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.

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…

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

Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014

PubMed Central

Glanz, Karen; Keenan, Brendan T.; Branas, Charles C.

2017-01-01

Objectives: We explored how restaurant inspection frequency and restaurant neighborhood sociodemographic characteristics are related to food safety inspection outcomes in chain and nonchain restaurants to better understand external factors that may influence inspection outcomes. Methods: We categorized the results of restaurant inspections in Philadelphia, Pennsylvania, in 2013 and 2014 by restaurant type (chain or nonchain), inspection frequency (1, 2, or ≥3 per 2-year study period), and violation type (total number of violations, foodborne-illness risk factor violation, or good retail practice violation). We collected 2013 US Census block group sociodemographic data for each restaurant neighborhood. We used nested mixed-effects regression analyses to determine the association between restaurant inspection frequency and inspection violations, as well as between inspection violations and restaurant neighborhood sociodemographic variables, stratified by restaurant type. Results: Compared with nonchain restaurants, chain restaurants had significantly fewer total violations per inspection (mean [SD]: 6.5 [4.6] vs 9.6 [6.8] violations, P < .001). For nonchain restaurants, an increase from 1 to 2 inspections resulted in 0.8 (P < .001) fewer mean violations per inspection, and an increase from 1 to ≥3 inspections resulted in 1.6 (P < .001) fewer mean violations; this association was not seen in chain restaurants. For nonchain restaurants, a higher proportion of black residents in a restaurant neighborhood was associated with 0.6 (P < .001) fewer mean foodborne-illness risk factor violations but 1.0 (P < .001) more mean good retail practice violations per inspection. Conclusions: A risk-based stratified approach to restaurant food safety inspection frequency, based on whether or not restaurants are part of chains, could reduce the frequency of violations, particularly in restaurants with the most violations. PMID:28060568

Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014.

PubMed

Leinwand, Sarah E; Glanz, Karen; Keenan, Brendan T; Branas, Charles C

We explored how restaurant inspection frequency and restaurant neighborhood sociodemographic characteristics are related to food safety inspection outcomes in chain and nonchain restaurants to better understand external factors that may influence inspection outcomes. We categorized the results of restaurant inspections in Philadelphia, Pennsylvania, in 2013 and 2014 by restaurant type (chain or nonchain), inspection frequency (1, 2, or ≥3 per 2-year study period), and violation type (total number of violations, foodborne-illness risk factor violation, or good retail practice violation). We collected 2013 US Census block group sociodemographic data for each restaurant neighborhood. We used nested mixed-effects regression analyses to determine the association between restaurant inspection frequency and inspection violations, as well as between inspection violations and restaurant neighborhood sociodemographic variables, stratified by restaurant type. Compared with nonchain restaurants, chain restaurants had significantly fewer total violations per inspection (mean [SD]: 6.5 [4.6] vs 9.6 [6.8] violations, P < .001). For nonchain restaurants, an increase from 1 to 2 inspections resulted in 0.8 ( P < .001) fewer mean violations per inspection, and an increase from 1 to ≥3 inspections resulted in 1.6 ( P < .001) fewer mean violations; this association was not seen in chain restaurants. For nonchain restaurants, a higher proportion of black residents in a restaurant neighborhood was associated with 0.6 ( P < .001) fewer mean foodborne-illness risk factor violations but 1.0 ( P < .001) more mean good retail practice violations per inspection. A risk-based stratified approach to restaurant food safety inspection frequency, based on whether or not restaurants are part of chains, could reduce the frequency of violations, particularly in restaurants with the most violations.

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.

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.

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

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.

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

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.

Evaluating Food Safety Knowledge and Practices of Food Processors and Sellers Working in Food Facilities in Hanoi, Vietnam.

PubMed

Tran, Bach Xuan; DO, Hoa Thi; Nguyen, Luong Thanh; Boggiano, Victoria; LE, Huong Thi; LE, Xuan Thanh Thi; Trinh, Ngoc Bao; DO, Khanh Nam; Nguyen, Cuong Tat; Nguyen, Thanh Trung; Dang, Anh Kim; Mai, Hue Thi; Nguyen, Long Hoang; Than, Selena; Latkin, Carl A

2018-04-01

Consumption of fast food and street food is increasingly common among Vietnamese, particularly in large cities. The high daily demand for these convenient food services, together with a poor management system, has raised concerns about food hygiene and safety (FHS). This study aimed to examine the FHS knowledge and practices of food processors and sellers in food facilities in Hanoi, Vietnam, and to identify their associated factors. A cross-sectional study was conducted with 1,760 food processors and sellers in restaurants, fast food stores, food stalls, and street vendors in Hanoi in 2015. We assessed each participant's FHS knowledge using a self-report questionnaire and their FHS practices using a checklist. Tobit regression was used to determine potential factors associated with FHS knowledge and practices, including demographics, training experience, and frequency of health examination. Overall, we observed a lack of FHS knowledge among respondents across three domains, including standard requirements for food facilities (18%), food processing procedures (29%), and food poisoning prevention (11%). Only 25.9 and 38.1% of participants used caps and masks, respectively, and 12.8% of food processors reported direct hand contact with food. After adjusting for socioeconomic characteristics, these factors significantly predicted increased FHS knowledge and practice scores: (i) working at restaurants and food stalls, (ii) having FHS training, (iii) having had a physical examination, and (iv) having taken a stool test within the last year. These findings highlight the need of continuous training to improve FHS knowledge and practices among food processors and food sellers. Moreover, regular monitoring of food facilities, combined with medical examination of their staff, should be performed to ensure food safety.

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.

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.

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.

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

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.

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

Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study

PubMed Central

Richardson, Andrea S.; Meyer, Katie A.; Howard, Annie Green; Boone-Heinonen, Janne; Popkin, Barry M.; Evenson, Kelly R.; Shikany, James M.; Lewis, Cora E.; Gordon-Larsen, Penny

2016-01-01

Objectives To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors. Methods We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985–86 to 2005–06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity. Results Higher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance. Conclusions Efforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI. PMID:26454248

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.

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.

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.

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

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…

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

Diving into the consumer nutrition environment: A Bayesian spatial factor analysis of neighborhood restaurant environment.

PubMed

Luan, Hui; Law, Jane; Lysy, Martin

2018-02-01

Neighborhood restaurant environment (NRE) plays a vital role in shaping residents' eating behaviors. While NRE 'healthfulness' is a multi-facet concept, most studies evaluate it based only on restaurant type, thus largely ignoring variations of in-restaurant features. In the few studies that do account for such features, healthfulness scores are simply averaged over accessible restaurants, thereby concealing any uncertainty that attributed to neighborhoods' size or spatial correlation. To address these limitations, this paper presents a Bayesian Spatial Factor Analysis for assessing NRE healthfulness in the city of Kitchener, Canada. Several in-restaurant characteristics are included. By treating NRE healthfulness as a spatially correlated latent variable, the adopted modeling approach can: (i) identify specific indicators most relevant to NRE healthfulness, (ii) provide healthfulness estimates for neighborhoods without accessible restaurants, and (iii) readily quantify uncertainties in the healthfulness index. Implications of the analysis for intervention program development and community food planning are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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.

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…

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

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

Case study of restaurant successfully designed, constructed, and operated for excellent dining acoustics

NASA Astrophysics Data System (ADS)

Bollard, Paul; Des Jardins, Stephen

2005-09-01

Prior to the construction of La Provence Restaurant in Roseville, California in 2004, the owner, Stephen Des Jardins, traveled with his cook, architect, and engineer to the Provence Region of France to study the cuisine, architecture, and acoustics of the local restaurants. This information was incorporated into the design, construction, and operation of his restaurant, with acoustical design assistance provided by the author, Paul Bollard. The result of the owner's painstaking attention to detail is a restaurant which has received very positive reviews for its architecture, quality of food, service, and acoustic ambience. This paper documents the measures included in the construction of the restaurant to ensure that the building acoustics enhance the dining experience, rather than detract from it. Photographs of acoustic treatments are included, as are reverberation time (RT60) test results and ambient noise level measurement results.

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

Improving children's menus in community restaurants: best food for families, infants, and toddlers (Best Food FITS) intervention, South Central Texas, 2010-2014.

PubMed

Crixell, Sylvia Hurd; Friedman, Bj; Fisher, Deborah Torrey; Biediger-Friedman, Lesli

2014-12-24

Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children's menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children's access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus. San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos's population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level. This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children's menus in local restaurants, administering owner-manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention. Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus. Improving menus in restaurants can be a simple step toward changing children's food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

Improving Children’s Menus in Community Restaurants: Best Food for Families, Infants, and Toddlers (Best Food FITS) Intervention, South Central Texas, 2010–2014

PubMed Central

Friedman, BJ; Fisher, Deborah Torrey; Biediger-Friedman, Lesli

2014-01-01

Background Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children’s menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children’s access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus. Community Context San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos’s population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level. Methods This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children’s menus in local restaurants, administering owner–manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention. Outcome Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus. Interpretation Improving menus in restaurants can be a simple step toward changing children’s food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition. PMID:25539127

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.

Restaurants as Learning Organizations: A Multiple-Site Case Study of U.S. Non-Chain Restaurants

ERIC Educational Resources Information Center

Boccia, Mark

2016-01-01

This study investigated the construct of the learning organization in the restaurant industry. Descriptive accounts of learning were gleaned from face-to-face interviews, focus groups, observations, document analysis, and data from the Dimensions of the Learning Organization Questionnaire (DLOQ) from 52 participants employed in three US…

An observational study of consumer use of fast-food restaurant drive-through lanes: implications for menu labelling policy.

PubMed

Roberto, Christina A; Hoffnagle, Elena; Bragg, Marie A; Brownell, Kelly D

2010-11-01

Some versions of restaurant menu labelling legislation do not require energy information to be posted on menus for drive-through lanes. The present study was designed to quantify the number of customers who purchase fast food through drive-in windows as a means of informing legislative labelling efforts. This was an observational study. The study took place at two McDonald's and Burger King restaurants, and single Dairy Queen, Kentucky Fried Chicken, Taco Bell and Wendy's restaurants. The number of customers entering the chain restaurants and purchasing food via the drive-through lane were recorded. A total of 3549 patrons were observed. The percentage of customers who made their purchases at drive-throughs was fifty-seven. The overall average (57 %) is likely a conservative estimate because some fast-food restaurants have late-night hours when only the drive-throughs are open. Since nearly six in ten customers purchase food via the drive-through lanes, menu labelling legislation should mandate the inclusion of menu labels on drive-through menu boards to maximise the impact of this public health intervention.

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.

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.

Effect of a promotional campaign on heart-healthy menu choices in community restaurants.

PubMed

Fitzgerald, Catherine M; Kannan, Srimathi; Sheldon, Sharon; Eagle, Kim Allen

2004-03-01

The research question examined in this study was: Does a promotional campaign impact the sales of heart-healthy menu items at community restaurants? The 8-week promotional campaign used professionally developed advertisements in daily and monthly print publications and posters and table tents in local restaurants. Nine restaurants tracked the sales of selected heart-healthy menu items and comparable menu items sold before and after a promotional campaign. The percentage of heart-healthy items sold after the campaign showed a trend toward a slight increase in heart-healthy menu item selections, although it was not statistically significant. This study and others indicate that dietetics professionals must continue to develop strategies to promote heart-healthy food choices in community restaurants.

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.

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).

An Observational Study of Consumers’ Accessing of Nutrition Information in Chain Restaurants

PubMed Central

Agnew, Henry; Brownell, Kelly D.

2009-01-01

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This very small percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions. PMID:19299679

An observational study of consumers' accessing of nutrition information in chain restaurants.

PubMed

Roberto, Christina A; Agnew, Henry; Brownell, Kelly D

2009-05-01

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This very small percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions.

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.

[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.

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.

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.

HYGIENE PRACTICES IN URBAN RESTAURANTS AND CHALLENGES TO IMPLEMENTING FOOD SAFETY AND HAZARD ANALYSIS CRITICAL CONTROL POINTS (HACCP) PROGRAMMES IN THIKA TOWN, KENYA.

PubMed

Muinde, R K; Kiinyukia, C; Rombo, G O; Muoki, M A

2012-12-01

To determine the microbial load in food, examination of safety measures and possibility of implementing an Hazard Analysis Critical Control Points (HACCP) system. The target population for this study consisted of restaurants owners in Thika. Municipality (n = 30). Simple randomsamples of restaurantswere selected on a systematic sampling method of microbial analysis in cooked, non-cooked, raw food and water sanitation in the selected restaurants. Two hundred and ninety eight restaurants within Thika Municipality were selected. Of these, 30 were sampled for microbiological testing. From the study, 221 (74%) of the restaurants were ready to eat establishments where food was prepared early enough to hold and only 77(26%) of the total restaurants, customers made an order of food they wanted. 118(63%) of the restaurant operators/staff had knowledge on quality control on food safety measures, 24 (8%) of the restaurants applied these knowledge while 256 (86%) of the restaurants staff showed that food contains ingredients that were hazard if poorly handled. 238 (80%) of the resultants used weighing and sorting of food materials, 45 (15%) used preservation methods and the rest used dry foods as critical control points on food safety measures. The study showed that there was need for implementation of Hazard Analysis Critical Control Points (HACCP) system to enhance food safety. Knowledge of HACCP was very low with 89 (30%) of the restaurants applying some of quality measures to the food production process systems. There was contamination with Coliforms, Escherichia coli and Staphylococcus aureus microbial though at very low level. The means of Coliforms, Escherichia coli and Staphylococcus aureas microbial in sampled food were 9.7 x 103CFU/gm, 8.2 x 103 CFU/gm and 5.4 x 103 CFU/gm respectively with Coliforms taking the highest mean.

Well, that's what came with it. A qualitative study of U.S. mothers' perceptions of healthier default options for children's meals at fast-food restaurants.

PubMed

Henry, Holly K M; Borzekowski, Dina L G

2015-04-01

Using a qualitative design, this study investigated mothers' perceptions of food choices and default options, for children, at fast-food restaurants. Mothers of 3- to 8-year-old children (n = 40) participated in phone interviews. Mothers praised fast-food restaurants for offering healthier choices, but voiced concerns about quality of the food. Half worried about meat products and several were distressed by the processing involved with food and beverages. Many said that their children wanted to visit fast-food restaurants because of advertised toys and not food offerings. Half liked bundled meals, as long as they could choose the specific items that were included. Having healthier defaults might eliminate battles, reduce forgetfulness and facilitate ordering. Most mothers favored healthier defaults because it would help "other parents." This small study provides strong support for offering healthier options at fast-food restaurants. Restaurants, schools and other food venues should design children's meals that make the healthy choice the easy choice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Change in indoor particle levels after a smoking ban in Minnesota bars and restaurants.

PubMed

Bohac, David L; Hewett, Martha J; Kapphahn, Kristopher I; Grimsrud, David T; Apte, Michael G; Gundel, Lara A

2010-12-01

Smoking bans in bars and restaurants have been shown to improve worker health and reduce hospital admissions for acute myocardial infarction. Several studies have also reported improved indoor air quality, although these studies generally used single visits before and after a ban for a convenience sample of venues. The primary objective of this study was to provide detailed time-of-day and day-of-week secondhand smoke-exposure data for representative bars and restaurants in Minnesota. This study improved on previous approaches by using a statistically representative sample of three venue types (drinking places, limited-service restaurants, and full-service restaurants), conducting repeat visits to the same venue prior to the ban, and matching the day of week and time of day for the before- and after-ban monitoring. The repeat visits included laser photometer fine particulate (PM₂.₅) concentration measurements, lit cigarette counts, and customer counts for 19 drinking places, eight limited-service restaurants, and 35 full-service restaurants in the Minneapolis/St. Paul metropolitan area. The more rigorous design of this study provides improved confidence in the findings and reduces the likelihood of systematic bias. The median reduction in PM₂.₅ was greater than 95% for all three venue types. Examination of data from repeated visits shows that making only one pre-ban visit to each venue would greatly increase the range of computed percentage reductions and lower the statistical power of pre-post tests. Variations in PM₂.₅ concentrations were found based on time of day and day of week when monitoring occurred. These comprehensive measurements confirm that smoking bans provide significant reductions in SHS constituents, protecting customers and workers from PM₂.₅ in bars and restaurants. Copyright © 2010 American Journal of Preventive Medicine. All rights reserved.

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study.

PubMed

Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

2015-07-16

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. Prelaw and postlaw design study. 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. 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. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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.

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.

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.

75 FR 29340 - Agency Information Collection Activities; Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-25

... marketers and quick service restaurant companies for information concerning, among other things, their..., snacks, baked goods, cereals, prepared meals, candy, dairy products, and restaurant food. The study found... and beverage manufacturers, distributors, and marketers and quick service restaurant companies in the...

A restaurant-based intervention to promote sales of healthy children's menu items: the Kids' Choice Restaurant Program cluster randomized trial.

PubMed

Ayala, Guadalupe X; Castro, Iana A; Pickrel, Julie L; Williams, Christine B; Lin, Shih-Fan; Madanat, Hala; Jun, Hee-Jin; Zive, Michelle

2016-03-10

Away-from-home eating is an important dietary behavior with implications on diet quality. Thus, it is an important behavior to target to prevent and control childhood obesity and other chronic health conditions. Numerous studies have been conducted to improve children's dietary intake at home, in early care and education, and in schools; however, few studies have sought to modify the restaurant food environment for children. This study adds to this body of research by describing the development and launch of an innovative intervention to promote sales of healthy children's menu items in independent restaurants in Southern California, United States. This is a cluster randomized trial with eight pair-matched restaurants in San Diego, California. Restaurants were randomized to a menu-only versus menu-plus intervention condition. The menu-only intervention condition involves manager/owner collaboration on the addition of pre-determined healthy children's menu items and kitchen manager/owner collaboration to prepare and plate these items and train kitchen staff. The menu-plus intervention condition involves more extensive manager/owner collaboration and kitchen staff training to select, prepare, and plate new healthy children's menu items, and a healthy children's menu campaign that includes marketing materials and server training to promote the items. The primary outcome is sales of healthy children's menu items over an 18-week period. In addition, dining parties consisting of adults with children under 18 years of age are being observed unobtrusively while ordering and then interviewed throughout the 18-week study period to determine the impact of the intervention on ordering behaviors. Manager/owner interviews and restaurant audits provide additional evidence of impact on customers, employees, and the restaurant environment. Our process evaluation assesses dose delivered, dose received, and intervention fidelity. Successful recruitment of the restaurants has been completed, providing evidence that the restaurant industry is open to working on the public health challenge of childhood obesity. Determining whether a restaurant intervention can promote sales of healthy children's menu items will provide evidence for how to create environments that support the healthy choices needed to prevent and control obesity. Despite these strengths, collection of sales data that will allow comprehensive analysis of intervention effects remains a challenge. NCT02511938.

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.

Is frequency of fast food and sit-down restaurant eating occasions differentially associated with less healthful eating habits?

PubMed

Close, Michael A; Lytle, Leslie A; Viera, Anthony J

2016-12-01

Studies have shown that frequency of fast food restaurant eating and sit-down restaurant eating is differentially associated with nutrient intakes and biometric outcomes. The objective of this study was to examine whether frequency of fast food and sit-down restaurant eating occasions was differentially associated with less healthful eating habits, independent of demographic characteristics. Data were collected from participants in 2015 enrolled in a worksite nutrition intervention trial ( n  = 388) in North Carolina who completed self-administered questionnaires at baseline. We used multiple logistic regressions to estimate associations between frequency of restaurant eating occasions and four less healthful eating habits, controlling for age, sex, race, education, marital status, and worksite. On average, participants in the highest tertile of fast food restaurant eating (vs. lowest tertile) had increased odds of usual intake of processed meat (OR = 3.00, 95% CI = 1.71, 5.28), red meat (OR = 2.30, 95% CI = 1.33, 4.00), refined grain bread (OR = 2.25, 95% CI = 1.23, 4.10), and sweet baked goods and candy (OR = 3.50, 95% CI = 2.00, 6.12). No associations were found between frequency of sit-down restaurant eating and less healthful eating habits. We conclude that greater frequency of fast food restaurant eating is associated with less healthful eating habits. Our findings suggest that taste preferences or other factors, independent of demographic characteristics, might explain the decision to eat at fast food or sit-down restaurants.

Barriers and facilitators of consumer use of nutrition labels at sit-down restaurant chains.

PubMed

Auchincloss, Amy H; Young, Candace; Davis, Andrea L; Wasson, Sara; Chilton, Mariana; Karamanian, Vanesa

2013-12-01

Numerous localities have mandated that chain restaurants post nutrition information at the point of purchase. However, some studies suggest that consumers are not highly responsive to menu labelling. The present qualitative study explored influences on full-service restaurant customers’ noticing and using menu labelling. Five focus groups were conducted with thirty-six consumers. A semi-structured script elicited barriers and facilitators to using nutrition information by showing excerpts of real menus from full-service chain restaurants. Participants were recruited from a full-service restaurant chain in Philadelphia, Pennsylvania, USA, in September 2011. Focus group participants were mostly female, African American, with incomes <$US 60 000, mean age 36 years and education 14·5 years. At recruitment, 33 % (n 12) reported changing their order after seeing nutrition information on the menu. Three themes characterized influences on label use in restaurants: nutrition knowledge, menu design and display, and normative attitudes and behaviours. Barriers to using labels were low prior knowledge of nutrition; displaying nutrition information using codes; low expectations of the nutritional quality of restaurant food; and restaurant discounts, promotions and social influences that overwhelmed interest in nutrition and reinforced disinterest in nutrition. Facilitators were higher prior knowledge of recommended daily intake; spending time reading the menu; having strong prior interest in nutrition/healthy eating; and being with people who reinforced dietary priorities. Menu labelling use may increase if consumers learn a few key recommended dietary reference values, understand basic energy intake/expenditure scenarios and if chain restaurants present nutrition information in a user-friendly way and promote healthier items.

Impact of San Francisco's toy ordinance on restaurants and children's food purchases, 2011-2012.

PubMed

Otten, Jennifer J; Saelens, Brian E; Kapphahn, Kristopher I; Hekler, Eric B; Buman, Matthew P; Goldstein, Benjamin A; Krukowski, Rebecca A; O'Donohue, Laura S; Gardner, Christopher D; King, Abby C

2014-07-17

In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children's menus), and the energy and nutrient content of all orders and children's-meal-only orders purchased for children aged 0 through 12 years. Restaurant responses were examined from January 2010 through March 2012. Parent-caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012. Both restaurant chains responded to the ordinance by selling toys separately from children's meals, but neither changed their menus to meet ordinance-specified nutrition criteria. Among children for whom children's meals were purchased, significant decreases in kilocalories, sodium, and fat per order were likely due to changes in children's side dishes and beverages at Chain A. Although the changes at Chain A did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results underscore the importance of policy wording, support the concept that more healthful defaults may be a powerful approach for improving dietary intake, and suggest that public policies may contribute to positive restaurant changes.

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.

Fast Food and Neighborhood Stroke Risk

PubMed Central

Morgenstern, Lewis B.; Escobar, James D.; Sánchez, Brisa N.; Hughes, Rebecca; Zuniga, Belinda G.; Garcia, Nelda; Lisabeth, Lynda D.

2009-01-01

Objective To investigate the association between the number of fast food restaurants and ischemic stroke in neighborhoods. Methods This work was a pre-specified part of the Brain Attack in Corpus Christi (BASIC) project. Ischemic stroke cases were prospectively ascertained in Nueces County, Texas. Home addresses were geocoded and used to establish the census tract for each stroke case. Census tracts were used as proxies for neighborhoods (n=64). Using a standard definition, fast food restaurants were identified from a commercial list. Poisson regression was used to study the association between the number of fast food restaurants in the neighborhood, using a 1-mile buffer around each census tract, and the risk of stroke in the neighborhood. Models were adjusted for demographics and neighborhood socioeconomic status (SES). Results There were 1,247 completed ischemic strokes from January 2000 through June 2003 and 262 fast food restaurants. The median number of fast food restaurants per census tract including buffer was 22 (IQR 12–33). Adjusting for neighborhood demographics and SES, the association of fast food restaurants with stroke was significant (p=0.02). The association suggested that the risk of stroke in a neighborhood increased by 1% for every fast food restaurant (RR 1.01 95% CI: 1.00–1.01). The relative risk of stroke comparing neighborhoods in the 75th to the 25th percentile of the distribution of fast food restaurants was 1.13 (95% CI: 1.02–1.25). Interpretation Controlling for demographic and SES factors, there was a significant association between fast food restaurants and stroke risk in neighborhoods in this community-based study. PMID:19743456

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.

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.

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

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.

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.

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.

Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study.

PubMed

Radke, Taylor J; Brown, Laura G; Hoover, E Rickamer; Faw, Brenda V; Reimann, David; Wong, Melissa R; Nicholas, David; Barkley, Jonathan; Ripley, Danny

2016-09-01

Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction.

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

U.S. consumer demand for restaurant calorie information: targeting demographic and behavioral segments in labeling initiatives.

PubMed

Kolodinsky, Jane; Reynolds, Travis William; Cannella, Mark; Timmons, David; Bromberg, Daniel

2009-01-01

To identify different segments of U.S. consumers based on food choices, exercise patterns, and desire for restaurant calorie labeling. Using a stratified (by region) random sample of the U.S. population, trained interviewers collected data for this cross-sectional study through telephone surveys. Center for Rural Studies U.S. national health survey. The final sample included 580 responses (22% response rate); data were weighted to be representative of age and gender characteristics of the U.S. population. Self-reported behaviors related to food choices, exercise patterns, desire for calorie information in restaurants, and sample demographics. Clusters were identified using Schwartz Bayesian criteria. Impacts of demographic characteristics on cluster membership were analyzed using bivariate tests of association and multinomial logit regression. Cluster analysis revealed three clusters based on respondents' food choices, activity levels, and desire for restaurant labeling. Two clusters, comprising three quarters of the sample, desired calorie labeling in restaurants. The remaining cluster opposed restaurant labeling. Demographic variables significantly predicting cluster membership included region of residence (p < .10), income (p < .05), gender (p < .01), and age (p < .10). Though limited by a low response and potential self-reporting bias in the phone survey, this study suggests that several groups are likely to benefit from restaurant calorie labeling. Specific demographic clusters could be targeted through labeling initiatives.

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.

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.

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.

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

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

Food allergy knowledge and attitude of restaurant personnel in Turkey.

PubMed

Sogut, Ayhan; Kavut, Ayşe Baççıoğlu; Kartal, İbrahim; Beyhun, Ercument Nazim; Çayır, Atilla; Mutlu, Mehmet; Özkan, Behzat

2015-02-01

The incidence of food-induced allergic reactions is gradually increasing. Most of these allergic reactions occur in restaurants. Therefore, this study aims to investigate the awareness of restaurant personnel about food allergy. The training, knowledge levels on food allergy, and comfort level in providing safe food of 351 restaurant personnel in Erzurum Province, Turkey, were assessed through a face-to-face survey. Among the participants, 81.5% were male (mean age 28.5 ± 8.5 years). Among them, 17.1% were chefs, 11.1% managers, 5.7% owners, and 66.1% waiters. Food allergy training was reported by 17.1% of the participants. The rates of restaurant personnel who gave the correct answers to the 4 questionnaire items, "Customers with food allergies can safely consume a small amount of that food/Food allergic reaction can cause death/If a customer is having an allergic reaction, it is appropriate to immediately serve them water to 'dilute' the allergen/Removing an allergen from a finished meal (eg, taking off nuts) may be all that is necessary to provide a safe meal for an allergic customer," which measure food allergy knowledge levels, were 46.4%, 65.7%, 55.0%, and 65.7%, respectively. According to our study, there are gaps in the food allergy knowledge of restaurant personnel. Because preparing and serving safe meals to patients with food allergy in restaurants is important, the training of restaurant personnel in food allergy is necessary. © 2014 ARS-AAOA, LLC.

Food ordering for children in restaurants: multiple sources of influence on decision making.

PubMed

Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

2016-09-01

Restaurants are playing an increasingly important role in children's dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child's gender, person ordering for the child and server interactions with the dining party. Interview data included: child's age, restaurant visit frequency, timing of child's decision making, and factors influencing decision making. Ten independent, table-service restaurants in San Diego, CA, USA participated. Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3-14 years). Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children's) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children's menu. Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.

Monitoring sodium content of restaurant foods: Public health challenges and opportunities

USDA-ARS?s Scientific Manuscript database

Excess sodium intake is a major preventable risk factor for high blood pressure, a leading cause for heart disease and stroke. The majority of sodium intake comes from packaged and restaurant foods. At present, data on the sodium content of restaurant foods is limited. The purpose of this study i...

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.

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.

Differences in nutrient and energy contents of commonly consumed dishes prepared in restaurants v. at home in Hunan Province, China.

PubMed

Jia, Xiaofang; Liu, Jiawu; Chen, Bo; Jin, Donghui; Fu, Zhongxi; Liu, Huilin; Du, Shufa; Popkin, Barry M; Mendez, Michelle A

2018-05-01

Eating away from home is associated with poor diet quality, in part due to less healthy food choices and larger portions. However, few studies account for the potential additional contribution of differences in food composition between restaurant- and home-prepared dishes. The present study aimed to investigate differences in nutrients of dishes prepared in restaurants v. at home. Eight commonly consumed dishes were collected in twenty of each of the following types of locations: small and large restaurants, and urban and rural households. In addition, two fast-food items were collected from ten KFC, McDonald's and food stalls. Five samples per dish were randomly pooled from every location. Nutrients were analysed and energy was calculated in composite samples. Differences in nutrients of dishes by preparation location were determined. Hunan Province, China. Na, K, protein, total fat, fatty acids, carbohydrate and energy in dishes. On average, both the absolute and relative fat contents, SFA and Na:K ratio were higher in dishes prepared in restaurants than households (P < 0·05). Protein was 15 % higher in animal food-based dishes prepared in households than restaurants (P<0·05). Quantile regression models found that, at the 90th quantile, restaurant preparation was consistently negatively associated with protein and positively associated with the percentage of energy from fat in all dishes. Moreover, restaurant preparation also positively influenced the SFA content in dishes, except at the highest quantiles. These findings suggest that compared with home preparation, dishes prepared in restaurants in China may differ in concentrations of total fat, SFA, protein and Na:K ratio, which may further contribute, beyond food choices, to less healthy nutrient intakes linked to eating away from home.

Media Outlet and Consumer Reactions to Promotional Activities of the Choose Health LA Restaurants Program in Los Angeles County.

PubMed

Gase, Lauren N; Montes, Christine; Robles, Brenda; Tyree, Rachel; Kuo, Tony

2016-01-01

This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options. We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey. The study was conducted in Los Angeles County, home to more than 10 million residents. An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data. Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign. Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media. Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health. Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.

Differences in nutrient and energy content of commonly-consumed dishes prepared in restaurants vs. at home in Hunan province, China

PubMed Central

Jia, Xiaofang; Liu, Jiawu; Chen, Bo; Jin, Donghui; Fu, Zhongxi; Liu, Huilin; Du, Shufa; Popkin, Barry M.; Mendez, Michelle A.

2017-01-01

Objective Eating away from home is associated with poor diet quality, in part due to less healthy food choices and larger portions. However, few studies take into account the potential additional contribution of differences in food composition between restaurant- and home-prepared dishes. This study aimed to investigate differences in nutrients of dishes prepared in restaurants vs. at home. Design Eight commonly consumed dishes were collected in 20 of each of the following types of locations: small and large restaurants, and urban and rural households. In addition, two fast-food items were collected from 10 KFC’s, McDonald’s, and food stalls. Five samples per dish were randomly pooled from every location. Nutrients were analyzed and energy was calculated in composite samples. Differences in nutrients of dishes by preparation location were determined. Setting Urban and rural. Subjects Sodium, potassium, protein, total fat, fatty acids, carbohydrate, and energy in dishes. Results On average, both the absolute and relative fat content, saturated fatty acid (SFA) and sodium/potassium ratio were higher in dishes prepared in restaurants than households (P<0.05). Protein was 15% higher in animal food-based dishes prepared in households than restaurants (P <0.05). Quantile regression models found that, at the 90th quantile, restaurant preparation was consistently negatively associated with protein and positively associated with the percentage energy from fat in all dishes. Moreover, restaurant preparation also positively influenced the SFA content in dishes, except at the highest quantiles. Conclusions These findings suggest that compared to home preparation, dishes prepared in restaurants in China may differ in concentrations of total fat, SFA, protein, and sodium/potassium ratio, which may further contribute, beyond food choices, to less healthy nutrient intake linked to eating away from home. PMID:29306339

Impact of San Francisco’s Toy Ordinance on Restaurants and Children’s Food Purchases, 2011–2012

PubMed Central

Saelens, Brian E.; Kapphahn, Kristopher I.; Hekler, Eric B.; Buman, Matthew P.; Goldstein, Benjamin A.; Krukowski, Rebecca A.; O’Donohue, Laura S.; Gardner, Christopher D.; King, Abby C.

2014-01-01

Introduction In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children’s meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children’s menus), and the energy and nutrient content of all orders and children’s-meal–only orders purchased for children aged 0 through 12 years. Methods Restaurant responses were examined from January 2010 through March 2012. Parent–caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012. Results Both restaurant chains responded to the ordinance by selling toys separately from children’s meals, but neither changed their menus to meet ordinance-specified nutrition criteria. Among children for whom children’s meals were purchased, significant decreases in kilocalories, sodium, and fat per order were likely due to changes in children’s side dishes and beverages at Chain A. Conclusion Although the changes at Chain A did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results underscore the importance of policy wording, support the concept that more healthful defaults may be a powerful approach for improving dietary intake, and suggest that public policies may contribute to positive restaurant changes. PMID:25032837

Occupational Noise Exposure of Employees at Locally-Owned Restaurants in a College Town

PubMed Central

Green, Deirdre R.; Anthony, T. Renée

2016-01-01

While many restaurant employees work in loud environments, in both dining and food preparation areas, little is known about worker exposures to noise. The risk of hearing loss to millions of food service workers around the country is unknown. This study evaluated full-shift noise exposure to workers at six locally-owned restaurants to examine risk factors associated with noise exposures during the day shift. Participants included cooks, counter attendants, bartenders, and waiters at full-service restaurants with bar service and at limited-service restaurants that provided counter service only. Assessments were made on weekdays and weekends, both during the summer and the fall (with a local university in session) to examine whether the time of week or year affects noise exposures to this population in a college town. In addition, the relationships between noise exposures and the type of restaurant and job classification were assessed. One-hundred eighty full-shift time-weighted average (TWA) exposures were assessed, using both Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) criteria. No TWA measurements exceeded the 90 dBA OSHA 8 hr permissible exposure limit, although six projected TWAs exceeded the 85 dBA OSHA hearing conservation action limit. Using NIOSH criteria, TWAs ranged from 69–90 dBA with a mean of 80 dBA (SD = 4 dBA). Nearly 8% (14) of the exposures exceeded the NIOSH 8-hr 85 dBA. Full-shift exposures were larger for all workers in full-service restaurants (p < 0.001) and for cooks (p = 0.003), regardless of restaurant type. The fall semester (p = 0.003) and weekend (p = 0.048) exposures were louder than summer and weekdays. Multiple linear regression analysis suggested that the combination of restaurant type, job classification, and season had a significant effect on restaurant worker noise exposures (p < 0.001) in this college town. While evening/night shift exposures, where noise exposures may be anticipated to be louder, were not assessed, this study identified that restaurant type, job classification, time of week, and season significantly affected the noise exposures for day-shift workers. Intervention studies to prevent noise-induced hearing loss (NIHL) should consider these variables. PMID:25738733

Occupational Noise Exposure of Employees at Locally-Owned Restaurants in a College Town.

PubMed

Green, Deirdre R; Anthony, T Renée

2015-01-01

While many restaurant employees work in loud environments, in both dining and food preparation areas, little is known about worker exposures to noise. The risk of hearing loss to millions of food service workers around the country is unknown. This study evaluated full-shift noise exposure to workers at six locally-owned restaurants to examine risk factors associated with noise exposures during the day shift. Participants included cooks, counter attendants, bartenders, and waiters at full-service restaurants with bar service and at limited-service restaurants that provided counter service only. Assessments were made on weekdays and weekends, both during the summer and the fall (with a local university in session) to examine whether the time of week or year affects noise exposures to this population in a college town. In addition, the relationships between noise exposures and the type of restaurant and job classification were assessed. One-hundred eighty full-shift time-weighted average (TWA) exposures were assessed, using both Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) criteria. No TWA measurements exceeded the 90 dBA OSHA 8 hr permissible exposure limit, although six projected TWAs exceeded the 85 dBA OSHA hearing conservation action limit. Using NIOSH criteria, TWAs ranged from 69-90 dBA with a mean of 80 dBA (SD = 4 dBA). Nearly 8% (14) of the exposures exceeded the NIOSH 8-hr 85 dBA. Full-shift exposures were larger for all workers in full-service restaurants (p < 0.001) and for cooks (p = 0.003), regardless of restaurant type. The fall semester (p = 0.003) and weekend (p = 0.048) exposures were louder than summer and weekdays. Multiple linear regression analysis suggested that the combination of restaurant type, job classification, and season had a significant effect on restaurant worker noise exposures (p < 0.001) in this college town. While evening/night shift exposures, where noise exposures may be anticipated to be louder, were not assessed, this study identified that restaurant type, job classification, time of week, and season significantly affected the noise exposures for day-shift workers. Intervention studies to prevent noise-induced hearing loss (NIHL) should consider these variables.

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.

Large outbreak of Salmonella enteritidis PT8 in Portsmouth, UK, associated with a restaurant.

PubMed

Severi, E; Booth, L; Johnson, S; Cleary, P; Rimington, M; Saunders, D; Cockcroft, P; Ihekweazu, C

2012-10-01

Seventy-five individuals with Salmonella infection were identified in the Portsmouth area during August and September 2009, predominantly Salmonella Enteritidis phage type 8. Five patients were admitted to hospital. A case-case comparison study showed that a local restaurant was the most likely source of the infection with a risk of illness among its customers 25-fold higher than that of those who did not attend the restaurant. A case-control study conducted to investigate specific risk factors for infection at the restaurant showed that eating salad was associated with a threefold increase in probability of illness. Changing from using ready washed lettuces to lettuces requiring washing and not adhering strictly to the 48 hours exclusion policy for food handlers with diarrhoea were likely to have contributed to the initiation and propagation of this outbreak. Possibilities for cross-contamination and environmental contamination were identified in the restaurant.

Changes in the energy and sodium content of main entrées in US chain restaurants from 2010 to 2011.

PubMed

Wu, Helen W; Sturm, Roland

2014-02-01

The food environment shapes individual diets, and as food options change, energy and sodium intake may also shift. Understanding whether and how restaurant menus evolve in response to labeling laws and public health pressures could inform future efforts to improve the food environment. To track changes in the energy and sodium content of US chain restaurant main entrées between spring 2010 (when the Affordable Care Act was passed, which included a federal menu labeling requirement) and spring 2011. Nutrition information was collected from top US chain restaurants' websites, comprising 213 unique brands. Descriptive statistics and regression analysis evaluated change across main entrées overall and compared entrées that were added, removed, and unchanged. Tests of means and proportions were conducted for individual restaurant brands to see how many made significant changes. Separate analyses were conducted for children's menus. Mean energy and sodium did not change significantly overall, although mean sodium was 70 mg lower across all restaurants in added vs removed menu items at the 75th percentile. Changes were specific to restaurant brands or service model: family-style restaurants reduced sodium among higher-sodium entrées at the 75th percentile, but not on average, and entrées still far exceeded recommended limits. Fast-food restaurants decreased mean energy in children's menu entrées by 40 kcal. A few individual restaurant brands made significant changes in energy or sodium, but the vast majority did not, and not all changes were in the healthier direction. Among those brands that did change, there were slightly more brands that reduced energy and sodium compared with those that increased it. Industry marketing and pledges may create a misleading perception that restaurant menus are becoming substantially healthier, but both healthy and unhealthy menu changes can occur simultaneously. Our study found no meaningful changes overall across a 1-year time period. Longer-term studies are needed to track changes over time, particularly after the federal menu labeling law is implemented. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

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.

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/.

Energy Content of U.S. Fast-Food Restaurant Offerings 14-Year Trends

PubMed Central

Bauer, Katherine W.; Hearst, Mary O.; Earnest, Alicia A.; French, Simone A.; Oakes, J. Michael; Harnack, Lisa J.

2012-01-01

Background Within the past decade there has been increasing attention to the role of fast food in the American diet, including a rise in legislative and media-based efforts that address the healthfulness of fast food. However, no studies have been undertaken to evaluate changes in the energy content of fast-food chain restaurant menu items during this period. Purpose To examine changes in the energy content of lunch/dinner menu offerings at eight of the leading fast-food chain restaurants in the U.S. between 1997/1998 and 2009/2010. Methods Menu offerings and nutrient composition information were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database. Nutrient composition information for items was updated biannually. Changes in median energy content of all lunch/dinner menu offerings and specific categories of menu items among all restaurants and for individual restaurants were examined. Data were collected between 1997 and 2010 and analysis was conducted in 2011. Results Spanning 1997/1998 and 2009/2010, the number of lunch/dinner menu items offered by the restaurants in the study increased by 53%. Across all menu items, the median energy content remained relatively stable over the study period. Examining specific food categories, the median energy content of desserts and condiments increased, the energy content of side items decreased, and energy content of entrees and drinks remained level. Conclusions While large increases in the number of menu items were observed, there have been few changes in the energy content of menu offerings at the leading fast-food chain restaurants examined in this study. PMID:23079171

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.

Food ordering for children in restaurants: multiple sources of influence on decision making

PubMed Central

Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

2017-01-01

Objective Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. Design A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making. Setting Ten independent, table-service restaurants in San Diego, CA, USA participated. Subjects Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years). Results Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu. Conclusions Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants. PMID:27334904

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.

