RESEARCH MENTOR: DR. JANE JUE

JOHN-PAUL JULIENUNIVERSITY OF PENNSYLVANIAJJULIEN89@GMAIL.COM

The Fixed Environment and Collegiate Health

Primary goal: Perform an exploratory examination of the food environment around the University of Pennsylvania’s campus

US HEALTH TRENDS AND NUTRITION

Background

Going Up….

Fast food consumption has increased 5 fold since 1977

Almost half of US food spending goes towards food eaten away from home

Fast food spending has increased 900% from 1975 to 2004

American average calorie intake has increase by 200 kcal/day from 1976 to 1996

Also Going Up…

Between 1962 and the year 2000, the number of obese Americans grew from 13% to an alarming 31% of the population.

Among Americans age 20 and older, 145.0 million are overweight or obese (BMI of 25.0 kg/m2 and higher)

According to the U.S. Surgeon General report in 2007, obesity is responsible for 300,000 deaths every year.

Previous Studies

Environment as it relates to childhood obesity (Davis and Carpenter, 2009; Nielsen et al, 2002; Duffy et al, 2007)

These studies have led to a number of troubling conclusions:

FF restaurants within ½ mile of child’s school resulted in child’s reduced consumption of fruits & vegetables, increased consumption of soda and greater chance of being overweight

Weekly consumption of fast food is related to 0.2 unit increase in BMI

Why a college campus?

Eating habits formed in college can continue throughout one’s life

Living on a college campus typically results in more away from home eating

Increased stress levels from work load, social life, and being away from home may increase the possibility of weight gain

Methods

A Brief Description

Using a highly validated food and nutrition survey, the NEMS-R tool (Glanz, 2007 ), we conducted on-site evaluations of 130 eateries (94 restaurants, 36 food trucks) around Penn’s campus

The parameters of Penn’s eating environment were determined by a student survey

Restaurants and food carts were rated on a number of characteristics, all of which had some bearing on their nutritional rating

The Nutrition Environment Measures Survey

The NEMS-R tool takes into account the following:• Restaurant type• Restaurant hours• Seating capacity• Signs and Promotions• Menu• Availability of low fat options• Availability of 100% fruit juice, low fat milk, fresh fruits an

vegetables• Healthy entree options• Main dish salad options• Factors that encourage healthy and unhealthy eating habits• Other factors

GRAPHICAL ANALYSIS

Results

Restaurant Type

SD Sit-Down Restaurant 21%

FC Fast Casual Restaurant 20%

FF Fast Food 41%SP Specialty 18%

RestaurantsYes (5) 5% No (89) 95%

RestaurantsYes (5) 5% No (89) 95%

Food TrucksYes (0) 0%No (36) 100%

Food TrucksYes (0) 0%No (36) 100%

Nutritional Information

RestaurantsNo (81) 86%

Yes (13) 14%

RestaurantsNo (81) 86%

Yes (13) 14%

Food TrucksNo (35) 97%Yes (1) 3%

Food TrucksNo (35) 97%Yes (1) 3%

Healthy Entrees

Minimum Delivery Charge (Restaurants)

No (69) 73%

Yes (25) 27%

Scoring

NEMS-R tool rated on a -27 to 63 point scale

The higher the score the more healthful the restaurant

Points awarded for survey characteristics

R: 14.093; FT:5.89; Overall: 11.81

0

2

4

6

8

10

12

14

16

R FT O

NEMS-RScore

Scoring Continued

RestaurantsWorst Score:(-3) Cupcake and Cookies CaféBest Score: (39); ABP & Potbelly Sandwich

Food Truck Best Score: (18); Lyn’s Food Truck

Discussion

The Difficulty with Eating Healthy

Availability of healthful entrees are few and far between

Few eateries provide nutritional information for their foods

The pricing and promotions of restaurants are encouraging overeating

Eateries around Penn’s campus lack healthful value

Relevance

Better eating behaviors of adults while in college may improve individual and population health.

Nutritional characteristics of campus restaurants will allow students to make better informed eating decisions

Help colleges and universities become more cognizant of their eating environments and which establishments they support

Reflections

Lessons Learned

Personal - Time Management

Project- It’s not easy being healthy

SUMR- Health services research is a field

Career – Many doors

Special Thanks

Dr. Jane Jue

To LDI, Joanne Levy, Kelly Johnson, Shanta Layton

SUMR scholars

References

Technomic Foodservice Segment Time Series: Limited Service Restaurants (1975–2005). Chicago, Ill: Technomic Inc; 2004.

Nielsen SJ, Siega-Riz AM, Popkin BM. Trends in food locations and sources among adolescents and young adults. Prev Med. 2002;35:107–113.

Clauson A. Share of food spending for eating out reaches 47 percent. Food Rev. 1999;22:20–22.

Bowman SA, Gortmaker SL, Ebbeling CA, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics. 2004;113:112–118.

Nielsen S, Siega-Riz A, Popkin B. Trends in energy intake in the U.S. between 1977 and 1996: similar shifts seen across age groups. Obes Res 2002;10:370–8.

K. Glanz, J. Sallis, B. Saelens, L. Frank. Nutrition Environment Measures Survey in Stores (NEMS-S) Development and Evaluation. American Journal of Preventive Medicine, Volume 32, Issue 4, Pages 282-289.

Cassady D, Housemann R, Dagher C, Measuring Cues for Healthy Choices on Restaurant Menus: Development and Testing of a Measurement Instrument, Am J of Health Promotion. 2004;6:444-449

Dietary Guidelines for Americans, USDA Center for Nutrition Policy and Promotion.