did not incorporate all FDA-recommended components. Additionally, restaurants do not always follow recommendations concerning specific cooling methods, such as refrigerating cooling food at shallow depths, ventilating cooling food, providing open-air space around the tops and sides of cooling food containers, and refraining from stacking cooling food containers on top of each other. Data from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts concerning cooling practices. These efforts should focus on the most frequent poor cooling practices, as identified by this study. PMID:23212014

Understanding the Relationships Between Inspection Results and Risk of Foodborne Illness in Restaurants.

PubMed

Lee, Petrona; Hedberg, Craig W

2016-10-01

Restaurants are important settings for foodborne disease outbreaks and consumers are increasingly using restaurant inspection results to guide decisions about where to eat. Although public posting of inspection results may lead to improved sanitary practices in the restaurant, the relationship between inspection results and risk of foodborne illness appears to be pathogen specific. To further examine the relationship between inspection results and the risk of foodborne disease outbreaks, we evaluated results of routine inspections conducted in multiple restaurants in a chain (Chain A) that was associated with a large Salmonella outbreak in Illinois. Inspection results were collected from 106 Chain A establishments in eight counties. Forty-six outbreak-associated cases were linked to 23 of these Chain A restaurants. There were no significant differences between the outbreak and nonoutbreak restaurants for overall demerit points or for the number of demerit points attributed to hand washing or cross-contamination. Our analyses strongly suggest that the outbreak resulted from consumption of a contaminated fresh produce item without further amplification within individual restaurants. Inspections at these facilities would be unlikely to detect or predict the foodborne illness outbreak because there are no Food Code items in place to stop the introduction of contaminated food from an otherwise approved commercial food source. The results of our study suggest that the agent and food item pairing and route of transmission must be taken into consideration to improve our understanding of the relationship between inspection results and the risk of foodborne illness in restaurants.

[Pollution Characteristics of Aldehydes and Ketones Compounds in the Exhaust of Beijing Typical Restaurants].

PubMed

Cheng, Jing-chen; Cui, Tong; He, Wan-qing; Nie, Lei; Wang, Jun-ling; Pan, Tao

2015-08-01

Aldehydes and ketones compounds, as one of the components in the exhaust of restaurants, are a class of volatile organic compounds (VOCs) with strong chemical reactivity. However, there is no systematic study on aldehydes and ketones compounds in the exhaust of restaurants. To further clarify the food source emission levels of aldehydes and ketones compounds and controlling measures, to access city group catering VOCs emissions control decision-making basis, this study selected 8 Beijing restaurants with different types. The aldehydes and ketones compounds were sampled using DNPH-silica tube, and then ultra performance liquid chromatography was used for quantitative measurement. The aldehydes and ketones concentrations of reference volume condition from 8 restaurants in descending order were Roasted Duck restaurant, Chinese Style Barbecue, Home Dishes, Western Fast-food, School Canteen, Chinese Style Fast-food, Sichuan Cuisine, Huaiyang Cuisine. The results showed that the range of aldehydes and ketones compounds (C1-C9) concentrations of reference volume condition in the exhaust of restaurants was 115.47-1035.99 microg x m(-3). The composition of aldehydes and ketones compounds in the exhaust of sampled restaurants was obviously different. The percentages of C1-C3 were above 40% in the exhaust from Chinese style restaurants. Fast food might emit more C4-C9 aldehydes and ketones compounds. From the current situation of existing aldehydes and ketones compounds control, the removal efficiency of high voltage electrostatic purifiers widely used in Beijing is limited.

Restaurant inspection frequency: The RestoFreq Study.