Frequency of inadequate chicken cross-contamination prevention and cooking practices in restaurants.

PubMed

Green Brown, Laura; Khargonekar, Shivangi; Bushnell, Lisa

2013-12-01

This study was conducted by the Environmental Health Specialists Network (EHS-Net) of the Centers for Disease Control and Prevention. The purpose was to examine restaurant chicken preparation and cooking practices and kitchen managers' food safety knowledge concerning chicken. EHS-Net members interviewed managers about chicken preparation practices in 448 restaurants. The study revealed that many restaurants were not following U.S. Food and Drug Administration Food Code guidance concerning cross-contamination prevention and proper cooking and that managers lacked basic food safety knowledge about chicken. Forty percent of managers said that they never, rarely, or only sometimes designated certain cutting boards for raw meat (including chicken). One-third of managers said that they did not wash and rinse surfaces before sanitizing them. Over half of managers said that thermometers were not used to determine the final cook temperature of chicken. Only 43% of managers knew the temperature to which raw chicken needed to be cooked for it to be safe to eat. These findings indicate that restaurant chicken preparation and cooking practices and manager food safety knowledge need improvement. Findings from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts to improve chicken preparation and cooking practices and knowledge concerning safe chicken preparation.

[Determinants of food and nutrition insecurity: a study conducted in Low-budget Restaurants in Belo Horizonte in the state of Minas Gerais, Brazil].

PubMed

Sobrinho, Fernanda Martins; Silva, Yara Cardoso; Abreu, Mery Natali Silva; Pereira, Simone Cardoso Lisboa; Dias Júnior, Cláudio Santiago

2014-05-01

The scope of this study is to evaluate the condition of household food and nutrition (in)security (IAN) of the users of low-budget restaurants in Belo Horizonte (BH). This is an analytical cross-sectional study carried out on all low-budget restaurants and cafeteria in BH with a sample of 1613 users. The IAN was assessed using the Brazilian Food Insecurity Scale and cross-checked with the socioeconomic profile of the users. The Chisquare and Mann-Whitney tests were applied. All p-value < 0.25 variables were included in the multivariate analysis. The groups most exposed to IAN among users of low-budget restaurants are those with a lower socioeconomic level and per capita income class and those with a large number of residents in the household. Also affected are those who admit to having different kinds of wants and needs, and those for whom price and living alone are the main reasons for frequenting low-budget restaurants. The factors affecting the IAN are varied and multifactorial, thus representing a major challenge for public policy makers and for those who live directly with these dietary restrictions. The low-budget restaurants serve as a strategy for promoting healthy eating habits.

Frequency of Inadequate Chicken Cross-Contamination Prevention and Cooking Practices in Restaurants

PubMed Central

Brown, Laura Green; Khargonekar, Shivangi; Bushnell, Lisa

2017-01-01

This study was conducted by the Environmental Health Specialists Network (EHS-Net) of the Centers for Disease Control and Prevention. The purpose was to examine restaurant chicken preparation and cooking practices and kitchen managers’ food safety knowledge concerning chicken. EHS-Net members interviewed managers about chicken preparation practices in 448 restaurants. The study revealed that many restaurants were not following U.S. Food and Drug Administration Food Code guidance concerning cross-contamination prevention and proper cooking and that managers lacked basic food safety knowledge about chicken. Forty percent of managers said that they never, rarely, or only sometimes designated certain cutting boards for raw meat (including chicken). One-third of managers said that they did not wash and rinse surfaces before sanitizing them. Over half of managers said that thermometers were not used to determine the final cook temperature of chicken. Only 43% of managers knew the temperature to which raw chicken needed to be cooked for it to be safe to eat. These findings indicate that restaurant chicken preparation and cooking practices and manager food safety knowledge need improvement. Findings from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts to improve chicken preparation and cooking practices and knowledge concerning safe chicken preparation. PMID:24290693

The Effect of an Electronic Checklist on Critical Care Provider Workload, Errors, and Performance.

PubMed

Thongprayoon, Charat; Harrison, Andrew M; O'Horo, John C; Berrios, Ronaldo A Sevilla; Pickering, Brian W; Herasevich, Vitaly

2016-03-01

The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist. This was a simulation-based study conducted at an academic tertiary hospital. All participants completed checklists for 6 ICU patients: 3 using an electronic checklist and 3 using an identical paper checklist. In both scenarios, participants had full access to the existing electronic medical record system. The outcomes measured were workload (defined using the National Aeronautics and Space Association task load index [NASA-TLX]), the number of checklist errors, and time to checklist completion. Two independent clinician reviewers, blinded to participant results, served as the reference standard for checklist error calculation. Twenty-one ICU providers participated in this study. This resulted in the generation of 63 simulated electronic checklists and 63 simulated paper checklists. The median NASA-TLX score was 39 for the electronic checklist and 50 for the paper checklist (P = .005). The median number of checklist errors for the electronic checklist was 5, while the median number of checklist errors for the paper checklist was 8 (P = .003). The time to checklist completion was not significantly different between the 2 checklist formats (P = .76). The electronic checklist significantly reduced provider workload and errors without any measurable difference in the amount of time required for checklist completion. This demonstrates that electronic checklists are feasible and desirable in the ICU setting. © The Author(s) 2014.

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

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

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.

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.

Changes in Georgia restaurant and bar smoking policies from 2006 to 2012.

PubMed

Chandora, Rachna D; Whitney, Carrie F; Weaver, Scott R; Eriksen, Michael P

2015-05-14

The purpose of this study is to examine the change in smoking policy status among Georgia restaurants and bars from 2006 to 2012 and to identify restaurant and bar characteristics that are associated with allowing smoking. Data were obtained from similar cross-sectional indoor air surveys conducted in 2006 and 2012 in Georgia. Both surveys were designed to gather information about restaurant and bar smoking policies. Weighted χ(2) analyses were performed to identify changes in smoking policy status and other variables from 2006 to 2012. Weighted logistic regression analysis was used to test for significant associations between an establishment's smoking policy and other characteristics. The percentage of restaurants and bars in Georgia that allowed smoking nearly doubled, from 9.1% in 2006 to 17.6% in 2012. The analyses also showed a significant increase in the percentage of establishments that allow smoking when minors are present. Having a liquor license was a significant predictor of allowing smoking. The Smokefree Air Act was enacted in 2005 to protect the health and welfare of Georgia citizens, but study results suggest that policy makers should reevaluate the law and consider strengthening it to make restaurants and bars 100% smokefree without exemptions.

Application of the Health Belief Model to customers' use of menu labels in restaurants.

PubMed

Jeong, Jin-Yi; Ham, Sunny

2018-04-01

Some countries require the provision of menu labels on restaurant menus to fight the increasing prevalence of obesity and related chronic diseases. This study views customers' use of menu labels as a preventive health behavior and applies the Health Belief Model (HBM) with the aim of determining the health belief factors that influence customers' use of menu labels. A self-administered survey was distributed for data collection. Responses were collected from 335 restaurant customers who experienced menu labels in restaurants within three months prior to the survey. The results of a structural equation model showed that all the HBM variables (perceived threats, perceived benefits, and perceived barriers of using menu labels) positively affected the customers' use of menu labels. Perceived threats were influenced by cues to action and cues to action had an indirect influence on menu label use through perceived threats. In conclusion, health beliefs were good predictors of menu label use on restaurant menus. This study validated the application of the HBM to menu labeling in restaurants, and its findings could offer guidelines for the industry and government in developing strategies to expand the use of menu labels among the public. Copyright © 2017 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

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.

An assessment of the ability of routine restaurant inspections to predict food-borne outbreaks in Miami-Dade County, Florida.

PubMed Central

Cruz, M A; Katz, D J; Suarez, J A

2001-01-01

OBJECTIVES: This study sought to determine the usefulness of restaurant inspections in predicting food-borne outbreaks in Miami-Dade County, Fla. METHODS: Inspection reports of restaurants with outbreaks in 1995 (cases; n = 51) were compared with those of randomly selected restaurants that had no reported outbreaks (controls; n = 76). RESULTS: Cases and controls did not differ by overall inspection outcome or mean number of critical violations. Only 1 critical violation--evidence of vermin--was associated with outbreaks (odds ratio = 3.3; 95% confidence interval = 1.1, 13.1). CONCLUSIONS: Results of restaurant inspections in Miami-Dade County did not predict outbreaks. If these findings are representative of the situation in other jurisdictions, inspection practices may need to be updated. PMID:11344897

Eat Smart! Ontario's Healthy Restaurant Program: focus groups with non-participating restaurant operators.

PubMed

Dwyer, John J M; Macaskill, Lesley A; Uetrecht, Connie L; Dombrow, Carol

2004-01-01

Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units give an award of excellence to restaurants that meet nutrition, food safety, and non-smoking seating standards. The purpose of this study was to determine why some restaurant operators have not applied to participate in the program, and how to get them to apply. Four focus group interviews were conducted with 35 operators who didn't apply to participate. The analysis of responses yielded various themes. The participants' perceived barriers to participation were misunderstandings about how to qualify for the program, lack of time, concern about different non-smoking bylaw requirements, and potential loss of revenue. Their perceived facilitators to participation were convenience of applying to participate, franchise executives' approval to participate, a 100% non-smoking bylaw, flexibility in the assessment of restaurants, the opportunity for positive advertising, alternative payment for food handler training, and customer demand. Program staff can use the findings to develop and use strategies to encourage participation.

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.

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®

Restaurant manager and worker food safety certification and knowledge.

PubMed

Brown, Laura G; Le, Brenda; Wong, Melissa R; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A

2014-11-01

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N=387) and workers (N=365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge.

Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items.

PubMed

Thayer, Linden M; Pimentel, Daniela C; Smith, Janice C; Garcia, Beverly A; Lee Sylvester, Laura; Kelly, Tammy; Johnston, Larry F; Ammerman, Alice S; Keyserling, Thomas C

2017-01-01

As Americans commonly consume restaurant foods with poor dietary quality, effective interventions are needed to improve food choices at restaurants. To design and evaluate a restaurant-based intervention to help customers select and restaurants promote heart healthy menu items with healthful fats and high quality carbohydrates. The intervention included table tents outlining 10 heart healthy eating tips, coupons promoting healthy menu items, an information brochure, and link to study website. Pre and post intervention surveys were completed by restaurant managers and customers completed a brief "intercept" survey. Managers (n = 10) reported the table tents and coupons were well received, and several noted improved personal nutrition knowledge. Overall, 4214 coupons were distributed with 1244 (30%) redeemed. Of 300 customers surveyed, 126 (42%) noticed the table tents and of these, 115 (91%) considered the nutrition information helpful, 42 (33%) indicated the information influenced menu items purchased, and 91 (72%) reported the information will influence what they order in the future. The intervention was well-received by restaurant managers and positively influenced menu item selection by many customers. Further research is needed to assess effective strategies for scaling up and sustaining this intervention approach.

Restaurant Manager and Worker Food Safety Certification and Knowledge

PubMed Central

Brown, Laura G.; Le, Brenda; Wong, Melissa R.; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A.

2017-01-01

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N = 387) and workers (N = 365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge. PMID:25361386

Eat Smart! Ontario's Healthy Restaurant Program: a survey of participating restaurant operators.

PubMed

Macaskill, Lesley A; Dwyer, John J M; Uetrecht, Connie L; Dombrow, Carol

2003-01-01

Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units grant an award of excellence to restaurants that meet designated standards in nutrition, food safety, and non-smoking seating. The purpose of this study was to assess whether program objectives for participating restaurant operators were achieved during the first year of program implementation, and to obtain operators' recommendations for improving the program. Dillman's tailored design method was used to design a mail survey and implement it among participating operators (n = 434). The design method, which consisted of four mail-outs, yielded a 74% response rate. Fifty percent of respondents operated family-style or quick-service restaurants, and 82% of respondents learned about the program from public health inspectors. Almost all respondents (98%) participated in the program mainly to have their establishments known as clean and healthy restaurants, 65% received and used either point-of-purchase table stands or postcards to promote the program, and 98% planned to continue participating. The respondents' suggestions for improving the program were related to the award ceremony and program materials, media promotion, communication, education, and program standards. Program staff can use the findings to enhance the program.

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.

Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study

PubMed Central

Radke, Taylor J.; Brown, Laura G.; Hoover, E. Rickamer; Faw, Brenda V.; Reimann, David; Wong, Melissa R.; Nicholas, David; Barkley, Jonathan; Ripley, Danny

2016-01-01

Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers’ food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant’s ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. PMID:28221943

Salmonella and Campylobacter contamination of ready-to-eat street-vended pork meat dishes in Antananarivo, Madagascar: a risk for the consumers?

PubMed

Cardinale, Eric; Abat, Cédric; Bénédicte, Contamin; Vincent, Porphyre; Michel, Rakotoharinome; Muriel, Maeder

2015-03-01

Street-food vending has been increasing in many developing countries and particularly in Madagascar since 2000. Gastroenteric diseases cause 37% of all deaths each year, and 50% of children <5 years are infected with intestinal pathogens. However, there has been little information regarding the incidence of street-food-related diseases, or foodborne pathogens in pork, which is the most commonly eaten meat, along with chicken. Thus, the aim of this study was to investigate the safety of traditional ready-to-eat street-vended pork dishes and to assess the association of restaurant characteristics and cooking practices with Salmonella and Campylobacter contamination of these meals. Sixty street-restaurants were studied from March 2012 to August 2012 in Antananarivo. A questionnaire was submitted to the managers, and samples of ready-to-eat pork dishes were bought. Salmonella spp. were isolated in 10% of the 60 street-restaurants studied and in 5% samples of pork dishes. The most prevalent serovars isolated were Salmonella Typhimurium (44%) and Senftenberg (33%). Campylobacter was not detected. Only 4 of the 43 variables tested in the screening analysis were significantly associated with Salmonella spp. contamination of the street-restaurants. The risk for a restaurant to be Salmonella positive decreased when there were specific premises for the restaurant and when the staff was wearing specific clothes when working. Conversely, that risk increased when the temperature of ready-to-eat pork was <52 °C and when tablecloths were used in the restaurant.

Energy content of U.S. fast-food restaurant offerings: 14-year trends.

PubMed

Bauer, Katherine W; Hearst, Mary O; Earnest, Alicia A; French, Simone A; Oakes, J Michael; Harnack, Lisa J

2012-11-01

Within the past decade, there has been increasing attention to the role of fast food in the American diet, including a rise in legislative and media-based efforts that address the healthfulness of fast food. However, no studies have been undertaken to evaluate changes in the energy content of fast-food chain restaurant menu items during this period. To examine changes in the energy content of lunch/dinner menu offerings at eight of the leading fast-food chain restaurants in the U.S. between 1997-1998 and 2009-2010. Menu offerings and nutrient composition information were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database. Nutrient composition information for items was updated biannually. Changes in median energy content of all lunch/dinner menu offerings and specific categories of menu items among all restaurants and for individual restaurants were examined. Data were collected between 1997 and 2010 and analysis was conducted in 2011. Spanning 1997-1998 and 2009-2010, the number of lunch/dinner menu items offered by the restaurants in the study increased by 53%. Across all menu items, the median energy content remained relatively stable over the study period. Examining specific food categories, the median energy content of desserts and condiments increased, the energy content of side items decreased, and energy content of entrées and drinks remained level. Although large increases in the number of menu items were observed, there have been few changes in the energy content of menu offerings at the leading fast-food chain restaurants examined in this study. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The exploration of effects of Chinese cultural values on the attitudes and behaviors of Chinese restaurateurs toward food safety training.

PubMed

Liu, Pei; Kwon, Junehee

2013-06-01

Foodborne illness is a challenge in the production and service of ethnic foods. The purpose of the study described in this article was to explore variables influencing the behaviors of U.S. Chinese restaurant owners/operators regarding the provision of food safety training in their restaurants. Seventeen major Chinese cultural values were identified through individual interviews with 20 Chinese restaurant owners/operators. Most participants felt satisfied with their previous health inspections. Several expressed having difficulty, however, following the health inspectors' instructions and in understanding the health inspection report. A few participants provided food safety training to their employees due to state law. Lack of money, time, labor/energy, and a perceived need for food safety training were recognized as major challenges to providing food safety training in Chinese restaurants. Videos, case studies, and food safety training handbooks were the most preferred food safety training methods of Chinese restaurant owners/operators, and Chinese was the preferred language in which to conduct the training.

Culinary culture and globalization: an analysis of British and German Michelin-starred restaurants.

PubMed

Lane, Christel

2011-12-01

The high-end restaurant segment in Britain and Germany has long been shaped by the cultural hegemony of French haute cuisine, perpetuated by multiple processes, including the influence of the Michelin or Red Guide. Traditionally, this hegemony has been expressed in the prevalence of French expatriate chefs, culinary techniques and style and even restaurant culture. This paper investigates whether processes of globalization have weakened or even undermined this French cultural dominance in fine-dining restaurants and their culinary culture. To this end, the study identifies the various forms taken by globalization processes in this industry segment and then assesses their impact on the dominance of the French paradigm of culinary culture. The investigation focuses on British and German Michelin-starred restaurants, underlining both commonalities and divergences in the process of interaction between French, global and local influences. The study employs a qualitative method, using a number of case studies to discern cross-industry patterns. All chefs with two or three stars in the two countries, i.e. 45 chefs, were selected for the analysis of their cuisine. © London School of Economics and Political Science 2011.

Public knowledge and attitudes regarding public health inspections of restaurants.

PubMed

Jones, Timothy F; Grimm, Karen

2008-06-01

Foodborne diseases cause 76 million illnesses in the U.S. each year, and almost half of all money spent on food is spent in restaurants. Restaurant inspections are a critical public health intervention for the prevention of foodborne disease. A telephone survey of randomly selected Tennessee residents aged > or =18 was performed. Data were collected on respondents' demographics, knowledge, attitudes, and expectations regarding restaurant inspections. Of 2000 respondents, 97% were aware that restaurants are inspected regularly by the health department. More than half of the respondents believed that inspections should be performed at least 12 times per year; only one third were aware that inspections currently occur only twice per year in Tennessee. More than one third of the respondents considered an inspection score of > or =90 acceptable for a restaurant at which they would eat; the mean score in Tennessee is 82. When presented with a variety of scenarios, an overwhelming number of respondents felt that public health responses to safety violations should be far more draconian than they actually are. Survey answers did not differ consistently based on respondents' race, gender, or history of having worked in a restaurant. This study identified a number of public misconceptions and unrealistically high expectations of the public health restaurant-inspection system. It is important to improve consumers' understanding of inspection scores and the limitations of regulatory inspections, as well as the role of such inspections in disease prevention.

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.

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

Economic impacts of the Pueblo Smoke-Free Air Act.

PubMed

Young, Walter F; Szychowski, Jeffery; Karp, Shelley; Liu, Lucia; Diedrich, Robert T

2010-03-01

On July 1, 2003, the city of Pueblo CO enacted a smokefree ordinance (Pueblo Smoke-Free Air Act [PSFAA]) that prohibited smoking in public places and workplaces, including taverns and restaurants. Opponents to this ordinance argued that it would have a negative impact on tavern and restaurant sales. The purpose of this study was to determine whether the PSFAA had a negative economic impact on tavern and restaurant sales tax revenues. With data gathered in 2007, this study implemented an interrupted time-series model in 2008, using 42 months of pre- and post-intervention sales tax revenue data for Pueblo to determine whether implementation of this ordinance had an effect on tavern and restaurant sales tax revenues. Ratios of tavern and restaurant openings to closings were also computed for the pre- and post-intervention periods. Pre-post sales tax revenue data showed slight losses in sales tax revenue for taverns, and gains for restaurants, which more than offset the tavern losses. After adjusting for the consumer price index, the city of Pueblo experienced a 20.3% gain in combined tavern and restaurant sales tax revenues from the pre-ordinance period to the post-ordinance period. The ratio of tavern openings to closings improved from 1:1 pre-period to 3.3:1 post-period and the restaurant ratio remained unchanged at approximately 1.78:1 from pre- to post-period. There is no evidence that the PSFAA had a negative economic impact on consumer price index-adjusted tavern and restaurant sales tax revenues. From a fiscal policy perspective, this ordinance may have contributed to a net increase in sales tax revenues for the city of Pueblo. The business openings/closings data suggest that the confidence Pueblo's business sector had in the local hospitality industry was not negatively influenced by the PSFAA. Copyright (c) 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

College Students' Intentions to Use Calorie Information on a Restaurant Menu: Application of the Theory of Planned Behavior

ERIC Educational Resources Information Center

Stran, Kimberly A.; Knol, Linda L.; Severt, Kimberly; Lawrence, Jeannine C.

2016-01-01

Background: Obesity continues to be an epidemic in the United States and is associated with multiple chronic diseases. Greater numbers of people eat in restaurants and select high calorie foods. Labeling laws require calorie information on menus in some restaurants. Purpose: The purpose of this study was to determine the predictors of intention to…

Commercial TV exposure, fast-food toy collecting and family visits to fast food restaurants among families living in rural communities

PubMed Central

Emond, Jennifer A.; Bernhardt, Amy M.; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D.

2015-01-01

Objective To assess the associations between children's exposure to TV networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. Study design One hundred parents of children 3–7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's television viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Results Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (adjusted odds ratio 2.84 for each one-unit increase in the child's commercial TV viewing scale, p<0.001); toy collecting partially mediated that positive association. Conclusions Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor. PMID:26526362

Neighborhood restaurant availability and frequency of eating out in relation to dietary intake in young Japanese women.

PubMed

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

2011-01-01

Exposure to food service establishments is considered to encourage consumption and contribute to poorer diet quality, and hence adverse health profiles. However, empirical verification of these links remains rare, particularly in young adults and non-Western populations. The objective of this cross-sectional study was to test the hypothesis that neighborhood restaurant availability and frequency of eating out are associated with unfavorable patterns of dietary intake and thus possibly higher body mass index (BMI) and waist circumference in young Japanese women. The subjects were 989 female Japanese dietetic students 18 to 22 y of age. Dietary intake and frequency of eating out (i.e., consumption of commercially prepared meals) during the preceding month were assessed using a comprehensive, self-administered diet history questionnaire. Neighborhood restaurant availability was defined as the number of restaurants within a 0.5-mile (0.8-km) radius of residence (i.e., full-service restaurants, limited-service restaurants, and cafeterias). Increasing frequency of eating out was associated with higher intake of meat, confectionery and bread, and dietary fat, lower intake of fruit and vegetables, rice, and dietary fiber, and higher dietary energy density. However, neighborhood restaurant availability was not associated with either the frequency of eating out or any of the dietary variables examined. Further, frequency of eating out and neighborhood restaurant availability were not associated with BMI or waist circumference. In conclusion, although frequency of eating out was positively associated with unfavorable dietary intake patterns in a group of young Japanese women, neighborhood restaurant availability was not associated with frequency of eating out or dietary intake.

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

Comparing nutrition environments in bodegas and fast food restaurants

PubMed Central

Lovasi, Laszlo; Yousefzadeh, Paulette; Sheehan, Daniel; Milinkovic, Karla; Baecker, Aileen; Bader, Michael D. M.; Weiss, Christopher; Lovasi, Gina S.; Rundle, Andrew

2015-01-01

Many small grocery stores or “bodegas” sell prepared or ready-to-eat items, filling a similar niche in the food environment as fast food restaurants. However, little comparative information is available about the nutrition environments of bodegas and fast food outlets. This study compared the nutrition environments of bodegas and national chain fast food restaurants using a common audit instrument, the Nutrition Environment Measures Study in Restaurants (NEMS-R) protocol. The analytic sample included 109 bodegas and 107 fast food restaurants located in New York City neighborhoods in the upper third and lower third of the census tract poverty rate distribution. Inter-rater reliability was evaluated in 102 food outlets including 31 from the analytic sample and 71 from a supplementary convenience sample. The analysis compared scores on individual NEMS-R items, a total summary score, and sub-scores indicating healthy food availability, nutrition information, promotions of healthy or unhealthy eating, and price incentives for healthy eating, using t-tests and chi-square statistics to evaluate differences by outlet type and neighborhood poverty. Fast food restaurants were more likely to provide nutritional information, while bodegas scored higher on healthy food availability, promotions, and pricing. Bodegas and fast food restaurants had similar NEMS-R total scores (bodegas: 13.09, fast food: 14.31, p=0.22). NEMS-R total scores were higher (indicating healthier environments) in low- than high-poverty neighborhoods among both bodegas (14.79 vs. 11.54, p=0.01) and fast food restaurants (16.27 vs. 11.60, p<.01). Results imply different policy measures to improve nutrition environments in the two types of food outlets. PMID:24035459

Comparing nutrition environments in bodegas and fast-food restaurants.

PubMed

Neckerman, Kathryn M; Lovasi, Laszlo; Yousefzadeh, Paulette; Sheehan, Daniel; Milinkovic, Karla; Baecker, Aileen; Bader, Michael D M; Weiss, Christopher; Lovasi, Gina S; Rundle, Andrew

2014-04-01

Many small grocery stores or "bodegas" sell prepared or ready-to-eat items, filling a niche in the food environment similar to fast-food restaurants. However, little comparative information is available about the nutrition environments of bodegas and fast-food outlets. This study compared the nutrition environments of bodegas and national chain fast-food restaurants using a common audit instrument, the Nutrition Environment Measures Study in Restaurants (NEMS-R) protocol. The analytic sample included 109 bodegas and 107 fast-food restaurants located in New York City neighborhoods in the upper third and lower third of the census tract poverty rate distribution. Inter-rater reliability was evaluated in 102 food outlets, including 31 from the analytic sample and 71 from a supplementary convenience sample. The analysis compared scores on individual NEMS-R items, a total summary score, and subscores indicating healthy food availability, nutrition information, promotions of healthy or unhealthy eating, and price incentives for healthy eating, using t tests and χ(2) statistics to evaluate differences by outlet type and neighborhood poverty. Fast-food restaurants were more likely to provide nutrition information, and bodegas scored higher on healthy food availability, promotions, and pricing. Bodegas and fast-food restaurants had similar NEMS-R total scores (bodegas 13.09, fast food 14.31; P=0.22). NEMS-R total scores were higher (indicating healthier environments) in low- than high-poverty neighborhoods among both bodegas (14.79 vs 11.54; P=0.01) and fast-food restaurants (16.27 vs 11.60; P<0.01). Results imply different policy measures to improve nutrition environments in the two types of food outlets. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

How major restaurant chains plan their menus: the role of profit, demand, and health.

PubMed

Glanz, Karen; Resnicow, Ken; Seymour, Jennifer; Hoy, Kathy; Stewart, Hayden; Lyons, Mark; Goldberg, Jeanne

2007-05-01

Increased away-from-home eating is associated with lower diet quality, and may contribute to the increasing prevalence of overweight and obesity. Healthier food choices in restaurants may help mitigate the rise in obesity and improve diet quality. This study sought to understand the views of executives at major U.S. restaurant chains regarding the process, motivation for, and challenges of offering healthier options on their menus. The Healthy Menu Study used in-depth structured telephone interviews with 41 senior menu development and marketing executives at leading casual dining and fast-food restaurant chains. The interview guide covered menu trends, influences on introduction and continuation of new menu items, and barriers to adding healthy foods. Data analysis included tabulation of responses, identification of themes, and examination of subgroup differences. Growing sales and increasing profits are the most important considerations, mentioned by 61% of respondents; health and nutrition were noted as important by 21%. Restaurants may try to avoid losing groups with a "health seeker" by offering healthier foods (low in fat and calories, more fruits and vegetables) (27% of chains), but operators believe demand for healthier foods is not widespread. Additional obstacles to including healthier menu items are short shelf life of produce (46%), increased preparation time, low sales, and high labor costs. Not surprisingly, profit margins are the primary determinants of why restaurants do or do not add and continue to serve healthier food options. Without an increase in consumer demand, it is unlikely the restaurant industry will increase their offering of healthy food choices. Insight into the restaurant industry perspective is important for developing promising strategies to encourage healthier eating patterns.

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.

Consumers' estimation of calorie content at fast food restaurants: cross sectional observational study.

PubMed

Block, Jason P; Condon, Suzanne K; Kleinman, Ken; Mullen, Jewel; Linakis, Stephanie; Rifas-Shiman, Sheryl; Gillman, Matthew W

2013-05-23

To investigate estimation of calorie (energy) content of meals from fast food restaurants in adults, adolescents, and school age children. Cross sectional study of repeated visits to fast food restaurant chains. 89 fast food restaurants in four cities in New England, United States: McDonald's, Burger King, Subway, Wendy's, KFC, Dunkin' Donuts. 1877 adults and 330 school age children visiting restaurants at dinnertime (evening meal) in 2010 and 2011; 1178 adolescents visiting restaurants after school or at lunchtime in 2010 and 2011. Estimated calorie content of purchased meals. Among adults, adolescents, and school age children, the mean actual calorie content of meals was 836 calories (SD 465), 756 calories (SD 455), and 733 calories (SD 359), respectively. A calorie is equivalent to 4.18 kJ. Compared with the actual figures, participants underestimated calorie content by means of 175 calories (95% confidence interval 145 to 205), 259 calories (227 to 291), and 175 calories (108 to 242), respectively. In multivariable linear regression models, underestimation of calorie content increased substantially as the actual meal calorie content increased. Adults and adolescents eating at Subway estimated 20% and 25% lower calorie content than McDonald's diners (relative change 0.80, 95% confidence interval 0.66 to 0.96; 0.75, 0.57 to 0.99). People eating at fast food restaurants underestimate the calorie content of meals, especially large meals. Education of consumers through calorie menu labeling and other outreach efforts might reduce the large degree of underestimation.

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.

Effects of a randomized intervention promoting healthy children's meals on children's ordering and dietary intake in a quick-service restaurant.

PubMed

Anzman-Frasca, Stephanie; Braun, Abbey C; Ehrenberg, Sarah; Epstein, Leonard H; Gampp, April; Leone, Lucia A; Singh, Anita; Tauriello, Sara

2018-08-01

Children's consumption of restaurant foods is associated with higher energy intake and lower nutritional quality compared to foods prepared at home. The aim of this pilot study was to test whether an in-restaurant intervention promoting healthy children's meals (i.e. two meals that met nutrition recommendations and were thus healthier than typical children's meal offerings across leading restaurants) affected children's meal selection and intake. Families with 4-to-8-year-old children were recruited from one location of Anderson's Frozen Custard, a regional quick-service restaurant chain. Families were randomly assigned to return to the restaurant during an intervention or control period and were blinded to group assignment. All families received free meals. During the intervention period families also received placemats featuring two healthy "Kids' Meals of the Day" upon restaurant entry. After families finished dining, researchers recorded children's orders and collected leftovers for quantifying dietary intake via weighed plate waste. Poisson regression and chi-square tests were used to compare children's orders between study groups, and t-tests were used to test for differences in dietary intake among children ordering a promoted healthy entrée (main dish) versus those who did not. Fifty-eight families participated. Children who were exposed to the study placemats prior to ordering ordered a significantly greater number of healthy food components compared to controls (p = 0.03). Overall, in the intervention group, 21% of children ordered a healthy entrée or side dish, versus 7% of controls. Children who ordered one of the promoted healthy entrées consumed less saturated fat across the total meal compared to those who did not (p = 0.04). Manipulating the prominence of healthy choices in restaurants may shift children's meal selections. Future research should build on these initial promising results, aiming to increase the potency of the intervention to achieve more widespread effects. Copyright © 2018 Elsevier Inc. All rights reserved.

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

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

Neighborhood and weight-related health behaviors in the Look AHEAD (Action for Health in Diabetes) study.

PubMed

Gary-Webb, Tiffany L; Baptiste-Roberts, Kesha; Pham, Luu; Wesche-Thobaben, Jacqueline; Patricio, Jennifer; Pi-Sunyer, F Xavier; Brown, Arleen F; Jones, LaShanda; Brancati, Frederick L

2010-06-04

Previous studies have shown that neighborhood factors are associated with obesity, but few studies have evaluated the association with weight control behaviors. This study aims to conduct a multi-level analysis to examine the relationship between neighborhood SES and weight-related health behaviors. In this ancillary study to Look AHEAD (Action for Health in Diabetes) a trial of long-term weight loss among individuals with type 2 diabetes, individual-level data on 1219 participants from 4 clinic sites at baseline were linked to neighborhood-level data at the tract level from the 2000 US Census and other databases. Neighborhood variables included SES (% living below the federal poverty level) and the availability of food stores, convenience stores, and restaurants. Dependent variables included BMI, eating patterns, weight control behaviors and resource use related to food and physical activity. Multi-level models were used to account for individual-level SES and potential confounders. The availability of restaurants was related to several eating and weight control behaviors. Compared to their counterparts in neighborhoods with fewer restaurants, participants in neighborhoods with more restaurants were more likely to eat breakfast (prevalence Ratio [PR] 1.29 95% CI: 1.01-1.62) and lunch (PR = 1.19, 1.04-1.36) at non-fast food restaurants. They were less likely to be attempting weight loss (OR = 0.93, 0.89-0.97) but more likely to engage in weight control behaviors for food and physical activity, respectively, than those who lived in neighborhoods with fewer restaurants. In contrast, neighborhood SES had little association with weight control behaviors. In this selected group of weight loss trial participants, restaurant availability was associated with some weight control practices, but neighborhood SES was not. Future studies should give attention to other populations and to evaluating various aspects of the physical and social environment with weight control practices.

Using practical ergonomic evaluations in the restaurant industry to enhance safety and comfort: a case study.

PubMed

Gentzler, Marc D; Smither, Janan A

2012-01-01

Restaurant employees must deal with loud noise, busy environments, difficult customers, heavy, awkward, sharp, and hot objects, repetitive motions, and stress on various joints, all of which can lead to fatigue, sudden accidents, and longterm musculoskeletal injury. The goal of this case study was to assess the risk of injuries and accidents from conducting various tasks in the restaurant, specifically carrying/lifting, table management, and polishing silverware. The nine participants were servers at a local country club restaurant. Physical workload was measured by a scale of physical exertion. Cognitive workload was assessed, as well as cumulative trauma disorder risk. Overall results show that there is sufficient risk in some of the tasks to warrant concern. Specific results are discussed, as well as recommendations for improved safety.

Obesogenic and youth oriented restaurant marketing in public housing neighborhoods.

PubMed

Lee, Rebecca E; Heinrich, Katie M; Reese-Smith, Jacqueline Y; Regan, Gail R; Adamus-Leach, Heather J

2014-03-01

To compare restaurant marketing by restaurant and neighborhood type. All restaurants (61=fast food, FF; 72=table service, TS) within an 800-meter radius of 13 public housing developments (HD) and 4 comparison neighborhoods were audited using the Restaurant Assessment Tool©2010. HD neighborhoods were lower income and higher minority than comparison neighborhoods with similar density and street connectivity. Restaurants in HD neighborhoods had fewer healthy entrées than comparison neighborhoods. FF restaurants had cheaper beverages and more children's meals, supersize drinks, free prize with purchase, super-size items, special characters, and more items geared to driving than TS restaurants. Residents of lower socioeconomic neighborhoods may be differentially exposed to unhealthy food options.

Reducing calories, fat, saturated fat and sodium in restaurant menu items: Effects on consumer acceptance

PubMed Central

Patel, Anjali A.; Lopez, Nanette V.; Lawless, Harry T.; Njike, Valentine; Beleche, Mariana; Katz, David L.

2016-01-01

OBJECTIVE This study assessed consumer acceptance of reductions of calories, fat, saturated fat, and sodium to current restaurant recipes. METHODS Twenty-four menu items, from six restaurant chains, were slightly modified and moderately modified by reducing targeted ingredients. Restaurant customers (n=1,838) were recruited for a taste test and were blinded to the recipe version as well as the purpose of the study. Overall consumer acceptance was measured using a 9-point hedonic (like/dislike) scale, likelihood to purchase scale, Just-About-Right (JAR) 5-point scale, penalty analysis and alienation analysis. RESULTS Overall, modified recipes of 19 menu items were scored similar to (or better than) their respective current versions. Eleven menu items were found to be acceptable at the slightly modified recipe version and eight menu items were found to be acceptable at the moderately modified recipe version. Acceptable ingredient reductions resulted in a reduction of up to 26% in calories and a reduction of up to 31% in sodium per serving. CONCLUSIONS The majority of restaurant menu items with small reductions of calories, fat, saturated fat and sodium were acceptable. Given the frequency of eating foods away from home, these reductions could be effective in creating dietary improvements for restaurant diners. PMID:27891828

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.

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

Investigating adolescents' sweetened beverage consumption and Western fast food restaurant visits in China, 2006-2011.

PubMed

Lee, Yen-Han; Chiang, Timothy C; Liu, Ching-Ti; Chang, Yen-Chang

2018-05-25

Background China has undergone rapid Westernization and established dramatic social reforms since the early 21st century. However, health issues led to challenges in the lives of the Chinese residents. Western fast food and sweetened beverages, two food options associated with chronic diseases and obesity, have played key roles to alter adolescents' dietary patterns. This study aims to examine the association between adolescents' visits to Western fast food restaurants and sweetened beverage consumption. Methods Applying three waves of the China Health and Nutrition Study (CHNS) between 2006 and 2011 (n = 1063), we used generalized Poisson regression (GPR) to investigate the association between adolescents' Western fast food restaurant visits and sweetened beverage consumption, as the popularity of fast food and sweetened beverages has skyrocketed among adolescents in contemporary China. A linear-by-linear association test was used as a trend test to study general patterns between sweetened beverage consumption and Western fast food restaurant visits. We adjusted all models with sweetened beverage consumption frequency, four food preferences (fast food, salty snacks, fruits and vegetables), school status, gross household income, provinces, rural/urban regions, age and gender. Results From the results of the trend test, frequent sweetened beverage consumption was highly associated with more Western fast food restaurant visits among Chinese adolescents in the three waves (p < 0.001). Furthermore, we observed that adolescents, who had less than monthly sweetened beverage consumption or did not drink them at all, had much less likelihood of visiting Western fast food restaurants (p < 0.05), compared with those daily consumers. Conclusion Adolescents' sweetened beverage consumption was highly associated with Western fast food restaurant visits in contemporary China. Further actions are needed from the Chinese central government to create a healthier dietary environment for adolescents.

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.

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

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.

Mandating nutrient menu labeling in restaurants: potential public health benefits.

PubMed

Stran, Kimberly A; Turner, Lori W; Knol, Linda

2013-03-01

Many Americans have replaced home-cooked meals with fast food and restaurants meals. This contributes to increased incidences of overweight and obesity. Implementing policies that require restaurants to disclose nutrition information has the potential to improve nutrition knowledge and food behaviors. The purpose of this paper was to examine the potential health benefits of nutrient menu labeling in restaurants, the progress of this legislation and to provide results regarding the implementation of these policies. Data sources were obtained from a search of multiple databases including PubMed, Science Direct, Academic Search Premier, and Google Scholar. Study inclusion criteria were publication in the past ten years, obesity prevention, and utilization of nutrition labeling on menus in restaurants. The initial policies to provide consumers with nutrition information in restaurant settings began at the state levels in 2006. These laws demonstrated success, other states followed, and a national law was passed and is being implemented. Mandating nutrient menu disclosure has the potential to influence a large number of people; this legislation has the opportunity to impact Americans who dine at a fast food or chain restaurant. Given the growing obesity epidemic, continued research is necessary to gauge the effectiveness of this new law and its effects on the health status of the American people.

Marketing nutrition in restaurants: a survey of current practices and attitudes.

PubMed

Sneed, J; Burkhalter, J P

1991-04-01

This study sought to determine attitudes toward nutrition, nutrition marketing practices, the relationship between attitudes toward nutrition and nutrition marketing practices, and nutrition training practices in restaurants. A written questionnaire was mailed to 200 research and development (R & D) directors in restaurant companies included in Restaurants & Institutions' list of top 400 foodservice organizations ranked by sales. Seventy (35%) responded. Most R & D directors did not think they were responsible for improving the health of their consumers. A positive relationship existed between attitudes toward nutrition and nutrition marketing practices (P = .013). Forty-four reported that they marketed nutrition and planned to add nutritious menu items in the future. Forty-six reported that nutritious meal options represented 0 to 10% of total sales. Nutrition information was provided to consumers by 27 restaurant companies but such information often had to be requested. The American Heart Association was a popular source of nutrition and menu-planning information. Twelve companies employed a registered dietitian, and 14 used registered dietitians as consultants. Nutrition-related training for restaurant employees was limited. These findings indicate that dietitians have opportunities to market their skills in developing nutritious menu items and providing staff training. Also, dietitians should encourage consumers (especially those with special dietary needs) to let restaurant managers know their menu and nutrition information needs.

Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items

PubMed Central

Thayer, Linden M.; Pimentel, Daniela C.; Smith, Janice C.; Garcia, Beverly A.; Lee Sylvester, Laura; Kelly, Tammy; Johnston, Larry F.; Ammerman, Alice S.; Keyserling, Thomas C.

2017-01-01

Background As Americans commonly consume restaurant foods with poor dietary quality, effective interventions are needed to improve food choices at restaurants. Purpose To design and evaluate a restaurant-based intervention to help customers select and restaurants promote heart healthy menu items with healthful fats and high quality carbohydrates. Methods The intervention included table tents outlining 10 heart healthy eating tips, coupons promoting healthy menu items, an information brochure, and link to study website. Pre and post intervention surveys were completed by restaurant managers and customers completed a brief “intercept” survey. Results Managers (n = 10) reported the table tents and coupons were well received, and several noted improved personal nutrition knowledge. Overall, 4214 coupons were distributed with 1244 (30%) redeemed. Of 300 customers surveyed, 126 (42%) noticed the table tents and of these, 115 (91%) considered the nutrition information helpful, 42 (33%) indicated the information influenced menu items purchased, and 91 (72%) reported the information will influence what they order in the future. Discussion The intervention was well-received by restaurant managers and positively influenced menu item selection by many customers. Translation to Health Education Practice Further research is needed to assess effective strategies for scaling up and sustaining this intervention approach. PMID:28947925

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program

PubMed Central

Ayala, Guadalupe X.; Castro, Iana A.; Pickrel, Julie L.; Lin, Shih-Fan; Williams, Christine B.; Madanat, Hala; Jun, Hee-Jin; Zive, Michelle

2017-01-01

Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants. PMID:29194392

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids' Choice Restaurant Program.

