Background
Lack of adherence is a primary reason people fail to maintain a healthy diet or lose weight. Multiple environmental factors, including aggressive marketing and convenience of nutrient‐poor ...food, undermine people's best intentions. The aim was to assess the feasibility, acceptability and impact of food prescriptions in which participants' exposure to commercial food outlets is reduced, because the groceries are delivered with weekly menu plans and recipes.
Methods
This is a series of pre‐post pilot proof‐of‐concept studies. We recruited 37 members of Kaiser Permanente interested in improving their diet or losing weight. Weekly meal plans meeting more than 90% of recommended dietary allowances were designed to be low cost, in line with Supplemental Nutrition Assistance Program (SNAP) allowances. Five separate pilots targeted different populations. Participants were required to provide 24‐h dietary recalls (ASA24) before and during the interventions. Weight management pilot participants had height, weight and blood pressure measured before and after 4‐week pilots and followed sustainability guidelines, limiting meat and dairy.
Results
Across pilots, the healthy eating index improved (+21.1 points; 95% CI confidence interval 15.9, 26.3). For the weight management pilots, most participants lost weight (average 10.3 lbs for men, 5.7 lbs for women; 95% CI −10.2, −5.4). The majority of participants liked the programme and considered it the easiest weight loss programme they ever tried.
Conclusions
These pilots suggest that meal planning and grocery delivery can be affordable and acceptable and could ultimately have a major impact on diet‐related chronic diseases. Longer‐term studies are needed to confirm how long compliance will endure.
FoodRx Improves Diet Quality and Supports Weight Loss
Key points
Healthy groceries meeting recommended dietary allowances and sustainability guidelines are affordable and fall within Supplemental Nutrition Assistance Program maximum allotments for <2000 calories per person per day.
Menu planning and grocery delivery resulted in significant improvements in the healthy eating index.
For overweight/obese individuals, 1500‐calorie meal plans/groceries resulted in significant weight loss among most participants.
Evidence suggests that improvements to the childcare nutrition environment can have a positive impact on child dietary intake. The primary aim of the present study was to assess, relative to usual ...care, the effectiveness of a multi-strategy implementation intervention in improving childcare compliance with nutrition guidelines. As a secondary aim, the impact on child dietary intake was assessed.
Parallel-group, randomised controlled trial design. The 6-month intervention was designed to overcome barriers to implementation of the nutrition guidelines that had been identified by applying the theoretical domains framework.
Hunter New England region, New South Wales, Australia.
Forty-five centre-based childcare services.
There were no differences between groups in the proportion of services providing food servings (per child) compliant with nutrition guideline recommendations for all five (5/5) food groups at follow-up (i.e. full compliance). Relative to control services, intervention services were more likely to be compliant with guidelines (OR; 95 % CI) in provision of fruit (10·84; 1·19, 551·20; P=0·0024), meat and meat alternatives (8·83; 1·55, -; P=0·023), dairy (8·41; 1·60, 63·62; P=0·006) and discretionary foods (17·83; 2·15, 853·73; P=0·002). Children in intervention services consumed greater servings (adjusted difference; 95 % CI) of fruit (0·41; 0·09, 0·73; P=0·014) and vegetables (0·70; 0·33, 1·08; P<0·001).
Findings indicate that service-level changes to menus in line with dietary guidelines can result in improvements to children's dietary intake. The study provides evidence to advance implementation research in the setting as a means of enhancing child public health nutrition.
Large chain restaurants reduced calories in their newly-introduced menu items from 2012 to 2015. The objective of this study was to provide updated calorie trends through 2018 and examine trends in ...the macronutrient composition of menu items across this time period.
Data were obtained from the MenuStat project and include 66 of the 100 largest revenue generating U.S. chain restaurants (N = 28,238 items) that had data available in all years from 2012 to 2018. Generalized linear models were used to examine per-item calorie and nutrient changes (saturated fat, trans fat, unsaturated fat, sugar, non-sugar carbohydrates, protein, sodium) among (1) items on the menu in all years (common items) and (2) newly introduced items (2013-2018). Overall, there were no significant changes in calories or nutrients among common items from 2012 to 2018. Among all newly introduced items, calories (-120 kcals, -25%, p = 0.01; p-for-trend = 0.02), saturated fat (-3.4g, -41%, p<0.01, p-for-trend = 0.06), unsaturated fat (-4.5g, -37%, p = 0.02; p-for-trend = 0.04), non-sugar carbohydrates (-10.3g, -40%, p = 0.02, p-for-trend = 0.69), and protein (-4.3g, -25%, p = 0.04, p-for-trend = 0.02) declined.
