Home Delivery Meal Kits Online Food Safety-Related Information: A Perspective.

The recent popularity of home delivery meal kits (HMK) has prompted concerns about its integrity and safety. On the basis of a food safety-related information evaluation of the common US-based HMK vendors' websites, this perspective highlights opportunities for improvement with the adequacy and accessibility of relevant information on HMK websites, an important resource for communicating food safety best practices to consumers. Identified gaps in information and inadequate delivery protocols potentially increase the risk of offering unsafe food to consumers. Suggestions for future research and recommendations for vendors, policymakers, and regulators to help protect consumers from potential foodborne illness risks are also discussed.

Fast-Food Optimal Defaults Reduce Calories Ordered, as Well as Dietary Autonomy: A Scenario-Based Experiment.

BACKGROUND: Low-calorie menu items as optimal defaults may encourage healthier choices when people eat out. Limited research has studied default effects from the restauranteurs' perspective, as well as the public health perspective. OBJECTIVE: To examine the effects of optimal defaults on calories ordered, dietary autonomy, and visit intention in the context of a fast-food drive-through. DESIGN: Between-subjects randomized scenario-based experiment. PARTICIPANTS/SETTING: In all, 377 adults who lived in the United States were recruited through a crowdsourcing platform in July 2020. INTERVENTION: Participants were asked to visualize ordering a combo meal in a fast-food drive-through. They were randomly assigned to order from 1 of 3 menu boards: (1) menu items available for combos by customer choice, (2) combos that included traditional high-calorie default items, or (3) combos that included low-calorie optimal defaults. MAIN OUTCOME MEASURES: Differences in calories ordered among groups, dietary autonomy, and restaurant visit intention. ANALYSIS: Statistical tests included multiple regression, Kruskal-Wallis, χ2, and 1-way analysis of variance. Covariates such as education and sex were tested in regression models as potential confounders. RESULTS: Compared with the choice combo meals, optimal combo meals reduced calories ordered by consumers (-337 kcal, standard error = 19, P < .001), while traditional combos increased them (+132 kcal, standard error = 20, P < .001). No significant difference was found in visit intention. Dietary autonomy was affected by the optimal defaults (P = .025), even in participants with high health concern. Conversely, the traditional combo's effect on dietary autonomy was moderated by health concern (B = -0.26, P = .023), with only individuals with very high levels of health concern perceiving less autonomy. CONCLUSIONS: Optimal defaults provided a robust reduction in calories ordered but had implications for dietary autonomy.

Visual Cues and Optimal Defaults in Fast-Food Combo Meals Benefit Health-Concerned Consumers-A Randomized Scenario-Based Experiment.

BACKGROUND: The use of low-calorie menu items as optimal defaults and visual cues may nudge consumers to healthier choices at restaurants. However, little is known regarding their effects on emotions and behavioral intentions, particularly among people with different levels of health concern. OBJECTIVE: Evaluate optimal defaults and visual cues' effect on anticipated pleasure and order intention depending upon consumers' health concern level. DESIGN: Between-subjects randomized scenario-based experiment. PARTICIPANTS/SETTING: In all, 636 US adults recruited through an online crowdsourcing platform in July 2020. INTERVENTION: Participants saw 1 of 6 menu boards in a fast-food drive-through simulation. Half the menu boards included meal photos with (1) menu items to be arranged as a combo by choice (ie, create-your-own combo); (2) traditional combos that included high-calorie default items; or (3) optimal combos that included low-calorie default items. The remaining 3 boards were identical without photos. MAIN OUTCOME MEASURES: Anticipated pleasure, order intention, and health concern were evaluated with 7-point Likert scales. ANALYSIS: Statistical tests included multiple regression, Kruskal-Wallis, χ2, and analysis of variance. Education and sex were tested as potential confounders. RESULTS: Optimal combos negatively affected anticipated pleasure (P = .003) and order intention (P < .001) compared with choice combos. Order intention reduction was the same for traditional and optimal combos (P = .128). The presence of photos changed order intention for optimal combos but varied by consumer's health concern level. When health concern was lower, photos decreased the likelihood of ordering the optimal combos (B = -3.06, P = .001), but when health concern was higher, photos enhanced ordering intention compared with the choice group (B = 0.60, P = .001). The photos did not affect anticipated pleasure for any level of health concern. CONCLUSIONS: The adverse effect of optimal defaults and how visual cues may reduce their negative effect should be considered in menu design.