PubMed

Ayala, Guadalupe X; Castro, Iana A; Pickrel, Julie L; Lin, Shih-Fan; Williams, Christine B; Madanat, Hala; Jun, Hee-Jin; Zive, Michelle

2017-12-01

Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants.

Fast food restaurant locations according to socioeconomic disadvantage, urban-regional locality, and schools within Victoria, Australia.

PubMed

Thornton, Lukar E; Lamb, Karen E; Ball, Kylie

2016-12-01

Features of the built environment provide opportunities to engage in both healthy and unhealthy behaviours. Access to a high number of fast food restaurants may encourage greater consumption of fast food products. The distribution of fast food restaurants at a state-level has not previously been reported in Australia. Using the location of 537 fast food restaurants from four major chains (McDonald׳s, KFC, Hungry Jacks, and Red Rooster), this study examined fast food restaurant locations across the state of Victoria relative to area-level disadvantage, urban-regional locality (classified as Major Cities, Inner Regional, or Outer Regional), and around schools. Findings revealed greater locational access to fast food restaurants in more socioeconomically disadvantaged areas (compared to areas with lower levels of disadvantage), nearby to secondary schools (compared to primary schools), and nearby to primary and secondary schools within the most disadvantaged areas of the major city region (compared to primary and secondary schools in areas with lower levels of disadvantage). Adjusted models showed no significant difference in location according to urban-regional locality. Knowledge of the distribution of fast food restaurants in Australia will assist local authorities to target potential policy mechanisms, such as planning regulations, where they are most needed.

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.

Chefs' opinions of restaurant portion sizes.

PubMed

Condrasky, Marge; Ledikwe, Jenny H; Flood, Julie E; Rolls, Barbara J

2007-08-01

The objectives were to determine who establishes restaurant portion sizes and factors that influence these decisions, and to examine chefs' opinions regarding portion size, nutrition information, and weight management. A survey was distributed to chefs to obtain information about who is responsible for determining restaurant portion sizes, factors influencing restaurant portion sizes, what food portion sizes are being served in restaurants, and chefs' opinions regarding nutrition information, health, and body weight. The final sample consisted of 300 chefs attending various culinary meetings. Executive chefs were identified as being primarily responsible for establishing portion sizes served in restaurants. Factors reported to have a strong influence on restaurant portion sizes included presentation of foods, food cost, and customer expectations. While 76% of chefs thought that they served "regular" portions, the actual portions of steak and pasta they reported serving were 2 to 4 times larger than serving sizes recommended by the U.S government. Chefs indicated that they believe that the amount of food served influences how much patrons consume and that large portions are a problem for weight control, but their opinions were mixed regarding whether it is the customer's responsibility to eat an appropriate amount when served a large portion of food. Portion size is a key determinant of energy intake, and the results from this study suggest that cultural norms and economic value strongly influence the determination of restaurant portion sizes. Strategies are needed to encourage chefs to provide and promote portions that are appropriate for customers' energy requirements.

Nutritional adequacy of meals from an independent catering facility versus chain restaurants for young adults.

PubMed

Nikolaou, Charoula Konstantia; Hankey, Catherine Ruth; Lean, Michael Ernest John

2017-03-01

Eating out of home has been associated with the increasing prevalence of obesity. While some chain restaurants provide nutritional information for their products, smaller independent catering facilities may not provide such information. The aim of this study was to assess the nutritional adequacy of meals provided to young adults at an independent catering facility and compare them with meals provided by chain restaurants. Meals were analysed in 2014 in the UK in relation of nutrient provision to targets for macro- and micro-nutrients. One-way ANOVA was performed to compare menus between the restaurants included in the analyses. 2056 meal combinations were analysed, 210 from the student accommodation and 1,846 from five largest national chain restaurants. Mean (SD) nutritional content was: student accommodation: 1193(269)kcal, fat 52.0(22)g, saturated fat 24.5(14.5)g, protein 42.4(28.5)g, carbohydrate 117.0(30)g; chain restaurants: 922(160)kcal, fat 40.0(9.7)g, saturated fat 14.5(5.8)g, protein 31.2(6.5)g, carbohydrate 104.2(16.6)g. Meals from the student accommodation presented significantly more calories than the meals in all five chain restaurants ( p = 0.0015). Meal provision in the student accommodation was in excess of energy requirements and higher than the meals offered in chain restaurants. Regulating or setting nutritional standards for all places that provide food is essential as current food provision may favour unwanted weight gain and diet-related diseases.

Restaurant industry preparedness against intentional food contamination: results of a South Carolina survey.

PubMed

Xirasagar, Sudha; Kanwat, C P; Smith, Lillian U; Li, Yi-Jhen; Sros, Lekhena; Shewchuk, Richard M

2010-01-01

Food safety and food defense are both responsibilities of public health agencies. Food safety practices within restaurants are regulated by state and local public health laws based on the US Food and Drug Administration Model Food Code. However, little is known about preemptive practices against intentional food-borne outbreaks within restaurants. The researchers administered a survey to a 50 percent random sample of South Carolina's restaurants, a state that relies heavily on tourism and the restaurant industry for its economic well-being. The survey received a response rate of 15 percent. The food defense practice items fall under three functional categories: employee management and training practices; vendor and delivery-related practices; and physical facilities and operational security practices. This study presents the results, classified by geographic region. Findings indicate some key areas of vulnerability that need attention to protect the public from mass food outbreaks due to intentional contamination. Of concern, there is much variation in practices by geographic region. On the basis of the survey, recommendations are made to improve restaurant preparedness against food-borne outbreaks from terrorism and malevolent contamination.

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

The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada.

PubMed

Luk, Rita; Ferrence, Roberta; Gmel, Gerhard

2006-05-01

On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. DATA AND MEASURES: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures. We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results. Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales. While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.

Absolute and relative densities of fast-food versus other restaurants in relation to weight status: Does restaurant mix matter?

PubMed

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

2016-01-01

Given the continuing epidemic of obesity, policymakers are increasingly looking for levers within the local retail food environment as a means of promoting healthy weights. To examine the independent and joint associations of absolute and relative densities of restaurants near home with weight status in a large, urban, population-based sample of adults. We studied 10,199 adults living in one of four cities in southern Ontario, Canada, who participated in the Canadian Community Health Survey (cycles 2005, 2007/08, 2009/10). Multivariate models assessed the association of weight status (obesity and body mass index) with absolute densities (numbers) of fast-food, full-service and other restaurants, and the relative density (proportion) of fast-food restaurants (FFR) relative to all restaurants within ~10-minute walk of residential areas. Higher numbers of restaurants of any type were inversely related to excess weight, even in models adjusting for a range of individual covariates and area deprivation. However, these associations were no longer significant after accounting for higher walkability of areas with high volumes of restaurants. In contrast, there was a direct relationship between the proportion of FFR relative to all restaurants and excess weight, particularly in areas with high volumes of FFR (e.g., odds ratio for obesity=2.55 in areas with 5+ FFR, 95% confidence interval: 1.55-4.17, across the interquartile range). Policies aiming to promote healthy weights that target the volume of certain retail food outlets in residential settings may be more effective if they also consider the relative share of outlets serving more and less healthful foods. Copyright © 2015 Elsevier Inc. All rights reserved.

Nutritional quality at eight U.S. fast-food chains: 14-year trends.

PubMed

Hearst, Mary O; Harnack, Lisa J; Bauer, Katherine W; Earnest, Alicia A; French, Simone A; Michael Oakes, J

2013-06-01

Frequent consumption of fast-food menu items that are high in fat, sugar, and sodium contribute to poor dietary quality, increasing individuals' risk for diet-related chronic diseases. To assess 14-year trends in the nutritional quality of menu offerings at eight fast-food restaurant chains in the U.S. Data on menu items and food and nutrient composition were obtained in 2011 from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database for eight fast-food restaurant chains. In this database, ingredient and nutrition information for all foods sold by the fast-food restaurants were updated biannually between 1997/1998 and 2009/2010. Healthy Eating Index (HEI)-2005 scores were calculated for each restaurant menu as a measure of the extent to which menu offerings were consistent with Dietary Guidelines for Americans and compared over time. Of a possible index total of 100 (healthiest), the HEI-2005 score across all eight fast-food restaurants was 45 in 1997/1998 and 48 in 2009/2010. Individually, restaurant scores in 1997/1998 ranged from 37 to 56 and in 2009/2010 ranged from 38 to 56. The greatest improvements in nutritional quality were seen in the increase of meat/beans, decrease in saturated fat, and decrease in the proportion of calories from solid fats and added sugars. The HEI-2005 score improved in six restaurants and decreased in two. The nutritional quality of menu offerings at fast-food restaurant chains included in this study increased over time, but further improvements are needed. Fast-food restaurants have an opportunity to contribute to a healthy diet for Americans by improving the nutritional quality of their menus. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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.

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

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.

Neighborhood Disparities in the Restaurant Food Environment.

PubMed

Martinez-Donate, Ana P; Espino, Jennifer Valdivia; Meinen, Amy; Escaron, Anne L; Roubal, Anne; Nieto, Javier; Malecki, Kristen

2016-11-01

Restaurant meals account for a significant portion of the American diet. Investigating disparities in the restaurant food environment can inform targeted interventions to increase opportunities for healthy eating among those who need them most. To examine neighborhood disparities in restaurant density and the nutrition environment within restaurants among a statewide sample of Wisconsin households. Households (N = 259) were selected from the 2009-2010 Survey of the Health of Wisconsin (SHOW), a population-based survey of Wisconsin adults. Restaurants in the household neighborhood were enumerated and audited using the Nutrition Environment Measures Survey for Restaurants (NEMS-R). Neighborhoods were defined as a 2- and 5-mile street-distance buffer around households in urban and non-urban areas, respectively. Adjusted linear regression models identified independent associations between sociodemographic household characteristics and neighborhood restaurant density and nutrition environment scores. On average, each neighborhood contained approximately 26 restaurants. On average, restaurants obtained 36.1% of the total nutrition environment points. After adjusting for household characteristics, higher restaurant density was associated with both younger and older household average age (P < .05), all white households (P = .01), and urban location (P < .001). Compared to rural neighborhoods, urban and suburban neighborhoods had slightly higher (ie, healthier) nutrition environment scores (P < .001). The restaurant food environment in Wisconsin neighborhoods varies by age, race, and urbanicity, but offers ample room for improvement across socioeconomic groups and urbanicity levels. Future research must identify policy and environmental interventions to promote healthy eating in all restaurants, especially in young and/or rural neighborhoods in Wisconsin.

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.

A prospective study of frequency of eating restaurant prepared meals and subsequent 9-year risk of all-cause and cardiometabolic mortality in US adults

PubMed Central

Graubard, Barry I.

2018-01-01

Restaurant prepared foods are known to be energy-dense and high in fat and sodium, but lower in protective nutrients. There is evidence of higher risk of adiposity, type II diabetes, and heart disease in frequent consumers of restaurant meals. However, the risk of mortality as a long-term health consequence of frequent consumption of restaurant meals has not been examined. We examined the prospective risk of all-cause and coronary heart disease, cerebrovascular disease and diabetes (cardiometabolic) mortality in relation to frequency of eating restaurant prepared meals in a national cohort. We used frequency of eating restaurant prepared meals information collected in the National Health and Nutrition Examination Surveys, conducted from 1999–2004, with mortality follow-up completed through Dec. 31, 2011 (baseline age ≥ 40y; n = 9107). We estimated the relative hazard of all-cause and cardiometabolic mortality associated with weekly frequency of eating restaurant meals using Cox-proportional hazards regression methods to adjust for multiple covariates. All analyses accounted for complex survey design and included sample weights. Over 33% of all respondents reported eating ≥3 restaurant prepared meals/week. In this cohort, 2200 deaths due to all causes and 665 cardiometabolic deaths occurred over a median follow-up of 9 years. The covariate-adjusted hazard ratio of all cause or cardiometabolic mortality in men and women reporters of <1 or 1–2 restaurant prepared meals did not differ from those reporting ≥3 meals/week (P>0.05). The results were robust to effect modification by baseline BMI, years of education, and baseline morbidity. Expectedly, the 24-h dietary intakes of whole grains, fruits, dietary fiber, folate, vitamin C, potassium and magnesium at baseline were lower, but energy, energy density, and energy from fat were higher in more frequent restaurant meal reporters (P<0.05). Baseline serum HDL cholesterol, folate, and some carotenoids were inversely associated with the frequency of eating restaurant prepared meals (P<0.05); however, serum concentrations of total cholesterol, triglycerides, fasting glucose, insulin, glycated hemoglobin, and c-reactive protein were unrelated (P<0.05). The weekly frequency of eating restaurant prepared meals and prospective risk of mortality after 9 years were not related in this cohort. PMID:29360850

Association between neighborhood need and spatial access to food stores and fast food restaurants in neighborhoods of colonias.

PubMed

Sharkey, Joseph R; Horel, Scott; Han, Daikwon; Huber, John C

2009-02-16

To determine the extent to which neighborhood needs (socioeconomic deprivation and vehicle availability) are associated with two criteria of food environment access: 1) distance to the nearest food store and fast food restaurant and 2) coverage (number) of food stores and fast food restaurants within a specified network distance of neighborhood areas of colonias, using ground-truthed methods. Data included locational points for 315 food stores and 204 fast food restaurants, and neighborhood characteristics from the 2000 U.S. Census for the 197 census block group (CBG) study area. Neighborhood deprivation and vehicle availability were calculated for each CBG. Minimum distance was determined by calculating network distance from the population-weighted center of each CBG to the nearest supercenter, supermarket, grocery, convenience store, dollar store, mass merchandiser, and fast food restaurant. Coverage was determined by calculating the number of each type of food store and fast food restaurant within a network distance of 1, 3, and 5 miles of each population-weighted CBG center. Neighborhood need and access were examined using Spearman ranked correlations, spatial autocorrelation, and multivariate regression models that adjusted for population density. Overall, neighborhoods had best access to convenience stores, fast food restaurants, and dollar stores. After adjusting for population density, residents in neighborhoods with increased deprivation had to travel a significantly greater distance to the nearest supercenter or supermarket, grocery store, mass merchandiser, dollar store, and pharmacy for food items. The results were quite different for association of need with the number of stores within 1 mile. Deprivation was only associated with fast food restaurants; greater deprivation was associated with fewer fast food restaurants within 1 mile. CBG with greater lack of vehicle availability had slightly better access to more supercenters or supermarkets, grocery stores, or fast food restaurants. Increasing deprivation was associated with decreasing numbers of grocery stores, mass merchandisers, dollar stores, and fast food restaurants within 3 miles. It is important to understand not only the distance that people must travel to the nearest store to make a purchase, but also how many shopping opportunities they have in order to compare price, quality, and selection. Future research should examine how spatial access to the food environment influences the utilization of food stores and fast food restaurants, and the strategies used by low-income families to obtain food for the household.

A prospective study of frequency of eating restaurant prepared meals and subsequent 9-year risk of all-cause and cardiometabolic mortality in US adults.

PubMed

Kant, Ashima K; Graubard, Barry I

2018-01-01

Restaurant prepared foods are known to be energy-dense and high in fat and sodium, but lower in protective nutrients. There is evidence of higher risk of adiposity, type II diabetes, and heart disease in frequent consumers of restaurant meals. However, the risk of mortality as a long-term health consequence of frequent consumption of restaurant meals has not been examined. We examined the prospective risk of all-cause and coronary heart disease, cerebrovascular disease and diabetes (cardiometabolic) mortality in relation to frequency of eating restaurant prepared meals in a national cohort. We used frequency of eating restaurant prepared meals information collected in the National Health and Nutrition Examination Surveys, conducted from 1999-2004, with mortality follow-up completed through Dec. 31, 2011 (baseline age ≥ 40y; n = 9107). We estimated the relative hazard of all-cause and cardiometabolic mortality associated with weekly frequency of eating restaurant meals using Cox-proportional hazards regression methods to adjust for multiple covariates. All analyses accounted for complex survey design and included sample weights. Over 33% of all respondents reported eating ≥3 restaurant prepared meals/week. In this cohort, 2200 deaths due to all causes and 665 cardiometabolic deaths occurred over a median follow-up of 9 years. The covariate-adjusted hazard ratio of all cause or cardiometabolic mortality in men and women reporters of <1 or 1-2 restaurant prepared meals did not differ from those reporting ≥3 meals/week (P>0.05). The results were robust to effect modification by baseline BMI, years of education, and baseline morbidity. Expectedly, the 24-h dietary intakes of whole grains, fruits, dietary fiber, folate, vitamin C, potassium and magnesium at baseline were lower, but energy, energy density, and energy from fat were higher in more frequent restaurant meal reporters (P<0.05). Baseline serum HDL cholesterol, folate, and some carotenoids were inversely associated with the frequency of eating restaurant prepared meals (P<0.05); however, serum concentrations of total cholesterol, triglycerides, fasting glucose, insulin, glycated hemoglobin, and c-reactive protein were unrelated (P<0.05). The weekly frequency of eating restaurant prepared meals and prospective risk of mortality after 9 years were not related in this cohort.

Strange bedfellows: the history of collaboration between the Massachusetts Restaurant Association and the tobacco industry.

PubMed Central

Ritch, W A; Begay, M E

2001-01-01

OBJECTIVES: This article examines the historical relationship between the tobacco industry and the Massachusetts Restaurant Association, a nonprofit trade association aligned with the food and beverage industry. METHODS: The study analyzed data from Web-based tobacco industry documents, public relations materials, news articles, testimony from public hearings, requests for injunctions, court decisions, economic impact studies, handbooks, and private correspondence. RESULTS: Tobacco industry documents that became public after various state lawsuits reveal that a long history of collaboration exists between the Massachusetts Restaurant Association and the tobacco industry. For more than 20 years, their joint efforts have focused primarily on the battle to defeat state and local laws that would restrict smoking in public places, particularly in beverage and food service establishments. The resources of the tobacco industry, combined with the association's grassroots mobilization of its membership, have fueled their opposition to many state and local smoke-free restaurant, bar, and workplace laws in Massachusetts. CONCLUSIONS: The universal opposition of the Massachusetts Restaurant Association to smoking bans in food and beverage establishments is a reflection of its historic relationship with the tobacco industry. PMID:11291372

Strange bedfellows: the history of collaboration between the Massachusetts Restaurant Association and the tobacco industry.

PubMed

Ritch, W A; Begay, M E

2001-04-01

This article examines the historical relationship between the tobacco industry and the Massachusetts Restaurant Association, a nonprofit trade association aligned with the food and beverage industry. The study analyzed data from Web-based tobacco industry documents, public relations materials, news articles, testimony from public hearings, requests for injunctions, court decisions, economic impact studies, handbooks, and private correspondence. Tobacco industry documents that became public after various state lawsuits reveal that a long history of collaboration exists between the Massachusetts Restaurant Association and the tobacco industry. For more than 20 years, their joint efforts have focused primarily on the battle to defeat state and local laws that would restrict smoking in public places, particularly in beverage and food service establishments. The resources of the tobacco industry, combined with the association's grassroots mobilization of its membership, have fueled their opposition to many state and local smoke-free restaurant, bar, and workplace laws in Massachusetts. The universal opposition of the Massachusetts Restaurant Association to smoking bans in food and beverage establishments is a reflection of its historic relationship with the tobacco industry.

Risk factors for contamination of ready-to-eat street-vended poultry dishes in Dakar, Senegal.

PubMed

Cardinale, E; Perrier Gros-Claude, J D; Tall, F; Guèye, E F; Salvat, G

2005-08-25

Our objective was to investigate the Salmonella and Campylobacter contamination of traditional ready-to-eat street-vended poultry dishes and to assess the association of some restaurant characteristics and cooking practices with the contamination of these meals. One hundred and forty-eight street-restaurants were studied from January 2003 to April 2004 in Dakar. A questionnaire was submitted to the managers, and samples of ready-to-eat poultry dishes were taken. Salmonella spp. was isolated in 20.1% of the 148 street-restaurants studied and in 10.1% samples of poultry dishes. The most prevalent serovars isolated were Salmonella hadar, Salmonella enteritidis and Salmonella brancaster. Campylobacter jejuni was detected in only 3 restaurants and 3 poultry dishes. Not peeling and not cleaning vegetables and other ingredients during meal preparation (OR=3.58), dirty clothing for restaurant employees (OR=4.65), reheating previously cooked foods (OR=5.2), and no kitchen and utensils disinfection (OR=3.47) were associated with an increasing risk of Salmonella contamination. Adequate cooking procedures decreased the risk of Salmonella contamination (OR=0.15).

Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil

PubMed Central

Duran, Ana Clara; Diez Roux, Ana V; do Rosario DO Latorre, Maria; Jaime, Patricia C

2013-01-01

Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010–2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods. PMID:23747923

Consumers’ estimation of calorie content at fast food restaurants: cross sectional observational study

PubMed Central

Condon, Suzanne K; Kleinman, Ken; Mullen, Jewel; Linakis, Stephanie; Rifas-Shiman, Sheryl; Gillman, Matthew W

2013-01-01

Objective To investigate estimation of calorie (energy) content of meals from fast food restaurants in adults, adolescents, and school age children. Design Cross sectional study of repeated visits to fast food restaurant chains. Setting 89 fast food restaurants in four cities in New England, United States: McDonald’s, Burger King, Subway, Wendy’s, KFC, Dunkin’ Donuts. Participants 1877 adults and 330 school age children visiting restaurants at dinnertime (evening meal) in 2010 and 2011; 1178 adolescents visiting restaurants after school or at lunchtime in 2010 and 2011. Main outcome measure Estimated calorie content of purchased meals. Results Among adults, adolescents, and school age children, the mean actual calorie content of meals was 836 calories (SD 465), 756 calories (SD 455), and 733 calories (SD 359), respectively. A calorie is equivalent to 4.18 kJ. Compared with the actual figures, participants underestimated calorie content by means of 175 calories (95% confidence interval 145 to 205), 259 calories (227 to 291), and 175 calories (108 to 242), respectively. In multivariable linear regression models, underestimation of calorie content increased substantially as the actual meal calorie content increased. Adults and adolescents eating at Subway estimated 20% and 25% lower calorie content than McDonald’s diners (relative change 0.80, 95% confidence interval 0.66 to 0.96; 0.75, 0.57 to 0.99). Conclusions People eating at fast food restaurants underestimate the calorie content of meals, especially large meals. Education of consumers through calorie menu labeling and other outreach efforts might reduce the large degree of underestimation. PMID:23704170

Feasibility of Workplace Health Promotion for Restaurant Workers, Seattle, 2012.

PubMed

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

2015-10-08

Restaurant workers are a large population at high risk for tobacco use, physical inactivity, and influenza. They are difficult to reach with health care interventions and may be more accessible through workplaces, yet few studies have explored the feasibility of workplace health promotion in this population. This study sought to identify barriers and facilitators to promotion of tobacco cessation, physical activity, and influenza vaccination in restaurants. Moderators conducted 7 focus groups, 3 with restaurant owners and managers, 2 with English-speaking workers, and 2 with Spanish-speaking workers. All groups were recorded, and recordings were transcribed and uploaded to qualitative-analysis software. Two researchers coded each transcript independently and analyzed codes and quotations for common themes. Seventy people from the restaurant industry participated. Barriers to workplace health promotion included smoking-break customs, little interest in physical activity outside of work, and misinformation about influenza vaccinations. Facilitators included creating and enforcing equitable break policies and offering free, on-site influenza vaccinations. Spanish-speakers were particularly amenable to vaccination, despite their perceptions of low levels of management support for health promotion overall. Owners required a strong business case to consider investing in long-term prevention for their employees. Tobacco cessation and influenza vaccinations are opportunities for health promotion among restaurant workers, whereas physical activity interventions face greater challenges. Promotion of equitable breaks, limited smoking-break policies, and free, on-site influenza vaccinations could improve health for restaurant workers, who often do not have health insurance. Workplace interventions may be particularly important for Hispanic workers who have additional access barriers.

Feasibility of Workplace Health Promotion for Restaurant Workers, Seattle, 2012

PubMed Central

Hammerback, Kristen; Harris, Jeffrey R.; Hannon, Peggy A.; Parrish, Amanda T.

2015-01-01

Introduction Restaurant workers are a large population at high risk for tobacco use, physical inactivity, and influenza. They are difficult to reach with health care interventions and may be more accessible through workplaces, yet few studies have explored the feasibility of workplace health promotion in this population. This study sought to identify barriers and facilitators to promotion of tobacco cessation, physical activity, and influenza vaccination in restaurants. Methods Moderators conducted 7 focus groups, 3 with restaurant owners and managers, 2 with English-speaking workers, and 2 with Spanish-speaking workers. All groups were recorded, and recordings were transcribed and uploaded to qualitative-analysis software. Two researchers coded each transcript independently and analyzed codes and quotations for common themes. Results Seventy people from the restaurant industry participated. Barriers to workplace health promotion included smoking-break customs, little interest in physical activity outside of work, and misinformation about influenza vaccinations. Facilitators included creating and enforcing equitable break policies and offering free, on-site influenza vaccinations. Spanish-speakers were particularly amenable to vaccination, despite their perceptions of low levels of management support for health promotion overall. Owners required a strong business case to consider investing in long-term prevention for their employees. Conclusion Tobacco cessation and influenza vaccinations are opportunities for health promotion among restaurant workers, whereas physical activity interventions face greater challenges. Promotion of equitable breaks, limited smoking-break policies, and free, on-site influenza vaccinations could improve health for restaurant workers, who often do not have health insurance. Workplace interventions may be particularly important for Hispanic workers who have additional access barriers. PMID:26447549

Behavior intentions of the public after bans on smoking in restaurants and bars.

PubMed Central

Biener, L; Siegel, M

1997-01-01

OBJECTIVES: This study assessed the potential effect of smoke-free policies on bar and restaurant patronage. METHODS: Random-digit dialing techniques were used in surveying a representative sample of Massachusetts adults (n = 2356) by telephone. RESULTS: Approximately 61% of the respondents predicted no change in their use of restaurants in response to smoke-free policies, 30% predicted increased use, and 8% predicted decreased use. In turn, 69% of the respondents predicted no change in their patronage of bars, while 20% predicted increased use and 11% predicted decreased use. CONCLUSIONS: These results suggest that smoke-free policies are likely to increase overall patronage of bars and restaurants. PMID:9431301

The impact of a new McDonald's restaurant on eating behaviours and perceptions of local residents: A natural experiment using repeated cross-sectional data.

PubMed

Thornton, Lukar E; Ball, Kylie; Lamb, Karen E; McCann, Jennifer; Parker, Kate; Crawford, David A

2016-05-01

Neighbourhood food environments are posited as an important determinant of eating behaviours; however causality is difficult to establish based on existing studies. Using a natural experiment study design (incorporating repeated cross-sectional data), we tested whether the development of a new McDonald's restaurant increased the frequency of consumption of McDonald's products amongst local residents in the suburbs of Tecoma (site of a new McDonald's restaurant development) and Monbulk (control site) in Victoria, Australia. Across both sites, the reported frequency of McDonald's consumption did not change during the follow-up surveys. In the context explored, the development of a new McDonald's restaurant has not resulted in an increased consumption of McDonald's products. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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

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

[Smoking ban in restaurants and respiratory symptoms among employees].

PubMed

Skogstad, Marit; Kjærheim, Kristina; Fladseth, Geir; Molander, Pål

2011-11-01

Along with the introduction of a smoking ban in restaurants in 2004, respiratory symptoms, urinary cotinine and lung function among employees in 13 different bars and restaurants were studied before and after the ban came into force. At the same time measurements of air quality were taken at the respective restaurants and bars. The purpose of this study was to compare self-respiratory symptoms before and after the smoking ban among the staff at the establishments. The study included 93 men and women. These were followed during a work-shift before the smoking ban and three to eight months later. Initially 86 of the participants answered a questionnaire about respiratory tract symptoms , while 67 did so at follow-up. Before the ban 39 of the subjects (45.3%) reported wheezing in the chest and 28 (32.6%) said they had recently had an upper respiratory tract infection. 43.3% of the participants reported fewer symptoms and 20.9% more symptoms after the ban, while 35.8% reported no change. The corresponding figures among smokers were 47.5%, 15.0% and 37.5%. This study shows that the introduction of a smoking ban in restaurants contributes to a reduction in reported respiratory symptoms among employees, and may therefore be advantageous for the health of this group.

Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study.

PubMed

Duffey, Kiyah J; Gordon-Larsen, Penny; Jacobs, David R; Williams, O Dale; Popkin, Barry M

2007-01-01

Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Similarly, higher consumption of fast food at year 7 was associated with a 0.16-unit higher BMI at year 10. After adjustment for baseline away-from-home eating, increased consumption of fast food only (beta: 0.20; 95% CI: 0.01, 0.39) and of both restaurant food and fast food (beta: 0.29; 95% CI: 0.06, 0.51) were positively associated with BMI change, though the estimates were not significantly different (P = 0.47). Increased consumption of restaurant food only was unrelated to BMI change (beta: -0.01; 95% CI: -0.21, 0.19), which differed significantly (P = 0.014) from the estimate for an increase in both restaurant food and fast food intake. We found differential effects of restaurant food and fast food intakes on BMI, although the observed differences were not always statistically significant. More research is needed to determine whether the differential effects are related to consumer characteristics or the food itself.

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.

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.

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...

Factors associated with worker slipping in limited-service restaurants.

PubMed

Courtney, Theodore K; Verma, Santosh K; Huang, Yueng-Hsiang; Chang, Wen-Ruey; Li, Kai Way; Filiaggi, Alfred J

2010-02-01

Slips, trips and falls (STF) are responsible for a substantial injury burden in the global workplace. Restaurant environments are challenged by STF. This study assessed individual and work environment factors related to slipping in US limited-service restaurant workers. Workers in 10 limited-service restaurants in Massachusetts were recruited to participate. Workers' occupational slip and/or fall history within the past 4 weeks was collected by multilingual written questionnaires. Age, gender, job tenure, work hours per week and work shift were also collected. Shoe type, condition and gross shoe contamination were visually assessed. Floor friction was measured and each restaurant's overall mean coefficient of friction (COF) was calculated. The logistic generalised estimating equations model was used to compute adjusted odds ratios (OR). Of 125 workers, 42 reported one or more slips in the past 4 weeks with two reporting a resultant fall. Results from multivariable regression showed that higher restaurant mean COF was significantly associated with a decreased risk of self-reported slipping (OR 0.59, 95% CI 0.42 to 0.82). From the highest to the lowest COF restaurant, the odds of a positive slip history increased by a factor of more than seven. Younger age, male gender, lower weekly work hours and the presence of gross contamination on worker's shoe sole were also associated with increased odds of slip history. Published findings of an association between friction and slipping and falling in actual work environments are rare. The findings suggest that effective intervention strategies to reduce the risk of slips and falls in restaurant workers could include increasing COF and improving housekeeping practices.

Compliance with smoke-free policies in Korean bars and restaurants: A descriptive analysis in California

PubMed Central

Irvin, Veronica L.; Hofstetter, C. Richard; Nichols, Jeanne F.; Chambers, Christina D.; Usita, Paula M.; Norman, Gregory J.; Kang, Sunny; Hovell, Melbourne F.

2015-01-01

Objective Compliance with California's smoke-free restaurant and bar policies may be more a function of social contingencies and less a function of legal contingencies. The aims of this study are: 1) to report indications of compliance with smoke-free legislation in Korean bars and restaurants in California; 2) to examine the demographic, smoking status, and acculturation factors of who smoked indoors; and 3) to report social cues in opposition to smoking among a sample of Koreans in California. Method Data were collected by telephone surveys administered by bilingual interviewers between 2007– 2009, and included California adults of Korean descent who visited a Korean bar or restaurant in a typical month (N=2,173, 55% female). Results 1% of restaurant-going participants smoked inside while 7% observed someone else smoke inside a Korean restaurant. 23% of bar-going participants smoked inside and 65% observed someone else smoke inside a Korean bar. Presence of ashtrays was related to indoor smoking in bars and restaurants. Among participants who observed smoking, a higher percentage observed someone ask a smoker to stop (17.6%) or gesture to a smoker (27.0%) inside Korean restaurants (N=169) than inside Korean bars (n=141, 17.0% observed verbal cue and 22.7% observed gesture). Participants who smoked inside were significantly younger and more acculturated than participants who did not. Less acculturated participants were significantly more to likely to be told to stop smoking. Conclusions Ten years after implementation of ordinances, smoking was common in Korean bars in California. PMID:25735336

Compliance with smoke-free policies in korean bars and restaurants in california: a descriptive analysis.

PubMed

Irvin, Veronica L; Hofstetter, C Richard; Nichols, Jeanne F; Chambers, Christina D; Usita, Paula M; Norman, Gregory J; Kang, Sunny; Hovell, Melbourne F

2015-01-01

Compliance with California's smoke-free restaurant and bar policies may be more a function of social contingencies and less a function of legal contingencies. The aims of this study were: 1) to report indications of compliance with smoke-free legislation in Korean bars and restaurants in California; 2) to examine the demographic, smoking status, and acculturation factors of who smoked indoors; and 3) to report social cues in opposition to smoking among a sample of Koreans in California. Data were collected by telephone surveys administered by bilingual interviewers between 2007-2009, and included California adults of Korean descent who visited a Korean bar or restaurant in a typical month (N=2,173, 55% female). 1% of restaurant-going participants smoked inside while 7% observed someone else smoke inside a Korean restaurant. Some 23% of bar-going participants smoked inside and 65% observed someone else smoke inside a Korean bar. Presence of ashtrays was related to indoor smoking in bars and restaurants. Among participants who observed smoking, a higher percentage observed someone ask a smoker to stop (17.6%) or gesture to a smoker (27.0%) inside Korean restaurants (N=169) than inside Korean bars (n=141, 17.0% observed verbal cue and 22.7% observed gesture). Participants who smoked inside were significantly younger and more acculturated than participants who did not. Less acculturated participants were significantly more to likely to be told to stop smoking. Ten years after implementation of ordinances, smoking appears to be common in Korean bars in California.

Noise exposure and hearing impairment among Chinese restaurant workers and entertainment employees in Hong Kong.

PubMed

Lao, Xiang Qian; Yu, Ignatius Tak Sun; Au, Dennis Kin Kwok; Chiu, Yuk Lan; Wong, Claudie Chiu Yi; Wong, Tze Wai

2013-01-01

Noise-induced hearing loss (NIHL) is a major concern in the non-manufacturing industries. This study aimed to investigate the occupational noise exposure and the NIHL among Chinese restaurant workers and entertainment employees working in the service industry in Hong Kong. This cross-sectional survey involved a total of 1,670 participants. Among them, 937 were randomly selected from the workers of Chinese restaurants and 733 were selected from workers in three entertainment sectors: radio and television stations; cultural performance halls or auditoria of the Leisure and Cultural Services Department (LCSD); and karaoke bars. Noise exposure levels were measured in the sampled restaurants and entertainment sectors. Each participant received an audiometric screening test. Those who were found to have abnormalities were required to take another diagnostic test in the health center. The "Klockhoff digit" method was used to classify NIHL in the present study. The main source of noise inside restaurants was the stoves. The mean hearing thresholds showed a typical dip at 3 to 6 KHz and a substantial proportion (23.7%) of the workers fulfilled the criteria for presumptive NIHL. For entertainment sectors, employees in radio and television stations generally had higher exposure levels than those in the halls or auditoria of the LCSD and karaoke bars. The mean hearing thresholds showed a typical dip at 6 KHz and a substantial proportion of the employees fulfilled the criteria for presumptive NIHL (38.6%, 95%CI: 35.1-42.1%). Being male, older, and having longer service and daily alcohol consumption were associated with noise-induced hearing impairment both in restaurant workers and entertainment employees. Excessive noise exposure is common in the Chinese restaurant and entertainment industries and a substantial proportion of restaurant workers and entertainment employees suffer from NIHL. Comprehensive hearing conservation programs should be introduced to the service industry in Hong Kong.

Noise Exposure and Hearing Impairment among Chinese Restaurant Workers and Entertainment Employees in Hong Kong

PubMed Central

Lao, Xiang Qian; Yu, Ignatius Tak Sun; Au, Dennis Kin Kwok; Chiu, Yuk Lan; Wong, Claudie Chiu Yi; Wong, Tze Wai

2013-01-01

Background Noise-induced hearing loss (NIHL) is a major concern in the non-manufacturing industries. This study aimed to investigate the occupational noise exposure and the NIHL among Chinese restaurant workers and entertainment employees working in the service industry in Hong Kong. Methods This cross-sectional survey involved a total of 1,670 participants. Among them, 937 were randomly selected from the workers of Chinese restaurants and 733 were selected from workers in three entertainment sectors: radio and television stations; cultural performance halls or auditoria of the Leisure and Cultural Services Department (LCSD); and karaoke bars. Noise exposure levels were measured in the sampled restaurants and entertainment sectors. Each participant received an audiometric screening test. Those who were found to have abnormalities were required to take another diagnostic test in the health center. The “Klockhoff digit” method was used to classify NIHL in the present study. Results The main source of noise inside restaurants was the stoves. The mean hearing thresholds showed a typical dip at 3 to 6 KHz and a substantial proportion (23.7%) of the workers fulfilled the criteria for presumptive NIHL. For entertainment sectors, employees in radio and television stations generally had higher exposure levels than those in the halls or auditoria of the LCSD and karaoke bars. The mean hearing thresholds showed a typical dip at 6 KHz and a substantial proportion of the employees fulfilled the criteria for presumptive NIHL (38.6%, 95%CI: 35.1–42.1%). Being male, older, and having longer service and daily alcohol consumption were associated with noise-induced hearing impairment both in restaurant workers and entertainment employees. Conclusion Excessive noise exposure is common in the Chinese restaurant and entertainment industries and a substantial proportion of restaurant workers and entertainment employees suffer from NIHL. Comprehensive hearing conservation programs should be introduced to the service industry in Hong Kong. PMID:23976950

An Assessment of Health Risks and Mortality from Exposure to Secondhand Smoke in Chinese Restaurants and Bars

PubMed Central

Liu, Ruiling; Jiang, Yuan; Li, Qiang; Hammond, S. Katharine

2014-01-01

Introduction Smoking is generally not regulated in restaurants or bars in China, or the restrictions are not fully implemented if there are any, while the related hazard health effects are not recognized by the majority of the Chinese population. Objectives This study aims to assess the excess health risks and mortality attributed to secondhand smoke (SHS) exposure in restaurants and bars for both servers and patrons to provide necessary evidence for advancing tobacco control in this microenvironment. Methods Two approaches were used for the assessment. One is a continuous approach based on existing field measurements and Repace and Lowrey’s dose-response model, and the other is a categorical approach based on exposure or not and epidemiological studies. Results Based on the continuous approach, servers were estimated to have a lifetime excess risk (LER) of lung cancer death (LCD) of 730 to 1,831×10−6 for working five days a week for 45 years in smoking restaurants and 1,862 to 8,136×10−6 in smoking bars, and patrons could have a LER of LCD of 47 to 117×10−6 due to visiting smoking restaurants for an average of 13 minutes a day for 60 years, and 119 to 522×10−6 due to visiting smoking bars. The categorical approach estimated that SHS exposure in restaurants and bars alone caused 84 LCD and 57 ischemic heart disease (IHD) deaths among nonsmoking servers and 1,2419 LCDs and 1,689 IHD deaths among the nonsmoking patron population. Conclusions SHS exposure in restaurants and bars alone can impose high lifetime excess risks of lung cancer death and ischemic heart disease deaths to both servers and patrons, and can cause a significant number of deaths each year in China. These health risks and deaths can be prevented by banning smoking in restaurants and bars and effectively implementing these smoking bans. PMID:24416289

Long term compliance with California's Smoke-Free Workplace Law among bars and restaurants in Los Angeles County

PubMed Central

Weber, M; Bagwell, D; Fielding, J; Glantz, S

2003-01-01

Objective: To assess long term compliance with the California Smoke-Free Workplace Law in Los Angeles County freestanding bars and bar/restaurants. Design: Population based annual site inspection survey of a random sample of Los Angeles County freestanding bars and bar/restaurants was conducted from 1998 to 2002. Main outcome measures: The primary outcomes of interest were patron and employee smoking. The secondary outcomes of interest were the presence of ashtrays and designated outdoor smoking areas. Results: Significant increases in patron non-smoking compliance were found for freestanding bars (45.7% to 75.8%, p < 0.0001) and bar/restaurants (92.2% to 98.5%, p < 0.0001) between 1998 and 2002. Increases in employee non-smoking compliance were found for freestanding bars (86.2% to 94.7%, p < 0.0003) and bar/restaurants (96.5% to 99.2%, p < 0.005). Conclusions: This study provides clear evidence that the California Smoke-Free Workplace Law has been effective at reducing patron and employee smoking in Los Angeles County bars and restaurants. Recommendations include educational campaigns targeted to freestanding bar owners and staff to counter perceptions of lost revenue, more rigorous enforcement, and more severe penalties for repeat violators such as alcohol licence revocation. Policymakers can enact smoke-free restaurant and bar policies to protect employees and patrons from secondhand smoke, confident that these laws can be successfully implemented. PMID:12958386

Investigation of Salmonella Enteritidis Outbreak Associated with Truffle Oil - District of Columbia, 2015.

