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

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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.</p

Household income differences in food sources and food items purchased

<p>Abstract</p> <p>Background</p> <p>The present study examined income-related household food purchases among a sample of 90 households from the community.</p> <p>Methods</p> <p>Annotated food purchase receipts were collected for a four-week period by the primary household shopper. Receipt food source and foods items were classified into specific categories, and food quantities in ounces were recorded by research staff. For home sources, a limited number of food/beverage categories were recorded. For eating out sources, all food/beverage items were recorded. Median monthly per person dollars spent and per person ounces purchased were computed. Food sources and food categories were examined by household income tertile.</p> <p>Subjects and Setting</p> <p>A community-based sample of 90 households.</p> <p>Results</p> <p>Higher income households spent significantly more dollars per person per month from both home and eating out sources compared with lower income households ($163 versus$100, p < .001). Compared with lower income households, higher income households spent significantly more home source dollars on both fruits/vegetables (21.5 versus 10.2, p < .001) and sweets/snacks (17.3 versus 8.3, p < .001), but did not differ on home dollars spent on sugar sweetened beverages (2.0 versus 1.7, p < .46). The proportion of home beverages that were sugar sweetened beverages was significantly higher among lower income households (45% versus 26%, p < .01). Within eating out sources, lower income households spent a significantly greater percent of dollars per person at carry out places (54% versus 37%, p < .01). No income differences were observed for dollars spent at discount grocery stores, small grocery stores or convenience stores.</p> <p>Conclusions</p> <p>Higher income households spent more money on both healthy and less healthy foods from a wide range of sources. Lower income households spent a larger proportion of their eating out dollars at carry out places, and a larger proportion of their home beverage purchases were sugar sweetened beverages.</p

Predictors of vigorous exercise adoption and maintenance over four years in a community sample

BACKGROUND: Very little is known about the correlates of adoption and maintenance of vigorous exercise. The purpose of this study was to understand the sociodemographic correlates of exercise adoption and maintenance in a community sample. METHODS: 917 women and 229 men completed annual surveys as part of a community-based weight gain prevention trial over four years. Multivariate regressions evaluated predictive factors for maintenance of vigorous exercise over time in regular exercisers, and predictors of adoption of exercise in adults who were sedentary at baseline. RESULTS: Exercise maintenance at Years 2 and 3 was associated with ethnicity and exercise level at baseline, while exercise maintenance at Year 4 was associated with television watching, BMI and exercise at baseline. Exercise level at baseline was associated with exercise initiation at Year 2 and Year 3. Income level, marital status, and smoking status predicted exercise initiation at Year 4. CONCLUSIONS: Predictors of vigorous exercise maintenance were more consistent than predictors of vigorous exercise initiation. Results suggest that those who adopt vigorous exercise are a heterogeneous group and intervention messages could be more broadly focused. These data also suggest that exercise maintenance interventions should continue to target low-income populations with messages regarding smoking, weight and television. Clearly further research is needed to understand the factors that contribute to exercise initiation and maintenance, and to develop effective interventions to improve levels of physical activity levels

Association between body weight, physical activity and food choices among metropolitan transit workers

<p>Abstract</p> <p>Background</p> <p>Associations between body weight, physical activity and dietary intake among a population of metropolitan transit workers are described.</p> <p>Methods</p> <p>Data were collected during October through December, 2005, as part of the baseline measures for a worksite weight gain prevention intervention in four metro transit bus garages. All garage employees were invited to complete behavioral surveys that assessed food choices and physical activity, and weight and height were directly measured. Seventy-eight percent (N = 1092) of all employees participated.</p> <p>Results</p> <p>The prevalence of obesity (BMI >= 30 kg/m²) was 56%. Over half of the transit workers reported consuming fruit (55%) and vegetables (59%) ≥ 3/week. Reported fast food restaurant frequency was low (13% visited ≥ 3/week). Drivers reported high levels of physical activity (eg. walking 93 minutes/day). However, an objective measure of physical activity measured only 16 minutes moderate/vigorous per day. Compared to other drivers, obese drivers reported significantly less vigorous physical activity, more time sitting, and more time watching television. Healthy eating, physical activity and weight management were perceived to be difficult at the worksite, particularly among obese transit workers, and perceived social support for these behaviors was modest. However, most workers perceived weight management and increased physical activity to be personally important for their health.</p> <p>Conclusion</p> <p>Although transit workers' self-report of fruit and vegetable intake, and physical activity was high, perceived access to physical activity and healthful eating opportunities at the worksite was low. Obese workers were significantly less physically active and were more likely to report work environmental barriers to physical activity.</p