Restaurants and COVID-19: What are consumers' risk perceptions about restaurant food and its packaging during the pandemic?

The COVID-19 pandemic and subsequent U.S. in-restaurant dining restrictions deleteriously affected the restaurant industry. While dining restrictions were adopted to prevent human contact, evidence suggests that consumers may mistakenly perceive that restaurant "food" and its "packaging" are risky sources of COVID-19. To explore consumers' COVID-19 risk perceptions about food itself, restaurant food specifically, and restaurant food packaging, this study collected nationwide U.S. consumer survey data (n = 958) using an online consumer panel. Findings showed that: (1) consumers were less concerned about contracting COVID-19 from food in general than restaurant food and its packaging, with consumer restaurant concern highest for food served in restaurants, and lowest for hot/cooked restaurant food followed by restaurant food from carry-out; and (2) the risk perceptions of consumers varied with financial concern for food, gender, and being in a high-risk category of COVID-19. Implications for researchers, restauranteurs, government, and food safety professionals are discussed.

Frequency of and Reasons for False-Positive Consults Generated by the Malnutrition Screening Tool.

BACKGROUND: Nutrition screening on admission is one way to identify patients with malnutrition. The Malnutrition Screening Tool (MST) is a commonly used screening tool but has been found to generate false-positive consults. PURPOSE: The purpose of this research was two-fold: (1) to determine the percentage of nursing screens, using the MST, that generated a false-positive consult for a registered dietitian, and (2) to identify the reasons for these false-positive consults. METHODS: During a 3-month period, registered dietitians documented the number of false-positive consults received from the MST and reasons they were received. RESULTS: Of the registered dietitian consults generated, 5.5% were deemed false-positive. The most common reason for a false-positive consult was patient-reported weight loss that had resolved. CONCLUSIONS: As nurses are integral to completion of the MST, data generated can be used in ongoing education of nursing staff.

Adding sodium information to casual dining restaurant menus: Beneficial or detrimental for consumers?

High sodium levels in restaurant food have prompted Philadelphia and New York City to require inclusion of sodium content in addition to calories on menus to "nudge" consumers toward lower sodium foods. However, taste perceptions may impact the effectiveness of this intervention. An online survey tested whether sodium and calorie menu nutrition information (MNI) influenced consumer choices from a casual dining restaurant menu, accounting for consumers' intuition about taste of food relative to sodium, calories, and healthiness. Consumer choices were assessed based on calorie and sodium content of the menu items they selected. Participants were randomized to a menu with (1) calorie MNI only, (2) calorie plus numeric sodium MNI, (3) calorie MNI plus a sodium warning symbol for foods with 2300 mg of sodium or more, or (4) no MNI. Calorie plus numeric sodium MNI was associated with selection of meals lower in sodium compared to meals from the calorie MNI only menu or no MNI menu, but only for consumers with a taste intuition that (relatively) lower sodium, lower calorie, healthy foods were tasty. Consumers with the opposite taste intuition *(foods with these characteristics are not tasty) ordered meals higher in sodium. Inclusion of the sodium warning symbol did not result in a significantly different meal sodium content compared to the other menu conditions, regardless of taste intuition. However, differing levels of taste intuition alone, without consideration of MNI, was associated with ordering meals of significantly different calorie content. Overall, findings suggest adding calorie plus numeric sodium MNI may lead to beneficial outcomes (i.e., selecting meals lower in sodium) for some consumers and detrimental outcomes (i.e., selecting meals higher in sodium) for others, depending on their taste intuition.

Reported Action to Decrease Sodium Intake Is Associated with Dining Out Frequency and Use of Menu Nutrition Information among US Adults.