PubMed

Kuramoto-Crawford, S Janet; McGee, Sasha; Li, Keith; Hennenfent, Andrew K; Dassie, Kossia; Carney, Jhetari T; Gibson, Arian; Cooper, Ivory; Blaylock, Morris; Blackwell, Reginald; Fields, Angela; Davies-Cole, John

2017-03-17

On September 8, 2015, the District of Columbia Department of Health (DCDOH) received a call from a person who reported experiencing gastrointestinal illness after eating at a District of Columbia (DC) restaurant with multiple locations throughout the United States (restaurant A). Later the same day, a local emergency department notified DCDOH to report four persons with gastrointestinal illness, all of whom had eaten at restaurant A during August 30-September 5. Two patients had laboratory-confirmed Salmonella group D by stool culture. On the evening of September 9, a local newspaper article highlighted a possible outbreak associated with restaurant A. Investigation of the outbreak by DCDOH identified 159 patrons who were residents of 11 states and DC with gastrointestinal illness after eating at restaurant A during July 1-September 10. A case-control study was conducted, which suggested truffle oil-containing food items as a possible source of Salmonella enterica serotype Enteritidis infection. Although several violations were noted during the restaurant inspections, the environmental, laboratory, and traceback investigations did not confirm the contamination source. Because of concern about the outbreak, the restaurant's license was suspended during September 10-15. The collaboration and cooperation of the public, media, health care providers, and local, state, and federal public health officials facilitated recognition of this outbreak involving a pathogen commonly implicated in foodborne illness.

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.

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.

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.

Baseline knowledge survey of restaurant food handlers in suburban Chicago: do restaurant food handlers know what they need to know to keep consumers safe?

PubMed

Manes, Mindi R; Liu, Li C; Dworkin, Mark S

2013-01-01

In the U.S., foodborne disease causes millions of illnesses annually, resulting in thousands of deaths. To reduce food poisoning, restaurant food handlers need accurate knowledge of food safety principles as a starting point for the outcome of optimal food safety behavior. The study described in this article determined food safety knowledge gaps among suburban Chicago restaurant food handlers. A cross-sectional survey of 729 food handlers at 211 suburban Chicago restaurants was conducted from June 2009 through February 2010. A 50-question survey was administered by a trained interviewer in either English or Spanish. Mixed-effects regression analysis identified risk factors associated with an overall food safety knowledge score. The mean overall knowledge score was only 72% and substantial knowledge gaps related to cross contamination, cooking, and holding and storage of food were identified. Spanish-speaking food handlers scored significantly lower than English-speaking food handlers (p < .05). Although certified food managers scored significantly higher than noncertified food handlers, their score was only 79%. These data provide targets for educational interventions to remedy knowledge gaps in food handlers in order to prevent food poisoning from restaurants.

Generation and collection of restaurant waste: Characterization and evaluation at a case study in Italy.

PubMed

Tatàno, Fabio; Caramiello, Cristina; Paolini, Tonino; Tripolone, Luca

2017-03-01

Because restaurants (as a division of the hospitality sector) contribute to the generation of commercial and institutional waste, thus representing both a challenge and an opportunity, the objective of the present study was to deepen the knowledge of restaurant waste in terms of the qualitative and quantitative characteristics of waste generation and the performance achievable by the implementation of a separate collection scheme. In this study, the generated waste was characterized and the implemented separate collection was evaluated at a relevant case study restaurant in a coastal tourist area of Central Italy (Marche Region, Adriatic Sea side). The qualitative (compositional) characterization of the generated total restaurant waste showed considerable incidences of, in decreasing order, food (28.2%), glass (22.6%), paper/cardboard (19.1%), and plastic (17.1%). The quantitative (parametric) characterization of the generated restaurant waste determined the unit generation values of total waste and individual fractions based on the traditional employee and area parameters and the peculiar meal parameter. In particular, the obtained representative values per meal were: 0.72kgmeal -1 for total waste, and ranging, for individual fractions, from 0.20 (for food) to 0.008kgmeal -1 (for textile). Based on the critical evaluation of some of the resulting unit waste generation values, possible influences of restaurant practices, conditions, or characteristics were pointed out. In particular, food waste generation per meal can likely be limited by: promoting and using local, fresh, and quality food; standardizing and limiting daily menu items; basing food recipes on consolidated cooking knowledge and experience; and limiting plate sizes. The evaluation of the monthly variation of the monitored separate collection, ranging from an higher level of 52.7% to a lower level of 41.4%, indicated the following: a reduction in the separate collection level can be expected at times of high working pressure or the closing of a seasonal business (typical for restaurants in tourist areas); and the monthly variation of the separate collection level is inversely correlated with that of the unit generation of total waste per meal. The interception rates of the different restaurant waste fractions collected separately presented a ranking order (i.e., 96.0% for glass, 67.7% for paper/cardboard, 34.4% for food, 20.6% for metal, and 17.9% for plastic) similar to the order of efficiencies achievable at both small and large urban levels. Finally, the original concept of the customer equivalent person (P ce ) was introduced and behaviorally evaluated at the case study restaurant, providing the values of 0.42 and 0.39kgP ce -1 day -1 for the food waste generation and the landfilling of biodegradable waste by the customer equivalent person, respectively. These values were compared, respectively, with the food waste generation per person at the household level and the landfilling of biodegradable waste per inhabitant at the territorial level. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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.

Comparison of Children's Menu Items at Full- and Quick-Service Restaurants.

PubMed

Eissa, Mona A; Hearne, Katherine; Saavedra, Nora

2018-04-01

The proportion of food consumed by children from restaurants tripled during the last 4 decades and that coincided with the increased rate of obesity. Despite the presence of data linking quick-service (QS) food consumption to poor diet quality, studies comparing the nutrition content of the children's menu items at QS restaurants (QSRs) with those at full-service restaurants (FSRs) are limited. The objectives of this study were to examine the nutrition content of common children's menu items at both QSRs and FSRs and compare these data with recommendations reported by the Dietary Guidelines for Americans 2015-2020, Eighth Edition . Using the 2014 data of the MenuStat project, 10 food items that are on both QSR and FSR children's menus were selected. Data from each restaurant category were aggregated and the overall average of the nutritional content of each individual food item was calculated and compared between the two restaurant categories. The average of calories, fat, carbohydrates, and added sugar of most items on the children's menu of QSRs are lower than those of FSRs. Also, most food items on children's menus of FSRs, and to a lesser extent those of QSRs, exceeded the national recommended calories and fat content per meal. Although some children's menu items of QSRs have less fat and fewer calories compared with those of FSRs, most menu items in both FSRs and QSRs do not meet national dietary recommendations. Healthcare professionals may expand discussions with patients to include both restaurant categories when counseling them and their families on obesity prevention. Also, educating children and families about reading the nutritional content information of children's menu items when eating out to make an informed choice can be a tool in fighting childhood obesity.

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.

Association between neighborhood need and spatial access to food stores and fast food restaurants in neighborhoods of Colonias

PubMed Central

Sharkey, Joseph R; Horel, Scott; Han, Daikwon; Huber, John C

2009-01-01

Objective To determine the extent to which neighborhood needs (socioeconomic deprivation and vehicle availability) are associated with two criteria of food environment access: 1) distance to the nearest food store and fast food restaurant and 2) coverage (number) of food stores and fast food restaurants within a specified network distance of neighborhood areas of colonias, using ground-truthed methods. Methods Data included locational points for 315 food stores and 204 fast food restaurants, and neighborhood characteristics from the 2000 U.S. Census for the 197 census block group (CBG) study area. Neighborhood deprivation and vehicle availability were calculated for each CBG. Minimum distance was determined by calculating network distance from the population-weighted center of each CBG to the nearest supercenter, supermarket, grocery, convenience store, dollar store, mass merchandiser, and fast food restaurant. Coverage was determined by calculating the number of each type of food store and fast food restaurant within a network distance of 1, 3, and 5 miles of each population-weighted CBG center. Neighborhood need and access were examined using Spearman ranked correlations, spatial autocorrelation, and multivariate regression models that adjusted for population density. Results Overall, neighborhoods had best access to convenience stores, fast food restaurants, and dollar stores. After adjusting for population density, residents in neighborhoods with increased deprivation had to travel a significantly greater distance to the nearest supercenter or supermarket, grocery store, mass merchandiser, dollar store, and pharmacy for food items. The results were quite different for association of need with the number of stores within 1 mile. Deprivation was only associated with fast food restaurants; greater deprivation was associated with fewer fast food restaurants within 1 mile. CBG with greater lack of vehicle availability had slightly better access to more supercenters or supermarkets, grocery stores, or fast food restaurants. Increasing deprivation was associated with decreasing numbers of grocery stores, mass merchandisers, dollar stores, and fast food restaurants within 3 miles. Conclusion It is important to understand not only the distance that people must travel to the nearest store to make a purchase, but also how many shopping opportunities they have in order to compare price, quality, and selection. Future research should examine how spatial access to the food environment influences the utilization of food stores and fast food restaurants, and the strategies used by low-income families to obtain food for the household. PMID:19220879

Listening to Chinese Immigrant Restaurant Workers in the Midwest: Application of the Culture-Centered Approach (CCA) to Explore Perceptions of Health and Health Care.

PubMed

Gao, Haijuan; Dutta, Mohan; Okoror, Titilayo

2016-01-01

This study engages with the culture-centered approach (CCA) to explore Chinese immigrant restaurant workers' perception of the U.S. health care system and their interactions with the health care system in interpreting meanings of health. Chinese restaurant workers are marginalized because of their struggles on the job, their immigrant identity, and their negotiations with the structural contexts of occupation, migration status, and culture. In-depth interviews were conducted with 18 Chinese immigrant restaurant workers that lasted an average of 1.5 hours each, and were audiotaped. Interviews with participants highlighted critical issues in access to health care and the struggles experienced by restaurant workers in securing access to health, understood in the context of work. Critical to the workers' discourse is the acknowledgment of structural constraints such as lack of insurance coverage, immigration status, and lack of understanding of how the U.S. health care system works.

Statistics of the Kolkata Paise Restaurant problem

NASA Astrophysics Data System (ADS)

Ghosh, Asim; Chatterjee, Arnab; Mitra, Manipushpak; Chakrabarti, Bikas K.

2010-07-01

We study the dynamics of a few stochastic learning strategies for the 'Kolkata Paise Restaurant' problem, where N agents choose among N equally priced but differently ranked restaurants every evening, such that each agent tries to get dinner in the best restaurant (with each restaurant serving only one customer and the rest of the customers arriving there going without dinner that evening). We consider the learning strategies to be similar for all the agents, and assume that each follows the same probabilistic or stochastic strategy dependent on information about past successes in the game. We show that some 'naive' strategies lead to much better utilization of services than some relatively 'smarter' strategies. We also show that a service utilization fraction as high as 0.80 can result for a stochastic strategy, where each agent sticks to his past choice (independent of success achieved or not, with probability decreasing inversely in the past crowd size). The numerical results for the utilization fraction of the services in some limiting cases are analytically examined.

A large community outbreak of salmonellosis caused by intentional contamination of restaurant salad bars.

PubMed

Török, T J; Tauxe, R V; Wise, R P; Livengood, J R; Sokolow, R; Mauvais, S; Birkness, K A; Skeels, M R; Horan, J M; Foster, L R

1997-08-06

This large outbreak of foodborne disease highlights the challenge of investigating outbreaks caused by intentional contamination and demonstrates the vulnerability of self-service foods to intentional contamination. To investigate a large community outbreak of Salmonella Typhimurium infections. Epidemiologic investigation of patients with Salmonella gastroenteritis and possible exposures in The Dalles, Oregon. Cohort and case-control investigations were conducted among groups of restaurant patrons and employees to identify exposures associated with illness. A community in Oregon. Outbreak period was September and October 1984. A total of 751 persons with Salmonella gastroenteritis associated with eating or working at area restaurants. Most patients were identified through passive surveillance; active surveillance was conducted for selected groups. A case was defined either by clinical criteria or by a stool culture yielding S Typhimurium. The outbreak occurred in 2 waves, September 9 through 18 and September 19 through October 10. Most cases were associated with 10 restaurants, and epidemiologic studies of customers at 4 restaurants and of employees at all 10 restaurants implicated eating from salad bars as the major risk factor for infection. Eight (80%) of 10 affected restaurants compared with only 3 (11%) of the 28 other restaurants in The Dalles operated salad bars (relative risk, 7.5; 95% confidence interval, 2.4-22.7; P<.001). The implicated food items on the salad bars differed from one restaurant to another. The investigation did not identify any water supply, food item, supplier, or distributor common to all affected restaurants, nor were employees exposed to any single common source. In some instances, infected employees may have contributed to the spread of illness by inadvertently contaminating foods. However, no evidence was found linking ill employees to initiation of the outbreak. Errors in food rotation and inadequate refrigeration on ice-chilled salad bars may have facilitated growth of the S Typhimurium but could not have caused the outbreak. A subsequent criminal investigation revealed that members of a religious commune had deliberately contaminated the salad bars. An S Typhimurium strain found in a laboratory at the commune was indistinguishable from the outbreak strain. This outbreak of salmonellosis was caused by intentional contamination of restaurant salad bars by members of a religious commune.

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

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.

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

Knowledge, perceptions, and behaviors related to salt use among Philadelphia Chinese take-out restaurant owners and chefs.

PubMed

Ma, Grace X; Shive, Steve; Zhang, Yolanda; Aquilante, Jennifer; Tan, Yin; Zhao, Mei; Solomon, Sara; Zhu, Steven; Toubbeh, Jamil; Colby, Lisa; Mallya, Giridhar; Zeng, Qiaoling

2014-09-01

Most of the sodium Americans consume comes from processed and restaurant foods. An upstream global strategy to promote health is to work with local restaurants to reduce sodium content in their food offerings, while accounting for food taste and economic considerations. In urban communities, Chinese take-out restaurants serve meals with large amounts of sodium and are clustered in low-income, racial/ethnic minority communities with a high prevalence of hypertension. The objective of this study is to assess baseline knowledge, attitudes, and behaviors related to sodium use/consumption among Chinese take-out owners and chefs recruited to participate in the Philadelphia Healthy Chinese Take-Out Initiative. A cross-sectional study of 221 Chinese take-out restaurants was conducted from August 2012 to February 2013. Items measured knowledge, attitudes, and behaviors related to salt use, salt consumption, and health. Most owners/chefs knew that excess sodium consumption contributes to high blood pressure but were less aware of other health effects and of major sources of sodium in the U.S. diet. The majority were willing and able to reduce sodium content in meals if customer demand could be maintained, and they desired training in food preparation, procurement, and marketing. Findings show a need to provide education, strategies, and support to Chinese take-out owners/chefs in preparing low-salt dishes. The results of this and future studies to reduce sodium content in meals by working with restaurant owners and chefs have global health promotion implications. © 2014 Society for Public Health Education.

Exposure to secondhand smoke in Germany: air contamination due to smoking in German restaurants, bars, and other venues.

PubMed

Schneider, Sven; Seibold, Bjoern; Schunk, Susanne; Jentzsch, Elmar; Pötschke-Langer, Martina; Dresler, Carolyn; Travers, Mark J; Hyland, Andrew

2008-03-01

This study quantified exposure to secondhand smoke in German restaurants, bars, and entertainment venues by determining the concentration of respirable suspended particles measuring 2.5 microm or less (PM2.5) in indoor air. The measurements were taken using an inconspicuous device placed on the investigator's table in the venue. The concentration of particulate matter in the indoor air was measured for a minimum of 30 min. A total of 39 restaurants, 20 coffee bars, 12 bars, 9 discothèques, and 20 restaurant cars in trains were visited throughout Germany from September 30 to October 31, 2005. The readings disclosed a median PM2.5 of 260 microg/m3 and an arithmetic mean PM2.5 of 333 microg/m3. Median values were 378 microg/m3 in bars, 131 microg/m3 in cafes, and 173 microg/m3 in restaurants. The highest medians were measured in discothèques and restaurant cars, with values averaging 432 microg/m3 and 525 microg/m3 PM2.5, respectively. This study was the first to show the magnitude and extent of exposure to secondhand smoke on such an extensive scale in Germany. The contaminated air due to smoking is a human carcinogenic and major health hazard, which would be prevented most effectively and completely by implementing a ban on smoking. This study is important for the ongoing national debate in Germany as well as for debates in all countries without smoke-free air legislation, which includes most countries around the world.

Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil.

PubMed

Duran, Ana Clara; Diez Roux, Ana V; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2013-09-01

Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010-2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods. © 2013 Elsevier Ltd. All rights reserved.

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.

Involuntary smoking in the restaurant workplace. A review of employee exposure and health effects.

PubMed

Siegel, M

1993-07-28

To determine the relative exposure to environmental tobacco smoke for bar and restaurant employees compared with office employees and with nonsmokers exposed in the home (part 1) and to determine whether this exposure is contributing to an elevated lung cancer risk in these employees (part 2). MEDLINE and bibliographies from identified publications. In part 1, published studies of indoor air quality were included if they reported a mean concentration of carbon monoxide, nicotine, or particulate matter from measurements taken in one or more bars, restaurants, offices, or residences with at least one smoker. In part 2, published epidemiologic studies that reported a risk estimate for lung cancer incidence or mortality in food-service workers were included if they controlled, directly or indirectly, for active smoking. In part 1, a weighted average of the mean concentration of carbon monoxide, nicotine, and respirable suspended particulates reported in studies was calculated for bars, restaurants, offices, and residences. In part 2, the relative lung cancer risk for food-service workers compared with that for the general population was examined in the six identified studies. Levels of environmental tobacco smoke in restaurants were approximately 1.6 to 2.0 times higher than in office workplaces of other businesses and 1.5 times higher than in residences with at least one smoker. Levels in bars were 3.9 to 6.1 times higher than in offices and 4.4 to 4.5 times higher than in residences. The epidemiologic evidence suggested that there may be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco smoke exposure in the workplace. Environmental tobacco smoke is a significant occupational health hazard for food-service workers. To protect these workers, smoking in bars and restaurants should be prohibited.

Enteric pathogen sampling of tourist restaurants in Bangkok, Thailand.

PubMed

Teague, Nathan S; Srijan, Apichai; Wongstitwilairoong, Boonchai; Poramathikul, Kamonporn; Champathai, Thanaporn; Ruksasiri, Supaporn; Pavlin, Julie; Mason, Carl J

2010-01-01

Travelers' diarrhea (TD) is the most prevalent disorder affecting travelers to developing countries. Thailand is considered "moderately risky" for TD acquisition, but the risk by city visited or behavior of the visitor has yet to be definitely defined. Restaurant eating is consistently associated with the acquisition of diarrhea while traveling, and pathogen-free meals serve as a marker of public health success. This study seeks to ascertain a traveler's risk of exposure to certain bacterial gastric pathogens while eating at Bangkok restaurants recommended in popular tourist guide books. A cross-sectional tourist restaurant survey was conducted. Thirty-five restaurants recommended in the two top selling Bangkok guidebooks on Amazon.com were sampled for bacterial pathogens known to cause diarrhea in Thailand, namely Salmonella, Campylobacter, and Arcobacter (a Campylobacter-like organism). A total of 70 samples from two meals at each restaurant were obtained. Suspected bacterial pathogens were isolated by differential culture and tested for antibiotic resistance. Salmonella group E was isolated from one meal (2%), and Arcobacter butzleri from nine meals (13%). Campylobacter spp. were not found. The large majority of A butzleri isolates were resistant to azithromycin but susceptible to ciprofloxacin and an aminoglycoside. A traveler's risk of exposure to established bacterial pathogens, Salmonella and Campylobacter, by eating in recommended restaurants is small. Arcobacter butzleri exposure risk is 13% per meal eaten, and rises to 75% when 10 meals are eaten. All restaurants, regardless of price, appear to be equally "risky." Current evidence points to Arcobacter being pathogenic in humans; however, further research is needed to conclusively define pathogenicity. Routine prophylaxis for diarrhea is not recommended; however, travelers should be aware of the risk and come prepared with adequate and appropriate self-treatment medications.

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

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.

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.

The weight of unfinished plate: A survey based characterization of restaurant food waste in Chinese cities.

PubMed

Wang, Ling-En; Liu, Gang; Liu, Xiaojie; Liu, Yao; Gao, Jun; Zhou, Bin; Gao, Si; Cheng, Shengkui

2017-08-01

Consumer food waste has attracted increasing public, academic, and political attention in recent years, due to its adverse resource, environmental, and socioeconomic impacts. The scales and patterns of consumer food waste, especially in developing countries, however, remain poorly understood, which may hinder the global effort of reducing food waste. In this study, based on a direct weighing method and a survey of 3557 tables in 195 restaurants in four case cities, we investigated the amount and patterns of restaurant food waste in China in 2015. Food waste per capita per meal in the four cities was 93g, consisting mainly of vegetables (29%), rice (14%), aquatic products (11%), wheat (10%), and pork (8%). This equals to approximately 11kg/cap/year and is not far from that of western countries, although per capita GDP of China is still much lower. We found also that food waste per capita per meal varies considerably by cities (Chengdu and Lhasa higher than Shanghai and Beijing), consumer groups (tourists higher than local residents), restaurant categories (more waste in larger restaurants), and purposes of meals (friends gathering and business banquet higher than working meal and private dining). Our pilot study provides a first, to our best knowledge, empirically determined scales and patterns of restaurant food waste in Chinese cities, and could help set targeted interventions and benchmark national food waste reduction targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Children's food store, restaurant, and home food environments and their relationship with body mass index: a pilot study.

PubMed

Holsten, Joanna E; Compher, Charlene W

2012-01-01

This pilot research assessed the feasibility and utility of a study designed to examine the relationship between children's BMI and food store, restaurant, and home food environments. Home visits were conducted with sixth-grade children (N = 12). BMI z-scores were calculated with weight and height measurements. Nutrition Environment Measures Surveys evaluated children's food environments. The study protocol involved a feasible time duration, minimal missing data for primary variables, and participant satisfaction. Potential design problems included the homogeneous store environments and low restaurant exposure of the sample recruited from one school, and the adequacy of a single cross-sectional measure of the home environment.

Influence of season and type of restaurants on sashimi microbiota.

PubMed

Miguéis, S; Moura, A T; Saraiva, C; Esteves, A

2016-10-01

In recent years, an increase in the consumption of Japanese food in European countries has been verified, including in Portugal. These specialities made with raw fish, typical Japanese meals, have been prepared in typical and on non-typical restaurants, and represent a challenge to risk analysis on HACCP plans. The aim of this study was to evaluate the influence of the type of restaurant, season and type of fish used on sashimi microbiota. Sashimi samples (n = 114) were directly collected from 23 sushi restaurants and were classified as Winter and Summer Samples. They were also categorized according to the type of restaurant where they were obtained: as typical or non-typical. The samples were processed using international standards procedures. A middling seasonality influence was observed in microbiota using mesophilic aerobic bacteria, psychrotrophic microorganisms, Lactic acid bacteria, Pseudomonas spp., H 2 S positive bacteria, mould and Bacillus cereus counts parameters. During the Summer Season, samples classified as unacceptable or potentially Hazardous were observed. Non-typical restaurants had the most cases of Unacceptable/potentially hazardous samples 83.33%. These unacceptable results were obtained as a result of high values of pathogenic bacteria like Listeria monocytogenes and Staphylococcus aureus No significant differences were observed on microbiota counts from different fish species. The need to implement more accurate food safety systems was quite evident, especially in the warmer season, as well as in restaurants where other kinds of food, apart from Japanese meals, was prepared. © Crown copyright 2016.

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.

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)

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

Factors influencing ordering practices at Baltimore City carryouts: qualitative research to inform an obesity prevention intervention.

PubMed

Noormohamed, Aliya; Lee, Seung Hee; Batorsky, Benjamin; Jackson, Ashley; Newman, Sara; Gittelsohn, Joel

2012-01-01

Low-income African Americans bear a disproportionately high burden of chronic diseases associated with intakes of prepared foods, including those commonly found in carryout restaurants. This study collected formative data to investigate the main factors that influence ordering practices in carryout restaurants and to identify possible intervention strategies. Twenty in-depth interviews and two focus groups were conducted. From the perspectives of carryout customers and owners, the most salient factors affecting ordering practices were habit, price, taste, and food appearance. Study recommendations include manipulating prices and adding photographs of healthy items to carryout menus to encourage healthier ordering practices in carryout restaurants.

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.

Restaurant and food shopping selections among Latino women in Southern California.

PubMed

Ayala, Guadalupe X; Mueller, Kristin; Lopez-Madurga, Eva; Campbell, Nadia R; Elder, John P

2005-01-01

This study describes and examines determinants of restaurant and food store selections in a sample of Latino women. Data were collected at the baseline home-based interview from women involved in a randomized community trial to improve dietary behaviors. The interview consisted of both a structured interview and the measurements of height, weight, and waist-to-hip ratio. Participants included 357 Latino women recruited via random-digit dial in the Southern and Central areas of San Diego County, California. Women were included if they were between 18 and 67 years of age, not currently pregnant, and Spanish-language dominant; women were excluded if a family member was on a special diet or was planning to leave the area during the study. Means and frequencies were used to describe preference for various types of restaurants and food stores based on the North American Industry Classification System (NAICS). Independent samples t tests examined differences in levels of importance for preferring fast-food vs other restaurants and supermarkets/produce markets vs other grocery stores. Logistic regression models examined correlates of preferring fast-food restaurants vs all other restaurants and preferring supermarkets/produce markets vs all other grocery stores. More women reported eating at fast-food restaurants, followed by full-service restaurants and cafeterias. Younger women, employed women, women living in higher income households, and women living in the United States for a greater number of years preferred fast food. Supermarkets; grocery stores; and discount, bulk-purchase stores were equally represented as the primary food store. Women who lived in smaller households, had a smaller measured body mass, were married, and were more acculturated to the Anglo culture were more likely to shop at supermarkets compared with women who shopped at other grocery stores. Our findings suggest specific recommendations for targeting dietary interventions for the growing Latino population that take into account differences in levels of acculturation. For example, young Latino women who more closely identify with the Anglo culture and/or who report living in the United States for a longer period of time may benefit from targeted information on healthy restaurant behavior. On the other hand, traditional Latino women may benefit from instrumental support interventions such as tours to large supermarkets.

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...

Reducing calories, fat, saturated fat, and sodium in restaurant menu items: Effects on consumer acceptance.

PubMed

Patel, Anjali A; Lopez, Nanette V; Lawless, Harry T; Njike, Valentine; Beleche, Mariana; Katz, David L

2016-12-01

To assess consumer acceptance of reductions of calories, fat, saturated fat, and sodium to current restaurant recipes. Twenty-four menu items, from six restaurant chains, were slightly modified and moderately modified by reducing targeted ingredients. Restaurant customers (n = 1,838) were recruited for a taste test and were blinded to the recipe version as well as the purpose of the study. Overall consumer acceptance was measured using a 9-point hedonic (like/dislike) scale, likelihood to purchase scale, Just-About-Right (JAR) 5-point scale, penalty analysis, and alienation analysis. Overall, modified recipes of 19 menu items were scored similar to (or better than) their respective current versions. Eleven menu items were found to be acceptable in the slightly modified recipe version, and eight menu items were found to be acceptable in the moderately modified recipe version. Acceptable ingredient modifications resulted in a reduction of up to 26% in calories and a reduction of up to 31% in sodium per serving. The majority of restaurant menu items with small reductions of calories, fat, saturated fat, and sodium were acceptable. Given the frequency of eating foods away from home, these reductions could be effective in creating dietary improvements for restaurant diners. © 2016 The Obesity Society.

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...

Factor structure of the Minnesota Satisfaction Questionnaire short form for restaurant employees.

PubMed

Hancer, Mura; George, R Thomas

2004-02-01

The factor structure of the Minnesota Satisfaction Questionnaire short form for nonsupervisory restaurant employees was explored in questions among 2000 employees of three full-service restaurant chains operating in midwestern United States. A total of 2000 surveys were distributed to hourly employees of the three chains. From the mailing, 924 surveys were returned and found useable, a 46.2% response rate. Principal factors analysis identified a four-factor structure for the employees, in contrast to the original two-factor structure, but as in other studies the structure was multifactorial.

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...

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.

Smoking status and associated factors among male Chinese restaurant workers in metropolitan Sydney.

PubMed

Jiang, Wei; Leung, Brenda; Tam, Nancy; Xu, Huilan; Gleeson, Suzanne; Wen, Li Ming

2017-03-01

Issue addressed The smoking rate among male Chinese migrants in Australia is higher than among the general population. This study investigated the smoking rate of male Chinese restaurant workers in metropolitan Sydney, and explored factors associated with smoking and quitting. Methods A self-administered questionnaire survey was completed by Chinese workers in selected Chinese restaurants in metropolitan Sydney from October-December 2012. Eighty-nine Chinese restaurants were approached and 54 (61%) took part in the study. The questionnaire asked participants about their smoking status, knowledge of and attitudes to smoking and quitting as well as socio-demographic information. Multivariable logistic regression was built to assess the associated factors. Results Of the 382 participants who completed the survey, 171 (45%) were current smokers and 50% of current smokers wanted to quit smoking. Participants who spoke Mandarin, had lower English proficiency, did not realise environmental smoke harms children, did not prefer a smoke-free environment or had more than 50% of relatives or friends who smoked were more likely to be current smokers. Participants who were aged 18-29 years, did not understand the benefits of quitting smoking or did not prefer a smoke-free environment were less likely to want to quit. Conclusions Nearly 50% of male Chinese restaurant workers surveyed in this study were current smokers. Key factors associated with the participants' smoking or quitting status are: aged 18-29 years; speaking Mandarin; lower English literacy; and not knowing the dangers of smoking. So what? Tobacco control programs targetted at male Chinese restaurant workers that raise awareness of the harm caused by smoking and the benefits of quitting smoking are required to enhance intention to quit smoking within this population.

Evaluation of a smoke-free law on indoor air quality and on workers' health in Portuguese restaurants.

PubMed

Madureira, Joana; Mendes, Ana; Teixeira, João Paulo

2014-01-01

Workplace bans on smoking are interventions to reduce exposure to secondhand smoke (SHS) to try to prevent harmful health effects. The Portuguese Government on January 1, 2008, introduced the first national law banning smoking in public workplaces, including restaurants. The main aim of this study was to examine the impact of this law on indoor air quality (IAQ) in restaurants and on the respiratory and sensory health of restaurant workers. Concentrations of respirable suspended particulate matter (RSP), total volatile organic compounds (TVOC), carbon monoxide (CO), and carbon dioxide (CO2) in 10 restaurants were measured and compared before and after the ban. Benzene (C6H6) concentrations were also measured in all restaurants. Fifty-two and twenty-eight restaurant workers, respectively, answered questionnaires on exposure to SHS, and respiratory and sensory symptoms in the pre- and post-ban phases. There was a statistically significant decrease in RSP, CO, TVOC, and C6H6 concentrations after the ban. Additionally, in both phases the monitored CO2 concentrations greatly exceeded 1800 mg x m(-3), suggesting inefficient ventilation of the indoor spaces. Between pre- and post-ban phases a significant reduction in self-reported workplace SHS exposure was also observed after the enforcement of the law, as well as a significant marked reduction in dry, itching, irritated, or watery eyes, nasal problems, sore or dry throat, cough, wheeze, and headache. This study provides, in a single investigation, comparison of IAQ and respiratory health in Portugal before and after the introduction of the smoke-free law, the first data reported in the literature to our knowledge. Our findings suggest that a total workplace smoking ban results in a significant reduction in indoor air pollution and an improvement in the respiratory health of restaurant workers. These observations may have implications for policymakers and legislators currently considering the nature and extent of their smoke-free workplace legislation and could provide a useful contribution to the implementation of public health prevention programs.

Food-service establishment wastewater characterization.

PubMed

Lesikar, B J; Garza, O A; Persyn, R A; Kenimer, A L; Anderson, M T

2006-08-01

Food-service establishments that use on-site wastewater treatment systems are experiencing pretreatment system and/or drain field hydraulic and/or organic overloading. This study included characterization of four wastewater parameters (five-day biochemical oxygen demand [BOD5]; total suspended solids [TSS]; food, oil, and grease [FOG]; and flow) from 28 restaurants located in Texas during June, July, and August 2002. The field sampling methodology included taking a grab sample from each restaurant for 6 consecutive days at approximately the same time each day, followed by a 2-week break, and then sampling again for another 6 consecutive days, for a total of 12 samples per restaurant and 336 total observations. The analysis indicates higher organic (BOD5) and hydraulic values for restaurants than those typically found in the literature. The design values for this study for BOD5, TSS, FOG, and flow were 1523, 664, and 197 mg/L, and 96 L/day-seat respectively, which captured over 80% of the data collected.

Effect of antibiotics on the prevalence of enterotoxigenic Escherichia coli in two populations in the Philippines.

PubMed Central

Echeverria, P; Mejia, P A; Duangmani, C

1981-01-01

Hostesses and restaurant employees in the Philippines were studied to determine whether an increased use of antibiotics was associated with a higher point prevalence of enterotoxigenic Escherichia coli. Of 1,030 hostesses and 628 restaurant employees, 28 and 4%, respectively, said that they had taken antibiotics within a week of being cultured (P less than 0.001). Of hostesses and restaurant employees, 10% (103 of 1,030) and 2% (14 of 628), respectively, had antibiotics detectable in their urine (P less than 0.001). Enterotoxigenic E. coli strains were isolated from 1.2% (12 of 1,030) of hostesses and 1.7% (11 of 628) of restaurant employees. In both populations, enterotoxigenic E. coli strains were never found in subjects who had antibacterial activity in their urine. Although resistance to two or more antibiotics was found more frequently in E. coli isolated from hostesses than in that isolated from restaurant workers (48 versus 33%; P less than 0.01), antibiotic selective pressure did not increase the prevalence of enterotoxigenic E. coli in these two populations. PMID:6751218

Effect of antibiotics on the prevalence of enterotoxigenic Escherichia coli in two populations in the Philippines.

PubMed

Echeverria, P; Mejia, P A; Duangmani, C

1981-02-01

Hostesses and restaurant employees in the Philippines were studied to determine whether an increased use of antibiotics was associated with a higher point prevalence of enterotoxigenic Escherichia coli. Of 1,030 hostesses and 628 restaurant employees, 28 and 4%, respectively, said that they had taken antibiotics within a week of being cultured (P less than 0.001). Of hostesses and restaurant employees, 10% (103 of 1,030) and 2% (14 of 628), respectively, had antibiotics detectable in their urine (P less than 0.001). Enterotoxigenic E. coli strains were isolated from 1.2% (12 of 1,030) of hostesses and 1.7% (11 of 628) of restaurant employees. In both populations, enterotoxigenic E. coli strains were never found in subjects who had antibacterial activity in their urine. Although resistance to two or more antibiotics was found more frequently in E. coli isolated from hostesses than in that isolated from restaurant workers (48 versus 33%; P less than 0.01), antibiotic selective pressure did not increase the prevalence of enterotoxigenic E. coli in these two populations.

Restaurant-associated outbreak of Salmonella typhi in Nauru: an epidemiological and cost analysis.

PubMed Central

Olsen, S. J.; Kafoa, B.; Win, N. S.; Jose, M.; Bibb, W.; Luby, S.; Waidubu, G.; O'Leary, M.; Mintz, E.

2001-01-01

Typhoid fever is endemic in the South Pacific. We investigated an outbreak in Nauru. Through interviews and medical records, we identified 50 persons with onset between 1 October 1998 and 10 May 1999, of fever lasting > or = 3 days and one other symptom. Salmonella Typhi was isolated from 19 (38%) cases. Thirty-two (64%) patients were school-aged children, and 17 (34%) were in four households. Case-control studies of (a) culture-confirmed cases and age- and neighbourhood-matched controls; and (b) household index cases and randomly selected age-matched controls implicated two restaurants: Restaurant M (matched OR [MOR] = 11, 95% confidence interval [CI] = 1.3-96) and Restaurant I (MOR = 5.8, 95% CI = 1.2-29). Food-handlers at both restaurants had elevated anti-Vi antibody titres indicative of carrier state. The annual incidence was 5.0/1000 persons. Outbreak-associated costs were $46,000. Routine or emergency immunization campaigns targeting school-aged children may help prevent or control outbreaks of typhoid fever in endemic disease areas. PMID:11811872

The Influence of U.S. Chain Restaurant Food Consumption and Obesity in China and South Korea: An Ecological Perspective of Food Consumption, Self-Efficacy in Weight Management, Willingness to Communicate About Weight/Diet, and Depression.

PubMed

Wright, Kevin B; Mazzone, Raphael; Oh, Hyun; Du, Joshua; Smithson, Anne-Bennett; Ryan, Diane; MacNeil, David; Tong, Xing; Stiller, Carol

2016-11-01

This study examined the impact of U.S. chain restaurant food consumption in China and South Korea from an ecological perspective. Specifically, it explored the relationships among several environmental and individual variables that have been found to affect obesity/weight management in previous research, including the prevalence/popularity of U.S. chain restaurants in these countries, frequency of U.S. chain restaurant food consumption, self-efficacy in weight management, willingness to communicate about weight/diet, self-perceptions of weight/obesity stigma, body mass index (BMI), and depression. The results indicated that willingness to communicate about weight/diet predicted increased self-efficacy in weight management. Higher BMI scores were found to predict increased weight/obesity stigma, and increased frequency of U.S. restaurant food consumption, weight/obesity stigma, and reduced self-efficacy in weight management were found to predict increased levels of depression. The theoretical and practical implications of the findings are discussed, along with limitations and directions for future research.

Menu labeling implementation in dine-in restaurants: the Public's knowledge, attitude and practices.

PubMed

Radwan, Hadia; Faroukh, Eman M; Obaid, Reyad Shaker

2017-01-01

The practice of menu labeling is gaining popularity worldwide as a potential policy to reduce energy intake as a means to decrease the prevalence of obesity. So the purpose of the present study is to identify the knowledge, attitudes, and practices of adults regarding the implementation of menu labeling in dine-in restaurants. A cross sectional survey included 2020 male or female adults (aged ≥ 18 years old) participants was collected from two cities in the United Arab Emirates(UAE). The participants filled a validated questionnaire in public places in two cities. A chi-squared test was conducted to compare responses for differences in proportions. Most participants were knowledgeable about energy requirements for moderately active men (60%) and women (59%), but underestimated energy requirements for inactive adults (34%). The majority of the respondents favored the requirement to post calorie information on menus of dine-in restaurants at the point of purchase (76%). About half the respondents (48%) were more likely to visit restaurants with labeled menus. The results from this study may form the basis for future strategies in mandating calorie labeling of restaurant menu items in UAE. Menu labeling may be a useful policy tool for promoting appropriate caloric consumption.

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.

Statewide Dissemination of a Rural, Non-Chain Restaurant Intervention: Adoption, Implementation and Maintenance

ERIC Educational Resources Information Center

Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

2014-01-01

The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States,…

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

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.

Reformulation of pizza crust in restaurants may increase whole-grain intake among children.

PubMed

Tritt, Aimee; Reicks, Marla; Marquart, Len

2015-06-01

Whole-grain intake among children is well below recommendations. The purpose of the present study was to test the acceptability and liking of pizza made with whole-grain crust compared with refined-grain crust among children in restaurant and school settings. Plate waste data were collected via observation from child restaurant patrons consuming pizza made with either whole-grain or refined-grain crust. Waste was estimated by trained observers over eight months (August 2012-March 2013). Percentage waste was calculated and compared by crust type. A taste test was conducted with school children who tasted pizza made with whole-grain crust alongside pizza made with refined-grain crust and rated their liking of each product. Liking ratings were compared by crust type. Five Green Mill restaurant (a Midwest US chain) locations and one elementary school in the Minneapolis/St. Paul metropolitan area, Minnesota, USA. Child restaurant patrons (n 394) and school children (n 120, grades 3-5). Children consumed as much of the pizza made with whole-grain crust (42·1 %) as the pizza made with refined-grain crust (44·6 %; P=0·55), based on an average serving size of 350-400 g. Liking ratings for both types of pizza were high (>4·5 of 5) and did not differ by crust type (P=0·47). These positive consumption and liking outcomes indicate that whole-grain pizza crust is well accepted among children in a restaurant setting. The impact on whole-grain intake could be substantial if large, national restaurant chains served pizza made with whole-grain crust.

Restaurant and Bar Owners’ Exposure to Secondhand Smoke and Attitudes Regarding Smoking Bans in Five Chinese Cities

PubMed Central

Liu, Ruiling; Hammond, S. Katharine; Hyland, Andrew; Travers, Mark J.; Yang, Yan; Nan, Yi; Feng, Guoze; Li, Qiang; Jiang, Yuan

2011-01-01

Despite the great progress made towards smoke-free environments, only 9% of countries worldwide mandate smoke-free restaurants and bars. Smoking was generally not regulated in restaurants and bars in China before 2008. This study was designed to examine the public attitudes towards banning smoking in these places in China. A convenience sample of 814 restaurants and bars was selected in five Chinese cities and all owners of these venues were interviewed in person by questionnaire in 2007. Eighty six percent of current nonsmoking subjects had at least one-day exposure to secondhand smoke (SHS) at work in the past week. Only 51% of subjects knew SHS could cause heart disease. Only 17% and 11% of subjects supported prohibiting smoking completely in restaurants and in bars, respectively, while their support for restricting smoking to designated areas was much higher. Fifty three percent of subjects were willing to prohibit or restrict smoking in their own venues. Of those unwilling to do so, 82% thought smoking bans would reduce revenue, and 63% thought indoor air quality depended on ventilation rather than smoking bans. These results showed that there was support for smoking bans among restaurant or bar owners in China despite some knowledge gaps. To facilitate smoking bans in restaurants and bars, it is important to promote health education on specific hazards of SHS, provide country-specific evidence on smoking bans and hospitality revenues, and disseminate information that restricting smoking and ventilation alone cannot eliminate SHS hazards. PMID:21655134

Factors influencing restaurant worker perception of floor slipperiness.

