Two online randomised controlled trials examining effects of alcohol calorie labelling on hypothetical ordering of calories from alcohol and food.

BACKGROUND: Providing calorie information for alcoholic beverages is a potential public-health intervention which may serve to reduce alcohol use but also prevalence of overweight/obesity. Equivocal evidence has been found for the effectiveness of alcohol calorie information at reducing drinking intentions as well as purchasing and consumption. However, the extent at which calorie information 'on-trade' will impact consumer behaviour for both alcohol and food consumption has not been investigated. AIMS: (1) To examine the presence of alcohol calorie labelling for hypothetical purchasing of alcohol and food in typical UK restaurant scenarios. (2) To determine the characteristics of individuals who will be likely to choose to view alcohol calorie labels. METHODS: Two online randomised control trials using a hypothetical menu selection. In experiment one (N = 325) participants were randomised to the presence or absence of alcohol calorie labels. In experiment two (N = 1081) individuals were randomised to alcohol calorie labels absent or the choice to view alcohol calorie labels. The primary outcome for each study was calories ordered from alcoholic beverages. RESULTS: There was no evidence that the presence of alcohol calorie information on restaurant menus impacted the number of calories ordered from alcoholic beverages or from food and soft drinks. Younger individuals and individuals who exhibit greater motives for good health were more likely to choose to view alcohol calorie labels. CONCLUSIONS: In two online, hypothetical experiments there is no evidence for alcohol calorie labelling impacting consumer decisions to order alcohol or food. Given the choice, a self-selecting group of individuals who are more motivated by health concerns will view alcohol calorie labels, and in turn may be less likely to order alcohol.

Prevalence of menu label use and its association with calorie intake among US adults.

The 2018 Federal Menu Labeling regulations require restaurants and similar retail food establishments that are part of a chain with 20 or more locations to provide calorie and other nutrition information for standard menu items. In this study, we describe the sociodemographic correlates of prevalence of menu label use at Food-Away-From-Home (FAFH) establishments and estimate the association between menu label use and calorie intake. We use nationally representative data spanning the years 2007-2018 and multivariable logit regression and ordinary least squares regression models. For FAFH establishments, we find that female respondents have about 26% (95% CI = [1.14, 1.39]) higher odds of using menu labels. Respondents with high school degree have 51 percent higher odds (95% CI = [1.24, 1.85]), respondents with some college education have 107 percent higher odds (95% CI = [1.74, 2.47]) of seeing menu labels. Higher income is associated with 12% (95% CI = [1.08, 1.15]) greater odds of seeing menu labels. Hispanic respondents have 29% (95% CI = [0.62, 0.81]) lower odds of seeing and 79% (95% CI = [1.41, 2.29]) higher odds of using menu labels. Black respondents have 54% (95% CI = [1.35,1.75] higher odds of seeing menu labels at sit-down restaurants. Menu label users at fast-food restaurants reported consuming 202 kcal (95% CI = [-252,-153]) fewer total calories than nonusers and menu label users at sit-down restaurants reported using 181 kcal (95% CI = [-256,-106]) fewer total calories than nonusers. Our findings highlight the sociodemographic disparities in menu label use and provide baseline estimates for future studies evaluating the federal menu labeling regulation.

How Salty Is Too Salty? Designing Sodium Warning Label Policies to Identify High-Sodium Items on Restaurant Menus in the United States.

Two U.S. cities require chain restaurants to label menu items that exceed 100% of the Daily Value (DV) for sodium, informing consumers and potentially prompting restaurant reformulation. To inform policy design for other localities, this study determined the percentage of the top 91 U.S. chain restaurants' menu items that would be labeled if a warning policy were established for menu items exceeding the thresholds of 20%, 33%, 50%, 65%, and 100% of the sodium DV for adults. We obtained U.S. chain restaurants' nutrition information from the 2019 MenuStat database and calculated the percentage of items requiring sodium warning labels across the food and beverage categories at all the restaurants and at the full- and limited-service restaurants separately. In total, 19,038 items were included in the analyses. A warning label covering items with >20%, >33%, >50%, >65%, and >100% of the sodium DV resulted in expected coverage of 42%, 30%, 20%, 13%, and 5% of menu items at all the restaurants, respectively. At each threshold, the average percentage of items labeled per restaurant was higher among the full-service restaurants than the limited-service restaurants. These results suggest that restaurant warning policies with a threshold of 100% of the sodium DV per item would cover a minority of high-sodium menu items and that lower thresholds should be considered to help U.S. consumers reduce their sodium consumption.

