Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam, South Korea: Comparison According to Stages of Behavioral Change

With the increase in meals eaten outside the home, sodium reduction in restaurant foods is essential for reducing sodium intake. This study aimed to assess the stages of behavioral change for reducing sodium and the differences in perceptions among restaurant staff by stage. Restaurant owners and cooks (n = 313) in Seongnam, South Korea were surveyed on their stage of behavioral change, practices, and perceptive factors related to sodium reduction in restaurant meals using a questionnaire. The proportion of behavioral change by stage was 20.4% in the maintenance and action (MA) stage, 32.3% in the preparation (P) stage, and 47.3% in the pre-preparation (PP) stage, which included contemplation and pre-contemplation stages. The items that represent differences among the groups were recognition of social environment for sodium reduction, practice of weighing condiments and measuring salinity, and feasibility of actions related to low-sodium cooking. Logistic regression analysis was used to estimate odds ratios for practice and perceptive factors by using stage of behavioral change as the independent variable. Factors associated with being in the MA stage were weighing condiments, measuring salinity, and high feasibility of actions related to low-sodium cooking. Recognition of sodium labeling and anticipation of better taste by reducing sodium increased the odds of being in the P stage rather than the PP stage. These results suggest that customized stepwise education and support are needed for the efficacy of restaurant-based sodium reduction programs.

Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

Emerging adults’ intersecting experiences of food insecurity, unsafe neighbourhoods and discrimination during the coronavirus disease 2019 (COVID-19) outbreak

Objective: To examine how food insecurity is related to emerging adults’ food behaviours and experiences of neighbourhood safety and discrimination and to identify resources needed to support their health during the COVID-19 outbreak. Design: Rapid response online survey. Participants completed the six-item US Household Food Security Survey Module, a brief measure of food insufficiency, and measures of food behaviours, neighbourhood safety and discrimination. Open-ended questions were used to assess changes in eating behaviours during COVID-19 and needed resources. Setting: C-EAT (COVID-19 Eating and Activity over Time) study invitations were sent by email and text message to a longitudinal cohort. Participants: A total of 218 emerging adults (mean age = 24·6 (sd 2·0) years, 70·2 % female) completed a survey in April–May 2020 during a stay-at-home order in Minnesota. Results: The past year prevalence of food insecurity was 28·4 %. Among food-insecure respondents, 41·0 % reported both eating less and experiencing hunger due to lack of money in the past month. Food-insecure respondents were less likely than those who were food secure to have fruits/vegetables at home and more likely to have frequent fast-food restaurant meals, feel unsafe in their neighbourhood and experience discrimination during the stay-at-home order. Food-insecure adults reported changes including eating more food prepared at home, eating more take-out restaurant meals and purchasing more energy-dense snacks as a result of events related to COVID-19. Resources most needed to support their health included eligibility for more food assistance and relief funds. Conclusions: Food-insecure emerging adults experience many barriers to maintaining healthful eating patterns during COVID-19.

Eating alone, or commensality redefined? Solo dining and the aestheticization of eating (out)

Consumers’ increasing fascination with recreational eating out has contributed to numerous transformations in the upmarket restaurant practice. This paper explores such changes in regard to the “social” aspects of eating out, focusing particularly on the “cultural phenomenon” and practice of eating publicly alone (solo dining). Specifically, the paper extends previous portrayals of solo dining as a bundle of aloneness and togetherness by exploring such interplay in the context of the aestheticization of eating and/or the aesthetic food(ie) movement. Based on the interviews of Finnish food/restaurant enthusiasts and exponents of solo dining, the paper firstly depicts solo dining as a practice in which eating publicly alone is celebrated for the sake of enhanced aesthetic immersion. Secondly, the paper argues that solo dining can indeed be interpreted as a form of eating together and depicts the myriad ways, both concrete and “anonymous”, through which solo restaurant meals are shared between like-minded enthusiasts. Thus, the aesthetically oriented slice of solo dining becomes not understood as a complete departure from the ideal of shared public meals but as an alternative manifestation of commensality within an enthusiasm-based consumer group characteristic of late modern consumer culture.