PubMed

Courtney, Theodore K; Huang, Yueng-Hsiang; Verma, Santosh K; Chang, Wen-Ruey; Li, Kai Way; Filiaggi, Alfred J

2006-11-01

Falls are responsible for a substantial injury burden in the global workplace. Restaurant environments are particularly challenged by slips, trips, and falls. This study explored those factors that could influence workers' self-reports of slipperiness in U.S. fast-food restaurants. One hundred and twenty-six workers employed in 10 fast-food restaurants in the northeastern United States participated in the study representing a study-wide response rate of 87.5%. Participants' ratings of floor slipperiness and occupational slip history within the past 4 weeks were collected through written questionnaire. Additional factors collected by questionnaire included age, gender, shift length, and shoe type. Shoe condition (wear) and shoe contamination were visually assessed by the investigators. Floor friction was also measured. Lower restaurant mean coefficient of friction and the presence of contamination on workers' shoe soles were environmental factors significantly associated with workers reporting more slippery conditions. A recent workplace history of slipping with or without a subsequent fall was also significantly associated with workers reporting more slippery conditions. Workers over the age of 45 reported conditions to be significantly less slippery than younger workers. The results suggest that worker ratings of slipperiness are influenced not only by the actual level of friction but also by the other individual and environmental factors noted above. Recommendations for future studies would include a longitudinal design to better capture the temporal sequence between these variables. More field research is needed to better understand the association between workplace conditions, worker perception of slipperiness, and slipping at work.

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

Systematic review and meta-analysis of the economic impact of smoking bans in restaurants and bars.

PubMed

Cornelsen, Laura; McGowan, Yvonne; Currie-Murphy, Laura M; Normand, Charles

2014-05-01

To review systematically the literature on the economic impact of smoking bans in bars and restaurants and provide an estimate of the impact size using meta-analysis. Studies were identified by systematic database searches and screening references of reviews and relevant studies. Google and web-pages of tobacco control agencies were also searched. The review identified 56 studies using absolute sales, sales ratio or employment data and employing regression methods to evaluate the impact of smoking bans in the United States, Australia or in countries in South America or Europe. The meta-analysis included 39 comparable studies, with 129 cases identified based on the outcome measure, scope of the ban, type of establishment and geographical location. Methodological quality was assessed based on four pre-determined criteria. Study and case selection and data extraction were conducted independently by two researchers. Random-effects meta-analysis of all cases showed no associations between smoking bans and changes in absolute sales or employment. An increase in the share of bar and restaurant sector sales in total retail sales was associated with smoking bans [0.23 percentage-points; 95% confidence interval (CI) 0.08-0.375]. When cases were separated by business type (bars or restaurants or wider hospitality including bars and restaurants), some differential impacts emerged. Meta-analysis of the economic impact of smoking bans in hospitality sector showed overall no substantial economic gains or losses. Differential impacts were observed across individual business types and outcome variable, but at aggregate level these appear to balance out. © 2014 Society for the Study of Addiction.

[The quality of a restaurant service at a geriatric rehabilitation facility].

PubMed

Donini, L M; Castellaneta, E; Magnano, L; Valerii, B; De Felice, M R; De Bernardini, L; Cannella, C

2003-01-01

The aim of our study was to measure the quality of a restaurant service of a geriatric rehabilitation and long-term setting as it is perceived from patients compared with an objective measure of the quality. We have also verified the weight of the restaurant service on the whole quality of the hospital. Our data showed some problems in the organisation of the service, a substantially negative judgment from patients, the necessity to integrate subjective judgments with objective evaluations. The data confirmed also the importance that patients give to taste and variability of food and to the way in which it is presented. The results we obtained suggested an audit of the organisation of the restaurant service. The outcome of the proposed changes will be followed up and bring, eventually, to further arrangements.

Restaurant foods, sugar-sweetened soft drinks, and obesity risk among young African American women.

PubMed

Boggs, Deborah A; Rosenberg, Lynn; Coogan, Patricia F; Makambi, Kepher H; Adams-Campbell, Lucile L; Palmer, Julie R

2013-01-01

The prevalence of obesity is disproportionately high in African American women, and consumption of fast foods and sugar-sweetened soft drinks is also especially high among African Americans. We investigated the relation of intakes of sugar-sweetened soft drinks and specific types of restaurant foods to obesity in the Black Women's Health Study. In this prospective cohort study, 19,479 non-obese women aged 21-39 years at baseline were followed for 14 years (1995-2009). Dietary intake was assessed by validated food frequency questionnaire in 1995 and 2001. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of intakes of restaurant foods and sugar-sweetened soft drinks with incident obesity. Higher intakes of burgers from restaurants and sugar-sweetened soft drinks were associated with greater risk of becoming obese. The associations were present in models that included both factors and adjusted for overall dietary pattern. The HR of obesity in relation to restaurant burger consumption of > or = 2 times/week compared with < 5 times/year was 1.26 (95% CI: 1.14-1.40; P-trend<.001). For sugar-sweetened soft drink intake, the HR was 1.10 (95% CI: .99-1.23; P-trend = .14) for > or = 2 drinks/day compared with < 1 drink/month. The associations were stronger among women younger than age 30 with normal weight at baseline. Frequent consumption of burgers from restaurants and sugar-sweetened soft drinks contribute to obesity among young African American women.

A Mexican restaurant-associated outbreak of Salmonella Enteritidis type 34 infections traced to a contaminated egg farm.

PubMed Central

McNeil, M. M.; Sweat, L. B.; Carter, S. L.; Watson, C. B.; Holloway, J. T.; Manning, R.; Altekruse, S. F.; Blake, P. A.

1999-01-01

In May 1996, the Georgia Division of Public Health was notified about a cluster of persons with Salmonella Enteritidis (SE) infections in Waycross, Georgia. A matched pair case-control study to determine risk factors for illness found a statistically significant association of SE infection with a history of having eaten at Restaurant A during the 5 days before onset of illness (relative risk = 13 [95% confidence interval (CI) = 3-62, P < 0.01]). In a second case-control study, to determine specific food exposures, consumption of a deep-fried Mexican dish (chile relleno) (4 of 21 cases vs. 0 of 26 controls, odds ratio undefined, 95% CI > 1.46, P = 0.034) was found to be significantly associated with SE infection. An environmental investigation found evidence of suboptimal food storage and cooking temperatures at Restaurant A; cross contamination of foods may have contributed to the low attributable risk identified for chile rellenos. Five of 37 Restaurant A food and environment specimens yielded SE strains. All five positive specimens were from chiles rellenos. Of the seven outbreak-associated strains (six patient isolates and one food isolate from Restaurant A) for which phage typing was conducted, all were phage type 34. A FDA traceback investigation through Restaurant A's single-egg supplier identified the potential source as three interrelated farms in South Carolina. Environmental culture from one of these farms yielded SE phage type 34. As a result of this outbreak, FDA helped institute a statewide egg quality-assurance programme in South Carolina to minimize SE contamination of eggs. PMID:10355784

A Mexican restaurant-associated outbreak of Salmonella Enteritidis type 34 infections traced to a contaminated egg farm.

PubMed

McNeil, M M; Sweat, L B; Carter, S L; Watson, C B; Holloway, J T; Manning, R; Altekruse, S F; Blake, P A

1999-04-01

In May 1996, the Georgia Division of Public Health was notified about a cluster of persons with Salmonella Enteritidis (SE) infections in Waycross, Georgia. A matched pair case-control study to determine risk factors for illness found a statistically significant association of SE infection with a history of having eaten at Restaurant A during the 5 days before onset of illness (relative risk = 13 [95% confidence interval (CI) = 3-62, P < 0.01]). In a second case-control study, to determine specific food exposures, consumption of a deep-fried Mexican dish (chile relleno) (4 of 21 cases vs. 0 of 26 controls, odds ratio undefined, 95% CI > 1.46, P = 0.034) was found to be significantly associated with SE infection. An environmental investigation found evidence of suboptimal food storage and cooking temperatures at Restaurant A; cross contamination of foods may have contributed to the low attributable risk identified for chile rellenos. Five of 37 Restaurant A food and environment specimens yielded SE strains. All five positive specimens were from chiles rellenos. Of the seven outbreak-associated strains (six patient isolates and one food isolate from Restaurant A) for which phage typing was conducted, all were phage type 34. A FDA traceback investigation through Restaurant A's single-egg supplier identified the potential source as three interrelated farms in South Carolina. Environmental culture from one of these farms yielded SE phage type 34. As a result of this outbreak, FDA helped institute a statewide egg quality-assurance programme in South Carolina to minimize SE contamination of eggs.

Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

PubMed

Malmivaara, Antti

2016-09-01

Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

A checklist is associated with increased quality of reporting preclinical biomedical research: A systematic review

PubMed Central

Olonisakin, Tolani F.; Pribis, John P.; Zupetic, Jill; Yoon, Joo Heung; Holleran, Kyle M.; Jeong, Kwonho; Shaikh, Nader; Rubio, Doris M.; Lee, Janet S.

2017-01-01

Irreproducibility of preclinical biomedical research has gained recent attention. It is suggested that requiring authors to complete a checklist at the time of manuscript submission would improve the quality and transparency of scientific reporting, and ultimately enhance reproducibility. Whether a checklist enhances quality and transparency in reporting preclinical animal studies, however, has not been empirically studied. Here we searched two highly cited life science journals, one that requires a checklist at submission (Nature) and one that does not (Cell), to identify in vivo animal studies. After screening 943 articles, a total of 80 articles were identified in 2013 (pre-checklist) and 2015 (post-checklist), and included for the detailed evaluation of reporting methodological and analytical information. We compared the quality of reporting preclinical animal studies between the two journals, accounting for differences between journals and changes over time in reporting. We find that reporting of randomization, blinding, and sample-size estimation significantly improved when comparing Nature to Cell from 2013 to 2015, likely due to implementation of a checklist. Specifically, improvement in reporting of the three methodological information was at least three times greater when a mandatory checklist was implemented than when it was not. Reporting the sex of animals and the number of independent experiments performed also improved from 2013 to 2015, likely from factors not related to a checklist. Our study demonstrates that completing a checklist at manuscript submission is associated with improved reporting of key methodological information in preclinical animal studies. PMID:28902887

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.

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.

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

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.

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

Calorie Labels on the Restaurant Menu: Is the Use of Weight-Control Behaviors Related to Ordering Decisions?

PubMed

Larson, Nicole; Haynos, Ann F; Roberto, Christina A; Loth, Katie A; Neumark-Sztainer, Dianne

2018-03-01

There is emerging evidence that calorie information on restaurant menus does not similarly influence the ordering decisions of all population groups and may have unintended consequences for individuals who struggle with disordered eating or other weight-related concerns. This study describes demographic patterns in the use of calorie information on restaurant menus and investigates relationships between using this information to limit calorie intake and measures of restaurant visit frequency and weight-related concerns and behavior. There were 788 men and 1042 women (mean age=31.0±1.6 years) who participated in the fourth wave of the Project EAT study. Participants were initially recruited from Minneapolis-St Paul, MN, schools and completed EAT-IV surveys online or by mail from 2015 to 2016. Participants self-reported weight-related concerns, restaurant eating, intuitive eating, dieting, healthy (eg, exercise) and unhealthy (eg, use of laxatives) weight-control behaviors, and binge eating. Descriptive statistics and linear and logistic regression models accounting for demographics and weight status. Approximately half of participants (52.7%) reported they had noticed calorie information while purchasing a meal or snack in a restaurant within the previous month. Among individuals who noticed calorie information, 38.2% reported they did not use it in deciding what to order. The most common use of calorie information was to avoid high-calorie menu items (50.1%) or to decide on a smaller portion (20.2%). Using menu labels to limit calories was related to binge eating among women and was associated with more weight-related concerns, dieting, and unhealthy weight-control behaviors among both women and men. Nutrition educators and other health care professionals should talk with clients who struggle with disordered eating or weight-related concerns to learn about their use of calorie information at restaurants, address any potential unintended consequences, and promote healthy uses of calorie information. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A Methodology for Determining Consumer Attitudes and Behavior Air Force Appropriated Dinning

DTIC Science & Technology

1990-08-01

concerns and some 8 deal with consumer preferences . Though none of the information was used as such for the questionnaires developed for this study, they...D.C.: National Restaurant Association, Research and Information Service Department. National Restaurant Association. (1984). Consumer preferences for

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.

PubMed

Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva

2017-01-01

Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.

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...

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants.

PubMed

Caspi, Caitlin Eicher; Wang, Qi; Shanafelt, Amy; Larson, Nicole; Wei, Susan; Hearst, Mary O; Nanney, Marilyn S

2017-10-01

Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Breakfast-skippers enrolled in a group-randomized intervention in 2014 to 2015 (N = 404 from 8 schools) completed 24-hour dietary recalls and pre/post surveys assessing food establishment purchase frequency. Healthy Eating Index Scores (HEI-2010) were calculated for each student. Student-level school breakfast participation (SBP) was obtained from school food service records. Mixed-effects regression models estimated: (1) whether SBP was associated with store/restaurant use at baseline, (2) whether an increase in SBP was associated with a decrease in store/restaurant use, and (3) whether stores/restaurant use was associated with HEI-2010 scores at baseline. Students with increased SBP were more likely to decrease fast-food restaurant purchases on the way home from school (OR 1.017, 95% CI 1.005, 1.029), but were less likely to decrease purchases at food stores for breakfast (OR 0.979, 95% CI 0.959, 0.999). Food establishment use was associated with lower HEI-2010 dairy component scores (p = .017). Increasing participation in school breakfast may result in modest changes in purchases at food establishments. © 2017, American School Health Association.

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.

Marketing fast food: impact of fast food restaurants in children's hospitals.

PubMed

Sahud, Hannah B; Binns, Helen J; Meadow, William L; Tanz, Robert R

2006-12-01

The objectives of this study were (1) to determine fast food restaurant prevalence in hospitals with pediatric residencies and (2) to evaluate how hospital environment affects purchase and perception of fast food. We first surveyed pediatric residency programs regarding fast food restaurants in their hospitals to determine the prevalence of fast food restaurants in these hospitals. We then surveyed adults with children after pediatric outpatient visits at 3 hospitals: hospital M with an on-site McDonald's restaurant, hospital R without McDonald's on site but with McDonald's branding, and hospital X with neither on-site McDonald's nor branding. We sought to determine attitudes toward, consumption of, and influences on purchase of fast food and McDonald's food. Fifty-nine of 200 hospitals with pediatric residencies had fast food restaurants. A total of 386 outpatient surveys were analyzed. Fast food consumption on the survey day was most common among hospital M respondents (56%; hospital R: 29%; hospital X: 33%), as was the purchase of McDonald's food (hospital M: 53%; hospital R: 14%; hospital X: 22%). McDonald's accounted for 95% of fast food consumed by hospital M respondents, and 83% of them bought their food at the on-site McDonald's. Using logistic regression analysis, hospital M respondents were 4 times more likely than respondents at the other hospitals to have purchased McDonald's food on the survey day. Visitors to hospitals M and R were more likely than those at hospital X to believe that McDonald's supported the hospital financially. Respondents at hospital M rated McDonald's food healthier than did respondents at the other hospitals. Fast food restaurants are fairly common in hospitals that sponsor pediatric residency programs. A McDonald's restaurant in a children's hospital was associated with significantly increased purchase of McDonald's food by outpatients, belief that the McDonald's Corporation supported the hospital financially, and higher rating of the healthiness of McDonald's food.

Health promotion practices of restaurants and cafés in Australia: changes from 1997 to 2000 using an annual telemarketing intervention.

PubMed

Licata, Milly; Gillham, Karen; Campbell, Elizabeth

2002-09-01

This study looked at whether rates of health promotion practices among restaurants and cafés in the Hunter Region of New South Wales (NSW), Australia, increased between 1997 and 2000. During the project period all restaurants and cafés in the region were offered an annual direct marketing telephone interview (1997, 1998 and 1999), during which resources were offered to assist in the adoption of health promotion practices. Owners or managers of restaurants and cafés completed phone interviews that assessed 18 health promotion practices relating to: environmental tobacco smoke (two practices); responsible service of alcohol (five practices); healthy food choices (one practice); food safety (four practices); occupational health and safety (three practices); and the prevention of infectious diseases (three practices). Changes in practices were examined by comparing data from cross-sectional samples in 1997 (before any offers of resources) and 2000 (after up to three annual telemarketing calls), and among a cohort interviewed in both 1997 and 2000. Ninety-one per cent of restaurants and cafés (321) participated in the 1997 survey and 239 (81%) participated in the 2000 survey. A cohort of 122 restaurants and cafés participated in both surveys. Significant increases were present for 14 of the 18 health promotion initiatives in the cross-sectional sample and for 10 of the 18 health promotion initiatives in the cohort. For both cross-sectional and cohort samples, a change in at least one practice in each area was evident, with the exception of nutrition. The proportion of restaurants and cafés in the project region that undertake health promotion initiatives is increasing. A telephone-based intervention may contribute to such an increase. The suggestion that the prevalence of health promotion initiatives in restaurants and cafés can be increased highlights the potential for health promotion to be more actively involved in this setting.

A Follow-Up Study of Junior College Hotel and Restaurant Education in Florida.

ERIC Educational Resources Information Center

Almarode, Richard L.

This study examines hospitality programs from the enabling legislation in 1961, which provided for an advisory committee to the Hotel and Restaurant Commission on education. Its purpose was to employ a director of the programs and two field representatives or consultants to offer on-the-job assistance to managers and employees in the state's…

Accuracy of stated energy contents of restaurant foods in a multi-site study

USDA-ARS?s Scientific Manuscript database

Context National recommendations for prevention and treatment of obesity emphasize reducing energy intake. Foods purchased in restaurants provide approximately 35% of daily energy intake, but the accuracy of information on the energy contents of these foods is unknown. Objective To examine the a...

[Analysis and spatial description to correlative factors on food hygiene appeal and food poison in restaurants of city zone in Qingdao].

PubMed

Liu, Ying; Guo, Xin-biao; Li, Hai-rong; Yang, Lin-sheng

2006-07-01

To study some factors that affected food poison and appeals in restaurants which were hidden danger on the cards. Data on food hygiene events from 2002 to 2004 in restaurants of 14 blocks which were located in the important city zone of Qingdao were collected and studied. The spatial distribution was conducted by means of Geographic Information System (GIS). Possible factors related to food hygiene events were investigated and analysed by NCSS Data statistics software. information of every block were marked on digitalized map by ARCVIEW3.2a software in order to show the spatial distribution of food hygiene events palpably in different areas in the course of three years. It was showed that air temperature, humidity, sunlight length were the important factors of food poison. Average amount of guests and floating population related to administration level of sanitation, the level of sanitation administration, geography location, business status of restaurants related to their status of food sanitation. This study showed the method that analysed and studied status of food sanitation from different areas by GIS were effective, simple and palpable.

Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES.

PubMed

Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

2009-05-27

While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) - a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant.Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 - 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors. Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.

Assessing validity of observational intervention studies – the Benchmarking Controlled Trials

PubMed Central

Malmivaara, Antti

2016-01-01

Abstract Background: Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. Aims: To create and pilot test a checklist for appraising methodological validity of a BCT. Methods: The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. Results: The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. Conclusions: The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies.Key messagesBenchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations.This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies.The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. PMID:27238631

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.

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.

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.

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.

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.

Factors related to the number of fast food meals obtained by college meal plan students.

PubMed

Dingman, Deirdre A; Schulz, Mark R; Wyrick, David L; Bibeau, Daniel L; Gupta, Sat N

2014-01-01

This study tested whether days on campus, financial access through a meal plan, and health consciousness were associated with number of meals that college students obtained from fast food restaurants. In April 2013, all students currently enrolled in a meal plan were invited to participate in an online survey (N = 1,246). Students were asked to report the total number of meals eaten in the past week and where they obtained them. Negative binomial regression was used, and it was found that the number of meals obtained from fast food restaurants was positively associated with financial access and negatively associated with health consciousness. An association between days on campus and the number of meals obtained from fast food restaurants was not found. Increasing levels of health consciousness and reducing access to fast food restaurants through flex plans may reduce college students' consumption of fast food.

The effect of ordinances requiring smoke-free restaurants and bars on revenues: a follow-up.

PubMed Central

Glantz, S A; Smith, L R

1997-01-01

OBJECTIVES: The purpose of this study was to extend an earlier evaluation of the economic effects of ordinances requiring smoke-free restaurants and bars. METHODS: Sales tax data for 15 cities with smoke-free restaurant ordinances, 5 cities and 2 counties with smoke-free bar ordinances, and matched comparison locations were analyzed by multiple regression, including time and a dummy variable for the ordinance. RESULTS: Ordinances had no significant effect on the fraction of total retail sales that went to eating and drinking places or on the ratio between sales in communities with ordinances and sales in comparison communities. Ordinances requiring smoke-free bars had no significant effect on the fraction of revenues going to eating and drinking places that serve all types of liquor. CONCLUSIONS: Smoke-free ordinances do not adversely affect either restaurant or bar sales. PMID:9357356

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.

A Checklist Intervention to Assess Resident Diagnostic Knee and Shoulder Arthroscopic Efficiency.

PubMed

Nwachukwu, Benedict; Gaudiani, Michael; Hammann-Scala, Jennifer; Ranawat, Anil

The purpose of this investigation was to apply an arthroscopic shoulder and knee checklist in the evaluation of orthopedic resident arthroscopic skill efficiency and to demonstrate the use of a surgical checklist for assessing resident surgical efficiency over the course of a surgical rotation. Orthopedic surgery residents rotating on the sports medicine service at our institution between 2011 and 2015 were enrolled in this study. Residents were administered a shoulder and knee arthroscopy assessment tool at the beginning and end of their 6-week rotation. The assessment tools consisted of checklist items for knee and shoulder arthroscopy skills. Residents were timed while performing these checklist tasks. The primary outcome measure was resident improvement as a function of time to completion for the checklist items, and the intervention was participation in a 6-week resident rotation with weekly arthroscopy didactics, cadaver simulator work, and operating room experience. A paired t test was used to compare means. Mean time to checklist completion during week 1 among study participants for the knee checklist was 787.4 seconds for the knee checklist and 484.4 seconds at the end of the rotation. Mean time to checklist completion during week 1 among study participants for the shoulder checklist was 1655.3 seconds and 832.7 seconds for the shoulder checklist at the end of the rotation. Mean improvement in time to completion was 303 seconds (p = 0.0006, SD = 209s) and 822.6 seconds (p = 0.00008, SD = 525.2s) for the arthroscopic knee and shoulder assessments, respectively. An arthroscopic checklist is 1 method to evaluate and assess resident efficiency and improvement during surgical training. Among residents participating in this study, we found statistically significant improvements in time for arthroscopic task completion. II. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Relation between local restaurant smoking regulations and attitudes towards the prevalence and social acceptability of smoking: a study of youths and adults who eat out predominantly at restaurants in their town.

PubMed

Albers, A B; Siegel, M; Cheng, D M; Biener, L; Rigotti, N A

2004-12-01

To examine the relation between strength of local restaurant smoking regulations and smoking related social norms among youths and adults. We used generalised estimating equations logistic regression analysis to examine the relation between regulation strength and youths' and adults' perceptions of adult smoking prevalence and the social acceptability of smoking in their town, while controlling for baseline anti-smoking sentiment in the town. Each of the 351 Massachusetts towns were classified as having strong (complete smoking ban), medium (restriction of smoking to enclosed, separately ventilated areas), or weak (all others) restaurant smoking regulations. 1147 Massachusetts youths ages 12-17 years and 2116 adults who reported that they often or always eat out in their own town, drawn from a random digit dial survey. Perceived adult smoking prevalence and perceived social acceptability of smoking in restaurants, in bars, or in general. Compared to youths from towns with weak regulations, youths from towns with strong regulations were more likely to perceive lower adult smoking prevalence (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.02 to 2.84) and social unacceptability of adult smoking (OR 2.00, 95% CI 1.29 to 3.08) in their town. Adults from towns with strong regulations were not more likely to perceive lower adult smoking prevalence, but had more than twice the odds of perceiving that smoking was unacceptable in restaurants (OR 2.19, 95% CI 1.58 to 3.02) or bars (OR 2.51, 95% CI 1.90 to 3.31). Strong local restaurant smoking regulations are associated with favourable smoking related social norms among youths and adults.

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

Fast-food and full-service restaurant consumption and daily energy and nutrient intakes in US adults.

PubMed

An, R

2016-01-01

Calorie intake and diet quality are influenced by the source of food and the place of consumption. This study examines the impacts of fast-food and full-service restaurant consumption on daily energy and nutrient intakes in US adults. Nationally representative data of 18,098 adults 18 years of age and above from the National Health and Nutrition Examination Survey 2003-2010 waves were analyzed. Outcomes included daily intake of total calories and 24 nutrients of public health concern. The key predictors were any food/beverage consumption in a day from fast-food or full-service restaurant, differentiated by consumption at home versus away from home. First-difference estimator addressed confounding bias from time-invariant unobservables such as personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two nonconsecutive 24-h dietary recalls. Fast-food and full-service restaurant consumption, respectively, were associated with a net increase in daily total energy intake of 190.29 and 186.74 kcal, total fat of 10.61 and 9.58 g, saturated fat of 3.49 and 2.46 g, cholesterol of 10.34 and 57.90 mg, and sodium of 297.47 and 411.92 mg. The impact of fast-food and full-service restaurant consumption on energy and nutrient intakes differed by sex, race/ethnicity, education, income and weight status. Increased total energy, total fat, saturated fat, cholesterol and sodium intake were substantially larger when full-service restaurant food was consumed away from home than at home. A holistic policy intervention is warranted to target the American's overall dining-out behavior rather than fast-food consumption alone.

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.

Relation between local restaurant smoking regulations and attitudes towards the prevalence and social acceptability of smoking: a study of youths and adults who eat out predominantly at restaurants in their town

PubMed Central

Albers, A; Siegel, M; Cheng, D; Biener, L; Rigotti, N

2004-01-01

Objective: To examine the relation between strength of local restaurant smoking regulations and smoking related social norms among youths and adults. Design: We used generalised estimating equations logistic regression analysis to examine the relation between regulation strength and youths' and adults' perceptions of adult smoking prevalence and the social acceptability of smoking in their town, while controlling for baseline anti-smoking sentiment in the town. Setting: Each of the 351 Massachusetts towns were classified as having strong (complete smoking ban), medium (restriction of smoking to enclosed, separately ventilated areas), or weak (all others) restaurant smoking regulations. Subjects: 1147 Massachusetts youths ages 12–17 years and 2116 adults who reported that they often or always eat out in their own town, drawn from a random digit dial survey. Main outcome measures: Perceived adult smoking prevalence and perceived social acceptability of smoking in restaurants, in bars, or in general. Results: Compared to youths from towns with weak regulations, youths from towns with strong regulations were more likely to perceive lower adult smoking prevalence (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.02 to 2.84) and social unacceptability of adult smoking (OR 2.00, 95% CI 1.29 to 3.08) in their town. Adults from towns with strong regulations were not more likely to perceive lower adult smoking prevalence, but had more than twice the odds of perceiving that smoking was unacceptable in restaurants (OR 2.19, 95% CI 1.58 to 3.02) or bars (OR 2.51, 95% CI 1.90 to 3.31). Conclusions: Strong local restaurant smoking regulations are associated with favourable smoking related social norms among youths and adults. PMID:15564617

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.

Presence of faecal coliforms, Escherichia coli and diarrheagenic E. coli pathotypes in ready-to-eat salads, from an area where crops are irrigated with untreated sewage water.

PubMed

Castro-Rosas, Javier; Cerna-Cortés, Jorge F; Méndez-Reyes, Eligio; Lopez-Hernandez, Daniel; Gómez-Aldapa, Carlos A; Estrada-Garcia, Teresa

2012-05-15

Consumption of ready-to-eat (RTE) salads has increased worldwide. Consequently, the number of outbreaks caused by food-borne pathogens, including diarrheagenic E. coli pathotypes (DEPs), associated with the consumption of RTE-salads has increased. DEPs include enterotoxigenic (ETEC), typical and atypical enteropathogenic (tEPEC, aEPEC), enteroinvasive (EIEC), enteroaggregative (EAEC), diffuse adherent (DAEC) and Shiga toxin-producing (STEC) E. coli. In less-developed areas of the world, fresh crops continue to be irrigated with untreated sewage water. The aims of this study were to evaluate the microbiological quality and prevalence of DEPs in RTE-salads of raw vegetables, purchased from restaurants at Pachuca-City, Hidalgo, Mexico, where most locally consumed vegetables are irrigated with untreated sewage water. A total of 130 salads were purchased from restaurants of three categories: A) national chain restaurants and B) local restaurants, both with the H distinctive (a recognition that the Secretary of Tourism grants to restaurants that manage supplies with high levels of hygiene); and C) local small inexpensive restaurants without H distinctive. A total of 6 restaurants were included, 2 per category (A(1-2), B(1-2), C(1-2)). Each sample was tested for the presence of faecal coliforms (FC) and E. coli by standard procedures. E. coli strains were further characterized for the presence of DEPs loci by two multiplex polymerase chain reactions. Among the 130 salad samples 99% (129) were contaminated with FC; 85% (110/129) harboured E. coli and 7% (8/110) DEPs. The amount of positive salad samples for FC and E. coli was similar between restaurants and categories. The FC mean (571 FC/g) of all samples was significantly higher (p<0.001) than the E. coli mean (63 E. coli/g). A weak correlation of 7.7% (r(2)=0.077, p=0.003) between median FC and E. coli MPN (most probable number) per sample was found. Of the 8 salad samples contaminated with DEPs, 2 were spinach salads from restaurant A(2) and 3 were (Mixed salad) samples from each C restaurant. Three samples harboured non-O157 STEC strains, 2 EIEC, 1 ETEC and 2 samples had non-O157 STEC and EIEC strains, simultaneously. A significant difference (p=0.008) between the prevalence of E. coli vs. DEPs was observed. Independently of the restaurants' overall hygienic status, most RTE-salads had a poor microbiological quality and some harboured DEPs that have been associated with illness in Mexico. Health authorities should focus on implementing DEPs screening in raw vegetables and enforcing the legislation that forbids irrigation with untreated sewage water of both root and leafy vegetables. Copyright © 2012 Elsevier B.V. All rights reserved.

Eating at restaurants, at work or at home. Is there a difference? A study among adults of 11 European countries in the context of the HECTOR* project.

PubMed

Orfanos, P; Naska, A; Rodrigues, S; Lopes, C; Freisling, H; Rohrmann, S; Sieri, S; Elmadfa, I; Lachat, C; Gedrich, K; Boeing, H; Katzke, V; Turrini, A; Tumino, R; Ricceri, F; Mattiello, A; Palli, D; Ocké, M; Engeset, D; Oltarzewski, M; Nilsson, L M; Key, T; Trichopoulou, A

2017-03-01

To compare macronutrient intakes out of home-by location-to those at home and to investigate differences in total daily intakes between individuals consuming more than half of their daily energy out of home and those eating only at home. Data collected through 24-h recalls or diaries among 23 766 European adults. Participants were grouped as 'non-substantial', 'intermediate' and 'very substantial out-of-home' eaters based on energy intake out of home. Mean macronutrient intakes were estimated at home and out of home (overall, at restaurants, at work). Study/cohort-specific mean differences in total intakes between the 'very substantial out-of-home' and the 'at-home' eaters were estimated through linear regression and pooled estimates were derived. At restaurants, men consumed 29% of their energy as fat, 15% as protein, 45% as carbohydrates and 11% as alcohol. Among women, fat contributed 33% of energy intake at restaurants, protein 16%, carbohydrates 45% and alcohol 6%. When eating at work, both sexes reported 30% of energy from fat and 55% from carbohydrates. Intakes at home were higher in fat and lower in carbohydrates and alcohol. Total daily intakes of the 'very substantial out-of-home' eaters were generally similar to those of individuals eating only at home, apart from lower carbohydrate and higher alcohol intakes among individuals eating at restaurants. In a large population of adults from 11 European countries, eating at work was generally similar to eating at home. Alcoholic drinks were the primary contributors of higher daily energy intakes among individuals eating substantially at restaurants.

Promoting healthier children's meals at quick-service and full-service restaurants: Results from a pilot and feasibility study.

PubMed

Lopez, Nanette V; Folta, Sara C; Glenn, Meaghan E; Lynskey, Vanessa M; Patel, Anjali A; Anzman-Frasca, Stephanie

2017-10-01

High-calorie restaurant foods contribute to childhood overweight. Increased consumer demand for healthier kids' meals may motivate the restaurant industry to provide additional healthy options. This study pilot-tested a combination of four strategies (toy incentive, placemats, server prompts, signage) designed to increase demand for healthier kids' meals, which were defined as those eligible for the National Restaurant Association's Kids LiveWell program. Relative sales of healthier kids' meals were examined before (n = 3473 total kids' meal orders) and during Month 1 (n = 3546 total kids' meal orders) and Month 2 of implementation (n = 3645 total kids' meal orders) of an 8-week intervention in two locations each of a quick-service (QSR) and full-service (FSR) restaurant chain. Convenience samples of children (n = 27) and their parents (n = 28) were surveyed regarding parent and child perceptions of intervention components. Findings regarding the effectiveness and feasibility of the intervention were mixed. At the FSRs, the relative percentage of monthly sales from healthier kids' meals increased from 5.0% of kids' meal orders at baseline to 8.3% during Month 1, ending at 6.4% during Month 2. At the QSRs, the relative percentage of monthly sales from healthier kids' entrees decreased from 27.5% at baseline to 25.2% during Month 1, ending at 25.9% during Month 2. Implementation quality tracking showed that consistent implementation of intervention components was a challenge; parent- and child-reported awareness of intervention components supported this finding. Future directions are discussed, aiming to build upon these findings and maximize the feasibility, effectiveness, and sustainability of efforts to promote healthier eating in restaurants. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perception of slipperiness and prospective risk of slipping at work

PubMed Central

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

2013-01-01

Objectives Falls are a leading cause of injury at work, and slipping is the predominant cause of falling. Prior research has suggested a modest correlation between objective measures (such as coefficient of friction, COF) and subjective measures of slipperiness (such as worker perceptions) in the workplace. However, the degree of association between subjective measures and the actual risk of slipping at the workplace is unknown. This study examined the association between perception of slipperiness and the risk of slipping. Methods 475 workers from 36 limited-service restaurants participated in a 12-week prospective cohort study. At baseline, demographic information was collected, participants rated floor slipperiness in eight areas of the restaurant, and work environment factors, such as COF, were measured. Restaurant-level and area-level mean perceptions of slipperiness were calculated. Participants then reported their slip experience at work on a weekly basis for the next 12 weeks. The associations between perception of slipperiness and the rate of slipping were assessed. Results Adjusting for age, gender, body mass index, education, primary language, mean COF, use of slip-resistant shoes, and restaurant chain, each 1-point increase in mean restaurant-level perception of slipperiness (4-point scale) was associated with a 2.71 times increase in the rate of slipping (95% CI 1.25 to 5.87). Results were similar for area-level perception within the restaurant (rate ratios (RR) 2.92, 95% CI 2.41 to 3.54). Conclusions Perceptions of slipperiness and the subsequent rate of slipping were strongly associated. These findings suggest that safety professionals, risk managers and employers could use aggregated worker perceptions of slipperiness to identify slipping hazards and, potentially, to assess intervention effectiveness. PMID:22935953

Restaurant foods, sugar-sweetened soft drinks, and obesity risk among young African American women

PubMed Central

Boggs, Deborah A.; Rosenberg, Lynn; Coogan, Patricia F.; Makambi, Kepher H.; Adams-Campbell, Lucile L.; Palmer, Julie R.

2013-01-01

Background The prevalence of obesity is disproportionately high in African American women, and consumption of fast foods and sugar-sweetened soft drinks is also especially high among African Americans. Objective We investigated the relation of intakes of sugar-sweetened soft drinks and specific types of restaurant foods to obesity in the Black Women's Health Study. Design In this prospective cohort study, 19,479 non-obese women aged 21–39 years at baseline were followed for 14 years (1995–2009). Dietary intake was assessed by validated food frequency questionnaire in 1995 and 2001. Main outcome measures Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of intakes of restaurant foods and sugar-sweetened soft drinks with incident obesity. Results Higher intakes of burgers from restaurants and sugar-sweetened soft drinks were associated with greater risk of becoming obese. The associations were present in models that included both factors and adjusted for overall dietary pattern. The HR of obesity in relation to restaurant burger consumption of ≥2 times/week compared with <5 times/year was 1.26 (95% CI: 1.14–1.40; P-trend<0.001). For sugar-sweetened soft drink intake, the HR was 1.10 (95% CI: 0.99–1.23; P-trend=0.14) for ≥2 drinks/day compared with <1 drink/month. The associations were stronger among women younger than age 30 with normal weight at baseline. Conclusions Frequent consumption of burgers from restaurants and sugar-sweetened soft drinks contribute to obesity among young African American women. PMID:24392607

Perception of slipperiness and prospective risk of slipping at work.

PubMed

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

2013-01-01

Falls are a leading cause of injury at work, and slipping is the predominant cause of falling. Prior research has suggested a modest correlation between objective measures (such as coefficient of friction, COF) and subjective measures of slipperiness (such as worker perceptions) in the workplace. However, the degree of association between subjective measures and the actual risk of slipping at the workplace is unknown. This study examined the association between perception of slipperiness and the risk of slipping. 475 workers from 36 limited-service restaurants participated in a 12-week prospective cohort study. At baseline, demographic information was collected, participants rated floor slipperiness in eight areas of the restaurant, and work environment factors, such as COF, were measured. Restaurant-level and area-level mean perceptions of slipperiness were calculated. Participants then reported their slip experience at work on a weekly basis for the next 12 weeks. The associations between perception of slipperiness and the rate of slipping were assessed. Adjusting for age, gender, body mass index, education, primary language, mean COF, use of slip-resistant shoes, and restaurant chain, each 1-point increase in mean restaurant-level perception of slipperiness (4-point scale) was associated with a 2.71 times increase in the rate of slipping (95% CI 1.25 to 5.87). Results were similar for area-level perception within the restaurant (rate ratios (RR) 2.92, 95% CI 2.41 to 3.54). Perceptions of slipperiness and the subsequent rate of slipping were strongly associated. These findings suggest that safety professionals, risk managers and employers could use aggregated worker perceptions of slipperiness to identify slipping hazards and, potentially, to assess intervention effectiveness.

Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke.

PubMed

Azagba, Sunday

2015-07-01

While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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 ...

Teaching the handicapped to eat in public places: acquisition, generalization and maintenance of restaurant skills.

PubMed Central

van den Pol, R A; Iwata, B A; Ivancic, M T; Page, T J; Neef, N A; Whitley, F P

1981-01-01

This study examined classroom-based instruction in restaurant skills for handicapped persons. Three male students were taught each of four skill components in sequential order: locating, ordering, paying, and eating and exiting. Training was implemented in a multiple baseline design across subjects and consisted of modeling and role playing in conjunction with photo slide sequences and a simulated ordering counter. The use of a menu containing general item classes and a finger matching procedure for identifying errors in the delivery of change greatly reduced the reading and math skills necessary to enter and complete the program. Periodic probes were conducted in a McDonald's restaurant prior to, during, and up to one-year following the termination of training. In addition, two probes (overt and covert observation) were conducted in a Burger King restaurant to assess further generalization to a location different from the one depicted throughout training. Results showed that students' performance on restaurant probes improved as a result of training, generalized to novel settings, maintained over an extended period of time, and was comparable to that of a normative sample of nonretarded persons. PMID:6452436

[Application of tobacco smoking regulations in restaurants in Tromsö 1998].

PubMed

Emaus, A; Løchen, M L; Høifødt, R

2001-02-10

Under the Norwegian Environmental Tobacco Smoke Act, a minimum of 50% of tables in restaurants have to be in smoke-free areas. The Ministry of Health and Social Affairs has defined "smoke-free restaurants" as a priority objective in its anti-tobacco strategy. We have investigated smoking policies in restaurants in the City of Tromsø in Northern Norway, as reported by restaurateurs in 1998. Representatives of all the 85 restaurants, bars and pubs in the city were interviewed and their smoking policies and habits reported. This study was part of the local health authority's evaluation of the degree of compliance with the legislation. In 71% of establishments, at least 50% of tables were smoke-free; in 88%, smoking areas were in compliance with the legislation. 86% of restaurateurs reported a positive or neutral attitude to the legislation, 80% thought that their guests were of the same opinion. 47% smoked every day; however, there was no association between smoking habits and smoking policies. Though the prevalence of smoking was high among restaurateurs, this did not affect their attitudes towards the Environmental Tobacco Smoke Act or their policies on smoking.

Restaurant consumer acceptance of beef loin strip steaks tenderized with calcium chloride.

PubMed

Hoover, L C; Cook, K D; Miller, M F; Huffman, K L; Wu, C K; Lansdell, J L; Ramsey, C B

1995-12-01

Beef strip loins from either the right or left side of 22 carcasses of Bos indicus-type steers were injected with 200 mM calcium chloride (CaCl2) solution at 5% (wt/wt) to determine its effect on tenderness and other selected quality traits of steaks. Loins from opposite sides of the carcasses were untreated and served as the control. The steaks were evaluated for tenderness, juiciness, flavor intensity, tenderness acceptability, and overall acceptability by 62 restaurant consumers over a 6-wk period. The CaCl2 injection improved (P < .05) tenderness and flavor intensity ratings by the restaurant consumers. Tenderness acceptability and overall acceptability were improved 23 and 17%, respectively, by the CaCl2 injection. Flavor was not compromised by the CaCl2 injection. The CaCl2-treated steaks were rated superior(P < .05) for flavor compared to the control steaks. Restaurant consumers preferred the beef loin strip steaks injected with 200 mM CaCl2 at 5% (wt/wt). The results of this study are interpreted to indicate that, from a restaurant consumer perspective, CaCl2 injection is an acceptable means of making beef a more consistently tender product.