A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities.

BACKGROUND: Older adults living in residential care facilities are commonly given laxatives to treat constipation; however, these may not always provide full relief, and side effects include diarrhea. Dietary fiber effectively prevents constipation, and international guidelines recommend 25 g/d for optimal laxation. Older adults in residential care rely on the facility menu to provide their nutritional requirements, including adequate dietary fiber. Little is known about how much dietary fiber is provided and consumed. OBJECTIVES: We aimed to determine the provision and consumption of dietary fiber for older adults living in residential care facilities. METHODS: We systematically searched available literature for studies reporting the analysis of residential care menus and meals consumed by residents aged over 65 y. A meta-analysis was performed on the studies that provided the mean amount of dietary fiber provided and consumed by residents. A random effect model was applied due to the heterogeneity of study methodologies. RESULTS: The literature search yielded 4406 publications, but only 28 studies were eligible for our meta-analysis. The study sample comprised 4817 residents. The mean amount of fiber provided to residents was 21.4 g/d [standard error (SE): 1.2; 95% confidence interval: 18.8, 24.2 g/d], the mean amount of fiber consumed by residents was 15.8 g/d (SE: 0.6; 95% confidence interval: 14.7, 16.9 g/d). CONCLUSIONS: Older adults living in care facilities are provided with dietary fiber below the recommended guidelines. Compounding this is that residents consume much less than what is provided and do not meet the recommendations for dietary fiber consumption. There is scope to improve dietary fiber provision, promote consumption to residents to aid laxation, and potentially reduce laxative use and the unwanted side effects of diarrhea. This trial was registered at PROSPERO as CRD42023427265.

Body dissatisfaction and beyond: Investigating attitudes towards calorie labels on UK food menus.

In 2022 the British government made calorie labels on menus a legal requirement to encourage healthier food choices while dining out. Yet, little research has explored perceptions of calorie labels on menus in the United Kingdom or tested whether there may be groups of people vulnerable to potential negative effects of calorie labels, such as those with body dissatisfaction. This between-subjects, convergent mixed-methods study addressed these enquiries. Participants were 562 adults who completed an online survey where hypothetical food orders were made from a menu. The study found that participants who viewed a menu with calorie labels ordered fewer calories. Quantitative results did not find that participants with higher levels of body dissatisfaction were at significantly greater odds of using calorie labels to order fewer calories. However, our qualitative (thematic) analysis revealed that experiences of calorie labels could be shaped by body image concerns. Themes further drew on how calorie labels were empowering, but there were also concerns about their oversimplicity. Findings are discussed in relation to implications for future calorie labelling policies. Given the inconsistent findings amongst the limited amount of literature investigating the role of body dissatisfaction in how calorie labels are used, future research is crucial. In the meantime, as a cautionary measure, clinicians involved in supporting individuals with body or food-related concerns should be aware of the challenges their clients may experience in facing calorie labels on menus when dining out.

Validation of Nutritional Approaches to Modulate Cardiovascular and Diabetic Risk Factors in Patients with Hypertriglyceridemia or Prediabetes-The MoKaRi II Randomized Controlled Study.