Newly introduced menu items in large chain restaurants have continued to decline in calories through 2018, which may help to reduce calorie intake. Other changes in macronutrient content were sporadic and not clearly toward improved dietary quality.
This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social ...solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the "Avaliação Qualitativa de Ementas Destinadas a Idosos" (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as "acceptable," with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning.
Access to good nutritional health is one of the principal objectives of current society. Several e-services offer dietary advice. However, multifactorial and more individualized nutritional ...recommendations should be developed to recommend healthy menus according to the specific user's needs. In this article, we present and validate a personalized nutrition system based on an application (APP) for smart devices with the capacity to offer an adaptable menu to the user. The APP was developed following a structured recommendation generation scheme, where the characteristics of the menus of 20 users were evaluated. Specific menus were generated for each user based on their preferences and nutritional requirements. These menus were evaluated by comparing their nutritional content versus the nutrient composition retrieved from dietary records. The generated menus showed great similarity to those obtained from the user dietary records. Furthermore, the generated menus showed less variability in micronutrient amounts and higher concentrations than the menus from the user records. The macronutrient deviations were also corrected in the generated menus, offering a better adaptation to the users. The presented system is a good tool for the generation of menus that are adapted to the user characteristics and a starting point to nutritional interventions.
The proportion of food consumed by children from restaurants tripled during the last 4 decades and that coincided with the increased rate of obesity. Despite the presence of data linking ...quick-service (QS) food consumption to poor diet quality, studies comparing the nutrition content of the children's menu items at QS restaurants (QSRs) with those at full-service restaurants (FSRs) are limited. The objectives of this study were to examine the nutrition content of common children's menu items at both QSRs and FSRs and compare these data with recommendations reported by the
.
Using the 2014 data of the MenuStat project, 10 food items that are on both QSR and FSR children's menus were selected. Data from each restaurant category were aggregated and the overall average of the nutritional content of each individual food item was calculated and compared between the two restaurant categories.
The average of calories, fat, carbohydrates, and added sugar of most items on the children's menu of QSRs are lower than those of FSRs. Also, most food items on children's menus of FSRs, and to a lesser extent those of QSRs, exceeded the national recommended calories and fat content per meal.
Although some children's menu items of QSRs have less fat and fewer calories compared with those of FSRs, most menu items in both FSRs and QSRs do not meet national dietary recommendations. Healthcare professionals may expand discussions with patients to include both restaurant categories when counseling them and their families on obesity prevention. Also, educating children and families about reading the nutritional content information of children's menu items when eating out to make an informed choice can be a tool in fighting childhood obesity.
Abstract No prior studies examining changes in the calorie content of chain restaurants have included national data before and after passage of federal menu labeling legislation, required by the 2010 ...Affordable Care Act. This paper describes trends in calories available in large U.S. chain restaurants in 2008 and 2012 to 2015 using data were obtained from the MenuStat project (2012 to 2015) and from the Center for Science in the Public Interest (2008). This analysis included 44 of the 100 largest U.S. restaurants which are available in all years of the data (2008 and 2012–2015) (N = 19,391 items). Generalized linear models were used to examine 1) per-item calorie changes from 2008 to 2015 among items on the menu in all years and 2) mean calories in new items in 2012, 2013, 2014 and 2015 compared to items on the menu in 2008 only. We found that Among items common to the menu in all years, overall calories declined from 327 kcal in 2008 to 318 kcal in 2015 (p-value for trend = 0.03). No differences in mean calories among menu items newly introduced in 2012, 2013, 2014, and 2015 relative to items only on the menu in 2008 were found. These results suggest that the federal menu labeling mandate (to be implemented in May 2017) appears to be influencing restaurant behavior towards lower average calories for menu items.
