Evaluating Mediterranean Diet-Adherent, Healthy and Allergen-Free Meals Offered in Tarragona Province Restaurants (Catalonia, Spain): A Cross-Sectional Study.

Restaurant meal consumption has increased substantially, but the ability of restaurants to adhere to guidelines for the Mediterranean diet, healthiness and food allergen management is a challenge. This cross-sectional study aims to assess the Mediterranean diet adherence, healthiness, nutritional quality and food allergen management of meals at restaurants in the Tarragona province (Catalonia, Spain). Primary outcomes included adherence to criteria for the Mediterranean diet (AMed) and gluten management (SMAP), nutritional quality of dishes indicated by a green traffic light rating, meal nutrient content and allergen-free options. Secondary outcomes included restaurant staff knowledge about the Mediterranean diet and food allergens. Forty-four restaurants and 297 dishes were analysed. The restaurants fulfilled an average (mean ± SD) of 5.1 ± 1.6 of 9 compulsory AMed criteria and 12.9 ± 2.8 of 18 SMAP criteria. Dishes were mainly rated green for sugar (n = 178/297; 59.9%) but not for energy (n = 23/297; 7.7%) or total fat (n = 18/297; 6.1%). Waiters and cooks received passing scores for food allergen knowledge (5.8 ± 1.7 and 5.5 ± 1.5 out of 10 points, respectively). Restaurants partially met the AMed and SMAP criteria. Increasing fibre and decreasing saturated fat content are necessary to improve consumers' adherence to healthy diets. For restaurant staff, training courses should be considered to improve their food allergen management.

Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children's Menu.

This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children's menu in April 2012. Orders of adult menu items were abstracted from before (September 2011-March 2012; PRE; n = 1,801,647) and after (September 2012-March 2013; POST; n = 1,793,582) the healthier children's menu was introduced. Entrées, appetizers, and sides listed as healthier options on the menu were coded as healthier. PRE to POST changes in the percentage of orders of healthier items, soda, and dessert were evaluated using McNemar tests of paired proportions. Orders of healthier entrées, appetizers, and sides on the adult menu increased PRE to POST (8.9% to 10.4%, 25.5% to 27.5%, and 7.3% to 9.3%, respectively), and soda and dessert orders decreased (23.2% to 21.7% and 29.0% to 28.3%, respectively). All shifts were statistically significant (p < 0.0001). Our findings demonstrate improvements in orders of healthier adult menu options during the same time frame as a healthy children's menu change. Future research can help elucidate mechanisms to inform future health promotion efforts in restaurants in ways that have the potential to impact both adults and children.

Attitudes and Consumer Behavior toward Foods Offered in Staff Canteens.

The aim of our study was to analyze the attitudes of employees toward food offered in staff canteens, to analyze their eating behavior and the factors determining the choice of meals in staff canteens. The survey was conducted on a sample of 600 adult respondents, who patronize staff canteens in Warsaw, Poland. The research enabled a detailed and comprehensive assessment of consumer behavior toward the use of staff canteens, as well as their opinions on the functioning of the canteens and meals offered. Factors determining the frequency of use of canteens, type of meals, and factors influencing the use of such establishments were identified. Respondents assessed the quality and variety of meals, with the size of portion being the most valued. They were satisfied with the functioning of the canteens and had very few comments. However, they pointed out the need for an increase in the variety of meals, including the availability of vegetarian and vegan dishes. Our research enabled us to establish consumer profiles based on the reasons for not using staff canteens and comments about staff canteens. Patrons of staff canteens were referred to as "canteen enthusiasts" or "canteen medium-enthusiasts", who are "snack lovers", as well as "food choice-oriented" or "quality-oriented". The results provide the basis for practical implications for owners or managers of staff canteens, part of whose work it is to analyze the needs and expectations of their potential customers.

Restaurant-based intervention to facilitate healthy eating choices and the identification of allergenic foods at a family-oriented resort and a campground.

BACKGROUND: Restaurant-based interventions can be an enjoyable way to encourage healthier eating choices by all members of a family. Thus, the principal aims of this study were a) to promote healthy diets by increasing healthy food offerings and b) to increase the number of foods offered specifically as gluten-free and lactose-free and to inform patrons by including nutritional and allergen information that complies with Regulation 1169/2011 regarding the food served in restaurants, takeaways and snack bars. METHODS: A restaurant-based intervention was implemented at 16 food establishments at 2 resorts (the Cambrils Park Resort and Camping Sangulí, Spain, from 2014 to 2015) based on the following 4 components: 1) providing nutritional and allergen analyses of the offered dishes, 2) increasing the number of healthy food choices, 3) identifying menu items associated with allergies and intolerance, and 4) training staff on healthy eating and allergens. Customer satisfaction regarding food aspects was assessed using surveys (10-point scale). RESULTS: Both resorts significantly increased their offerings of healthy dishes (28.6% to 44.7%; P = 0.003) and desserts with fruit (20% to 51.3%; P = 0.013), thus obtaining the Spanish Government's Mediterranean Diet certification. Additionally, both resorts obtained Catalan Celiac Association certification. Moreover, both resorts significantly increased their percentages of gluten-free dishes (2.1% to 50.5%; P < 0.001) and lactose-free dishes (5.5% to 37.5%; P < 0.001) after the intervention. Customer satisfaction increased (mean ± standard deviation) from 6.9 ± 1.6 to 8.5 ± 1.5 (P < 0.001). CONCLUSION: This restaurant-based intervention expanded the number of healthy and allergen-free foods offered in a family-oriented holiday resort environment to encourage healthy food choices, resulting in increased customer satisfaction.