Child and parent perspectives on healthier side dishes and beverages in restaurant kids' meals: results from a national survey in the United States.

PubMed

Shonkoff, Eleanor T; Anzman-Frasca, Stephanie; Lynskey, Vanessa M; Chan, Grace; Glenn, Meaghan E; Economos, Christina D

2017-07-25

Children frequently consume foods from restaurants; considering the quick-service sector alone, 1/3 of children eat food from these restaurants on a given day, and among these consumers, 1/3 of their daily calories come from fast food. Restaurant foods and beverages are second only to grocery store foods and beverages in their contribution to total energy intake of U.S. 4- to 11-year-olds. Shifting their restaurant consumption in healthier directions could have a positive impact on child health. In 2014 this study examined self-reported child receptivity and parent awareness of child receptivity to ordering a fruit or vegetable side dish instead of French fries; and milk, water, or flavored water instead of soda/pop with a kids' meal when eating out. Child receptivity to side dishes was compared between 2010 and 2014. An online survey was administered by Nielsen via their Harris Poll Online to a national panel of 711 parents and their 8- to 12-year-old child, as part of a larger study. Frequencies, logistic regressions, t-tests, chi-square tests, and percent agreement were used to evaluate child likelihood of ordering certain side dishes; receptivity to healthier side dish and beverage alternatives; changes in receptivity to healthier sides across years; and parent awareness. A majority of children said they were likely to order a meal with a vegetable (60%), fruit (78%), or French fry (93%) side dish. They were receptive to receiving a fruit or vegetable (FV) side dish instead of French fries (68%); or milk, water, or flavored water instead of soda (81%) with their restaurant kids' meal. Liking/taste was the most common reason for children's feelings. Child receptivity to a FV side dish instead of French fries was high in both years and significantly higher in 2014 (t = -2.12, p = 0.034). The majority of parent and child reports of child receptivity were concordant (85%). These national survey results indicate that children are receptive to FV side dishes and healthier beverage options with their restaurant meals. Their receptivity has remained high in the recent past, and parents are aware of child receptivity. An opportunity exists for restaurants to leverage child receptivity to healthier sides and beverages by providing and promoting healthy options.

Checklists for powder inhaler technique: a review and recommendations.

PubMed

Basheti, Iman A; Bosnic-Anticevich, Sinthia Z; Armour, Carol L; Reddel, Helen K

2014-07-01

Turbuhaler and Diskus are commonly used powder inhaler devices for patients with respiratory disease. Their effectiveness is limited in part by a patient's ability to use them correctly. This has led to numerous studies being conducted over the last decade to assess the correct use of these devices by patients and health care professionals. These studies have generally used device-specific checklists to assess technique, this being the most feasible and accessible method for assessment. However, divergence between the checklists and scoring systems for the same device in different studies makes direct comparison of results difficult and at times inappropriate. Little evidence is available to assess the relative importance of different criteria; however, brief patient training based on specific inhaler technique checklists leads to significant improvement in asthma outcomes. This paper reviews common checklists and scoring systems used for Turbuhaler and Diskus, discusses the problem of heterogeneity between different checklists, and finally recommends suitable checklists and scoring systems for these devices based on the literature and previous findings. Only when similar checklists are used across different research studies will accurate comparisons and meta-analysis be possible. Copyright © 2014 by Daedalus Enterprises.

Computer-Based Video Instruction to Teach the Use of Augmentative and Alternative Communication Devices for Ordering at Fast-Food Restaurants

ERIC Educational Resources Information Center

Mechling, Linda C.; Cronin, Beth

2006-01-01

In the study reported on here, the authors used computer-based video instruction (CBVI) to teach 3 high school students with moderate or severe intellectual disabilities how to order in fast-food restaurants by using an augmentative, alternative communication device. The study employed a multiple probe design to institute CBVI as the only…

Evaluation and Customization of WHO Safety Checklist for Patient Safety in Otorhinolaryngology.

PubMed

Dabholkar, Yogesh; Velankar, Haritosh; Suryanarayan, Sneha; Dabholkar, Twinkle Y; Saberwal, Akanksha A; Verma, Bhavika

2018-03-01

The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist. The feedback from respondents (surgeons, nurses and anaesthetists) was used to arrive at a customised checklist for otolaryngology as per WHO guidelines. The checklist significantly improved team member's awareness of patient's identity (from 17 to 86%) and each other's identity and roles (from 46 to 94%) and improved team communication (from 73 to 92%) in operation theatre. There was a significant improvement in preoperative check of equipment and critical events were discussed more frequently. The checklist could be effectively customised to suit otolaryngology needs as per WHO guidelines. The modified checklist needs to be validated by otolaryngology associations. We conclude from our study that the WHO Surgical safety check-list has a favourable impact on patient safety awareness, team-work and communication of operating team and can be customised for otolaryngology setting.

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 ...

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

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…

GUIDE FOR COURSE OF STUDY FOR COOK (HOTEL AND RESTAURANT) (ENTRY).

ERIC Educational Resources Information Center

GUNN, VIRLAH

DESIGNED FOR TEACHER USE, THIS GUIDE FOR TRAINING COOKS IN HOTEL AND RESTAURANT OCCUPATIONS AIMS--(1) TO DEVELOP MANIPULATIVE SKILLS, (2) TO DEVELOP UNDERSTANDING OF THE BASIC PRINCIPLES OF SCIENCE, MATHEMATICS, AND RELATED KNOWLEDGE THAT CONDITION THESE SKILLS, (3) TO UNDERSTAND THE ADVANTAGES OF STEADY EMPLOYMENT, (4) TO DEVELOP HIGH STANDARDS…

Hearing Managers of Deaf Workers: A Phenomenological Investigation in the Restaurant Industry

ERIC Educational Resources Information Center

Stokar, Hayley; Orwat, John

2018-01-01

The study examined the experiences of hearing managers of Deaf restaurant employees regarding accommodation and social integration. Deaf workers who use American Sign Language have diff erent social and accommodation needs than hearing coworkers, but most hearing managers are unfamiliar with these needs. Using stigma theory to frame issues of…

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants

ERIC Educational Resources Information Center

Caspi, Caitlin Eicher; Wang, Qi; Shanafelt, Amy; Larson, Nicole; Wei, Susan; Hearst, Mary O.; Nanney, Marilyn S.

2017-01-01

Background: Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Methods: Breakfast-skippers enrolled in a group-randomized intervention…

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.

Surgical checklists: a systematic review of impacts and implementation

PubMed Central

Treadwell, Jonathan R; Lucas, Scott; Tsou, Amy Y

2014-01-01

Background Surgical complications represent a significant cause of morbidity and mortality with the rate of major complications after inpatient surgery estimated at 3–17% in industrialised countries. The purpose of this review was to summarise experience with surgical checklist use and efficacy for improving patient safety. Methods A search of four databases (MEDLINE, CINAHL, EMBASE and the Cochrane Database of Controlled Trials) was conducted from 1 January 2000 to 26 October 2012. Articles describing actual use of the WHO checklist, the Surgical Patient Safety System (SURPASS) checklist, a wrong-site surgery checklist or an anaesthesia equipment checklist were eligible for inclusion (this manuscript summarises all but the anaesthesia equipment checklists, which are described in the Agency for Healthcare Research and Quality publication). Results We included a total of 33 studies. We report a variety of outcomes including avoidance of adverse events, facilitators and barriers to implementation. Checklists have been adopted in a wide variety of settings and represent a promising strategy for improving the culture of patient safety and perioperative care in a wide variety of settings. Surgical checklists were associated with increased detection of potential safety hazards, decreased surgical complications and improved communication among operating staff. Strategies for successful checklist implementation included enlisting institutional leaders as local champions, incorporating staff feedback for checklist adaptation and avoiding redundancies with existing systems for collecting information. Conclusions Surgical checklists represent a relatively simple and promising strategy for addressing surgical patient safety worldwide. Further studies are needed to evaluate to what degree checklists improve clinical outcomes and whether improvements may be more pronounced in particular settings. PMID:23922403

Hospitalizations among employees in the Danish hotel and restaurant industry.

PubMed

Hannerz, Harald; Tüchsen, Finn; Kristensen, Tage S

2002-09-01

The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. Cohorts of all 20-59-year-old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age-standardized hospitalization ratios (SHR) and time trends (1981-1997) for many different diagnoses. Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group.

An outbreak of salmonellosis associated with duck prosciutto at a Northern Territory restaurant.

PubMed

Draper, Anthony Dk; Morton, Claire N; Heath, Joshua Ni; Lim, Justin A; Schiek, Anninka I; Davis, Stephanie; Krause, Vicki L; Markey, Peter G

2017-03-31

In June 2015, an outbreak of salmonellosis occurred among people who had eaten at a restaurant in Darwin, Northern Territory over 2 consecutive nights. We conducted a retrospective cohort study of diners who ate at the restaurant on 19 and 20 June 2015. Diners were telephoned and a questionnaire recorded symptoms and menu items consumed. An outbreak case was defined as anyone with laboratory confirmed Salmonella Typhimurium PT9 (STm9) or a clinically compatible illness after eating at the restaurant. Environmental health officers inspected the premises and collected food samples. We contacted 79/83 of the cohort (response rate 95%); 21 were cases (attack rate 27%), and 9 had laboratory confirmed STm9 infection. The most commonly reported symptoms were diarrhoea (100%), abdominal pain (95%), fever (95%) and nausea (95%). Fifteen people sought medical attention and 7 presented to hospital. The outbreak was most likely caused by consumption of duck prosciutto, which was consumed by all cases (OR 18.6, CI 3.0-∞, P < 0.01) and was prepared on site. Salmonella was not detected in any food samples but a standard plate count of 2 x 10 7 colony forming units per gram on samples of duck prosciutto demonstrated bacterial contamination. The restaurant used inappropriate methodology for curing the duck prosciutto. Restaurants should consider purchasing pre-made cured meats, or if preparing them on site, ensure that they adhere to safe methods of production.

Field validation of food outlet databases: the Latino food environment in North Carolina, USA.

PubMed

Rummo, Pasquale E; Albrecht, Sandra S; Gordon-Larsen, Penny

2015-04-01

Obtaining valid, reliable measures of food environments that serve Latino communities is important for understanding barriers to healthy eating in this at-risk population. The primary aim of the study was to examine agreement between retail food outlet data from two commercial databases, Nielsen TDLinx (TDLinx) for food stores and Dun & Bradstreet (D&B) for food stores and restaurants, relative to field observations of food stores and restaurants in thirty-one census tracts in Durham County, NC, USA. We also examined differences by proportion of Hispanic population (

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

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.

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

Alcohol Policy Comprehension, Compliance and Consequences Among Young Adult Restaurant Workers

PubMed Central

Ames, Genevieve M.; Cunradi, Carol B.; Duke, Michael R.

2012-01-01

SUMMARY This study explores relationships between young adult restaurant employees' understanding and compliance with workplace alcohol control policies and consequences of alcohol policy violation. A mixed method analysis of 67 semi-structured interviews and 1,294 telephone surveys from restaurant chain employees found that alcohol policy details confused roughly a third of employees. Among current drinkers (n=1,093), multivariable linear regression analysis found that frequency of alcohol policy violation was positively associated with frequency of experiencing problems at work; perceived supervisor enforcement of alcohol policy was negatively associated with this outcome. Implications for preventing workplace alcohol-related problems include streamlining confusing alcohol policy guidelines. PMID:22984360

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

Practices related to tobacco sale, promotion and protection from tobacco smoke exposure in restaurants and bars in Kampala before implementation of the Uganda tobacco control Act 2015.

PubMed

Kabwama, Steven Ndugwa; Kadobera, Daniel; Ndyanabangi, Sheila; Nyamurungi, Kellen Namusisi; Gravely, Shannon; Robertson, Lindsay; Guwatudde, David

2017-01-01

The Word Health Organization's Framework Convention on Tobacco Control calls on parties to implement evidenced-based tobacco control policies, which includes Article 8 (protect the public from exposure to tobacco smoke), and Article 13 (tobacco advertising, promotion and sponsorship (TAPS)). In 2015, Uganda passed the Tobacco Control Act 2015 which includes a comprehensive ban on smoking in all public places and on all forms of TAPS. Prior to implementation, we sought to assess practices related to protection of the public from tobacco smoke exposure, limiting access to tobacco products and TAPS in restaurants and bars in Kampala City to inform implementation of the new law. This was a cross-sectional study that used an observational checklist to guide observations. Assessments were: whether an establishment allows for tobacco products to be smoked on premises, offer of tobacco products for sale, observation of tobacco products for sale, tobacco advertising posters, illuminated tobacco advertisements, tobacco promotional items, presence of designated smoking zones, no-smoking signs and posters, and observation of indoor smoking. Managers of establishments were also asked whether they conducted tobacco product sales promotions within establishments. Data were collected in May 2016, immediately prior to implementation of the smoke-free and TAPS laws. Of the 218 establishments in the study, 17% ( n  = 37) had no-smoking signs, 50% ( n  = 108) allowed for tobacco products to be smoked on premises of which, 63% ( n  = 68) had designated smoking zones. Among the respondents in the study, 33.3% ( n  = 72) reported having tobacco products available for sale of which 73.6% ( n  = 53) had manufactured cigarettes as the available tobacco products. Eleven percent ( n  = 24) of respondents said they conducted tobacco promotion within their establishment while 7.9% ( n  = 17) had promotional items given to them by tobacco companies. Hospitality establishments in Kampala are not protecting the public from tobacco smoke exposure nor adequately limiting access to tobacco products. Effective dissemination of the Tobacco Control Act 2015 is important in ensuring that owners of public places are aware of their responsibility of complying with critical tobacco control laws. This would also likely increase self-enforcement among owners of hospitality establishments and public patrons of the no-smoking restrictions.

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- ...

Barriers to the implementation of checklists in the office-based procedural setting.

PubMed

Shapiro, Fred E; Fernando, Rohesh J; Urman, Richard D

2014-01-01

Patient safety is critical for the patients, providers, and risk managers in the office-based procedural setting, and the same standard of care should be maintained regardless of the healthcare environment. Checklists may improve patient safety and potentially decrease risk. This study explored utilization of checklists in the office-based setting and the potential barriers to their implementation. A cross-sectional prospective study was performed by using a 19-question anonymous survey designed with REDCap®. Medical providers including physicians and nurses from 25 different offices that performed procedures participated, and 38 individual responses were included in the study. Only 50% of offices surveyed use safety checklists in their practice. Only 34% had checklists or equivalent protocol for emergencies such as anaphylaxis or failed airway. As many as 23.7% of respondents indicated that they encountered barriers to implementing checklists. The top barriers identified in the study were no incentive to use a checklist (77.8%), no mandate from a local or federal regulatory agency (44.4%), being too time consuming (33.3%), and lack of training (33.3%). Reasons identified that would encourage providers to use checklists included a clear mandate (36.8%) and evidence-based research (26.3%). Checklists are not being universally utilized in the office-based setting. There are barriers preventing their successful implementation. Risk managers may be able to improve patient safety and decrease risk by encouraging practitioners, possibly through incentives, to use customizable safety checklists. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

Mixed methods study on the use of and attitudes towards safety checklists in interventional radiology.

PubMed

Munn, Zachary; Giles, Kristy; Aromataris, Edoardo; Deakin, Anita; Schultz, Timothy; Mandel, Catherine; Peters, Micah Dj; Maddern, Guy; Pearson, Alan; Runciman, William

2018-02-01

The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists. A mixed methods approach employing both quantitative and qualitative techniques was used for this study. Direct observations of checklist use during radiological procedures were performed to determine compliance. Medical records were also audited to investigate whether there was any discrepancy between practice (actual care measured by direct observation) and documentation (documented care measured by an audit of records). A focus group with Australian radiologists was conducted to determine attitudes towards the use of checklists. Among the four participating radiology departments, overall observed mean completion of the components of the checklist was 38%. The checklist items most commonly observed to be addressed by the operating theatre staff as noted during observations were correct patient (80%) and procedure (60%). Findings from the direct observations conflicted with the medical record audit, where there was a higher percentage of completion (64% completion) in comparison to the 38% observed. The focus group participants spoke of barriers to the use of checklists, including the culture of radiology departments. This is the first study of safety checklist use in radiology within Australia. Overall completion was low across the sites included in this study. Compliance data collected from observations differed markedly from reported compliance in medical records. There remain significant barriers to the proper use of safety checklists in Australian radiology departments. © 2017 The Royal Australian and New Zealand College of Radiologists.

What is the value of the SAGES/AORN MIS checklist? A multi-institutional practical assessment.

PubMed

Benham, Emily; Richardson, William; Dort, Jonathan; Lin, Henry; Tummers, A Michael; Walker, Travelyan M; Stefanidis, Dimitrios

2017-04-01

Surgical safety checklists reduce perioperative complications and mortality. Given that minimally invasive surgery (MIS) is dependent on technology and vulnerable to equipment failure, SAGES and AORN partnered to create a MIS checklist to optimize case flow and minimize errors. The aim of this project was to evaluate the effectiveness of the SAGES/AORN checklist in preventing disruptions and determine its ease of use. The checklist was implemented across four institutions and completed by the operating team. To assess its effectiveness, we recorded how often the checklist identified problems and how frequently each of the 45 checklist items were not completed. The perceived usefulness, ease of use, and frustration associated with checklist use were rated on a 5-point Likert scale by the surgeon. We assessed any differences dependent on timing of checklist completion and among institutions. The checklist was performed during MIS procedures (n = 114). When used before the procedure (n = 36), the checklist identified missing items in 13 cases (36.11 %). When used after the procedure (n = 61), the checklist identified missing items in 18 cases (29.51 %) that caused a delay of 4.1 ± 11.1 min. The most frequently missed items included preference card review (14.0 %), readiness of the carbon dioxide insufflator (8.7 %), and availability of the Veress needle (3.6 %). The checklist took an average of 3.6 ± 2.7 min to complete with its usefulness rated 2.6 ± 1.5, ease of use 2.0 ± 1.2, and frustration 1.3 ± 1.1. The checklist identified problems in 24 % of cases that led to preventable delays. The checklist was easy to complete and not frustrating, indicating it could improve operative flow. This study also identified the most useful items which may help abbreviate the checklist, minimizing the frustration and time taken to complete it while maximizing its utility. These attributes of the SAGES/AORN MIS checklist should be explored in future larger-scale studies.

Use of Probabilistic Topic Models for Search

DTIC Science & Technology

2009-09-01

Franchise . The metaphor is as follows: There is a number of restaurants ; each has an infinite number of tables. All restaurants serve dishes from a...via moment matching. This gives an approximate distri- bution for the total number of tables in the Chinese Restaurant Franchise as the sum of oc...described by a stick-breaking construction. Second, it can be defined as a distribution over partitions of a measurable space by the Chinese Restaurant

Feasibility of voluntary menu labeling among locally owned restaurants.

PubMed

Britt, John W; Frandsen, Kirsten; Leng, Kirsten; Evans, Diane; Pulos, Elizabeth

2011-01-01

In 2007, Tacoma-Pierce County Health Department launched a restaurant menu labeling project called SmartMenu. The objective was to recruit locally owned restaurants to voluntarily post basic nutrition information on their menus or menu boards. Participating restaurants submitted recipes to an independent contractor for nutritional analysis and agreed to post calorie, fat, carbohydrate, and sodium values on new menus within 90 days of receiving results. Vigorous recruitment efforts by the Health Department between June 2007 and September 2008 included free advertising, consultation with a Registered Dietitian, and free nutritional analysis. By the end of 2008, a total of 24 restaurants participated in the program. Significant barriers to participation included infrequent use of standardized recipes, perceived business risk of labeling, and low perceived customer demand for nutrition information. Key program elements, recruitment strategies, and costs are discussed. Results have important implications for future efforts to increase the adoption of menu labeling by locally owned and operated restaurants.

SARS-CoV Infection in a Restaurant from Palm Civet

PubMed Central

Wang, Ming; Yan, Meiying; Xu, Huifang; Liang, Weili; Kan, Biao; Zheng, Bojian; Chen, Honglin; Zheng, Han; Xu, Yanmei; Zhang, Enmin; Wang, Hongxia; Ye, Jingrong; Li, Guichang; Li, Machao; Cui, Zhigang; Liu, Yu-Fei; Guo, Rong-Tong; Liu, Xiao-Ning; Zhan, Liu-Hua; Zhou, Duan-Hua; Zhao, Ailan; Hai, Rong; Yu, Dongzhen; Guan, Yi

2005-01-01

Epidemiologic investigations showed that 2 of 4 patients with severe acute respiratory syndrome (SARS) identified in the winter of 2003–2004 were a waitress at a restaurant in Guangzhou, China, that served palm civets as food and a customer who ate in the restaurant a short distance from animal cages. All 6 palm civets at the restaurant were positive for SARS-associated coronavirus (SARS-CoV). Partial spike (S) gene sequences of SARS-CoV from the 2 patients were identical to 4 of 5 S gene viral sequences from palm civets. Phylogenetic analysis showed that SARS-CoV from palm civets in the restaurant was most closely related to animal isolates. SARS cases at the restaurant were the result of recent interspecies transfer from the putative palm civet reservoir, and not the result of continued circulation of SARS-CoV in the human population. PMID:16485471

SARS-CoV infection in a restaurant from palm civet.

PubMed

Wang, Ming; Yan, Meiying; Xu, Huifang; Liang, Weili; Kan, Biao; Zheng, Bojian; Chen, Honglin; Zheng, Han; Xu, Yanmei; Zhang, Enmin; Wang, Hongxia; Ye, Jingrong; Li, Guichang; Li, Machao; Cui, Zhigang; Liu, Yu-Fei; Guo, Rong-Tong; Liu, Xiao-Ning; Zhan, Liu-Hua; Zhou, Duan-Hua; Zhao, Ailan; Hai, Rong; Yu, Dongzhen; Guan, Yi; Xu, Jianguo

2005-12-01

Epidemiologic investigations showed that 2 of 4 patients with severe acute respiratory syndrome (SARS) identified in the winter of 2003-2004 were a waitresss at a restaurant in Guangzhou, China, that served palm civets as food and a customer who ate in the restaurant ashort distance from animal cages. All 6 palm civets at the restaurant were positive for SARS-associated coronavirus (SARS-CoV). Partial spike (S) gene sequences of SARS-CoV from the 2 patients were identical to 4 of 5 Sgene viral sequences from palm civets. Phylogenetic analysis showed that SARS-CoV from palm civets in the restaurant was most closely related to animal isolates. SARS cases at the restaurant were the result of recent interspecies transfer from the putative palm civet reservoir, and not the result of continued circulation of SARS-CoV in the human population.

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.

Wage theft as a neglected public health problem: an overview and case study from San Francisco's Chinatown District.

PubMed

Minkler, Meredith; Salvatore, Alicia L; Chang, Charlotte; Gaydos, Megan; Liu, Shaw San; Lee, Pam Tau; Tom, Alex; Bhatia, Rajiv; Krause, Niklas

2014-06-01

Wage theft, or nonpayment of wages to which workers are legally entitled, is a major contributor to low income, which in turn has adverse health effects. We describe a participatory research study of wage theft among immigrant Chinatown restaurant workers. We conducted surveys of 433 workers, and developed and used a health department observational tool in 106 restaurants. Close to 60% of workers reported 1 or more forms of wage theft (e.g., receiving less than minimum wage [50%], no overtime pay [> 65%], and pay deductions when sick [42%]). Almost two thirds of restaurants lacked required minimum wage law signage. We discuss the dissemination and use of findings to help secure and enforce a wage theft ordinance, along with implications for practice.

North Carolina Chefs Who Cultivate Restaurant Gardens: A Population with a Hunger for Extension Information

ERIC Educational Resources Information Center

Sommerfeld, Kelsie; Bruce, Jackie; Jayaratne, Jay; Chapman, Ben; Gunter, Chris

2016-01-01

As part of a larger study designed to explore the gardening practices and educational needs of North Carolina chefs who cultivate restaurant gardens, the chefs' desired areas of knowledge and preferences for delivery of educational material were identified. As a result, a plan for North Carolina Cooperative Extension to use in developing…

Reliability and Validity of a Questionnaire to Measure Consumer Knowledge regarding Safe Practices to Prevent Microbiological Contamination in Restaurants

ERIC Educational Resources Information Center

Uggioni, Paula Lazzarin; Salay, Elisabette

2013-01-01

Objective: The objective of this study was to develop a validated and reliable questionnaire to measure consumer knowledge regarding safe practices to prevent microbiological contamination in restaurants and commercial kitchens. Methods: Non-probabilistic samples of individuals were interviewed in the city of Campinas, Brazil. Questionnaire items…

Implementing a pediatric surgical safety checklist in the OR and beyond.

PubMed

Norton, Elizabeth K; Rangel, Shawn J

2010-07-01

An international study about implementation of the World Health Organization Surgical Safety Checklist showed that use of the checklist reduced complication and death rates in adult surgical patients. Clinicians at Children's Hospital Boston, Massachusetts, modified the Surgical Safety Checklist for pediatric populations. We pilot tested the Pediatric Surgical Safety Checklist and created a large checklist poster for each OR to allow the entire surgical team to view the checklist simultaneously and to promote shared responsibility for conducting the time out. Results of the pilot test showed improvements in teamwork, communication, and adherence to process measures. Parallel efforts were made in other areas of the hospital where invasive procedures are performed. Compliance with the checklist at our facility has been good, and team members have expressed satisfaction with the flow and content of the checklist. Copyright (c) 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Commercial Television Exposure, Fast Food Toy Collecting, and Family Visits to Fast Food Restaurants among Families Living in Rural Communities.

PubMed

Emond, Jennifer A; Bernhardt, Amy M; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D

2016-01-01

To assess the associations between children's exposure to television (TV) networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. One hundred parents of children 3-7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's TV viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (aOR 2.84 for each 1-unit increase in the child's commercial TV viewing scale, P < .001); toy collecting partially mediated that positive association. Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Food Allergy Training for Schools and Restaurants (The Food Allergy Community Program): Protocol to Evaluate the Effectiveness of a Web-Based Program.

PubMed

Pádua, Inês; Moreira, André; Moreira, Pedro; Barros, Renata

2018-06-12

Food allergy is a growing public health concern. The literature suggests that a significant number of reactions occur in community services, such as schools and restaurants. Therefore, suitable training and education for education and catering professionals using viable and practical tools is needed. The objective of this study is to evaluate the effectiveness of a Web-based food allergy training program for professionals working in schools and restaurants, designed to improve knowledge and good practices in the community. Free learning programs which contain educational animated videos about food allergy were developed for professionals working at schools and restaurants. The learning programs comprise of nine 5-minute videos, developed in video animation format using GoAnimate, with a total course length of 45-60 minutes. The courses for professionals at both schools and restaurants include contents about food allergy epidemiology, clinical manifestations, diagnosis and treatment, dietary avoidance, emergencies, labelling, and accidental exposure prevention. Additionally, specific topics for work practices at schools and restaurants were provided. Food allergy knowledge survey tools were developed to access the knowledge and management skills about food allergy of school and restaurant staff, at baseline and at the end of the food allergy program. The courses will be provided on the e-learning platform of the University of Porto and professionals from catering and education sectors will be invited to participate. Data collection will take place between September 2017 and October 2017, corresponding to a 2-month intervention. Final results will be disseminated in scientific journals and presented at national and international conferences. The Food Allergy Community Program intervention may improve school and restaurant professionals' commitment and skills to deal with food allergy in the community. Furthermore, this e-intervention program will provide an innovative contribution to understanding the impact of electronic health technologies on the learning process and the development of strategies for community interventions. RR1-10.2196/9770. ©Inês Pádua, André Moreira, Pedro Moreira, Renata Barros. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.06.2018.

Indoor air quality in Virginia waterpipe cafés

PubMed Central

Cobb, Caroline Oates; Vansickel, Andrea Rae; Blank, Melissa D; Jentink, Kade; Travers, Mark J; Eissenberg, Thomas

2014-01-01

Introduction A revised indoor air quality law has been implemented in Virginia to protect the public from the harmful effects of secondhand smoke exposure. This legislation contains exemptions that include allowances for smoking in a room that is structurally separated and separately ventilated. The objective of the current study was to examine the impact of this law on air quality in waterpipe cafés, as well as to compare the air quality in these cafés to restaurants that allow cigarette smoking and those where no smoking is permitted. Methods Indoor air quality in 28 venues (17 waterpipe cafés, five cigarette smoking-permitted restaurants and six smoke-free restaurants (five with valid data)) in Virginia was assessed during 4 March to 27 May 2011. Real-time measurements of particulate matter (PM) with 2.5 µm aerodynamic diameter or smaller (PM2.5) were obtained and occupant behaviour/venue characteristics were assessed. Results The highest mean PM2.5 concentration was observed for waterpipe café smoking rooms (374 µg/m3, n=17) followed by waterpipe café non-smoking rooms (123 µg/m3, n=11), cigarette smoking-permitted restaurant smoking rooms (119 µg/m3, n=5), cigarette smoking-permitted restaurant non-smoking rooms (26 µg/m3, n=5) and smoke-free restaurants (9 µg/m3, n=5). Smoking density was positively correlated with PM2.5 across smoking rooms and the smoke-free restaurants. In addition, PM2.5 was positively correlated between smoking and non-smoking rooms of venues. Conclusions The PM2.5 concentrations observed among the waterpipe cafés sampled here indicated air quality in the waterpipe café smoking rooms was worse than restaurant rooms in which cigarette smoking was permitted, and state-required non-smoking rooms in waterpipe cafés may expose patrons and employees to PM2.5 concentrations above national and international air quality standards. Reducing the health risks of secondhand smoke may require smoke-free establishments in which tobacco smoking sources such as water pipes are, like cigarettes, prohibited. PMID:22447194

75 FR 25281 - Food Protection Workshop; Public Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... establishments such as farms, manufacturers, processors, distributors, retailers, and restaurants. Date and Time... establishments (such as farms, manufacturers, processors, distributors, retailers, and restaurants) originating..., distributors, retailers, and restaurants) to better comply with any regulations authorized by the Public Health...

Impact of Checklist Use on Wellness and Post-Elective Surgery Appointments in a Veterinary Teaching Hospital.

PubMed

Ruch-Gallie, Rebecca; Weir, Heather; Kogan, Lori R

Cognitive functioning is often compromised with increasing levels of stress and fatigue, both of which are often experienced by veterinarians. Many high-stress fields have implemented checklists to reduce human error. The use of these checklists has been shown to improve the quality of medical care, including adherence to evidence-based best practices and improvement of patient safety. Although it has been recognized that veterinary medicine would likely demonstrate similar benefits, there have been no published studies to date evaluating the use of checklists for improving quality of care in veterinary medicine. The purpose of the current study was to evaluate the impact of checklists during wellness and post-elective surgery appointments conducted by fourth-year veterinary students within their Community Practice rotation at a US veterinary teaching hospital. Students were randomly assigned to one of two groups: those who were specifically asked to use the provided checklists during appointments, and those who were not asked to use the checklists but had them available. Two individuals blinded to the study reviewed the tapes of all appointments in each study group to determine the amount and type of medical information offered by veterinary students. Students who were specifically asked to use the checklists provided significantly more information to owners, with the exception of keeping the incision clean. Results indicate the use of checklists helps students provide more complete information to their clients, thereby potentially enhancing animal care.

Environmental Assessment: Proposed Construction of Army and Air Force Exchange Service Mini-Mall

DTIC Science & Technology

2003-10-01

fast food style restaurant would be accommodated in the mini-mall. Data on electrical consumption for the Burger King restaurant at MAFB (Building...MAFB-Gunter Annex. Assuming the new restaurant in the mini-mall consumes approximately the same quantity of electricity annually as the Burger King ...in the mini-mall. Data on natural gas consumption for the Burger King restaurant at MAFB (Building 1087) in FY 2001 reveals that this facility

I saw the sign: the new federal menu-labeling law and lessons from local experience.

PubMed

Banker, Michelle I

2010-01-01

Following the lead of several state and local governments, Congress recently imposed menu-labeling requirements on chain restaurants as part of the federal health care reform bill signed into law in March 2010. Section 4205 of the Patient Protection and Affordable Care Act requires restaurant chains with 20 or more locations nationwide to display calorie information for standard menu items on menus, menu boards, and drive-thru displays. This paper examines the new federal law in light of existing state and local regulations and considers the arguments for and against mandatory calorie labeling at restaurants as a federal tool for preventing obesity. Specifically, this paper examines the provisions of the new federal law, highlights how it differs from the municipal and state menu-labeling laws already in effect, reviews early studies of the effectiveness of these state and local laws, and considers the propriety of requiring restaurants to disclose calorie information on menus by discussing arguments for and against menu labeling generally and calorie labeling in particular. This paper finds that based on initial studies of state and local menu-labeling regulations, the efficacy of compulsory menu labeling as a tool to combat obesity remains uncertain. Finally, this paper raises practical considerations associated with the new federal law, including implementation issues, potential collateral effects of the law, a survey of legal challenges that may arise, and a discussion of the Food and Drug Administration's competence to enforce a menu-labeling requirement against restaurants.

An ecological analysis of food outlet density and prevalence of type II diabetes in South Carolina counties.

PubMed

AlHasan, Dana M; Eberth, Jan Marie

2016-01-05

Studies suggest that the built environment with high numbers of fast food restaurants and convenience stores and low numbers of super stores and grocery stores are related to obesity, type II diabetes mellitus, and other chronic diseases. Since few studies assess these relationships at the county level, we aim to examine fast food restaurant density, convenience store density, super store density, and grocery store density and prevalence of type II diabetes among counties in South Carolina. Pearson's correlation between four types of food outlet densities- fast food restaurants, convenience stores, super stores, and grocery stores- and prevalence of type II diabetes were computed. The relationship between each of these food outlet densities were mapped with prevalence of type II diabetes, and OLS regression analysis was completed adjusting for county-level rates of obesity, physical inactivity, density of recreation facilities, unemployment, households with no car and limited access to stores, education, and race. We showed a significant, negative relationship between fast food restaurant density and prevalence of type II diabetes, and a significant, positive relationship between convenience store density and prevalence of type II diabetes. In adjusted analysis, the food outlet densities (of any type) was not associated with prevalence of type II diabetes. This ecological analysis showed no associations between fast food restaurants, convenience stores, super stores, or grocery stores densities and the prevalence of type II diabetes. Consideration of environmental, social, and cultural determinants, as well as individual behaviors is needed in future research.

Health department inspection criteria more likely to be associated with outbreak restaurants in Minnesota.

PubMed

Petran, Ruth L; White, Bruce W; Hedberg, Craig W

2012-11-01

Millions of routine restaurant inspections are performed each year in the United States, and the Centers for Disease Control and Prevention has reported that a majority of foodborne illness outbreaks occur in restaurant settings. In an attempt to relate the data collected during inspections in Minnesota to illness likelihood, data from routine inspections conducted at outbreak restaurants were compared with data from routine inspections conducted at nonoutbreak restaurants. The goal was to identify differences in recorded violations. Significantly more violations were recorded at restaurants that had outbreaks. The majority of these violations were related to contamination in the facility and environment and to food handling procedures. Relative risks also were calculated for violations significantly more likely to occur at locations that had outbreaks of norovirus infection, Clostridium perfringens infection or toxin-type illness, and Salmonella infection. These three pathogens are estimated to cause the majority of foodborne illnesses in the United States. Meta-analysis of composited data for the three pathogens revealed 11 violations significantly more likely (α < 0.05) to be identified during routine inspections at outbreak restaurants than during inspections at nonoutbreak restaurants. Application of this information permits assessment of health department inspection data in a consistent fashion. This approach can help identify criteria more likely to be associated with outbreak locations and allow operators to focus on interventions that will have the most significant impact in higher risk establishments.

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.

A Call to Digital Health Practitioners: New Guidelines Can Help Improve the Quality of Digital Health Evidence

PubMed Central

Agarwal, Smisha; Lefevre, Amnesty E

2017-01-01

Background Despite the rapid proliferation of health interventions that employ digital tools, the evidence on the effectiveness of such approaches remains insufficient and of variable quality. To address gaps in the comprehensiveness and quality of reporting on the effectiveness of digital programs, the mHealth Technical Evidence Review Group (mTERG), convened by the World Health Organization, proposed the mHealth Evidence Reporting and Assessment (mERA) checklist to address existing gaps in the comprehensiveness and quality of reporting on the effectiveness of digital health programs. Objective We present an overview of the mERA checklist and encourage researchers working in the digital health space to use the mERA checklist for reporting their research. Methods The development of the mERA checklist consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot-testing the checklist. Results The mERA checklist consists of 16 core mHealth items that define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features). Additionally, a 29-item methodology checklist guides authors on reporting critical aspects of the research methodology employed in the study. We recommend that the core mERA checklist is used in conjunction with an appropriate study-design specific checklist. Conclusions The mERA checklist aims to assist authors in reporting on digital health research, guide reviewers and policymakers in synthesizing evidence, and guide journal editors in assessing the completeness in reporting on digital health studies. An increase in transparent and rigorous reporting can help identify gaps in the conduct of research and understand the effects of digital health interventions as a field of inquiry. PMID:28986340

The Child Dissociative Checklist: Preliminary Findings of a Screening Measure.

ERIC Educational Resources Information Center

Wherry, Jeffrey N.; And Others

1994-01-01

Reports on the use of a screening instrument for dissociative behaviors in two separate but related studies. Results of a concurrent validity study between the Child Dissociative Checklist (CDC) and the Child Behavior Checklist indicate significant, positive correlations. A second study found that parent-completed CDC scores differentiate between…

Nasal carriage of enterotoxin-producing Staphylococcus aureus among restaurant workers in Kuwait City.

PubMed Central

al Bustan, M. A.; Udo, E. E.; Chugh, T. D.

1996-01-01

Enterotoxin-producing Staphylococcus aureus is a common cause of staphylococcal food poisoning. To determine the incidence of carriage of enterotoxin-producing S. aureus in a sample of the healthy population in Kuwait city, restaurant workers in the city were screened for nasal carriage of S. aureus. 26.6% of 500 workers studied carried S. aureus and 86.6% of the S. aureus produced staphylococcal enterotoxins. 28% produced enterotoxin A, 28.5% produced enterotoxin B, 16.4% produced enterotoxin C and 3.5% produced enterotoxin D. Ten isolates produced both enterotoxins A and B or A and C. 73% of the isolates were untypeable with standard phages. However, 17.1%, 3% and 6% belonged to phage groups I, II and III respectively. The results demonstrated a high level of enterotoxigenic S. aureus carriage among restaurant workers which although lower than that reported for the general population and hospital workers may be important in the restaurant industry. PMID:8666076

Improving queuing service at McDonald's

NASA Astrophysics Data System (ADS)

Koh, Hock Lye; Teh, Su Yean; Wong, Chin Keat; Lim, Hooi Kie; Migin, Melissa W.

2014-07-01

Fast food restaurants are popular among price-sensitive youths and working adults who value the conducive environment and convenient services. McDonald's chains of restaurants promote their sales during lunch hours by offering package meals which are perceived to be inexpensive. These promotional lunch meals attract good response, resulting in occasional long queues and inconvenient waiting times. A study is conducted to monitor the distribution of waiting time, queue length, customer arrival and departure patterns at a McDonald's restaurant located in Kuala Lumpur. A customer survey is conducted to gauge customers' satisfaction regarding waiting time and queue length. An android app named Que is developed to perform onsite queuing analysis and report key performance indices. The queuing theory in Que is based upon the concept of Poisson distribution. In this paper, Que is utilized to perform queuing analysis at this McDonald's restaurant with the aim of improving customer service, with particular reference to reducing queuing time and shortening queue length. Some results will be presented.

A baseline evaluation of casino air quality after enactment of Nevada's Clean Indoor Air Act.

PubMed

York, Nancy L; Lee, Kiyoung

2010-01-01

The U.S. Surgeon General reports that there is no safe level of exposure to secondhand smoke (SHS). The purpose of this study was to measure levels of fine particulate matter in nonsmoking casino restaurants after enactment of Nevada's Clean Indoor Air Act (NCIAA). Fine particulate matter<2.5 microm in diameter (PM2.5) concentrations were measured in 16 casino hotel restaurants and gaming areas for a total of 32 venues. A battery-operated SidePak aerosol monitor was discreetly used for at least 30 min in each venue. Nonsmoking restaurant PM2.5 levels ranged from 5 to 101 microg/m3 (M=31; SD=22.9) while gaming areas ranged from 20 to 73 microg/m3 (M=48; SD=15.9). There was a significant difference in PM2.5 between restaurants and gaming areas, t30=-2.54, p=.017. There was also a strong correlation between the levels of restaurant PM2.5 and gaming area PM2.5 (r=.71; p=.005). Fine PM2.5 in all casino areas was above what the Environmental Protection Agency recommends as healthy. This information can be used to educate policy decision makers when discussing potential strengthening of the law.

Perceptions of university students regarding calories, food healthiness, and the importance of calorie information in menu labelling.