PubMed

Medu, Olanrewaju; Turner, Hollie; Cushon, Jennifer A; Melis, Deborah; Rea, Leslie; Abdellatif, Treena; Neudorf, Cory O; Schwandt, Michael

2017-03-01

Foodborne illness is an important contributor to morbidity and health system costs in Canada. Using number of critical hazards as a proxy for food safety, we sought to better understand how to improve food safety in restaurants. We compared the current standard of annual inspections to twice-yearly inspections among restaurants "at risk" for food safety infractions. These were restaurants that had three or more elevated-risk inspection ratings in the preceding 36 months. We conducted a two-arm randomized controlled trial between November 2012 and October 2014. The intervention was twice-yearly routine restaurant inspection compared to standard once-yearly routine inspection. Included were all restaurants within Saskatoon Health Region that were assessed as "at risk", with 73 restaurants in the intervention arm and 78 in the control arm. Independent sample t-tests were conducted between groups to compare: i) average number of critical hazards per inspection; and ii) proportion of inspections resulting in a rating indicating an elevated hazard. Over time we noted statistically significant improvements across both study arms, in number of both critical food safety hazards (decreased by 61%) and elevated-risk inspection ratings (decreased by 45%) (p < 0.0001). We observed no significant differences between the two groups pre- or post-intervention. Results suggest increasing the number of annual routine inspections in high-risk restaurants was not associated with a significant difference in measures of compliance with food safety regulations. Findings of this study do not provide evidence supporting increased frequency of restaurant inspection from annually to twice annually.

Fourteen-year trends in sodium content of menu offerings at eight leading fast-food restaurants in the USA.

PubMed

Rudelt, Amanda; French, Simone; Harnack, Lisa

2014-08-01

To examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010. Menu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant. Lunch/dinner food menu of eight leading US fast-food restaurants. Between 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined. Results suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.

Restaurant food cooling practices.

PubMed

Brown, Laura Green; Ripley, Danny; Blade, Henry; Reimann, Dave; Everstine, Karen; Nicholas, Dave; Egan, Jessica; Koktavy, Nicole; Quilliam, Daniela N

2012-12-01

Improper food cooling practices are a significant cause of foodborne illness, yet little is known about restaurant food cooling practices. This study was conducted to examine food cooling practices in restaurants. Specifically, the study assesses the frequency with which restaurants meet U.S. Food and Drug Administration (FDA) recommendations aimed at reducing pathogen proliferation during food cooling. Members of the Centers for Disease Control and Prevention's Environmental Health Specialists Network collected data on food cooling practices in 420 restaurants. The data collected indicate that many restaurants are not meeting FDA recommendations concerning cooling. Although most restaurant kitchen managers report that they have formal cooling processes (86%) and provide training to food workers on proper cooling (91%), many managers said that they do not have tested and verified cooling processes (39%), do not monitor time or temperature during cooling processes (41%), or do not calibrate thermometers used for monitoring temperatures (15%). Indeed, 86% of managers reported cooling processes that did not incorporate all FDA-recommended components. Additionally, restaurants do not always follow recommendations concerning specific cooling methods, such as refrigerating cooling food at shallow depths, ventilating cooling food, providing open-air space around the tops and sides of cooling food containers, and refraining from stacking cooling food containers on top of each other. Data from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts concerning cooling practices. These efforts should focus on the most frequent poor cooling practices, as identified by this study.

Store Impulse Marketing Strategies and Body Mass Index.

PubMed

Cohen, Deborah A; Collins, Rebecca; Hunter, Gerald; Ghosh-Dastidar, Bonnie; Dubowitz, Tamara

2015-07-01

We quantified the use of placement and price reduction marketing strategies in different food retail outlets to identify associations between these strategies and the risk of overweight and obesity among customers. In 2011 we collected dietary and health information from 1372 residents in "food deserts" in Pittsburgh, PA. We audited neighborhood restaurants and food stores (n = 40) including 16 distant food venues at which residents reported shopping. We assessed end-aisle displays, special floor displays, cash register displays, and price reductions for sugar-sweetened beverages (SSBs); foods high in saturated oils, fats, and added sugars; and nutritious foods such as fruits, vegetables, and products with at least 51% whole grains. Supermarkets and superstores had the largest numbers of displays and price reductions for low-nutrient foods. Exposure to displays of SSBs and foods high in saturated oils, fats, and added sugars and price reduction of SSBs was associated with increased body mass index. In-store marketing strategies of low-nutrient foods appear to be risk factors for a higher body mass index among regular shoppers. Future research is needed to confirm the causal role of marketing strategies in obesity.

Nutritional quality of food items on fast-food 'kids' menus': comparisons across countries and companies.