BACKGROUND: Restaurant foods have been shown to be high in sodium and limited sodium content information provided through menu nutrition information (MNI) is available at the point of purchase. Dining out and use of MNI are behaviors that can be altered by consumers who are trying to decrease their sodium intake. OBJECTIVE: The aim of this study was to determine the relationship between reported consumer actions to decrease sodium intake and dining out frequency and awareness and use/or intended use of MNI. DESIGN/PARTICIPANTS: A secondary analysis was conducted using responses from 5,588 US adults aged 20 years or older who participated in the 2013-2014 cross-sectional National Health and Nutrition Examination Survey household interview. MAIN OUTCOME MEASURES: The main outcomes were dining out frequency and seeing MNI, using MNI if seen, or would use MNI if provided. STATISTICAL ANALYSES PERFORMED: Linear and logistic regression models were used to assess the relationship of consumers reporting and not reporting action to decrease sodium intake and the outcome measures. RESULTS: Reported consumer action to decrease sodium intake compared to no action was associated with an overall decreased dining out frequency of approximately one meal per week (mean±standard error=3.12±0.10 compared to 4.11±0.14; P<0.01). When separated by type of restaurant, the relationship was significant for fast-food or pizza establishments (mean±standard error=1.35±0.05 meals compared to 2.00±0.07 meals; P<0.001), but not other types of foodservice operations. The odds of seeing MNI, using MNI when seen, or would use MNI if provided were higher for consumers reporting actions to decrease their sodium intake compared to those who were not for both fast-food or pizza establishments and restaurants with wait staff (odds ratio ranged from 1.17 [95% CI 1.04 to 1.32] to 2.24 [95% CI 1.82 to 2.76]; P values ranged from <0.05 to <0.001). CONCLUSIONS: Compared to consumers reporting no actions to decrease sodium intake, consumers reporting actions indicate they dine out less frequently, specifically at fast-food or pizza restaurants and report they are more likely to use MNI. These results may inform the restaurant industry of the actions of a potentially growing consumer group and provide insights for future public health initiatives targeting population sodium reduction.

Cookbooks in U.S. history: How do they reflect food safety from 1896 to 2014?

Historical cookbooks as a source of recipes and food preparation information would be expected to document advancements in food safety related to kitchen equipment, cleaning, foodborne illness knowledge, and consumer education materials. In turn, this food safety information might be expected to contribute to consumers' food safety behaviors. Using both quantitative and qualitative research methodology, this study assessed how food safety information in cookbooks changed and how quickly advancements were incorporated. Faster assimilation into cookbooks was associated with kitchen equipment, educational resources (hotlines and websites), and foodborne illness outbreaks. The rate of incorporation of education materials was moderate. Cleaning advances were the slowest to be incorporated. Modern cookbooks published after the 1980's rapidly evolved with advances in food safety knowledge.

A new home-based mental health program for older adults: description of the first 100 cases.

BACKGROUND: The Geriatric Psychiatry Outreach (GO) Program began in 2005 and provides in-home psychiatric evaluation and treatment for older adults who have difficulty getting to an office-based setting. METHOD: An initial assessment was conducted on the first 100 patients seen by the program and follow-up treatment was provided as clinically indicated. RESULTS: The mean age of patients seen was 79.7 (SD: 8.2), 74% were women, and the most common psychiatric diagnoses were depression (50%) and dementia (45%), with a mean of 1.4 (SD: 0.6) psychiatric diagnoses per patient. The patients had a mean of 4.8 (SD: 2.9) medical diagnoses and were on a mean of 6.8 (SD: 4.0) prescription and 2.2 (SD: 1.2) nonprescription medications. Patients received a mean of 4.2 (SD: 4.2) in-person visits and a mean of 30.2 (SD: 36.5) additional contacts related to their care, such as phone calls, e-mails, and faxes. CONCLUSIONS: Providing psychiatric services at home for older adults with mental illness is a much needed but rarely available service. Such patients typically have a complex combination of medical and psychiatric diagnoses and benefit from contacts in addition to the face-to-face visits.