School lunch and snacking patterns among high school students: Associations with school food environment and policies

OBJECTIVES: This study examined associations between high school students' lunch patterns and vending machine purchases and the school food environment and policies. METHODS: A randomly selected sample of 1088 high school students from 20 schools completed surveys about their lunch practices and vending machine purchases. School food policies were assessed by principal and food director surveys. The number of vending machines and their hours of operation were assessed by trained research staff. RESULTS: Students at schools with open campus policies during lunchtime were significantly more likely to eat lunch at a fast food restaurant than students at schools with closed campus policies (0.7 days/week vs. 0.2 days/week, p < .001). Student snack food purchases at school were significantly associated with the number of snack machines at schools (p < .001) and policies about the types of food that can be sold. In schools with policies, students reported making snack food purchases an average of 0.5 ± 1.1 days/week as compared to an average of 0.9 ± 1.3 days/week in schools without policies (p < .001). In schools in which soft drink machines were turned off during lunch time, students purchased soft drinks from vending machines 1.4 ± 1.6 days/week as compared to 1.9 ± 1.8 days/week in schools in which soft drink machines were turned on during lunch (p = .040). CONCLUSION: School food policies that decrease access to foods high in fats and sugars are associated with less frequent purchase of these items in school among high school students. Schools should examine their food-related policies and decrease access to foods that are low in nutrients and high in fats and sugars

Annotated receipts capture household food purchases from a broad range of sources

<p>Abstract</p> <p>Background</p> <p>Accurate measurement of household food purchase behavior (HFPB) is important for understanding its association with household characteristics, individual dietary intake and neighborhood food retail outlets. However, little research has been done to develop measures of HFPB. The main objective of this paper is to describe the development of a measure of HFPB using annotated food purchase receipts.</p> <p>Methods</p> <p>Households collected and annotated food purchase receipts for a four-week period as part of the baseline assessment of a household nutrition intervention. Receipts were collected from all food sources, including grocery stores and restaurants. Households (n = 90) were recruited from the community as part of an obesity prevention intervention conducted in 2007–2008 in Minneapolis, Minnesota, USA. Household primary shoppers were trained to follow a standardized receipt collection and annotation protocol. Annotated receipts were mailed weekly to research staff. Staff coded the receipt data and entered it into a database. Total food dollars, proportion of food dollars, and ounces of food purchased were examined for different food sources and food categories. Descriptive statistics and correlations are presented.</p> <p>Results</p> <p>A total of 2,483 receipts were returned by 90 households. Home sources comprised 45% of receipts and eating-out sources 55%. Eating-out entrees were proportionally the largest single food category based on counts (16.6%) and dollars ($106 per month). Two-week expenditures were highly correlated (r = 0.83) with four-week expenditures.</p> <p>Conclusion</p> <p>Receipt data provided important quantitative information about HFPB from a wide range of sources and food categories. Two weeks may be adequate to reliably characterize HFPB using annotated receipts.</p

Increasing weight-bearing physical activity and calcium-rich foods to promote bone mass gains among 9–11 year old girls: outcomes of the Cal-Girls study

BACKGROUND: A two-year, community-based, group-randomized trial to promote bone mass gains among 9–11 year-old girls through increased intake of calcium-rich foods and weight-bearing physical activity was evaluated. METHODS: Following baseline data collection, 30 5th-grade Girl Scout troops were randomized to a two-year behavioral intervention program or to a no-treatment control group. Evaluations were conducted at baseline, one year, and two years. Measures included bone mineral content, density, and area (measured by DXA), dietary calcium intake (24-hour recall), and weight-bearing physical activity (physical activity checklist interview). Mixed-model regression was used to evaluate treatment-related changes in bone mineral content (g) for the total body, lumbar spine (L1-L4), proximal femur, one-third distal radius, and femoral neck. Changes in eating and physical activity behavioral outcomes were examined. RESULTS: Although the intervention was implemented with high fidelity, no significant intervention effects were observed for total bone mineral content or any specific bone sites. Significant intervention effects were observed for increases in dietary calcium. No significant intervention effects were observed for increases in weight-bearing physical activity. CONCLUSION: Future research needs to identify the optimal dosage of weight-bearing physical activity and calcium-rich dietary behavior change required to maximize bone mass gains in pre-adolescent and adolescent girls