Hypertriglyceridemia and diabetes mellitus type 2 are among the most important metabolic diseases globally. Diet plays a vital role in the development and progression of both clinical pictures. For the 10-week randomized, controlled, intervention study, 67 subjects with elevated plasma triglyceride (TG) concentrations (≥1.7 mmol/L) and 69 subjects with elevated fasting glucose concentrations (≥5.6 < 7.0 mmol/L) were recruited. The intervention groups received specially developed, individualized menu plans and regular counseling sessions to lower (A) TG or (B) fasting glucose and glycated hemoglobin A1c as well as other cardiovascular and diabetic risk factors. The hypertriglyceridemia intervention group was further supplemented with fish oil (3.5 g/d eicosapentaenoic acid + docosahexaenoic acid). The two control groups maintained a typical Western diet. Blood samples were taken every 2 weeks, and anthropometric data were collected. A follow-up examination was conducted after another 10 weeks. In both intervention groups, there were comparable significant reductions in blood lipids, glucose metabolism, and anthropometric parameters. These results were, with a few exceptions, significantly more pronounced in the intervention groups than in the corresponding control groups (comparison of percentage change from baseline). In particular, body weight was reduced by 7.4% (6.4 kg) and 7.5% (5.9 kg), low-density lipoprotein cholesterol concentrations by 19.8% (0.8 mmol/L) and 13.0% (0.5 mmol/L), TG concentrations by 18.2% (0.3 mmol/L) and 13.0% (0.2 mmol/L), and homeostatic model assessment for insulin resistance by 31.8% (1.1) and 26.4% (0.9) (p < 0.05) in the hypertriglyceridemia and prediabetes intervention groups, respectively. Some of these changes were maintained until follow-up. In patients with elevated TG or fasting glucose, implementing individualized menu plans in combination with regular counseling sessions over 10 weeks led to a significant improvement in cardiovascular and diabetic risk factors.

Despite advances, the menus of schools served by the National School Meals Program can still be healthier / Pese a los avances, los menús en las escuelas atendidos por el Programa Nacional de Alimentación Escolar aún pueden ser más saludables / Apesar dos avanços, os cardápios de escolas atendidas pelo Programa Nacional de Alimentação Escolar ainda podem ser mais saudáveis

The objective of this study was to evaluate the quality of Brazilian school meals. Cross-sectional study that used 2785 daily menus, from 557 municipalities in the country, offered between 2022 and 2024, in elementary schools. For evaluation, the Quality Index for School Meal Menus Revised was used. It was observed that the majority of menus presented intermediate quality (70.74%) and the other categories presented similar frequencies. The groups of cereals and tubers; vegetables; and fruits were the most frequent, followed by legumes; red meat; and eggs, chicken and fish. Already ultra-processed; regional foods appeared on a quarter of the menus; dairy products; candy; processed foods; and time compatibility; socio-biodiversity foods and sweet regional preparations were less frequent. This study provides an overview of Brazilian school meals with a high frequency of fresh and minimally processed foods. However, it was also possible to observe the presence of foods that are not allowed in school meals.

El objetivo de este estudio fue evaluar la calidad de la alimentación escolar brasileña. Estudio transversal que utilizó 2785 menús diarios, de 557 municipios del país, ofrecidos entre 2022 y 2024, en escuelas primarias. Para la evaluación se utilizó el Índice de Calidad de Menús de Alimentación Escolar Revisado. Se observó que la mayoría de los menús presentaron calidad intermedia (70,74%) y las demás categorías presentaron frecuencias similares. Los grupos de cereales y tubérculos; hortalizas y verduras; y las frutas fueron las más frecuentes, seguidas de las legumbres; carne roja; y huevos y carne blanca. Ya ultraprocesados; los alimentos regionales aparecían en una cuarta parte de los menús; productos lácteos; dulce; alimentos procesados; y compatibilidad horaria; fueron menos frecuentes los alimentos de sociobiodiversidad y las preparaciones dulces regionales. Este estudio ofrece una visión general de la alimentación escolar brasileña con alta frecuencia de alimentos frescos y mínimamente procesados. Sin embargo, también fue posible observar la presencia de alimentos no permitidos en la alimentación escolar.

O objetivo foi avaliar a qualidade da alimentação escolar brasileira. Estudo transversal que utilizou 2785 cardápios diários, de 557 municípios do país, ofertados de 2022 a 2024. Para avaliação foi utilizado o Índice de Qualidade para Cardápios da Alimentação Escolar Revisado. Observou-se que a maioria dos cardápios apresentou qualidade intermediária (70,74%) e as demais categorias apresentaram frequências semelhantes. Os grupos de cereais e tubérculos; legumes e verduras; e frutas foram os mais frequentes, seguidos de  leguminosas; carnes vermelhas; e ovos aves e peixes. Já ultraprocessados; alimentos regionais apareceram em um quarto dos cardápios; laticínios; doces; alimentos processados; e compatibilidade de horário; alimentos da sociobiodiversidade e preparações regionais doces foram menos frequentes. Foi possível concluir a presença de alta frequência de alimentos in natura e minimamente processados. Contudo, também observou-se a presença de alimentos que não são permitidos na alimentação escolar.