The Association of Romantic Relationships, Eating Out Habits, Physical Activity, and Alcohol Consumption in College Freshman Over Time

Objectives While a growing body of literature acknowledges the role that close relationships have on nutrition outcomes, little research has assessed how significant others impact health during youth. This study assessed how being in a relationship during freshman year is associated with fast food consumption, restaurant meals, physical activity (PA), and alcohol intake. Methods The current study is a secondary analysis from SPARC (Social impact of Physical Activity and nutRition in College), a longitudinal study of nutrition and weight outcomes among college freshman. Participants (n = 535; 73% female; 50% non-white) completed web-based surveys during the 2015–2016 academic year at two different time points: August 2015 (T1) and November 2015 (T2). Mixed generalized logistic regression, adjusted for participant sociodemographic and clustering of students within residence halls, examined the association between fast food consumption, restaurant meals, PA, and alcohol intake at T2, after controlling for T1 relationship status and T1 eating out, PA, and alcohol intake. Results At T1, 34% of participants were in a relationship, 23% of participants reported fast food consumption &gt;2 days/week, 31% reported restaurant meals &gt;1 day/week, 26% of participants reported high levels of PA, and 43% reported weekly alcohol intake. Participants in a relationship at T1 were significantly more likely to eat in a restaurant at T2, after controlling for T1 restaurant use (OR = 1.78, P = 0.009). No association was observed with relationship status and fast food consumption (OR = 1.36, P = 0.226), physical activity (OR = 1.14, P = 0.588), or alcohol consumption (OR = 0.67, P = 0.096). Conclusions Findings suggest romantic relationships are associated with greater restaurant use in college freshman, but none of the other assessed behaviors. Future research is needed to assess the extent to which being in a relationship influences eating behavior among college freshman, and how it may relate to weight changes. Funding Sources This work was supported by the NIH Common Fund from the Office of the Director and Office of Behavioral and Social Sciences Research and by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of Maternal Child Health Bureau Nutrition Training Grant.

Measured energy content of frequently purchased restaurant meals: multi-country cross sectional study

Objective To measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data. Design Cross sectional survey. Setting 223 meals from 111 randomly selected full service and fast food restaurants serving popular cuisines in Brazil, China, Finland, Ghana, and India were the primary sampling unit; 10 meals from five worksite canteens were also studied in Finland. The observational unit was frequently ordered meals in selected restaurants. Main outcome measure Meal energy content, measured by bomb calorimetry. Results Compared with the US, weighted mean energy of restaurant meals was lower only in China (719 (95% confidence interval 646 to 799) kcal versus 1088 (1002 to 1181) kcal; P<0.001). In analysis of variance models, fast food contained 33% less energy than full service meals (P<0.001). In Finland, worksite canteens provided 25% less energy than full service and fast food restaurants (mean 880 (SD 156) versus 1166 (298); P=0.009). Country, restaurant type, number of meal components, and meal weight predicted meal energy in a factorial analysis of variance (R 2 =0.62, P<0.001). Ninety four per cent of full service meals and 72% of fast food meals contained at least 600 kcal. Modeling indicated that, except in China, consuming current servings of a full service and a fast food meal daily would supply between 70% and 120% of the daily energy requirements for a sedentary woman, without additional meals, drinks, snacks, appetizers, or desserts. Conclusion Very high dietary energy content of both full service and fast food restaurant meals is a widespread phenomenon that is probably supporting global obesity and provides a valid intervention target.

(Over)eating out at major UK restaurant chains: observational study of energy content of main meals

Objectives To examine the energy content of main meals served in major UK restaurant chains and compare the energy content of meals in fast food and “full service” restaurant chains. Design Observational study. Setting Menu and nutritional information provided by major UK restaurant chains. Main outcome measures Mean energy content of meals, proportion of meals meeting public health recommendations for energy consumption (≤600 kcal), and proportion of meals with excessive energy content (≥1000 kcal). Results Main meals from 27 restaurant chains (21 full service; 6 fast food) were sampled. The mean energy content of all eligible restaurant meals (13 396 in total) was 977 (95% confidence interval 973 to 983) kcal. The percentage of all meals that met public health recommendations for energy content was low (9%; n=1226) and smaller than the percentage of meals with an excessive energy content (47%; 6251). Compared with fast food restaurants, full service restaurants offered significantly more excessively calorific main meals, fewer main meals meeting public health recommendations, and on average 268 (103 to 433) kcal more in main meals. Conclusions The energy content of a large number of main meals in major UK restaurant chains is excessive, and only a minority meet public health recommendations. Although the poor nutritional quality of fast food meals has been well documented, the energy content of full service restaurant meals in the UK tends to be higher and is a cause for concern. Registration Study protocol and analysis strategy pre-registered on Open Science Framework ( https://osf.io/w5h8q/ ).