ABSTRACT Objective Eating out in restaurants is a common family behavior, but it has been persistently associated with unbalanced nutrient intakes, contributing to create and reinforce unhealthy food ...habits among children. The purpose of this study was to evaluate the kids’ meals from three common well-known restaurant chains in Portugal. Methods The nutritional composition (total fat, carbohydrates, protein, and sodium content) of the menus was analyzed bromatologicaly, and food portions were also examined. The assessment was carried out according to the European Food Safety Authority recommendations. Results Analyses of the menus from the two points of view revealed that the evaluations for macronutrients and food portions may return contradictory results. Protein, carbohydrates, and fats are compliant with the requirements for most of the meals. The analysis from the food portion perspective exceeds the requirements for the meat, fish, and eggs groups, as well as for fats and oils. Fruits, vegetables, and pulses are not present in the menus. Despite the balance associated with the macronutrients, the salt content exceeds the recommendations for most of the meals. Conclusions Popular fast-food chain restaurants have already adapted to comply with nutritional recommendations, whilst neglecting important recommended foods such as fruit, pulses, and vegetables. This study points not only to the need of investing in the improvement of the offerings, but also to the importance of fighting the tendency to reduce the perception of food quality to its nutritional content, leading consumers to believe that the meals offered are balanced when they are not.
RESUMO Objetivo Comer fora de casa tem se tornado um comportamento cada vez mais frequente entre as famílias, fato que tem sido persistentemente associado à ingestão desequilibrada de nutrientes e contribuído para reforçar hábitos alimentares infantis pouco saudáveis. Este estudo avaliou menus infantis de três redes de restaurantes bem conhecidas em Portugal. Métodos A composição nutricional (gordura total, carboidratos, proteína e sódio) dos cardápios foi analisada bromatologicamente, assim como as porções dos alimentos fornecidas. A avaliação foi realizada de acordo com as recomendações da Autoridade Europeia para a Segurança dos Alimentos. Resultados A análise dos cardápios, na perspetiva da composição em macronutrientes e das porções alimentares, apresentou resultados contraditórios. Os teores de proteínas, carboidratos e gorduras cumprem os requisitos na maioria das refeições. A análise das porções alimentares excede as recomendações para os grupos da carne, peixe e ovos, bem como para gorduras e óleos. No entanto, frutas, hortícolas e leguminosas não estão presentes nos menus. Apesar do equilíbrio associado aos macronutrientes, o teor de sal supera as recomendações na maioria das refeições. Conclusão As redes de fast-food mais populares já adaptaram a sua oferta às recomendações nutricionais. No entanto, verifica-se que negligenciaram algumas recomendações alimentares importantes, como incluir frutas, leguminosas e hortícolas nas refeições. Este estudo aponta para a necessidade de investir não só na melhoria da oferta, como também para a importância de combater a tendência crescente dos consumidores se focarem nos nutrientes e se esquecerem dos alimentos, o que os leva a acreditar que as refeições oferecidas são equilibradas, quando não o são.
► Do physical activity based labels result in the selection of lower calorie meals from a sample menu? ► Physical activity based labels were effective in influencing the selection of lower calorie ...meals. ► A majority of participants reported a preference for these physical activity based menu labels.
In this study we examined the effect of physical activity based labels on the calorie content of meals selected from a sample fast food menu. Using a web-based survey, participants were randomly assigned to one of four menus which differed only in their labeling schemes (n=802): (1) a menu with no nutritional information, (2) a menu with calorie information, (3) a menu with calorie information and minutes to walk to burn those calories, or (4) a menu with calorie information and miles to walk to burn those calories. There was a significant difference in the mean number of calories ordered based on menu type (p=0.02), with an average of 1020 calories ordered from a menu with no nutritional information, 927 calories ordered from a menu with only calorie information, 916 calories ordered from a menu with both calorie information and minutes to walk to burn those calories, and 826 calories ordered from the menu with calorie information and the number of miles to walk to burn those calories. The menu with calories and the number of miles to walk to burn those calories appeared the most effective in influencing the selection of lower calorie meals (p=0.0007) when compared to the menu with no nutritional information provided. The majority of participants (82%) reported a preference for physical activity based menu labels over labels with calorie information alone and no nutritional information. Whether these labels are effective in real-life scenarios remains to be tested.
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