Benchmarking online food delivery applications against menu labelling laws: a cross-sectional observational analysis.

OBJECTIVE: It is unknown how well menu labelling schemes that enforce the display of kilojoule (kJ) labelling at point-of-sale have been implemented on online food delivery (OFD) services in Australia. This study aimed to examine the prevalence of kJ labelling on the online menus of large food outlets with more than twenty locations in the state or fifty locations nationally. A secondary aim was to evaluate the nutritional quality of menu items on OFD from mid-sized outlets that have fewer locations than what is specified in the current scheme. DESIGN: Cross-sectional analysis. Prevalence of kJ labelling by large food outlets on OFD from August to September 2022 was examined. Proportion of discretionary ('junk food') items on menus from mid-sized outlets was assessed. SETTING: Forty-three unique large food outlets on company (e.g. MyMacca's) and third party OFD (Uber Eats, Menulog, Deliveroo) within Sydney, Australia. Ninety-two mid-sized food outlets were analysed. PARTICIPANTS: N/A. RESULTS: On company OFD apps, 35 % (7/23) had complete kJ labelling for each menu item. In comparison, only 4·8 % (2/42), 5·3 % (2/38) and 3·6 % (1/28) of large outlets on Uber Eats, Menulog and Deliveroo had complete kJ labelling at all locations, respectively. Over three-quarters, 76·3 % (345/452) of menu items from mid-sized outlets were classified as discretionary. CONCLUSIONS: Kilojoule labelling was absent or incomplete on a high proportion of online menus. Mid-sized outlets have abundant discretionary choices and yet escape criteria for mandatory menu labelling laws. Our findings show the need to further monitor the implementation of nutrition policies on OFD.

Development of an electronic food ordering system and a la carte menu: Enhancing patient involvement in nutritional care.

BACKGROUND: Malnutrition is a significant issue in hospitals, leading to weight loss and reduced quality of life for patients. Hospital food plays a crucial role in preventing malnutrition, especially for patients with high nutritional risk or malnourishment. However, barriers to providing adequate nutritional care include a lack of tools to record patients' nutritional intake and a limited understanding of energy and protein content in hospital menus. OBJECTIVE: The study aimed to develop an electronic patient-centered food ordering system and an à la carte menu to improve patients' nutritional care and involvement in their dietary choices. METHODS: The study was conducted in two parts. Part 1 involved a questionnaire survey among hospitalized patients to determine their food preferences, self-assessed ability to use an electronic food ordering system, and preferences for different types of cuisine. The survey also investigated patients' meal choices for a full day, including portion sizes. Part 2 comprised usability tests of the electronic food ordering system prototype, conducted on hospitalized patients to identify interface issues and assess overall satisfaction. RESULTS: A total of 99 patients participated in the questionnaire survey. The majority (78.7 %) found the selection of dishes appropriate. Patients' preferences were used to adjust the à la carte menu to reflect their meal choices. In the usability tests, the electronic food ordering system prototype showed positive results, and the System Usability Score was above the threshold for minor adjustments. CONCLUSION: The study successfully developed an electronic patient-centered food ordering system and an à la carte menu that aligned with patients' preferences and needs. The system demonstrated usability and potential to improve patients' nutritional care and involvement in their dietary decisions. By addressing the barriers to nutritional care, this system offers a feasible solution to prevent and treat malnutrition in hospitalized patients.

Long-Term Effectiveness of a Multi-Strategy Choice Architecture Intervention in Increasing Healthy Food Choices of High-School Students From Online Canteens (Click & Crunch High Schools): Cluster Randomized Controlled Trial.

