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

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

From innervation density to tactile acuity 2: embryonic and adult pre- and postsynaptic somatotopy in the dorsal horn.

We tested the hypothesis that dorsal horn laminae III-IV cell receptive fields (RFs) are initially established in three steps: cutaneous axons penetrate the dorsal horn near their rostrocaudal (RC) levels of entry into the spinal cord. Their terminal branches distribute mediolaterally (ML) according to their relative distoproximal RF locations on the leg, and form nonselective synapses with nearby dorsal horn cell dendrites, establishing the initial dorsal horn cell RFs. Rootlet axon RFs in adult cats were used to approximate the RC entry levels of hindlimb skin input. Cord dorsum recordings of monosynaptic field potentials evoked by electrical skin stimulation provided the RC distributions of synaptic input. These were in close agreement. Simulated projections of all 22,000 hindlimb axons were similar to projections predicted from EPSP distributions, and with the observed projections of dorsal roots, cutaneous nerves, and individual axons. The simulated terminals were connected nonselectively to nearby dendrites of 135,000 simulated lamina III-IV cells whose dendritic surface area distributions were based on intracellularly stained cells. There was an overall similarity among pre- and postsynaptic embryonic and adult somatotopies, with a progressive transformation of RF angular location as a function of RC, ML dorsal horn location from an initial embryonic presynaptic concentric pattern to an adult postsynaptic radial one. The initial embryonic dorsal horn cell RF assembly hypothesis was supported by the simulations, as was the additional hypothesis that further refinement of connections would be necessary to establish sufficient selectivity to account for observed adult RFs and somatotopy.