PubMed

Hobin, Erin; White, Christine; Li, Ye; Chiu, Maria; O'Brien, Mary Fodor; Hammond, David

2014-10-01

To compare energy (calories), total and saturated fats, and Na levels for 'kids' menu' food items offered by four leading multinational fast-food chains across five countries. A content analysis was used to create a profile of the nutritional content of food items on kids' menus available for lunch and dinner in four leading fast-food chains in Australia, Canada, New Zealand, the UK and the USA. Food items from kids' menus were included from four fast-food companies: Burger King, Kentucky Fried Chicken (KFC), McDonald's and Subway. These fast-food chains were selected because they are among the top ten largest multinational fast-food chains for sales in 2010, operate in high-income English-speaking countries, and have a specific section of their restaurant menus labelled 'kids' menus'. The results by country indicate that kids' menu foods contain less energy (fewer calories) in restaurants in the USA and lower Na in restaurants in the UK. The results across companies suggest that kids' menu foods offered at Subway restaurants are lower in total fat than food items offered at Burger King and KFC, and food items offered at KFC are lower in saturated fat than items offered at Burger King. Although the reasons for the variation in the nutritional quality of foods on kids' menus are not clear, it is likely that fast-food companies could substantially improve the nutritional quality of their kids' menu food products, translating to large gains for population health.

The Critical Infrastructure Portfolio Selection Model

DTIC Science & Technology

2008-06-13

equal to zero (0.0). In terms of what a DMU might represent in reality, consider a restaurant owner who owns a set of restaurant franchises . That...that is described within this thesis, the DMUs are CI reconstruction projects. Just like the aforementioned restaurant franchise owner, a leader...owner is justifiably interested in knowing which restaurants turn a profit or provide quality service, both necessary benefits (outputs), based on the

Adolescent calorie/fat menu ordering at fast food restaurants compared to other restaurants.

PubMed

Yamamoto, Julienne A; Yamamoto, Joelle B; Yamamoto, Brennan E; Yamamoto, Loren G

2006-08-01

Childhood and adolescent obesity is an increasing public health problem. Fast food consumption has been linked to obesity. The purpose of this study is to determine adolescent calorie and fat consumption patterns at different types of restaurants. Study subjects (104 adolescents) were asked to order a dinner meal from 10 restaurant menus with an estimate of how much they would actually consume. A paired T-test was used to compare the calories and fat values for each restaurant vs. McDonald's. Mean calories/fat (g) ordered at each restaurant were: California Pizza Kitchen (CPK).: 1284/70, Chili's (Ch). 1333/62, Denny's (Den): 1226/61, McDonald's (MD): 1016/45, Outback Steakhouse (OS): 1656/93, Panda Express (PE): 873/29, Red Lobster (RL): 1016/49, Stuart Anderson's (SA). 1058/52, Taco Bell (TB): 800/34, Wendy's (Wen): 879/32. Calorie/fat content of the ordered items were significantly higher at CPK, Ch, Den, and OS compared to McDonald's. RL and SA were not significantly different from MD. Calorie/fat content of the ordered items were significantly lower at PE, TB and Wen compared with McDonald's. More calories/fat were ordered at many sit down restaurants compared to McDonald's. The lowest calories/fat were ordered at other fast food restaurants (Taco Bell, Wendy's and Panda Express).

Predictors of total calories purchased at fast-food restaurants: restaurant characteristics, calorie awareness, and use of calorie information.

PubMed

Brissette, Ian; Lowenfels, Ann; Noble, Corina; Spicer, Deborah

2013-01-01

To examine purchase patterns at fast-food restaurants and their relation to restaurant characteristics, customer characteristics, and use of calorie information. Cross-sectional survey. Fast-food restaurants in New York State. Adult fast-food restaurant customers (n = 1,094). Restaurant characteristics (fast-food chain type, presence of calorie labels, and poverty of location), participant characteristics (demographics, calorie knowledge, awareness, and use), and customer purchasing patterns (ordering low-calorie or no beverage, small or no fries, or < 3 items) were used as predictors of total calories purchased. Multiple regression. In a regression model including restaurant and customer characteristics, fast-food chain customer age, sex, calorie use, and calorie awareness were independently associated with total calories purchased (all P < .05; model R2 = .19). When 3 purchasing patterns were added to the model, calorie use (P = .005), but not calorie awareness, remained associated with total calories purchased. The 3 purchase patterns collectively accounted for the majority of variance in calorie totals (Δ model R2 = .40). Promoting use of calorie information, purchase strategies, and calorie awareness represents complementary ways to support lower-calorie choices at fast-food chains. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