BACKGROUND: School canteens are a recommended setting to influence adolescent nutrition due to their scope to improve student food choices. Online lunch ordering systems ("online canteens") are increasingly used and represent attractive infrastructure to implement choice architecture interventions that nudge users toward healthier food choices. A recent cluster randomized controlled trial demonstrated the short-term effectiveness (2-month follow-up) of a choice architecture intervention to increase the healthiness of foods purchased by high school students from online canteens. However, there is little evidence regarding the long-term effectiveness of choice architecture interventions targeting adolescent food purchases, particularly those delivered online. OBJECTIVE: This study aimed to determine the long-term effectiveness of a multi-strategy choice architecture intervention embedded within online canteen infrastructure in high schools at a 15-month follow-up. METHODS: A cluster randomized controlled trial was undertaken with 1331 students (from 9 high schools) in New South Wales, Australia. Schools were randomized to receive the automated choice architecture intervention (including menu labeling, positioning, feedback, and prompting strategies) or the control (standard online ordering). The foods purchased were classified according to the New South Wales Healthy Canteen strategy as either "everyday," "occasional," or "should not be sold." Primary outcomes were the average proportion of "everyday," "occasional," and "should not be sold" items purchased per student. Secondary outcomes were the mean energy, saturated fat, sugar, and sodium content of purchases. Outcomes were assessed using routine data collected by the online canteen. RESULTS: From baseline to 15-month follow-up, on average, students in the intervention group ordered significantly more "everyday" items (+11.5%, 95% CI 7.3% to 15.6%; P<.001), and significantly fewer "occasional" (-5.4%, 95% CI -9.4% to -1.5%; P=.007) and "should not be sold" items (-6%, 95% CI -9.1% to -2.9%; P<.001), relative to controls. There were no between-group differences over time in the mean energy, saturated fat, sugar, or sodium content of lunch orders. CONCLUSIONS: Given their longer-term effectiveness, choice architecture interventions delivered via online canteens may represent a promising option for policy makers to support healthy eating among high school students. TRIAL REGISTRATION: Australian Clinical Trials ACTRN12620001338954, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380546 ; Open Science Framework osf.io/h8zfr, https://osf.io/h8zfr/.

Response of the consumers to the menu calorie-labeling on online food ordering applications in Saudi Arabia.

BACKGROUND: The use of online food ordering applications is widespread; however, to date, there have been no studies on the effect of the menu calorie labeling in online food ordering applications on the consumers' dietary habits and food choices in Saudi Arabia. Therefore, this study aimed to evaluate the response of the consumers to the menu energy-labeling on online food ordering applications in Saudi Arabia by exploring: (a) the consumers' preference and frequency of ordering from online food applications; (b) the consumers' self-reported knowledge, awareness, and interest towards menu calorie information on online food ordering applications; (c) the impact of menu calorie information on online food ordering applications on consumers' food choices. METHODS: This is a cross-sectional study conducted between October and November of 2022. A total of 419 participants were recruited using an online questionnaire. RESULTS: The findings showed that most participants (59%) preferred to order using online food ordering applications. Saving time and effort are the main reasons for using online food ordering applications (61%). Nearly half of the participants (45%) were interested in viewing calorie information on online food ordering applications menus and (47%) did notice calorie information displayed on the menu when ordering from an online food ordering application. Calorie information in online food ordering applications menus is primarily utilized to monitor intake for weight maintenance (19%). The ability to calculate energy requirements and interest in viewing calorie information on online food ordering applications menus were linked to younger age and a higher level of education (p < 0.05). CONCLUSIONS: Overall, consumers showed limited awareness and interest towards the menu calorie information displayed in the online food ordering applications. These findings highlight the importance of developing public health programs to increase public awareness about calorie labeling on menus to aid in the success and effectiveness of the calorie labeling in online food ordering applications as a tool to promote balanced energy intake. Further research is needed to understand the most effective way to deliver calorie information to consumers on an online food ordering application.

Importance, performance frequency, and predicted future importance of dietitians' jobs by practicing dietitians in Korea: a survey study.

PURPOSE: This study aimed to explore the perceptions held by practicing dietitians of the importance of their tasks performed in current work environments, the frequency at which those tasks are performed, and predictions about the importance of those tasks in future work environments. METHODS: This was a cross-sectional survey study. An online survey was administered to 350 practicing dietitians. They were asked to assess the importance, performance frequency, and predicted changes in the importance of 27 tasks using a 5-point scale. Descriptive statistics were calculated, and the means of the variables were compared across categorized work environments using analysis of variance. RESULTS: The importance scores of all surveyed tasks were higher than 3.0, except for the marketing management task. Self-development, nutrition education/counseling, menu planning, food safety management, and documentation/data management were all rated higher than 4.0. The highest performance frequency score was related to documentation/data management. The importance scores of all duties, except for professional development, differed significantly by workplace. As for predictions about the future importance of the tasks surveyed, dietitians responded that the importance of all 27 tasks would either remain at current levels or increase in the future. CONCLUSION: Twenty-seven tasks were confirmed to represent dietitians' job functions in various workplaces. These tasks can be used to improve the test specifications of the Korean Dietitian Licensing Examination and the curriculum of dietetic education programs.