PubMed

Fernandes, Ana Carolina; de Oliveira, Renata Carvalho; Rodrigues, Vanessa Mello; Fiates, Giovanna Medeiros Rataichesck; da Costa Proença, Rossana Pacheco

2015-08-01

This study investigated Brazilian university students' perceptions of the concept of calories, how it relates to food healthiness, and the role of calorie information on menus in influencing food choices in different restaurant settings. Focus groups were conducted with 21 undergraduate students from various universities. Transcriptions were analysed for qualitative content, by coding and grouping words and phrases into similar themes. Two categories were obtained: Calorie concept and connection to healthiness; and Calorie information and food choices in restaurants. Calories were understood as energy units, and their excessive intake was associated with weight gain or fat gain. However, food healthiness was not associated to calorie content, but rather to food composition as a whole. Calorie information on restaurant menus was not considered enough to influence food choices, with preferences, dietary restrictions, food composition, and even restaurant type mentioned as equally or more important. Only a few participants mentioned using calorie information on menus to control food intake or body weight. Students' discussions were suggestive of an understanding of healthy eating as a more complex issue than calorie-counting. Discussions also suggested the need for more nutrition information, besides calorie content, to influence food choices in restaurants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reducing heavy alcohol consumption in young restaurant workers.

PubMed

Broome, Kirk M; Bennett, Joel B

2011-01-01

Restaurant employees often have high rates of heavy drinking and problems with alcohol. This study evaluates reductions in drinking and associated problems at work, in connection with a new program for prevention and early intervention. The program, called Team Resilience, is designed for young restaurant workers. A cluster-randomized trial design was used, with 28 stores from a national casual-dining restaurant chain and 235 of their employees (54% male, 46% female). Fourteen stores received the Team Resilience training workshop, consisting of three 2-hour sessions held on 3 consecutive days. Sessions included group discussion, role-play and practice activities, and a learning game. Workers in trained stores reported significantly greater decreases in recurring heavy drinking (i.e., having five or more drinks on the same occasion, on 5 or more days in the past month) and work-related problems with alcohol than workers in control stores. In the intervention group, the odds of recurring heavy drinking declined by about one half and the number of work-related problem areas declined by one third following training. In addition, drinking behaviors and problems were tied to age and were most common among employees in their middle 20s. Findings support Team Resilience as an effective intervention for reducing drinking and associated problems among young restaurant workers, a population with substantial needs.

Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

PubMed Central

Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

2009-01-01

Background While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. Methods The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Results Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors. Conclusion Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses. PMID:19473503

Fate of Campylobacter jejuni in butter.

PubMed

Zhao, T; Doyle, M P; Berg, D E

2000-01-01

An outbreak of Campylobacter enteritis was associated with a restaurant in Louisiana during the summer of 1995. Thirty cases were identified, and four required hospitalization. Campylobacter jejuni was isolated from the patients, and epidemiologic studies revealed illness associated with eating garlic butter served at the restaurant. Three batches of garlic butter prepared by the restaurant associated with the outbreak and a C. jejuni isolate obtained from a patient involved in the outbreak were used for studies to determine the fate of C. jejuni in garlic butter. Studies also were done to determine the efficacy of the heat treatment used by the restaurant to prepare garlic bread to kill C. jejuni. Garlic butter was inoculated with approximately 10(4) and 10(6) CFU/g of C. jejuni and held at 5 or 21 degrees C. Results revealed that the survival of C. jejuni differed greatly, depending on the presence or absence of garlic. At 5 degrees C, C. jejuni populations decreased to an undetectable level (<10 CFU/g) within 3 h for two batches and within 24 h for another batch. In contrast, C. jejuni could survive at 5 degrees C for 13 days in butter with no garlic. At 21 degrees C, C. jejuni populations decreased to an undetectable level within 5 h for two batches and to 50 CFU/g in 5 h for another batch. In contrast, C. jejuni was detected at 500 CFU/g at 28 h after inoculation but was undetectable at 3 days in butter with no garlic held at 21 degrees C. The heating procedure (135 degrees C, 4 min) used to make garlic bread by the implicated restaurant was determined not to be sufficient for killing C. jejuni, with the internal temperature of the buttered bread after heating ranging from 19 to 22 degrees C. This study revealed that C. jejuni can survive for many days in refrigerated butter, but large populations (10(3) to 10(5) CFU/g) are killed within a few hours in butter that contains garlic. Furthermore, the heat treatment used by the restaurant to melt garlic butter in making garlic bread was not adequate to kill C. jejuni.

A Feedback Intervention to Increase Digital and Paper Checklist Performance in Technically Advanced Aircraft Simulation

ERIC Educational Resources Information Center

Rantz, William G.; Van Houten, Ron

2011-01-01

This study examined whether pilots operating a flight simulator completed digital or paper flight checklists more accurately after receiving postflight graphic and verbal feedback. The dependent variable was the number of checklist items completed correctly per flight. Following treatment, checklist completion with paper and digital checklists…

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.

Proximity of fast-food restaurants to schools and adolescent obesity.

PubMed

Davis, Brennan; Carpenter, Christopher

2009-03-01

We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. We used geocoded data (obtained from the 2002-2005 California Healthy Kids Survey) on over 500,000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity

PubMed Central

Carpenter, Christopher

2009-01-01

Objectives. We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. Methods. We used geocoded data (obtained from the 2002–2005 California Healthy Kids Survey) on over 500 000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. Results. We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). Conclusions. Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity. PMID:19106421

Impact of a letter-grade program on restaurant sanitary conditions and diner behavior in New York City.

PubMed

Wong, Melissa R; McKelvey, Wendy; Ito, Kazuhiko; Schiff, Corinne; Jacobson, J Bryan; Kass, Daniel

2015-03-01

We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. We analyzed data from 43,448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI]=31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI=88%, 94%) of New Yorkers approved of the program and 88% (95% CI=85%, 92%) considered grades in dining decisions in 2012. Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool.

Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998-2013.

PubMed

Angelo, K M; Nisler, A L; Hall, A J; Brown, L G; Gould, L H

2017-02-01

Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618-629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

Constructing a consumption model of fine dining from the perspective of behavioral economics

PubMed Central

Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants. PMID:29641554

Constructing a consumption model of fine dining from the perspective of behavioral economics.

PubMed

Hsu, Sheng-Hsun; Hsiao, Cheng-Fu; Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants.

[A survey on the contents of nutrient and nutrition in the orderings of customers when eating at three restaurants in Beijing].

PubMed

Liang, Baojing; Zhao, Nanxi; Li, Liming; Lyu, Jun

2016-04-01

To study the median nutrient content of customers' ordering in the restaurants in Beijing. The median contents of nutrients regarding ordering/per person from the customers were estimated, via combining the nutrient content of menu offering. Data, based on all weights of ingredients and Chinese food composition with all the ordered records from customers, was collected within a set period of time, from 2011 to 2013. Nutrition status was then estimated, under the Nutrient-Rich Foods (NRF). The median energy intake reached 4 973.9 (P25-P75: 3 575.6-6 971.0) kJ and 88.2% of the tables were exceeding the recommended energy limits, respectively, with 3 347.2 kJ for lunch and 2 510.4 kJ for dinner. Data was gathered from three restaurants in Beijing. In all the three restaurants, the median nutrient contents appeared 70% outnumbered the daily value of fat and cholesterol. The median sodium contents (87.9%) were also over the standard set for sodium adequate intake. In addition, the median nutrition on fibers, calcium, vitamin A, vitamin C and vitamin E were far below the recommended nutritional intakes (RNI), in the ordering. For NRF9.3, the Wenzhou restaurant showed the highest score (5.50) but the restaurant in Yunnan appeared the lowest (2.26), with difference statistically significant (P<0.001). Eating-out habit ended in taking low nutrition with higher limited nutrients, but with low recommended nutrients, when compared to the recommended Chinese Dietary Reference Intake.

Changes in sodium levels in processed and restaurant foods, 2005 to 2011.

PubMed

Jacobson, Michael F; Havas, Stephen; McCarter, Robert

2013-07-22

Excess consumption of sodium is an important cause of hypertension, a major risk factor for heart disease and stroke. The higher the level of consumption, the greater is a person's likelihood of developing hypertension. Numerous organizations have recommended reductions in sodium intake in the United States. Roughly 80% of the sodium consumed by Americans has been added by food manufacturers and restaurants. To compare the mean (SD) levels of sodium for identical products ascertained in 2005, 2008, and 2011. Comparison study in an academic research setting. Center for Science in the Public Interest staff have monitored sodium levels in selected processed foods and fast-food restaurant foods for many years. The sodium content in identical foods, as measured in 2005, 2008, and 2011. Between 2005 and 2011, the sodium content in 402 processed foods declined by approximately 3.5%, while the sodium content in 78 fast-food restaurant products increased by 2.6%. Although some products showed decreases of at least 30%, a greater number of products showed increases of at least 30%. The predominant finding is the absence of any appreciable or statistically significant changes in sodium content during 6 years. Based on our sample, reductions in sodium levels in processed and restaurant foods are inconsistent and slow. These findings are in accord with other data indicating the slow pace of voluntary reductions in sodium levels in processed and restaurant foods. Stronger action (eg, phased-in limits on sodium levels set by the federal government) is needed to lower sodium levels and reduce the prevalence of hypertension and cardiovascular diseases.

Urinary 1-hydroxypyrene and malondialdehyde in male workers in Chinese restaurants

PubMed Central

Pan, C-H; Chan, C-C; Huang, Y-L; Wu, K-Y

2008-01-01

Objectives: To assess internal dose and oxidative stress in male restaurant workers exposed to polycyclic aromatic hydrocarbons (PAHs) from cooking oil fumes (COFs) in Chinese restaurants. Methods: The study participants included 288 male restaurant workers (171 kitchen and 117 service staff) in Chinese restaurants in Taiwan. Airborne particulate PAHs were measured over 12 h on each of two consecutive work days and then identified using high performance liquid chromatography. Urinary 1-hydroxypyrene (1-OHP) measurements were used to indicate COF exposure, and urinary malondialdehyde (MDA) was adopted as an oxidative stress marker. Multiple regression models were used to assess the relationship between MDA and 1-OHP levels after adjusting for key personal covariates. Results: Summed particulate PAH levels in kitchens (median 23.9 ng/m3) were significantly higher than those in dining areas (median 4.9 ng/m3). For non-smoking kitchen staff, mean MDA and 1-OHP levels were 344.2 (SD 243.7) and 6.0 (SD 8.0) μmol/mol creatinine, respectively. These levels were significantly higher than those for non-smoking service staff, which were 244.2 (SD 164.4) and 2.4 (SD 4.3) μmol/mol creatinine, respectively. Urinary 1-OHP levels were significantly associated with work in kitchens (p<0.05). Furthermore, urinary MDA levels were significantly associated with urinary 1-OHP levels (p<0.001) and working hours per day (p<0.05). Conclusions: These findings indicate that urinary 1-OHP and MDA levels reflect occupational exposure to PAHs from COFs and oxidative stress in workers in Chinese restaurants. PMID:18940956

The effect of providing nutritional information about fast-food restaurant menus on parents' meal choices for their children.

PubMed

Ahn, Jae-Young; Park, Hae-Ryun; Lee, Kiwon; Kwon, Sooyoun; Kim, Soyeong; Yang, Jihye; Song, Kyung-Hee; Lee, Youngmi

2015-12-01

To encourage healthier food choices for children in fast-food restaurants, many initiatives have been proposed. This study aimed to examine the effect of disclosing nutritional information on parents' meal choices for their children at fast-food restaurants in South Korea. An online experimental survey using a menu board was conducted with 242 parents of children aged 2-12 years who dined with them at fast-food restaurants at least once a month. Participants were classified into two groups: the low-calorie group (n = 41) who chose at least one of the lowest calorie meals in each menu category, and the high-calorie group (n = 201) who did not. The attributes including perceived empowerment, use of provided nutritional information, and perceived difficulties were compared between the two groups. The low-calorie group perceived significantly higher empowerment with the nutritional information provided than did the high-calorie group (P = 0.020). Additionally, the low-calorie group was more interested in nutrition labeling (P < 0.001) and considered the nutritional value of menus when selecting restaurants for their children more than did the high-calorie group (P = 0.017). The low-calorie group used the nutritional information provided when choosing meals for their children significantly more than did the high-calorie group (P < 0.001), but the high-calorie group had greater difficulty using the nutritional information provided (P = 0.012). The results suggest that improving the empowerment of parents using nutritional information could be a strategy for promoting healthier parental food choices for their children at fast-food restaurants.

Urinary 1-hydroxypyrene and malondialdehyde in male workers in Chinese restaurants.

PubMed

Pan, C-H; Chan, C-C; Huang, Y-L; Wu, K-Y

2008-11-01

To assess internal dose and oxidative stress in male restaurant workers exposed to polycyclic aromatic hydrocarbons (PAHs) from cooking oil fumes (COFs) in Chinese restaurants. The study participants included 288 male restaurant workers (171 kitchen and 117 service staff) in Chinese restaurants in Taiwan. Airborne particulate PAHs were measured over 12 h on each of two consecutive work days and then identified using high performance liquid chromatography. Urinary 1-hydroxypyrene (1-OHP) measurements were used to indicate COF exposure, and urinary malondialdehyde (MDA) was adopted as an oxidative stress marker. Multiple regression models were used to assess the relationship between MDA and 1-OHP levels after adjusting for key personal covariates. Summed particulate PAH levels in kitchens (median 23.9 ng/m(3)) were significantly higher than those in dining areas (median 4.9 ng/m(3)). For non-smoking kitchen staff, mean MDA and 1-OHP levels were 344.2 (SD 243.7) and 6.0 (SD 8.0) mumol/mol creatinine, respectively. These levels were significantly higher than those for non-smoking service staff, which were 244.2 (SD 164.4) and 2.4 (SD 4.3) mumol/mol creatinine, respectively. Urinary 1-OHP levels were significantly associated with work in kitchens (p<0.05). Furthermore, urinary MDA levels were significantly associated with urinary 1-OHP levels (p<0.001) and working hours per day (p<0.05). These findings indicate that urinary 1-OHP and MDA levels reflect occupational exposure to PAHs from COFs and oxidative stress in workers in Chinese restaurants.

Sociocultural contexts and worker safety and health: findings of a study with Chinese immigrant restaurant workers.

PubMed

Tsai, Jenny; Bruck, Annie

2009-02-01

More immigrants are seeking employment in restaurants. Drawing data from an ethnographic study, this article discusses what and how sociocultural contexts shape the safety and health of immigrant restaurant workers. Eighteen Chinese immigrants from China, Hong Kong, and Taiwan participated in the study. Data generation methods included a questionnaire, individual and focus group interviews, and participant observations. Ethnographic analysis revealed that immigration mechanisms, demands of English proficiency for employment, and existence of networks and ethnic communities shaped the participants' employment choices. Working hours and schedules, interpersonal relationships at work, job design and training, occupational safety and health training, and national events and economy further influenced the participants' occupational experiences and well-being. Issues were noted with job security, mental health, family relationships, and risks for occupational injuries and illnesses. Implications for occupational health nursing research and practice to reduce immigrant workers' vulnerability to poor safety and health outcomes conclude this article.

76 FR 19741 - Exemption for Retail Store Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... a retail store can sell to hotels, restaurants, and similar institutions without disqualifying... the types of operations traditionally and usually conducted at retail stores and restaurants when those operations are conducted at any retail store or restaurant or similar retail-type establishment...

9 CFR 303.1 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operations of types traditionally and usually conducted at retail stores and restaurants, when conducted at any retail store or restaurant or similar retail-type establishment for sale in normal retail... restaurants are the following: (a) Cutting up, slicing, and trimming carcasses, halves, quarters, or wholesale...

The effect of fast-food restaurants on childhood obesity: a school level analysis.

PubMed

Alviola, Pedro A; Nayga, Rodolfo M; Thomsen, Michael R; Danforth, Diana; Smartt, James

2014-01-01

We analyze, using an instrumental variable approach, the effect of the number of fast-food restaurants on school level obesity rates in Arkansas. Using distance to the nearest major highway as an instrument, our results suggest that exposure to fast-food restaurants can impact weight outcomes. Specifically, we find that the number of fast-food restaurants within a mile from the school can significantly affect school level obesity rates. Copyright © 2013 Elsevier B.V. All rights reserved.

Kolkata Restaurant Problem as a Generalised El Farol Bar Problem

NASA Astrophysics Data System (ADS)

Chakrabarti, Bikas K.

Generalisation of the El Farol bar problem to that of many bars here leads to the Kolkata restaurant problem, where the decision to go to any restaurant or not is much simpler (depending on the previous experience of course, as in the El Farol bar problem). This generalised problem can be exactly analysed in some limiting cases discussed here. The fluctuation in the restaurant service can be shown to have precisely an inverse cubic behavior, as widely seen in the stock market fluctuations.

Improving the preoperative care of patients with femoral neck fractures through the development and implementation of a checklist.

PubMed

Agha, Riaz; Edison, Eric; Fowler, Alexander

2014-01-01

The incidence of femoral neck fractures (FNFs) is expected to rise with life expectancy. It is important to improve the safety of these patients whilst under the care of orthopaedic teams. This study aimed to increase the performance of vital preoperative tasks in patients admitted for femoral neck fracture operations by producing and implementing a checklist as an aide memoir. The checklist was designed primarily for use by senior house officers (SHOs) admitting patients from the emergency department. A list of 12 preoperative tasks was identified. A baseline audit of 10 random patients showed that the mean proportion of the 12 tasks completed was 53% (range 25% - 83%). A survey of 14 nurses and surgeons found that the majority of respondents agreed that there was a problem with the performance of most of the tasks. The tasks were incorporated into a checklist which was refined in three plan-do-study-act cycles and introduced into the femoral neck fracture pathway. In the week following the introduction of the checklist, 77% of the checklist tasks were completed, 24% more than at the baseline audit (53%). In week 3, the completion of checklist tasks rose to 88% and to 95% in week 4. In conclusion, a simple checklist can markedly improve the performance and recording of preoperative tasks by SHOs. We recommend the wider adoption of the new checklist to be produced as a sticker for patients' medical records. Further study is required to ascertain the effect of the checklist on clinical outcomes.

A toy story: Association between young children's knowledge of fast food toy premiums and their fast food consumption.

PubMed

Longacre, Meghan R; Drake, Keith M; Titus, Linda J; Cleveland, Lauren P; Langeloh, Gail; Hendricks, Kristy; Dalton, Madeline A

2016-01-01

Fast food restaurants spend millions of dollars annually on child-targeted marketing, a substantial portion of which is allocated to toy premiums for kids' meals. The objectives of this study were to describe fast food toy premiums, and examine whether young children's knowledge of fast food toy premiums was associated with their fast food consumption. Parents of 3- to 5-year old children were recruited from pediatric and WIC clinics in Southern New Hampshire, and completed a cross-sectional survey between April 2013-March 2014. Parents reported whether their children usually knew what toys were being offered at fast food restaurants, and whether children had eaten at any of four restaurants that offer toy premiums with kids' meals (McDonald's, Burger King, Subway, Wendy's) during the 7 days preceding the survey. Seventy-one percent of eligible parents participated (N = 583); 48.4% did not receive any education beyond high school, and 27.1% of children were non-white. Half (49.7%) the children had eaten at one or more of the four fast food restaurants in the past week; one-third (33.9%) had eaten at McDonald's. The four restaurants released 49 unique toy premiums during the survey period; McDonald's released half of these. Even after controlling for parent fast food consumption and sociodemographics, children were 1.38 (95% CI = 1.04, 1.82) times more likely to have consumed McDonald's if they usually knew what toys were offered by fast food restaurants. We did not detect a relationship between children's toy knowledge and their intake of fast food from the other restaurants. In this community-based sample, young children's knowledge of fast food toys was associated with a greater frequency of eating at McDonald's, providing evidence in support of regulating child-directed marketing of unhealthy foods using toys. Copyright © 2015 Elsevier Ltd. All rights reserved.

The influence of recipe modification and nutritional information on restaurant food acceptance and macronutrient intakes.

PubMed

Stubenitsky, K; Aaron, J; Catt, S; Mela, D

2000-06-01

To examine the influences of nutritional information and consumer characteristics on meal quality expectations, food selection and subsequent macronutrient intakes of consumers offered a reduced-fat option in a restaurant. A target, full-fat (FF) main restaurant meal option was developed in a version substantially reduced in fat and energy (RF). Restaurant patrons were randomly placed into one of four treatment groups varying in provision of menu information about the target dish, and the actual version of that dish served (if ordered). A full-fat blind (FFB) control group was given no nutritional information in the menu and was served the FF version. The other three groups were all served the modified RF version: (i) reduced-fat blind (RFB), who were given no nutritional information; (ii) reduced-fat informed (RFI), who were given nutritional information; and (iii) reduced-fat informed with details (RFID), who were given the same nutritional information plus recipe modification details. Subjects rated their expected and actual liking, the pleasantness of taste, texture and appearance of the dish, how well the dish matched their expectations, and the likelihood of purchase again. Additional measures included the other dish selections, sociodemographic and attitudinal information. A silver service (training) restaurant. Members of the public (n = 279) consuming meals in the restaurant. The presence of nutritional information on the menu did not significantly increase subsequent intakes of energy and fat from the rest of the meal, and did not significantly influence sensory expectations or post-meal acceptance measures (which also did not differ between the FF and RF versions). Consumer characteristics relating to fat reduction attitudes and behaviours were significantly related to the selection of different dishes. Provision of RF alternatives in a restaurant can have significant positive dietary benefits. Menu nutritional information did not affect measures of meal acceptance. Further studies should identify which types of information formats might be most effective in enhancing the selection of 'healthy' options.

Restaurant menu labelling: Is it worth adding sodium to the label?

PubMed

Scourboutakos, Mary J; Corey, Paul N; Mendoza, Julio; Henson, Spencer J; L'Abbe, Mary R

2014-07-31

Several provincial and federal bills have recommended various forms of menu labelling that would require information beyond just calories; however, the additional benefit of including sodium information is unknown. The objective of this study was to determine whether sodium information on menus helps consumers make lower-sodium choices and to understand what other factors influence the effect of menu labelling on consumers' meal choices. A total of 3,080 Canadian consumers completed an online survey that included a repeated measures experiment in which consumers were asked to select what they would typically order from four mock-restaurant menus. Subsequently, consumers were randomly allocated to see one of three menu-labelling treatments (calories; calories and sodium; or calories, sodium and serving size) and were given the option to change their order. There was a significant difference in the proportion of consumers who changed their order, varying from 17% to 30%, depending on the restaurant type. After participants had seen menu labelling, sodium levels decreased in all treatments (p<0.0001). However, in three of the four restaurant types, consumers who saw calorie and sodium information ordered meals with significantly less sodium than consumers who saw only calorie information (p<0.01). Consumers who saw sodium labelling decreased the sodium level of their meal by an average of 171-384 mg, depending on the restaurant. In the subset of consumers who saw sodium information and chose to change their order, sodium levels decreased by an average of 681-1,360 mg, depending on the restaurant. Sex, intent to lose weight and the amount of calories ordered at baseline were the most important predictors of who used menu labelling. Eighty percent of survey panelists wanted to see nutrition information when dining out. Including sodium information alongside calorie information may result in a larger decrease in the amount of sodium ordered by restaurant-goers.

A Toy Story: Association between Young Children’s Knowledge of Fast Food Toy Premiums and their Fast Food Consumption

PubMed Central

Longacre, Meghan R.; Drake, Keith M.; Titus, Linda J.; Cleveland, Lauren P.; Langeloh, Gail; Hendricks, Kristy; Dalton, Madeline A.

2015-01-01

Fast food restaurants spend millions of dollars annually on child-targeted marketing, a substantial portion of which is allocated to toy premiums for kids’ meals. The objectives of this study were to describe fast food toy premiums, and examine whether young children’s knowledge of fast food toy premiums was associated with their fast food consumption. Parents of 3- to 5-year old children were recruited from pediatric and WIC clinics in Southern New Hampshire, and completed a cross-sectional survey between April 2013–March 2014. Parents reported whether their children usually knew what toys were being offered at fast food restaurants, and whether children had eaten at any of four restaurants that offer toy premiums with kids’ meals (McDonald’s, Burger King, Subway, Wendy’s) during the 7 days preceding the survey. Seventy-one percent of eligible parents participated (N=583); 48.4% did not receive any education beyond high school, and 27.1% of children were non-white. Half (49.7%) the children had eaten at one or more of the four fast food restaurants in the past week; one-third (33.9%) had eaten at McDonald’s. The four restaurants released 49 unique toy premiums during the survey period; McDonald’s released half of these. Even after controlling for parent fast food consumption and sociodemographics, children were 1.38 (95% CI=1.04, 1.82) times more likely to have consumed McDonald’s if they usually knew what toys were offered by fast food restaurants. We did not detect a relationship between children’s toy knowledge and their intake of fast food from the other restaurants. In this community-based sample, young children’s knowledge of fast food toys was associated with a greater frequency of eating at McDonald’s, providing evidence in support of regulating child-directed marketing of unhealthy foods using toys. PMID:26471803

Taste and Safety: Is the Exceptional Cuisine Offered by High End Restaurants Paralleled by High Standards of Food Safety?

PubMed Central

Kanagarajah, Sanch; Mook, Piers; Crook, Paul; Awofisayo-Okuyelu, Adedoyin; McCarthy, Noel

2016-01-01

Introduction: Restaurant guides such as the Good Food Guide Top 50 create a hierarchy focussing on taste and sophistication. Safety is not explicitly included. We used restaurant associated outbreaks to assess evidence for safety. Methods: All foodborne disease outbreaks in England reported to the national database from 2000 to 2014 were used to compare the Top 50 restaurants (2015) to other registered food businesses using the Public Health England (PHE) outbreak database. Health Protection Teams were also contacted to identify any outbreaks not reported to the national database. Among Good Food Guide Top 50 restaurants, regression analysis estimated the association between outbreak occurrence and position on the list. Results: Four outbreaks were reported to the PHE national outbreak database among the Top 50 giving a rate 39 times higher (95% CI 14.5–103.2) than other registered food businesses. Eight outbreaks among the 44 English restaurants in the Top 50 were identified by direct contact with local Health Protection Teams. For every ten places higher ranked, Top 50 restaurants were 66% more likely to have an outbreak (Odds Ratio 1.66, 95% CI 0.89–3.13). Discussion: Top 50 restaurants were substantially more likely to have had reported outbreaks from 2000-2014 than other food premises, and there was a trend for higher rating position to be associated with higher probability of reported outbreaks. Our findings, that eating at some of these restaurants may pose an increased risk to health compared to other dining out, raises the question of whether food guides should consider aspects of food safety alongside the clearly important complementary focus on taste and other aspects of the dining experience. PMID:27617168

Developing and Implementing "Waupaca Eating Smart": A Restaurant and Supermarket Intervention to Promote Healthy Eating Through Changes in the Food Environment.

PubMed

Escaron, Anne L; Martinez-Donate, Ana P; Riggall, Ann Josie; Meinen, Amy; Hall, Beverly; Nieto, F Javier; Nitzke, Susan

2016-03-01

Restaurants and food stores are suitable settings for healthy eating interventions. A community-academic partnership developed and implemented "Waupaca Eating Smart" (WES), a healthy eating program in restaurants and supermarkets of a rural, Midwest community. Previous interventions targeted either restaurants or small food stores nearly all in urban areas. Intervention design and implementation is rarely documented, making replication difficult for interested researchers and communities. In this article, we report the activities we undertook to develop and implement WES. Working with a local nutrition and activity coalition, we used evidence-based strategies guided by the social ecological model and social marketing principles to inform the content of WES. Formative assessment included a review of the literature, statewide key informant interviews and focus groups with restaurant and food store operators and patrons, a local community survey, and interviews with prospective WES businesses. WES was implemented in seven restaurants and two supermarkets and evaluated for feasibility and acceptance using surveys and direct observation of WES implementation. Prior to this intervention, only one of seven restaurants had three or more meals that met WES nutrition criteria. By the end of the program, 38 meals were labeled and promoted to restaurant customers, and the team had staffed four side salad taste tests for supermarket customers. Four and 10 months after intervention launch, the majority of the program's strategies were observed in participating outlets, suggesting that these program's strategies are feasible and can be sustained. Operators reported strong satisfaction overall. A combined restaurant- and supermarket-based healthy eating intervention is feasible and positively valued in rural communities. Further research is needed to better understand how to foster sustainability of these interventions and their impact on customer food choices. © 2015 Society for Public Health Education.

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.

Getting Down to Business: Restaurant Business, Module 22. [Student Guide]. Entrepreneurship Training Components.

ERIC Educational Resources Information Center

Kingi, Marcella

This module on owning and operating a restaurant is one of 36 in a series on entrepreneurship. The introduction tells the student what topics will be covered and suggests other modules to read in related occupations. Each unit includes student goals, a case study, and a discussion of the unit subject matter. Learning activities are divided into…

Energy contents of frequently ordered restaurant meals and comparison with human energy requirements and US Department of Agriculture database information: a multisite randomized study

USDA-ARS?s Scientific Manuscript database

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 o...

The Effects of Performance Feedback and Social Reinforcement on Up-Selling at Fast-Food Restaurants

ERIC Educational Resources Information Center

Wiesman, Daryl W.

2006-01-01

The present study sought to evaluate the effects of feedback and positive social reinforcement on the performance of restaurant drive-thru window order-takers in asking customers to "upsize" their order at a specific prompt. A multiple baseline across settings was followed by the introduction of an intervention of weekly performance feedback and…

An Outbreak of Norovirus Infections Among Lunch Customers at a Restaurant, Tampere, Finland, 2015.

PubMed

Vo, Thuan Huu; Okasha, Omar; Al-Hello, Haider; Polkowska, Aleksandra; Räsänen, Sirpa; Bojang, Merja; Nuorti, J Pekka; Jalava, Katri

2016-09-01

On January 29, 2015, the city of Tampere environmental health officers were informed of a possible foodborne outbreak among customers who had eaten lunch in restaurant X. Employees of electric companies A and B had a sudden onset of gastrointestinal symptoms. We conducted a retrospective cohort study to identify the vehicle, source, and causative agent of the outbreak. A case was defined as an employee of companies A or B with diarrhea and/or vomiting who ate lunch at Restaurant X on January 26, 2015. All employees of the companies attending the implicated lunch were invited to participate in the cohort study. Environmental investigation was conducted. Twenty-one responders were included in statistical analysis, of which 11 met with the case definition. Of the 15 food items consumed by participants, four food items were associated with gastroenteritis. Of four kitchen staff, three tested positive for norovirus GIP7, the strain was found earlier in the community. No patient samples were obtained. Level of hygiene in the kitchen was inadequate. Infected kitchen staff probably transmitted norovirus by inadequate hygiene practices. No new cases associated with Restaurant X were reported after the hygiene practices were improved.

[Factors associated with being overweight among adults using low-budget restaurants in Belo Horizonte, Brazil].

PubMed

Machado, Ísis Eloah; Pereira, Simone Cardoso Lisboa; Dias Júnior, Cláudio Santiago; Abreu, Mery Natali Silva; Borges, Angélica Marques; Filgueiras, Jullyane Hott

2014-05-01

The scope of this article is to assess the nutritional status of users of low-budget restaurants and soup kitchens in Belo Horizonte and to identify factors associated with being overweight. It involved a cross-sectional analytical study conducted among adults of both sexes in low-budget restaurants and soup kitchens in Belo Horizonte. Being overweight was the dependent variable and was defined as body mass index (BMI) ≥ 25 kg/m2. This was correlated with socio-demographic variables and the level of physical activity. The data were obtained directly through weight and height measurement and a semi-structured questionnaire. The study involved 1334 individuals, the majority being male. The prevalence of being overweight was 42.9% among the men and 45.8% among the women. The following factors were positively associated with being overweight: being older for both sexes; having a partner for the women; taking less physical exercise and higher socioeconomic level for the men. Detection of factors associated with being overweight reveals that there is a need to implement an effective systematic program of dietary and nutritional education in order to prevent and remedy this condition, so that low-budget restaurants fulfill their objective.

Associations between a voluntary restaurant menu designation initiative and patron purchasing behavior.

PubMed

Sosa, Erica T; Biediger-Friedman, Lesli; Banda, Martha

2014-03-01

Restaurant initiatives provide an efficient opportunity to impact large numbers of patrons. The purpose of this study is to measure patron purchasing behaviors during the ¡Por Vida! menu designation initiative. This study used a cross-sectional design and survey data to assess 23 restaurants throughout Bexar County and 152 restaurant patrons. The Patron Awareness Questionnaire assessed if patrons noticed the logo; believed nutrition, cost, and taste were important in making purchasing decisions; and purchased a ¡Por Vida! item. Descriptive statistics, Spearman correlations, and logistic regression were used to analyze the data. Most (93.4%) patrons considered taste very important when deciding what to eat. Cost was very important to 63.8% and nutrition was very important to 55.9% of the sample. The strongest predictors of purchasing a ¡Por Vida! item were the patrons' ages being between 18 and 35 years (odds ratio = 1.474; confidence interval = 0.017, 0.812; p < .05) and if patrons saw the logo (odds ratio = 4.327; confidence interval = 1.696-11.036; p < .01). Menu logo designation initiatives can potentially influence patron purchasing behaviors among a segment of the population when the logo is visible.

Statewide dissemination of a rural, non-chain restaurant intervention: adoption, implementation and maintenance

PubMed Central

Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

2014-01-01

The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States, the study targeted randomly selected, non-chain, family-style restaurants. Owners were recruited through mail, then telephone follow-up. Data were collected through telephone at baseline, and 3, 6, 12 and 18 months post-adoption. Using mixed methods, measures captured the program adoption rate, characteristics of adopters and non-adopters, program implementation and maintenance issues, and owner and customer satisfaction. Analyses involved descriptive statistics and summaries of qualitative data. The program adoption rate was 28%. Adopters were similar to responding non-adopters demographically, but varied in attitudes. The majority of restaurants maintained the program for at least 12 months. Adopters and their customers expressed satisfaction with the program. With some adjustments, the RE-AIM model was helpful in guiding evaluation of this process. Results provide implications for future dissemination of this and other programs with regard to research procedures and potential barriers that may be encountered. Research on alternative strategies for widespread dissemination of such programs is needed in this and other settings. PMID:24650944

The tipping point: A mathematical model for the profit-driven abandonment of restaurant tipping.

PubMed

Clifton, Sara M; Herbers, Eileen; Chen, Jack; Abrams, Daniel M

2018-02-01

The custom of voluntarily tipping for services rendered has gone in and out of fashion in America since its introduction in the 19th century. Restaurant owners that ban tipping in their establishments often claim that social justice drives their decisions, but we show that rational profit-maximization may also justify the decisions. Here, we propose a conceptual model of restaurant competition for staff and customers, and we show that there exists a critical conventional tip rate at which restaurant owners should eliminate tipping to maximize profits. Because the conventional tip rate has been increasing steadily for the last several decades, our model suggests that restaurant owners may abandon tipping en masse when that critical tip rate is reached.

The tipping point: A mathematical model for the profit-driven abandonment of restaurant tipping

NASA Astrophysics Data System (ADS)

Clifton, Sara M.; Herbers, Eileen; Chen, Jack; Abrams, Daniel M.

2018-02-01

The custom of voluntarily tipping for services rendered has gone in and out of fashion in America since its introduction in the 19th century. Restaurant owners that ban tipping in their establishments often claim that social justice drives their decisions, but we show that rational profit-maximization may also justify the decisions. Here, we propose a conceptual model of restaurant competition for staff and customers, and we show that there exists a critical conventional tip rate at which restaurant owners should eliminate tipping to maximize profits. Because the conventional tip rate has been increasing steadily for the last several decades, our model suggests that restaurant owners may abandon tipping en masse when that critical tip rate is reached.

26 CFR 31.3121(q)-1 - Tips included for employee taxes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 1966, A is employed as a waiter by X restaurant and is paid wages by X restaurant at the rate of $100 a... of $100 and on November 9, 1966, A furnishes X restaurant a report of tips actually received by him...

77 FR 24456 - Retail Exemptions Adjusted Dollar Limitations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... hotels, restaurants, and similar institutions without disqualifying itself for exemption from Federal... the type that are traditionally and usually conducted at retail stores and restaurants (21 U.S.C. 661... food, poultry, and poultry products. Sales to Hotels, Restaurants, and Similar Institutions Under these...

75 FR 13168 - American Vantage Companies; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... Vantage Media Corporation to Genius, together with a 49% interest in the Border Grill Restaurant (``Border... other than gaming, media, restaurants and entertainment and has always emphasized its operating results... ongoing business operations in the placement agency, restaurant, gaming and entertainment fields and that...

26 CFR 31.3121(d)-1 - Who are employees.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., retailers, contractors, or operators of hotels, restaurants, or other similar establishments for merchandise..., retailers, contractors, or operators of hotels, restaurants, or other similar establishments for merchandise... solicits such orders from retail stores and restaurants. C is not within this occupational group. (4)(i...

An assessment of burn prevention knowledge in a high burn-risk environment: restaurants.

PubMed

Piazza-Waggoner, Carrie; Adams, C D; Goldfarb, I W; Slater, H

2002-01-01

Our facility has seen an increase in the number of cases of children burned in restaurants. Fieldwork has revealed many unsafe serving practices in restaurants in our tristate area. The current research targets what appears to be an underexamined burn-risk environment, restaurants, to examine server knowledge about burn prevention and burn care with customers. Participants included 71 local restaurant servers and 53 servers from various restaurants who were recruited from undergraduate courses. All participants completed a brief demographic form as well as a Burn Knowledge Questionnaire. It was found that server knowledge was low (ie, less than 50% accuracy). Yet, most servers reported that they felt customer burn safety was important enough to change the way that they serve. Additionally, it was found that length of time employed as a server was a significant predictor of servers' burn knowledge (ie, more years serving associated with higher knowledge). Finally, individual items were examined to identify potential targets for developing prevention programs.

Do smoke-free laws affect revenues in pubs and restaurants?

PubMed

Melberg, Hans Olav; Lund, Karl E

2012-02-01

In the debate about laws regulating smoking in restaurants and pubs, there has been some controversy as to whether smoke-free laws would reduce revenues in the hospitality industry. Norway presents an interesting case for three reasons. First, it was among the first countries to implement smoke-free laws, so it is possible to assess the long-term effects. Second, it has a cold climate so if there is a negative effect on revenue one would expect to find it in Norway. Third, the data from Norway are detailed enough to distinguish between revenue from pubs and restaurants. Autoregressive integrated moving average (ARIMA) intervention analysis of bi-monthly observations of revenues in restaurants and pubs show that the law did not have a statistically significant long-term effect on revenue in restaurants or on restaurant revenue as a share of personal consumption. Similar analysis for pubs shows that there was no significant long-run effect on pub revenue.

Partnering with REACH to Create a “Diabetes-Friendly” Restaurant - A Restaurant Owner's Experience

PubMed Central

Chen, Roxana; Carrillo, Mayra; Kapp, Janet; Cheadle, Allen; Angulo, Antoinette; Chrisman, Noel; Rubio, Ramiro

2013-01-01

We describe a Latino restaurateur's perspectives and partnership with Seattle-King County REACH to improve the healthfulness of his restaurant as a step toward tackling diabetes in his community. We interviewed the owner and reviewed other documentation to capture his perspectives and identify key elements in this restaurant intervention. The impact of diabetes in the owner's family and Latino community motivated him to make changes at his restaurant. If changes were successful, he hoped this would motivate other Latino restaurateurs to make similar changes. At his request, REACH gathered consumer feedback, provided diabetes education and nutritional guidance, and worked with him to develop simple, economically-feasible, healthier items. Positive consumer response and media coverage motivated the owner to explore additional changes at his restaurant and encourage other restaurateurs to make healthful changes. This intervention illustrates the potential for local businesses to collaborate with community partners, like REACH, to promote healthy food environments. PMID:22080779

Wage Theft as a Neglected Public Health Problem: An Overview and Case Study From San Francisco’s Chinatown District

PubMed Central

Salvatore, Alicia L.; Chang, Charlotte; Gaydos, Megan; Liu, Shaw San; Lee, Pam Tau; Tom, Alex; Bhatia, Rajiv; Krause, Niklas

2014-01-01

Wage theft, or nonpayment of wages to which workers are legally entitled, is a major contributor to low income, which in turn has adverse health effects. We describe a participatory research study of wage theft among immigrant Chinatown restaurant workers. We conducted surveys of 433 workers, and developed and used a health department observational tool in 106 restaurants. Close to 60% of workers reported 1 or more forms of wage theft (e.g., receiving less than minimum wage [50%], no overtime pay [> 65%], and pay deductions when sick [42%]). Almost two thirds of restaurants lacked required minimum wage law signage. We discuss the dissemination and use of findings to help secure and enforce a wage theft ordinance, along with implications for practice. PMID:24825200

[Application and effects of smoking ban in bars and restaurants of Rome].

PubMed

Fontana, L; Di Martino, T; Iavicoli, I

2007-01-01

Both active and passive tobacco smoke is carcinogenic. In the last years the most important countries of European Community developed and passed smoke-free public places and smoke-free workplace legislations. The aim of this study was to investigate the real application of smoking ban in bars and restaurants of Rome and to value social, economic and health effects caused by the application of the law. The study was carried out in 200 public places (100 restaurants and 100 bars) with an inspection of the sites and the administration of a questionnaire to the managers of the public places. Results demonstrate that smoking ban in public places is widely respected and that the application of the law had a very positive impact on the quality of life and health of workers and general population.