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

BACKGROUND: 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. METHODS: 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. DISCUSSION: 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. TRIAL REGISTRATION: NCT02511938.

Characteristics and Current Status of Well-being Menus Served in Contract-managed Workplace Foodservice

This study was conducted to characterize well-being menus and to examine the service frequency and profitability of those served in the contract-managed workplace foodservice. In-depth interviews were conducted with six persons who were in charge of menu management in the headquarters of six different foodservice management companies during March, 2007. In addition, 122 set menus consisting of 777 menu items, which were on one month menus served during January to April, 2007, were collected from three workplace operations managed by three different foodservice management companies. As a result of the in-depth interviews, four categories of well-being menu items were extracted: 'medicinal, functional menu item', 'environmentally- friendly menu item', 'natural food menu item', and 'harmful components-limiting menu item'. Accordingly, a well-being menu item was defined as 'a menu item with increased nutrition value or decreased health risk by changing food material or cooking method'. When the menu items (n=777) were analyzed by applying the definition and categories, approximately 14% of the items were identified as well-being menu items and most of them were either medicinal, functional (65%) or natural food menu items (33%). Approximately 59% of the 122 set menus included at least one well-being menu item, and therefore they were named the well-being set menus. These well-being set menus, however, were not significantly different from the rest set menus in terms of profitability as measured by the contribution margin. The results of this study could be useful for foodservice management companies to develop and plan well-being menus targeting workplace foodservice operations.

Construction of web-based nutrition education contents and searching engine for usage of healthy menu of children.

A diet habit, which is developed in childhood, lasts for a life time. In this sense, nutrition education and early exposure to healthy menus in childhood is important. Children these days have easy access to the internet. Thus, a web-based nutrition education program for children is an effective tool for nutrition education of children. This site provides the material of the nutrition education for children with characters which are personified nutrients. The 151 menus are stored in the site together with video script of the cooking process. The menus are classified by the criteria based on age, menu type and the ethnic origin of the menu. The site provides a search function. There are three kinds of search conditions which are key words, menu type and "between" expression of nutrients such as calorie and other nutrients. The site is developed with the operating system Windows 2003 Server, the web server ZEUS 5, development language JSP, and database management system Oracle 10 g.

Construction of web-based nutrition education contents and searching engine for usage of healthy menu of children

A diet habit, which is developed in childhood, lasts for a life time. In this sense, nutrition education and early exposure to healthy menus in childhood is important. Children these days have easy access to the internet. Thus, a web-based nutrition education program for children is an effective tool for nutrition education of children. This site provides the material of the nutrition education for children with characters which are personified nutrients. The 151 menus are stored in the site together with video script of the cooking process. The menus are classified by the criteria based on age, menu type and the ethnic origin of the menu. The site provides a search function. There are three kinds of search conditions which are key words, menu type and "between" expression of nutrients such as calorie and other nutrients. The site is developed with the operating system Windows 2003 Server, the web server ZEUS 5, development language JSP, and database management system Oracle 10 g.

Comparison of Nutrient Intake and Meal Service Satisfaction of Elderly at the Local Community Centers:Free and Reduced Meal Service Charge / 대한지역사회영양학회지

The purpose of this study was to compare the nutrient intake and foodservice satisfaction of homebound elderly had lunch at the local community centers by the difference of meal service charge. Two local community center with congregate meal service program located in Daegu and Gyongsan were selected; one with free of meal service charge (F), and the other with 500-1,000 won for meal service charge (K). According to the dietary assessment, energy and nutrient intakes of the 156 elderly subjects were as a whole under the Korean Recommended Dietary Allowance (RDA). Elderly of F service center showed higher % RDA for the selected nutrients and MAR (mean adequacy ratio) than those of K service center (p<0.001). Participants were satisfied with most of the congregation meal service from community center with different reasons such as 'tasty (K service center)' and 'free of charge (F service center)'. In conclusion, elderly had the lunch at the community center with free of meal service charge was poor nutrition status and lower socioeconomic level than the other type of community center in this area. Therefore, healthy menu for elderly should be developed and managed by professional dietitian, as well as its impact on health status of this group, and congregate meal service system might be extended to the homebound elderly of whole community with free of charge.

Comparison of Nutrient Intake and Meal Service Satisfaction of Elderly at the Local Community Centers:Free and Reduced Meal Service Charge / 대한지역사회영양학회지

The purpose of this study was to compare the nutrient intake and foodservice satisfaction of homebound elderly had lunch at the local community centers by the difference of meal service charge. Two local community center with congregate meal service program located in Daegu and Gyongsan were selected; one with free of meal service charge (F), and the other with 500-1,000 won for meal service charge (K). According to the dietary assessment, energy and nutrient intakes of the 156 elderly subjects were as a whole under the Korean Recommended Dietary Allowance (RDA). Elderly of F service center showed higher % RDA for the selected nutrients and MAR (mean adequacy ratio) than those of K service center (p<0.001). Participants were satisfied with most of the congregation meal service from community center with different reasons such as 'tasty (K service center)' and 'free of charge (F service center)'. In conclusion, elderly had the lunch at the community center with free of meal service charge was poor nutrition status and lower socioeconomic level than the other type of community center in this area. Therefore, healthy menu for elderly should be developed and managed by professional dietitian, as well as its impact on health status of this group, and congregate meal service system might be extended to the homebound elderly of whole community with free of charge.