Menu choice stated preference tasks to capture demand complementarity in health.

Health programs/services are often bundled, allowing for both substitution and complementarity. We adapt Discrete Choice Experiments to capture bundling, with application to a case study of exercise and nutrition; complementarity arises due to the goal of improving health. Our contributions are (1) to present a menu-based choice experiment to explore bundling; (2) to analyse the menu-based data using an extension of the choice set generation model (GenL) to account for correlations between bundles and component singles. A nationally representative sample of 333 Australians chose between a nutrition program only; exercise program only; both nutrition and exercise programs; or their status quo. Overall, we show that by incorporating the menu choice task and introducing the combined alternative, we capture a significant portion of the population seeking both exercise and nutrition components. We estimate a latent class GenL model, and identify two latent classes: Class 1 preferred to choose programs on offer, and Class 2 was more price sensitive and had a stronger preference for staying with their status quo. We show in the post-estimation analysis that heterogeneity in preferences translates into heterogeneity in the way alternatives are bundled, indicating that the combined offering is appealing to specific classes of individuals who prefer bundling. By implementing the menu choice task, researchers and policymakers can effectively identify, cater to and influence the demand for combined exercise and nutrition options, leading to more targeted and impactful interventions in promoting healthier lifestyle choices.

Front-of-Package-Label-Style Health Logos on Menus-Do Canadian Consumers Really Care about Menu Health Logos?

Public health policies have been widely utilized to improve population nutrition, such as the newly announced front-of-pack labels (FOPLs) that will be applied to Canadian prepackaged foods to help consumers make healthier selections. However, research on similar health logos in the food service sector has been limited. This study explores the potential application of FOPL-style health logos in the food service sector and its impact on consumer behaviors. A survey was conducted among 1070 Canadians to assess their awareness, perception, and support for health logos on restaurant menus. The results indicate that while participants value healthy food options when dining out, taste, price, and convenience remain the primary factors influencing their choices. Most participants were unaware of existing FOPL policies and demonstrated mixed responses regarding the influence of similar health logos on their restaurant selection. However, a majority expressed a desire to see FOPL-style health logos on menus, and nutrient profile ratings and logos indicating nutrient limitations or encouragements were listed as preferred health logos. Notably, females indicated higher supportiveness for FOPL-style health logos on menus and individuals with food allergies exhibited higher agreement in the likelihood of eating at a restaurant displaying labels. Additionally, findings revealed that FOPL-style health logos alone may not significantly deter consumers from purchasing labelled menu items, especially if price is affected. Overall, this study highlights the need for further understanding consumer perceptions to effectively develop and implement FOPL initiatives in the food service sector.

Transitioning to a Plant-Based Menu in Childcare: Identifying the Nutritional, Financial, and Logistical Considerations.

International health organizations have called for a shift towards more plant-based foods as a way of promoting both individual health and environmental sustainability. Given the high percentage of children in Canada who attend childcare and the high volume of food provided in childcare, transitioning menus to incorporate plant-based foods could have important implications for both planetary and child health. The purpose of this case study is to describe a childcare centre's transition to a plant-based menu. A detailed nutritional analysis of the menu was conducted. The financial and logistical implications of the transitions to a plant-based menu were also assessed. Nutritional analysis revealed that the plant-based menu met or exceeded the daily nutrient requirement for all the key nutrients explored. Financially, the transition led to a 9% reduction in food costs. Logistically, the transition led to improved efficiency and safety with regard to food preparation, with substantially fewer tailored meals due to allergies and dietary restrictions required after the transition. These novel findings are relevant for food service administrators interested in transitioning to a plant-based menu as well as public health dietitians who could support the transition.

Assessing the healthiness of menus of all out-of-home food outlets and its socioeconomic patterns in Great Britain.