Monitoring the Sodium Content of Restaurant Foods: Public Health Challenges and Opportunities

PubMed Central

Cogswell, Mary E.; Gunn, Janelle P.; Curtis, Christine J.; Rhodes, Donna; Hoy, Kathy; Pehrsson, Pamela; Nickle, Melissa; Merritt, Robert

2013-01-01

We reviewed methods of studies assessing restaurant foods’ sodium content and nutrition databases. We systematically searched the 1964–2012 literature and manually examined references in selected articles and studies. Twenty-six (5.2%) of the 499 articles we found met the inclusion criteria and were abstracted. Five were conducted nationally. Sodium content determination methods included laboratory analysis (n = 15), point-of-purchase nutrition information or restaurants’ Web sites (n = 8), and menu analysis with a nutrient database (n = 3). There is no comprehensive data system that provides all information needed to monitor changes in sodium or other nutrients among restaurant foods. Combining information from different sources and methods may help inform a comprehensive system to monitor sodium content reduction efforts in the US food supply and to develop future strategies. PMID:23865701

Checklists and Monitoring in the Cockpit: Why Crucial Defenses Sometimes Fail

NASA Technical Reports Server (NTRS)

Dismukes, R. Key; Berman, Ben

2010-01-01

Checklists and monitoring are two essential defenses against equipment failures and pilot errors. Problems with checklist use and pilots failures to monitor adequately have a long history in aviation accidents. This study was conducted to explore why checklists and monitoring sometimes fail to catch errors and equipment malfunctions as intended. Flight crew procedures were observed from the cockpit jumpseat during normal airline operations in order to: 1) collect data on monitoring and checklist use in cockpit operations in typical flight conditions; 2) provide a plausible cognitive account of why deviations from formal checklist and monitoring procedures sometimes occur; 3) lay a foundation for identifying ways to reduce vulnerability to inadvertent checklist and monitoring errors; 4) compare checklist and monitoring execution in normal flights with performance issues uncovered in accident investigations; and 5) suggest ways to improve the effectiveness of checklists and monitoring. Cognitive explanations for deviations from prescribed procedures are provided, along with suggestions for countermeasures for vulnerability to error.

Checklists in the operating room: Help or hurdle? A qualitative study on health workers' experiences

PubMed Central

2010-01-01

Background Checklists have been used extensively as a cognitive aid in aviation; now, they are being introduced in many areas of medicine. Although few would dispute the positive effects of checklists, little is known about the process of introducing this tool into the health care environment. In 2008, a pre-induction checklist was implemented in our anaesthetic department; in this study, we explored the nurses' and physicians' acceptance and experiences with this checklist. Method Focus group interviews were conducted with a purposeful sample of checklist users (nurses and physicians) from the Department of Anaesthesia and Intensive Care in a tertiary teaching hospital. The interviews were analysed qualitatively using systematic text condensation. Results Users reported that checklist use could divert attention away from the patient and that it influenced workflow and doctor-nurse cooperation. They described senior consultants as both sceptical and supportive; a head physician with a positive attitude was considered crucial for successful implementation. The checklist improved confidence in unfamiliar contexts and was used in some situations for which it was not intended. It also revealed insufficient equipment standardisation. Conclusion Our findings suggest several issues and actions that may be important to consider during checklist use and implementation. PMID:21171967

Systematic Review and Meta-analysis of the Impact of Restaurant Menu Calorie Labeling

PubMed Central

Tobias, Deirdre K.; Cradock, Angie L.; Batchelder, Holly; Gortmaker, Steven L.

2015-01-01

We conducted a systematic review and meta-analysis evaluating the relationship between menu calorie labeling and calories ordered or purchased in the PubMed, Web of Science, PolicyFile, and PAIS International databases through October 2013. Among 19 studies, menu calorie labeling was associated with a −18.13 kilocalorie reduction ordered per meal with significant heterogeneity across studies (95% confidence interval = −33.56, −2.70; P = .021; I2 = 61.0%). However, among 6 controlled studies in restaurant settings, labeling was associated with a nonsignificant −7.63 kilocalorie reduction (95% confidence interval = −21.02, 5.76; P = .264; I2 = 9.8%). Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings. PMID:25790388

A feedback intervention to increase digital and paper checklist performance in technically advanced aircraft simulation.

PubMed

Rantz, William G; Van Houten, Ron

2011-01-01

This study examined whether pilots operating a flight simulator completed digital or paper flight checklists more accurately after receiving postflight graphic and verbal feedback. The dependent variable was the number of checklist items completed correctly per flight. Following treatment, checklist completion with paper and digital checklists increased from 38% and 39%, respectively, to nearly 100% and remained close to 100% after feedback and praise for improvement were withdrawn. Performance was maintained at or near 100% during follow-up probes.

Trends in Consumption of Solid Fats, Added Sugars, Sodium, Sugar-Sweetened Beverages, and Fruit from Fast Food Restaurants and by Fast Food Restaurant Type among US Children, 2003-2010.

PubMed

Rehm, Colin D; Drewnowski, Adam

2016-12-13

Energy intakes from fast food restaurants (FFRs) have declined among US children. Less is known about the corresponding trends for FFR-sourced solid fats, added sugars, and sodium, and food groups of interest, such as fruit and sugar-sweetened beverages (SSBs). Using data from a single 24-h dietary recall among 12,378 children aged 4-19 years from four consecutive cycles of the nationally-representative National Health and Nutrition Examination Survey (NHANES), 2003-2010 a custom algorithm segmented FFRs into burger, pizza, sandwich, Mexican cuisine, chicken, Asian cuisine, fish restaurants, and coffee shops. There was a significant population-wide decline in FFR-sourced solid fats (-32 kcal/day, p -trend < 0.001), added sugars (-16 kcal/day; p -trend < 0.001), SSBs (-0.12 servings (12 fluid ounces or 355 mL)/day; p -trend < 0.001), and sodium (-166 mg/day; p -trend < 0.001). Declines were observed when restricted to fast food consumers alone. Sharp declines were observed for pizza restaurants; added sugars, solid fats, and SSBs declined significantly from burger restaurants. Fruit did not change for fast food restaurants overall. Temporal analyses of fast food consumption trends by restaurant type allow for more precise monitoring of the quality of children's diets than can be obtained from analyses of menu offerings. Such analyses can inform public health interventions and policy measures.

Trends in Consumption of Solid Fats, Added Sugars, Sodium, Sugar-Sweetened Beverages, and Fruit from Fast Food Restaurants and by Fast Food Restaurant Type among US Children, 2003–2010

PubMed Central

Rehm, Colin D.; Drewnowski, Adam

2016-01-01

Energy intakes from fast food restaurants (FFRs) have declined among US children. Less is known about the corresponding trends for FFR-sourced solid fats, added sugars, and sodium, and food groups of interest, such as fruit and sugar-sweetened beverages (SSBs). Using data from a single 24-h dietary recall among 12,378 children aged 4–19 years from four consecutive cycles of the nationally-representative National Health and Nutrition Examination Survey (NHANES), 2003–2010 a custom algorithm segmented FFRs into burger, pizza, sandwich, Mexican cuisine, chicken, Asian cuisine, fish restaurants, and coffee shops. There was a significant population-wide decline in FFR-sourced solid fats (−32 kcal/day, p-trend < 0.001), added sugars (−16 kcal/day; p-trend < 0.001), SSBs (−0.12 servings (12 fluid ounces or 355 mL)/day; p-trend < 0.001), and sodium (−166 mg/day; p-trend < 0.001). Declines were observed when restricted to fast food consumers alone. Sharp declines were observed for pizza restaurants; added sugars, solid fats, and SSBs declined significantly from burger restaurants. Fruit did not change for fast food restaurants overall. Temporal analyses of fast food consumption trends by restaurant type allow for more precise monitoring of the quality of children’s diets than can be obtained from analyses of menu offerings. Such analyses can inform public health interventions and policy measures. PMID:27983573

Lower-fat menu items in restaurants satisfy customers.

PubMed

Fitzpatrick, M P; Chapman, G E; Barr, S I

1997-05-01

To evaluate a restaurant-based nutrition program by measuring customer satisfaction with lower-fat menu items and assessing patrons' reactions to the program. Questionnaires to assess satisfaction with menu items were administered to patrons in eight of the nine restaurants that volunteered to participate in the nutrition program. One patron from each participating restaurant was randomly selected for a semistructured interview about nutrition programming in restaurants. Persons dining in eight participating restaurants over a 1-week period (n = 686). Independent samples t tests were used to compare respondents' satisfaction with lower-fat and regular menu items. Two-way analysis of variance tests were completed using overall satisfaction as the dependent variable and menu-item classification (ie, lower fat or regular) and one of eight other menu item and respondent characteristics as independent variables. Qualitative methods were used to analyze interview transcripts. Of 1,127 menu items rated for satisfaction, 205 were lower fat, 878 were regular, and 44 were of unknown classification. Customers were significantly more satisfied with lower-fat than with regular menu items (P < .001). Overall satisfaction did not vary by any of the other independent variables. Interview results indicate the importance of restaurant during as an indulgent experience. High satisfaction with lower-fat menu items suggests that customers will support restaurant providing such choices. Dietitians can use these findings to encourage restaurateurs to include lower-fat choices on their menus, and to assure clients that their expectations of being indulged are not incompatible with these choices.

Differences in perceptions and fast food eating behaviours between Indians living in high- and low-income neighbourhoods of Chandigarh, India.

PubMed

Aloia, Christopher Robert; Gasevic, Danijela; Yusuf, Salim; Teo, Koon; Chockalingam, Arun; Patro, Binod Kumar; Kumar, Rajesh; Lear, Scott Alexander

2013-01-07

Increased density of fast food restaurants is associated with increased prevalence of obesity in developed countries. However, less is known about this relationship in developing countries undergoing rapid urbanization and how differences in neighbourhood income affect the patronage of fast food outlets. The purpose of the study is to explore the differences in fast food preferences, perceptions, and patronage between Indians living in high- and low-income neighbourhoods. This cross-sectional study recruited 204 men and women (35 to 65 years in age) from high- and low-income neighbourhoods who completed a questionnaire on fast food consumption. The questionnaire asked participants to define fast food and to provide reasons for and frequency of visits to fast food restaurants. The differences were analyzed using Chi square and t-tests for categorical and continuous variables, respectively. Participants from a high-income neighbourhood were more likely to perceive Western -style fast food as fast food, while people from the low-income neighbourhood were more likely to identify food sold by street vendors as fast food (p <0.001). Furthermore, compared to participants from the high-income neighbourhood, people from the low-income neighbourhood were more likely to report buying food from street vendors while less likely to dine out at both fast food and non-fast food restaurants (p<0.001). Although the high-income neighbourhood group was more likely to report enjoying eating at fast food restaurants than their low-income neighbourhood counterparts, there were no significant differences in the reasons for visiting fast food restaurants (convenience, price, social enjoyment, and quality of meals) between the two groups. Both groups preferred home cooked over restaurant meals, and they recognized that home cooked food was healthier. Overall, consumption of fast food was low. People from a high-income neighbourhood dined out more frequently and were more likely to perceive Western-style food as fast food compared to their counterparts from the low-income neighbourhood.

Health and Safety Checklist for Early Care and Education Programs to Assess Key National Health and Safety Standards.

PubMed

Alkon, Abbey; Rose, Roberta; Wolff, Mimi; Kotch, Jonathan B; Aronson, Susan S

2016-01-01

The project aims were to (1) develop an observational Health and Safety Checklist to assess health and safety practices and conditions in early care and education (ECE) programs using Stepping Stones To Caring For Our Children, 3rd Edition national standards, (2) pilot test the Checklist, completed by nurse child care health consultants, to assess feasibility, ease of completion, objectivity, validity, and reliability, and (3) revise the Checklist based on the qualitative and quantitative results of the pilot study. The observable national health and safety standards were identified and then rated by health, safety, and child care experts using a Delphi technique to validate the standards as essential to prevent harm and promote health. Then, child care health consultants recruited ECE centers and pilot tested the 124-item Checklist. The pilot study was conducted in Arizona, California and North Carolina. The psychometric properties of the Checklist were assessed. The 37 participating ECE centers had 2627 children from ethnically-diverse backgrounds and primarily low-income families. The child care health consultants found the Checklist easy to complete, objective, and useful for planning health and safety interventions. The Checklist had content and face validity, inter-rater reliability, internal consistency, and concurrent validity. Based on the child care health consultant feedback and psychometric properties of the Checklist, the Checklist was revised and re-written at an 8th grade literacy level. The Health and Safety Checklist provides a standardized instrument of observable, selected national standards to assess the quality of health and safety in ECE centers.

Activities Using a Restaurant Theme.

ERIC Educational Resources Information Center

Modlin, Ruth

Designed for use with elementary students, 44 activities using a restaurant theme integrate creative thinking and decision-making skills with language arts, mathematics, and art. The activities, which can be used independently by the students, deal with types of restaurants, names and themes, floor plans, interior and exterior design, house…

49 CFR 1245.6 - Cross reference to standard occupational classification manual.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: Manager Lodging House 1351. Restaurant Manager 1351. Dining Car Supv. 5211, and 1473. Dinning car Steward 5211. 514Transportation and Dining Service Inspectors: Instructor Chef 5214. Restaurant Inspector 828. Freight Service Inspector 828. Baggage Inspector 828. 515Waiters and Kitchen Helpers (Restaurant and...

9 CFR 381.10 - Exemptions for specified operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... consumers, restaurants, hotels, and boardinghouses, for use in their own dining rooms, or in the preparation... operations of types traditionally and usually conducted at retail stores and restaurants, when conducted at any retail store or restaurant or similar-retail-type establishment for sale in normal retail...

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.

A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

PubMed

Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

2018-02-27

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating room setting. © 2018 ARS-AAOA, LLC.

76 FR 5380 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... Request; Restaurant Menu and Vending Machine Labeling: Recordkeeping and Mandatory Third Party Disclosure... submitted the following proposed collection of information to OMB for review and clearance. Restaurant Menu...), requires chain restaurants and similar retail food establishments (SRFE) with 20 or more locations doing...

75 FR 17796 - American Vantage Companies; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... 49% interest in the Border Grill Restaurant (``Border Grill''). The Company privately placed most of... represented or stated that it is involved in any business other than gaming, media, restaurants and..., restaurant, gaming and entertainment fields and that it has never been an investment company as defined by...

75 FR 43182 - Voluntary Registration by Authorized Officials of Non-Covered Retail Food Establishments and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Act) established requirements for nutrition labeling of standard menu items for restaurants and..., pending promulgation of regulations. FDA is issuing this notice to assist restaurants and similar retail... INFORMATION: I. Background Section 4205 of the Affordable Care Act (Public Law 111-148) requires restaurants...

75 FR 61604 - Small Business Size Standards; Accommodation and Food Services Industries

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... 721120, Casino Hotels, from $7.0 million to $30 million; NAICS 722211, Limited Service Restaurants, from...--Limited Service Restaurants..... 7.0 10.0 722212--Cafeterias 7.0 25.5 722310--Food Service Contractors.... 721120 Casino Hotels 30.0 * * * * * * * 722211 Limited-Service Restaurants 10.0 722212 Cafeterias, Grill...

78 FR 23902 - Retail Exemptions Adjusted Dollar Limitations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

..., restaurants, and similar institutions without disqualifying itself for exemption from Federal inspection... conducted at retail stores and restaurants when those operations are conducted at any retail store or restaurant or similar retail-type establishment for sale in normal retail quantities (21 U.S.C. 661(c)(2) and...

78 FR 65663 - Agency Information Collection Activities; Proposed Collection; Comment Request; Food Labeling...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... elements required by Sec. 101.9(j)(18). Section 101.10 requires that restaurants provide nutrition... or regulatory officials upon request. Section 101.13(q)(5) requires that restaurants document and... their products. Some of the regulations affect food retailers, such as supermarkets and restaurants. We...

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.

Correlates of Sugar-Sweetened Beverages Purchased for Children at Fast-Food Restaurants.

PubMed

Cantor, Jonathan; Breck, Andrew; Elbel, Brian

2016-11-01

To determine consumer and fast-food purchase characteristics associated with the purchase of a sugar-sweetened beverage, as well as calories and grams of sugar, for children at a fast-food restaurant. We completed cross-sectional analyses of fast-food restaurant receipts and point-of-purchase surveys (n = 483) collected during 2013 and 2014 in New York City and Newark and Jersey City, New Jersey. Caregivers purchased beverages for half of all children in our sample. Approximately 60% of these beverages were sugar-sweetened beverages. Fast-food meals with sugar-sweetened beverages had, on average, 179 more calories than meals with non-sugar-sweetened beverages. Being an adolescent or male, having a caregiver with a high school degree or less, having a caregiver who saw the posted calorie information, ordering a combination meal, and eating the meal in the restaurant were associated with ordering a sugar-sweetened beverage. Purchases that included a combination meal or were consumed in the restaurant included more beverage grams of sugar and calories. Characteristics of fast-food purchases appear to have the largest and most important association to beverage calories for children at fast-food restaurants. Targeting fast-food restaurants, particularly combination meals, may improve childhood obesity rates.

Correlates of Sugar-Sweetened Beverages Purchased for Children at Fast-Food Restaurants

PubMed Central

Cantor, Jonathan; Breck, Andrew

2016-01-01

Objectives. To determine consumer and fast-food purchase characteristics associated with the purchase of a sugar-sweetened beverage, as well as calories and grams of sugar, for children at a fast-food restaurant. Methods. We completed cross-sectional analyses of fast-food restaurant receipts and point-of-purchase surveys (n = 483) collected during 2013 and 2014 in New York City and Newark and Jersey City, New Jersey. Results. Caregivers purchased beverages for half of all children in our sample. Approximately 60% of these beverages were sugar-sweetened beverages. Fast-food meals with sugar-sweetened beverages had, on average, 179 more calories than meals with non–sugar-sweetened beverages. Being an adolescent or male, having a caregiver with a high school degree or less, having a caregiver who saw the posted calorie information, ordering a combination meal, and eating the meal in the restaurant were associated with ordering a sugar-sweetened beverage. Purchases that included a combination meal or were consumed in the restaurant included more beverage grams of sugar and calories. Conclusions. Characteristics of fast-food purchases appear to have the largest and most important association to beverage calories for children at fast-food restaurants. Targeting fast-food restaurants, particularly combination meals, may improve childhood obesity rates. PMID:27715306

Impact of a Letter-Grade Program on Restaurant Sanitary Conditions and Diner Behavior in New York City

PubMed Central

McKelvey, Wendy; Ito, Kazuhiko; Schiff, Corinne; Jacobson, J. Bryan; Kass, Daniel

2015-01-01

Objectives. We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. Methods. We analyzed data from 43 448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. Results. After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI] = 31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI = 88%, 94%) of New Yorkers approved of the program and 88% (95% CI = 85%, 92%) considered grades in dining decisions in 2012. Conclusions. Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool. PMID:25602861

A novel briefing checklist at shift handoff in an emergency department improves situational awareness and safety event identification.

PubMed

Mullan, Paul C; Macias, Charles G; Hsu, Deborah; Alam, Sartaj; Patel, Binita

2015-04-01

Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. This is a descriptive observational study in a large academic pediatric ED. Checklists were evaluated for rates of use, completion, and identification of potential safety events. We defined a complete checklist as 80% or more of items checked.  A user perception survey was used. After 1 year, all checklist users (residents, fellows, faculty, and charge nurses with ED experience before and after checklist implementation) were anonymously surveyed to assess the checklist's usability, perceived contributions to Institute of Medicine quality domains, and situational awareness. The electronically administered survey used Likert frequency scales. Of 732 handoffs, 98% used the checklist, and 89% were complete. A mean of 1.7 potential safety events were identified per handoff. The most frequent potential safety events were identification of intensive care unit-level patients in the ED (48%), equipment problems (46%), staffing issues (21%), and intensive care unit-level patients in transport (16%). Eighty-one subjects (88%) responded to the survey. The users agreed that the checklist promoted better communication, safety, efficiency, effective care, and situational awareness. The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.

Requirements for the design and implementation of checklists for surgical processes.

PubMed

Verdaasdonk, E G G; Stassen, L P S; Widhiasmara, P P; Dankelman, J

2009-04-01

The use of checklists is a promising strategy for improving patient safety in all types of surgical processes inside and outside the operating room. This article aims to provide requirements and implementation of checklists for surgical processes. The literature on checklist use in the operating room was reviewed based on research using Medline, Pubmed, and Google Scholar. Although all the studies showed positive effects and important benefits such as improved team cohesion, improved awareness of safety issues, and reduction of errors, their number still is limited. The motivation of team members is considered essential for compliance. Currently, no general guidelines exist for checklist design in the surgical field. Based on the authors' experiences and on guidelines used in the aviation industry, requirements for the checklist design are proposed. The design depends on the checklist purpose, philosophy, and method chosen. The methods consist of the "call-do-response" approach," the "do-verify" approach, or a combination of both. The advantages and disadvantages of paper versus electronic solutions are discussed. Furthermore, a step-by-step strategy of how to implement a checklist in the clinical situation is suggested. The use of structured checklists in surgical processes is most likely to be effective because it standardizes human performance and ensures that procedures are followed correctly instead of relying on human memory alone. Several studies present promising and positive first results, providing a solid basis for further investigation. Future research should focus on the effect of various checklist designs and strategies to ensure maximal compliance.

Comparing the accuracy of performing digital and paper checklists using a feedback package during normal workload conditions in simulated flight

NASA Astrophysics Data System (ADS)

Rantz, William Gene

This study examined whether pilots completed airplane digital or paper checklists more accurately when they received post-flight graphic and verbal feedback. Participants were 6 college student pilots with instrument rating. The task consisted of flying flight patterns using a Frasca 241 Flight Training Device which emulates a Cirrus SR20 aircraft. The main dependent variable was the number of checklist items completed correctly per flight. An alternating treatment, multiple baseline design across pairs with reversal, was used. During baseline, the average percent of correctly completed items per flight varied considerably across participants, ranging from 13% to 57% for traditional paper checklists and ranging from 11% to 67% for digital checklists. Checklist performance increased to an average of 90% for paper checklist and an average of 89% for digital checklists after participants were given feedback and praise, and continued to improve to an average of nearly 100% for paper checklists and an average of 99% for digital checklists after the feedback and praise were removed. A slight decrement in performance was observed during a post-experiment probe between 60--90 days. Visual inspection and statistical analysis of the data suggest that paper checklist accuracy does not differ significantly from digital checklist accuracy. The results suggest that graphic feedback and praise can be used to increase the extent to which pilots use both digital and paper checklists accurately during normal workload conditions.

Effect of frying instructions for food handlers on acrylamide concentration in French fries: an explorative study.

PubMed

Sanny, M; Luning, P A; Jinap, S; Bakker, E J; van Boekel, M A J S

2013-03-01

The objective of this study was to obtain insight into the effect of frying instructions on food handlers' control decisions in restaurants and to investigate the impact of control decisions on the variation and concentration of acrylamide in French fries. The concentrations of acrylamide and reducing sugars were analyzed, the frying temperature and time were measured, and thawing practices were observed. The results obtained before and after instructions were provided to the food handlers were compared for restaurants as a group and for each restaurant. Frying instructions supported food handlers' decisions to start frying when the oil temperature reached 175°C; all handlers started frying at the correct temperature. However, the effect of the instructions on the food handlers' decisions for frying time differed; most handlers increased the frying time beyond 240 s to achieve crispier French fries with a final color dictated by their preference. Providing instructions did not result in a significant difference in the mean concentration of acrylamide in French fries for the restaurants as a group. However, data analyzed for each restaurant revealed that when food handlers properly followed the instructions, the mean concentration of acrylamide was significantly lower (169 μg/kg) than that before instructions were provided (1,517 μg/kg). When food handlers did not complying with the frying instructions, mean acrylamide concentrations were even higher than those before instructions were provided. Two different strategies were developed to overcome the noncompliant behavior of food handlers: establishing requirements for the features of commercial fryers and strict monitoring of compliance with instructions.

Heterocyclic aromatic amine content in chicken burgers and chicken nuggets sold in fast food restaurants and effects of green tea extract and microwave thawing on their formation

USDA-ARS?s Scientific Manuscript database

The aims of the current study were to investigate the presence of carcinogenic and mutagenic heterocyclic aromatic amines (HAAs) in chicken burgers (CBs) and chicken nuggets (CNs) purchased from fast food restaurants and the effects of green tea extract addition (GTE) to the covering material as wel...

Using Task Clarification, Goal Setting, and Feedback to Decrease Table Busing Times in a Franchise Pizza Restaurant

ERIC Educational Resources Information Center

Amigo, Seth; Smith, Andrew; Ludwig, Timothy

2008-01-01

The current study investigated the effects of task-clarification, and manager verbal and graphic feedback on employee busing times at a pizza restaurant. Using an ABC design, task-clarification was provided in a memo, which described the process, priority, and goal time of busing. The busing time decreased slightly, from an average of 315 seconds…

[Environmental tobacco smoke exposure in public places in Florence, Italy].

PubMed

Gorini, Giuseppe; Fondelli, Maria Cristina; Lopez, Maria Josè; Salles, Joan; Serrahima, Eulàlia; Centrich, Francesc; Costantini, Adele Seniori; Nebot, Manel

2004-01-01

Measurements of the environmental tobacco smoke (ETS) exposure in public places in Florence. This study was part of the first European multicenter project, intended to measure ETS exposure in public places in a number of European Cities (Florence, Barcelona, Paris, Oporto, Athens, Wien and Orebro). Nicotine vapour phase was measured using passive samplers, composed of a sodium bisulphate treated filter held in a plastic cassette with a windscreen on one side. The filters were analysed at the Laboratory of the Public Health Agency of Barcelona, Spain, by gas-chromatography/mass spectrometry (GC/MS). Nicotine concentration (in microg/m3) by public place, by smoking policy, and, for restaurants with separated areas, by smoking and non-smoking section. Nicotine measurements were conducted in 5 schools, 3 university departments, 5 hospitals, 1 railway station, 1 airport, 7 bars, 7 restaurants, and 4 discotheques in Florence. The average nicotine concentration in discotheques and restaurants were respectively 26.78 microg/m3 and 2.32 microg/m3. In the other public places the concentration was about 1 microg/m3. In smoke-free public places the average concentration was 0.85 microg/m3; in public places where smoking is allowed concentration was higher (11.53 microg/m3). In the smoking section and non-smoking section of restaurants with separated areas the average concentration was respectively 2.54 and 2.14 microg/m3. The highest nicotine concentrations were recorded in discos and restaurants. A smoke-free public place is effective in reducing ETS exposure. Smoking and non-smoking sections in restaurants without a separate ventilation system seem not to solve ETS exposure.

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.

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.

Where are kids getting their empty calories? Stores, schools, and fast food restaurants each play an important role in empty calorie intake among US children in 2009-2010

PubMed Central

Poti, Jennifer M.; Slining, Meghan M.; Popkin, Barry M.; Kenan, W.R.

2013-01-01

Consumption of empty calories, the sum of energy from added sugar and solid fat, exceeds recommendations, but little is known about where US children obtain these empty calories. The objectives of this study were to compare children's empty calorie consumption from retail food stores, schools, and fast food restaurants; to identify food groups that were top contributors of empty calories from each location; and to determine the location providing the majority of calories for these key food groups. This cross-sectional analysis used data from 3,077 US children aged 2-18 years participating in the 2009-2010 National Health and Nutrition Examination Survey. The empty calorie content of children's intake from stores (33%), schools (32%), and fast food restaurants (35%) was not significantly different in 2009-2010. In absolute terms, stores provided the majority of empty calorie intake (436 kcal). The top contributors of added sugar and solid fat from each location were similar: sugar sweetened beverages (SSBs), grain desserts, and high-fat milk from stores; high-fat milk, grain desserts, and pizza from schools; and SSBs, dairy desserts, french fries, and pizza from fast food restaurants. Schools contributed about 20% of children's intake of high-fat milk and pizza. In conclusion, these findings support the need for continued efforts to reduce empty calorie intake among US children aimed not just at fast food restaurants, but also at stores and schools. The importance of reformed school nutrition standards was suggested, as prior to their implementation, schools resembled fast food restaurants in their contributions to empty calorie intake. PMID:24200654

Where are kids getting their empty calories? Stores, schools, and fast-food restaurants each played an important role in empty calorie intake among US children during 2009-2010.

PubMed

Poti, Jennifer M; Slining, Meghan M; Popkin, Barry M

2014-06-01

Consumption of empty calories, the sum of energy from added sugar and solid fat, exceeds recommendations, but little is known about where US children obtain these empty calories. The objectives of this study were to compare children's empty calorie consumption from retail food stores, schools, and fast-food restaurants; to identify food groups that were top contributors of empty calories from each location; and to determine the location providing the majority of calories for these key food groups. This cross-sectional analysis used data from 3,077 US children aged 2 to 18 years participating in the 2009-2010 National Health and Nutrition Examination Survey. The empty calorie content of children's intake from stores (33%), schools (32%), and fast-food restaurants (35%) was not significantly different in 2009-2010. In absolute terms, stores provided the majority of empty calorie intake (436 kcal). The top contributors of added sugar and solid fat from each location were similar: sugar-sweetened beverages, grain desserts, and high-fat milk∗ from stores; high-fat milk, grain desserts, and pizza from schools; and sugar-sweetened beverages, dairy desserts, french fries, and pizza from fast-food restaurants. Schools contributed about 20% of children's intake of high-fat milk and pizza. These findings support the need for continued efforts to reduce empty calorie intake among US children aimed not just at fast-food restaurants, but also at stores and schools. The importance of reformed school nutrition standards was suggested, as prior to implementation of these changes, schools resembled fast-food restaurants in their contributions to empty calorie intake. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The effect of providing nutritional information about fast-food restaurant menus on parents' meal choices for their children

PubMed Central

Ahn, Jae-Young; Park, Hae-Ryun; Lee, Kiwon; Kwon, Sooyoun; Kim, Soyeong; Yang, Jihye; Song, Kyung-Hee

2015-01-01

BACKGROUND/OBJECTIVES To encourage healthier food choices for children in fast-food restaurants, many initiatives have been proposed. This study aimed to examine the effect of disclosing nutritional information on parents' meal choices for their children at fast-food restaurants in South Korea. SUBJECTS/METHODS An online experimental survey using a menu board was conducted with 242 parents of children aged 2-12 years who dined with them at fast-food restaurants at least once a month. Participants were classified into two groups: the low-calorie group (n = 41) who chose at least one of the lowest calorie meals in each menu category, and the high-calorie group (n = 201) who did not. The attributes including perceived empowerment, use of provided nutritional information, and perceived difficulties were compared between the two groups. RESULTS The low-calorie group perceived significantly higher empowerment with the nutritional information provided than did the high-calorie group (P = 0.020). Additionally, the low-calorie group was more interested in nutrition labeling (P < 0.001) and considered the nutritional value of menus when selecting restaurants for their children more than did the high-calorie group (P = 0.017). The low-calorie group used the nutritional information provided when choosing meals for their children significantly more than did the high-calorie group (P < 0.001), but the high-calorie group had greater difficulty using the nutritional information provided (P = 0.012). CONCLUSIONS The results suggest that improving the empowerment of parents using nutritional information could be a strategy for promoting healthier parental food choices for their children at fast-food restaurants. PMID:26634057

A Call to Digital Health Practitioners: New Guidelines Can Help Improve the Quality of Digital Health Evidence.

PubMed

Agarwal, Smisha; Lefevre, Amnesty E; Labrique, Alain B

2017-10-06

Despite the rapid proliferation of health interventions that employ digital tools, the evidence on the effectiveness of such approaches remains insufficient and of variable quality. To address gaps in the comprehensiveness and quality of reporting on the effectiveness of digital programs, the mHealth Technical Evidence Review Group (mTERG), convened by the World Health Organization, proposed the mHealth Evidence Reporting and Assessment (mERA) checklist to address existing gaps in the comprehensiveness and quality of reporting on the effectiveness of digital health programs. We present an overview of the mERA checklist and encourage researchers working in the digital health space to use the mERA checklist for reporting their research. The development of the mERA checklist consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot-testing the checklist. The mERA checklist consists of 16 core mHealth items that define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features). Additionally, a 29-item methodology checklist guides authors on reporting critical aspects of the research methodology employed in the study. We recommend that the core mERA checklist is used in conjunction with an appropriate study-design specific checklist. The mERA checklist aims to assist authors in reporting on digital health research, guide reviewers and policymakers in synthesizing evidence, and guide journal editors in assessing the completeness in reporting on digital health studies. An increase in transparent and rigorous reporting can help identify gaps in the conduct of research and understand the effects of digital health interventions as a field of inquiry. ©Smisha Agarwal, Amnesty E Lefevre, Alain B Labrique. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 06.10.2017.

Food advertising on Australian television: the extent of children's exposure.

PubMed

Neville, Leonie; Thomas, Margaret; Bauman, Adrian

2005-06-01

The objective of this study was to investigate the extent and nature of food advertising during Australian children's television (TV) viewing hours and programs, and to determine whether confectionery and fast food restaurant advertisements were more likely to be broadcast during children's programs than during adults' programs on Sydney television stations. One week (390 h) of Australian advertising data broadcast during children's TV viewing hours over 15 television stations were analysed to determine the proportion of food advertisements and, in turn, the proportion of those advertisements promoting foods high in fat and/or sugar. One week (346 h) of confectionery and fast food restaurant advertisements broadcast over three Sydney television stations were analysed to determine whether these types of advertisements were more likely to be advertised during children's programs than adults' programs. Half of all food advertisements promoted foods high in fat and/or sugar. 'Confectionery' and 'fast food restaurants' were the most advertised food categories during children's TV viewing hours. Confectionery advertisements were three times as likely, and fast food restaurant advertisements twice as likely, to be broadcast during children's programs than adults' programs. It can be concluded that foods most advertised during children's viewing hours are not those foods that contribute to a healthy diet for children. Confectionery and fast food restaurant advertising appears to target children. Australian children need protection from the targeted promotion of unhealthy foods on television, but currently little exists.

An outbreak of infections with a new Salmonella phage type linked to a symptomatic food handler.

PubMed

Hundy, Rebecca L; Cameron, Scott

2002-01-01

In December 2001, the South Australian Communicable Disease Control Branch investigated an outbreak of gastrointestinal illness linked to a Korean style restaurant in metropolitan Adelaide. Twenty-eight people were identified as having experienced gastrointestinal symptoms subsequent to dining at the restaurant between 9 and 12 December 2001. A case-control study implicated mango pudding dessert (OR 16.67 95% CI 2.03-177.04) and plain chicken (OR 10.67 95% CI 1.04-264.32). Nineteen cases and one food handler submitted faecal specimens that grew Salmonella Typhimurium 64var. Two samples of mango pudding and one sample of pickled Chinese cabbage also grew Salmonella Typhimurium 64var. The infected food handler reported an onset of illness 2 days before cases first reported eating at the restaurant. The food handler's only role was to prepare the mango pudding dessert in an area external to the restaurant's kitchen. Illness was strongly associated with consumption of a contaminated mango pudding dessert, with contamination most likely resulting from the symptomatic and culture positive food handler who prepared the dish. This outbreak demonstrates the importance of excluding symptomatic food handlers, and the need for appropriately informing and educating food handlers regarding safe food handling procedures. Restaurants with staff and management from non-English speaking backgrounds should be specifically targeted for education that is both culturally sensitive and language specific.

[Feasibility and relevance of an operating room safety checklist for developing countries: Study in a French hospital in Djibouti].

PubMed

Becret, A; Clapson, P; Andro, C; Chapelier, X; Gauthier, J; Kaiser, E

2013-01-01

The use of the World Health Organization surgical safety checklist, mandatory in operating rooms (OR) in France, significantly reduces morbidity and mortality. Our objective was to evaluate the use of this checklist in the OR of a French military hospital in Djibouti (Horn of Africa). The study was performed in three stages: a retrospective evaluation of the checklist use over the previous two months, to assess the utilization and completeness rates; provision of information to the OR staff; and thereafter, prospective evaluation for a one-month period of checklist use, the reasons for non-compliance, and the cases in which the checklist identified errors and thus prevented serious adverse events. The initial utilization rate was 49%, with only 24% complete. After staff training and during the study these rates reached 100% and 99%. The staff encountered language difficulties in 53% of cases, and an interpreter was available for 81% of them. The capacity of the surgical safety checklist to detect serious adverse events was highlighted. The utilization and completeness rates were initially worse than those observed in metropolitan French ORs, but a simple staff information program was rapidly effective. Language difficulties are frequent but an interpreter is often available, unlike in developed countries where language problems are uncommon and the availability of interpreters difficult. Moreover, this study illustrates the ability of the checklist to detect and therefore prevent potentially serious adverse events.

A new method to monitor the contribution of fast food restaurants to the diets of US children.

PubMed

Rehm, Colin D; Drewnowski, Adam

2014-01-01

American adults consume 11.3% of total daily calories from foods and beverages from fast food restaurants. The contribution of different types of fast food restaurants to the diets of US children is unknown. To estimate the consumption of energy, sodium, added sugars, and solid fats among US children ages 4-19 y by fast food restaurant type. Analyses used the first 24-h recall for 12,378 children in the 2003-2010 cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2003-2010). NHANES data identify foods by location of origin, including stores and fast food restaurants (FFR). A novel custom algorithm divided FFRs into 8 segments and assigned meals and snacks to each. These included burger, pizza, sandwich, Mexican, Asian, fish, and coffee/snack restaurants. The contribution of each restaurant type to intakes of energy and other dietary constituents was then assessed by age group (4-11 y and 12-19 y) and by race/ethnicity. Store-bought foods and beverages provided 64.8% of energy, 61.9% of sodium, 68.9% of added sugars, and 60.1% of solid fats. FFRs provided 14.1% of energy, 15.9% of sodium, 10.4% of added sugars and 17.9% of solid fats. Among FFR segments, burger restaurants provided 6.2% of total energy, 5.8% of sodium, 6.2% of added sugars, and 7.6% of solid fats. Less energy was provided by pizza (3.3%), sandwich (1.4%), Mexican (1.3%), and chicken restaurants (1.2%). Non-Hispanic black children obtained a greater proportion of their total energy (7.4%), sodium (7.1%), and solid fats (9.5%) from burger restaurants as compared to non-Hispanic white children (6.0% of energy, 5.5% of sodium, and 7.3% of solid fat). These novel analyses, based on consumption data by fast food market segment, allow public health stakeholders to better monitor the effectiveness of industry efforts to promote healthier menu options.

A New Method to Monitor the Contribution of Fast Food Restaurants to the Diets of US Children

PubMed Central

Rehm, Colin D.; Drewnowski, Adam

2014-01-01

Background American adults consume 11.3% of total daily calories from foods and beverages from fast food restaurants. The contribution of different types of fast food restaurants to the diets of US children is unknown. Objective To estimate the consumption of energy, sodium, added sugars, and solid fats among US children ages 4–19 y by fast food restaurant type. Methods Analyses used the first 24-h recall for 12,378 children in the 2003–2010 cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2003–2010). NHANES data identify foods by location of origin, including stores and fast food restaurants (FFR). A novel custom algorithm divided FFRs into 8 segments and assigned meals and snacks to each. These included burger, pizza, sandwich, Mexican, Asian, fish, and coffee/snack restaurants. The contribution of each restaurant type to intakes of energy and other dietary constituents was then assessed by age group (4–11 y and 12–19 y) and by race/ethnicity. Results Store-bought foods and beverages provided 64.8% of energy, 61.9% of sodium, 68.9% of added sugars, and 60.1% of solid fats. FFRs provided 14.1% of energy, 15.9% of sodium, 10.4% of added sugars and 17.9% of solid fats. Among FFR segments, burger restaurants provided 6.2% of total energy, 5.8% of sodium, 6.2% of added sugars, and 7.6% of solid fats. Less energy was provided by pizza (3.3%), sandwich (1.4%), Mexican (1.3%), and chicken restaurants (1.2%). Non-Hispanic black children obtained a greater proportion of their total energy (7.4%), sodium (7.1%), and solid fats (9.5%) from burger restaurants as compared to non-Hispanic white children (6.0% of energy, 5.5% of sodium, and 7.3% of solid fat). Conclusions These novel analyses, based on consumption data by fast food market segment, allow public health stakeholders to better monitor the effectiveness of industry efforts to promote healthier menu options. PMID:25062277

Evaluating the efficacy of different smoking policies in restaurants and bars in Beijing, China: a four-year follow-up study.

PubMed

Liu, Ruiling; Jiang, Yuan; Travers, Mark J; Li, Qiang; Hammond, S Katharine

2014-01-01

In 2006, the World Health Organization Framework Convention on Tobacco Control became effective in mainland China. In 2007, advocacy on voluntary smoking bans in restaurants was initiated in Beijing, and in 2008 the Beijing government implemented a smoking regulation, requiring big restaurants to prohibit or restrict smoking. To evaluate the efficacy of different smoking policies adopted by Beijing restaurants and bars from 2006 to 2010. The study conducted field observations of patron smoking behavior and monitored fine particulate matter from secondhand smoke (SHS PM) from 91, 85, 94 and 79 Beijing restaurants and bars in 2006, 2007, 2008 and 2010, respectively, during peak-patronage times, with overlaps of venues during each two years. Area nicotine sampling during peak patronage times and servers' personal nicotine sampling during their working shifts were also conducted in 2010. Smoking was nominally prohibited or restricted in 18% of restaurants and bars monitored in 2006, in 11% of venues in 2007, in 83% of venues in 2008, and in 69% of venues in 2010. However, smoking was observed in more than 40% of the nominal nonsmoking venues/sections in 2008 and 2010. The median of observed patron active smoker density (ASD) was 0.24, 0.27, 0.00 and 0.10 active smokers per 100 m3 in 2006, 2007, 2008 and 2010, respectively. The median of SHS PM concentrations was 53, 83, 18 and 27 μg/m3, respectively. In 2010, both the median SHS PM and air nicotine concentrations in designated nonsmoking sections were about 40% of those in designated smoking sections, according to simultaneous sampling in both sections. Servers' personal exposure to air nicotine was quite similar in venues with different nominal smoking policies. In the 15 venues followed from 2006 to 2010, SHS PM concentrations changed randomly from 2006 to 2007, decreased in most venues in 2008, and then increased to some extent in 2010. Voluntary smoking policy is rarely adopted and cannot protect people from SHS exposure in restaurants and bars. The 2008 Beijing governmental smoking regulation failed to significantly reduce SHS exposure shortly or two years after its implementation. Restricting smoking to designated sections cannot eliminate SHS exposure. Copyright © 2013 Elsevier GmbH. All rights reserved.