75 FR 67392 - Notice of Availability: HUD's Fiscal Year (FY) NOFA for the Choice Neighborhoods Initiative-Round...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

..., HUD. ACTION: Notice extension of deadline. SUMMARY: On August 26, 2010, HUD posted on http://www...--Round 1. Today's Federal Register notice announces that HUD has posted on http://www.Grants.gov a... to the Mapping Tool used to determine neighborhood eligibility. HUD will post on http://www.Grants...

Fruit and Vegetable Intake and Obesity in Preadolescent Children: The Role of Neighborhood Poverty and Grocery Store Access

ERIC Educational Resources Information Center

Mushi-Brunt, Christina; Haire-Joshu, Debra; Elliott, Michael; Brownson, Ross

2007-01-01

Background: The prevalence of obesity among children continues to rise. Individual-focused health education efforts have been minimally successful in producing the necessary changes to curb this epidemic. Purpose: The purpose of this study was to examine the relationships between neighborhood characteristics, grocery store availability and…

Examining the Sociolinguistic Context in Schools and Neighborhoods of Pre-Adolescent Latino Students: Implications for Ethnic Identity

ERIC Educational Resources Information Center

Feinauer, Erika; Whiting, Erin F.

2012-01-01

This study examined the sociolinguistic contexts of neighborhoods and schools in two predominantly Latino communities in the United States. We used census data to assess social and ethnic composition and observational data to compare and contrast environmental print, language use, and availability of community services in Spanish in these schools…

Targeting interventions for ethnic minority and low-income populations.

PubMed

Kumanyika, Shiriki; Grier, Sonya

2006-01-01

Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers-and thus contribute to disparities in obesity rates. The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment-breast-feeding, television viewing, and parental behaviors-that may contribute to childhood obesity but be amenable to change through targeted intervention. Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical environments in which these communities exist.

Achieving health for a lifetime: a community engagement assessment focusing on school-age children to decrease obesity in Durham, North Carolina.

PubMed

Corsino, Leonor; McDuffie, Jennifer R; Kotch, Jonathan; Coeytaux, Remy; Fuemmeler, Bernard F; Murphy, Gwen; Miranda, Marie Lynn; Poirier, Brenda; Morton, Janet; Reese, David; Baker, Sharon; Carter, Heidi; Freeman, Rebecca; Blue, Colleen; Yancy, William S

2013-01-01

Obesity is a prominent problem in the United States and in North Carolina. One way of combating it is with community-engaged interventions that foster collaboration between health-oriented organizations and community residents. Our purpose was to assemble a multifaceted group in Durham, North Carolina, to identify factors affecting obesity-related lifestyle behaviors; assess policies, resources, and the population's perception of the problem of obesity; and develop plans to improve health outcomes related to obesity. A team consisting of more than 2 dozen partners was assembled to form Achieving Health for a Lifetime (AHL) in order to study and address obesity in the community, initially focusing on elementary school-age children. The team developed a resource guide by collecting information by telephone interviews of provider organizations; geospatial resource maps were created using high-resolution geographic information systems, Duke's Data Support Repository, and county and city records; and focus groups were conducted using the nominal group technique. The AHL team, in collaboration with 2 other teams focused on diabetes and cardiovascular disease, identified 32 resources for diabetes, 20 for obesity, and 13 for cardiovascular disease. Using Geographic Information Systems (GIS), the team identified an area of Durham that had only 1 supermarket, but 34 fast-food restaurants and 84 convenience stores. The focus on particular neighborhoods means that the information obtained might not pertain to all neighborhoods. The AHL team was able to assemble a large community partnership in Durham that will allow the members of the community to continue to work toward making residents healthier. Communities facing similar challenges can learn from this experience.

Celiac Disease

MedlinePlus

... be able to figure out which dishes at restaurants or friends' homes contain gluten. Some restaurants in your town might offer gluten-free dishes ... local support group may have a list of restaurants where the chef is familiar with the gluten- ...