Food environment research predominantly focuses on the spatial distribution of out-of-home food outlets. However, the healthiness of food choices available within these outlets has been understudied, largely due to resource constraints. In this study, we propose an innovative, low-resource approach to characterise the healthiness of out-of-home food outlets at scale. Menu healthiness scores were calculated for food outlets on JustEat, and a deep learning model was trained to predict these scores for all physical out-of-home outlets in Great Britain, based on outlet names. Our findings highlight the "double burden" of the unhealthy food environment in deprived areas where there tend to be more out-of-home food outlets, and these outlets tend to be less healthy. This methodological advancement provides a nuanced understanding of out-of-home food environments, with potential for automation and broad geographic application.

Pembentukan Panduan Pemakanan ‘Right Diet 4 Senior’ dan Tahap Penerimaannya dalam Kalangan Warga Emas di Mukim Beranang, Selangor (Development and Evaluation of Menu and Therapeutic Diet Guideline ‘Right Diet 4 Senior’ among Older Adults and Their Caregivers in Rural Area of Malaysia) / Jurnal Sains Kesihatan Malaysia

@#Older adults often had multiple non-communicable diseases (NCD) that will increase the risk of malnutrition. This study aimed to determine the health and nutrition status of the older adults residing in a rural area of Malaysia in Beranang, Selangor and to develop a nutrition guideline for older adults in community. This study involved two phases that includes need assessment (phase 1) and development of nutrition guideline and acceptance evaluation phase (phase 2). A total of 36 older adults were conveniently recruited for the need assessment phase in obtaining sociodemographic, health and nutrition status data. Results from phase 1 shows that 66.7% of older adults were diagnosed with a minimum one NCD, mainly hypertension (50%) and diabetes mellitus (27.8%). Food history showed that the older adults did not meet their requirement for energy, fat, folate, calcium, vitamin A, vitamin D, vitamin E, zinc and potassium. They also did not meet the requirement of serving size for fruits, vegetables, legumes, milk and milk products. Therefore, a nutrition guideline and diet therapeutic menu focuses on diabetes mellitus and hypertension has been developed for older adults and the caregivers. Evaluation of acceptance of the content of the guideline involved caregivers (n=20) and health professionals (n=7). A total of 85% caregivers agreed that the content was easy to understand, however, a few modifications must be done to attract and increase understanding towards the contents of the guideline. Professionals agreed that the addition of pictures, illustration and colours can help to transfer the information more effectively and more acceptable by caregivers and older adults. In conclusion, half of the older adults in this particular rural area have NCD and did not meet requirement for several macronutrients and micronutrients and serving size of fruits, vegetables, legumes and milk and milk products. Thus, a guideline for menu and therapeutic diet (Right Diet for Senior) was developed and was well accepted by the caregivers and health professionals.

Análise das preparações de um serviço de alimentação hospitalar segundo o Escore para Avaliação Qualitativa de Preparação / Analysis of the preparations of a hospital food service according to the Score for Qualitative Assessment of Preparation

Introdução: A oferta de ambientes alimentares saudáveis e sustentáveis deve contar com a avaliação de cardápios que estejam adequados para além da dimensão nutricional, devendo contemplar, entre outros fatores, o grau de processamento dos alimentos conforme recomendações do Guia Alimentar para a População Brasileira. Objetivo: Analisar as preparações de um serviço de alimentação hospitalar segundo o Escore para Avaliação Qualitativa de Preparação. Métodos: O estudo foi do tipo quantitativo, observacional, transversal e analítico, desenvolvido em um serviço de nutrição hospitalar no município de Fortaleza - CE no período de janeiro a junho de 2023. A amostra foi composta por todas as preparações do cardápio de almoço e jantar dos colaboradores, pacientes e acompanhantes. Para análise, foi utilizado o Escore de Avaliação Qualitativa das Preparações, que avalia o grau de processamento industrial do ingrediente, além de outras recomendações. Resultados: Os resultados mostraram que 80% das 315 preparações foram classificadas como de "alta qualidade". As sobremesas e saladas apresentaram maior percentual de preparações classificadas como de "alta qualidade", 97% e 95,7% respectivamente (p <0,001). Uma preparação (1,2%) foi classificada como de "muito baixa qualidade". A qualidade das refeições dos pacientes foi superior à dos colaboradores e acompanhantes (p < 0,05) confirmando a hipótese do trabalho. Conclusões: A qualidade das preparações analisadas apresentou resultados satisfatórios e em concordância com as recomendações do Guia Alimentar para a População Brasileira.

Introduction: The provision of healthy and sustainable food environments should include the assessment of adequate menus beyond the nutritional dimension, and, among other factors, the food processing levels recommended by the Food Guide for the Brazilian Population. Objective: To analyze the preparations of a hospital food service under the Qualitative Preparation Assessment Score. Methods: This quantitative, observational, cross-sectional, and analytical study was conducted in a hospital nutrition service in Fortaleza, Ceará, Brazil, from January to June 2023. The sample consisted of all the lunch and dinner menu preparations for employees, patients, and companions. Besides other recommendations, we adopted the Qualitative Preparation Assessment Score for analysis to evaluate the ingredient industrial processing level. Results: The results showed that 80% of the 315 preparations were classified as "high quality". Desserts and salads had the highest percentage of preparations classified as "high quality", 97% and 95.7%, respectively (p<0.001). One preparation (1.2%) was classified as "very low quality". The quality of patients' meals was higher than that of employees and companions (p<0.05), confirming the study's hypothesis. Conclusions: The quality of the preparations analyzed was satisfactory and aligned with the recommendations of the Food Guide for the Brazilian Population.

Getting Into the Goldilocks Zone: Finding the Right Nutrient Balance in Saudi Prison Food.

Background The general characteristics of prison menus worldwide can include unhealthy, low-quality options. This imbalance can lead to poor health consequences. In seeking the optimal "Goldilocks Zone" of nutritional adequacy, this study analyzed the uniform seven-day cycle menu for both Saudi female and male prisons and compared it to standard dietary recommendations. Aim The United Nations recognizes that the "food security and nutritional status of the most vulnerable" are projected to "deteriorate further due to the health and socio-economic impacts of the COVID-19 pandemic, according to the State of Food Security and Nutrition in the World 2021 report. This study focuses on the nutritional status of female and male Saudi prisoners and is designed to understand and quantify the prevailing levels of nutrient provision to Saudi prisoners based on a seven-day cycle menu. Methods A cross-sectional, descriptive study design was utilized to examine the seven-day cycle national menu, which is consistently applied to both male and female Saudi prisoners. We calculated the nutrient provision from this menu using data on the typical nutrient content of the provided food. Subsequently, we compared the determined levels of nutrients with the reference Dietary Reference Intakes (DRIs). Results For most nutrients, the levels provided in the menu were adequate. Prisoners receive an adequate supply of energy and macronutrients, as well as sufficient quantities of most minerals and vitamins. The fiber content of the diet was notably low, and the sodium content was above the recommended upper limits. Mineral and vitamin levels were low for potassium and Vitamin A and slightly below the recommended level for calcium. The potential health implications of long-term nutrient imbalances are discussed, along with suggestions for addressing these imbalances by introducing different foods. Conclusion The Saudi prison menu operates within the Goldilocks Zone of nutritional balancing. However, optimizing the standard prison menu to more closely meet nutritional and prisoner health goals and to offer more plant-based options for prisoners to help address the United Nations - Sustainable Development Goals and Saudi Vision 2030 is worthy of further discussion and research.

Balancing Accuracy and Speed in Gaze-Touch Grid Menu Selection in AR via Mapping Sub-Menus to a Hand-Held Device.

Eye gaze can be a potentially fast and ergonomic method for target selection in augmented reality (AR). However, the eye-tracking accuracy of current consumer-level AR systems is limited. While state-of-the-art AR target selection techniques based on eye gaze and touch (gaze-touch), which follow the "eye gaze pre-selects, touch refines and confirms" mechanism, can significantly enhance selection accuracy, their selection speeds are usually compromised. To balance accuracy and speed in gaze-touch grid menu selection in AR, we propose the Hand-Held Sub-Menu (HHSM) technique.tou HHSM divides a grid menu into several sub-menus and maps the sub-menu pointed to by eye gaze onto the touchscreen of a hand-held device. To select a target item, the user first selects the sub-menu containing it via eye gaze and then confirms the selection on the touchscreen via a single touch action. We derived the HHSM technique's design space and investigated it through a series of empirical studies. Through an empirical study involving 24 participants recruited from a local university, we found that HHSM can effectively balance accuracy and speed in gaze-touch grid menu selection in AR. The error rate was approximately 2%, and the completion time per selection was around 0.93 s when participants used two thumbs to interact with the touchscreen, and approximately 1.1 s when they used only one finger.