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The Fixed Environment and Collegiate Health

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1 The Fixed Environment and Collegiate Health

2 We didn’t really see how it affects the nutrition of Penn students
We didn’t really see how it affects the nutrition of Penn students. All we really did was to describe and characterize the environment. Primary goal: Perform an exploratory examination of the food environment around the University of Pennsylvania’s campus

3 US Health Trends and Nutrition
Background US Health Trends and Nutrition

4 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 Very good

5 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, 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. Maybe take out first and third points and just say it. And move the last point to just before the Surgeon general point .

6 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

7 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

8 Methods

9 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 Mention that the NEMS-R is created by Karen Glanz (who is recently appointed as UPenn faculty).

10 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

11 Results Graphical Analysis

12 Restaurant Type SD Sit-Down Restaurant 21%
For all the graphs, I would break up the restaurants from the food carts. They are different and so having two separate sets of graphs would be most useful. Restaurant Type SD Sit-Down Restaurant % FC Fast Casual Restaurant 20% FF Fast Food 41% SP Specialty 18%

13 Nutritional Information
Food Trucks Yes (0) 0% No (36) 100% Restaurants Yes (5) 5% No (89) 95% Break out the food carts and the restaurants

14 Healthy Entrees Food Trucks Restaurants No (35) 97% No (81) 86%
Yes (1) 3% Restaurants No (81) 86% Yes (13) 14% Make your own graph so “other” doesn’t appear, break up the carts and restaurants

15 Minimum Delivery Charge (Restaurants)
No (69) 73% Yes (25) 27% Make your own graph so it doesn’t have “other” as your yes, and take out the food carts from the denominator as delivery doesn’t apply to them.

16 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: ; FT:5.89; Overall: 11.81

17 Scoring Continued Restaurants
Worst Score:(-3) Cupcake and Cookies Café Best Score: (39); ABP & Potbelly Sandwich Food Truck Best Score: (18); Lyn’s Food Truck

18 Discussion

19 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 It is unclear if college students are aware of the caloric content of the foods they are consuming. However, unfortunately the local food environment does not provide much help in deciphering the nutritional content of foods. Look over the scoring and bring a copy and we’ll talk it over on Monday.

20 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

21 Reflections

22 Lessons Learned Personal - Time Management
Project- It’s not easy being healthy SUMR- Health services research is a field Career – Many doors Maybe break it up by 1- personal reflections on what YOU learning about your food environment and how it will affect your future decisions (one or two) 2- Reflections on your research (as above, maybe just one or two). 3-Reflections on the broader experience of your summer and it’s role in your career decision and development (maybe one or two, maybe mention the ER experience).

23 Special Thanks Dr. Jane Jue
To LDI, Joanne Levy, Kelly Johnson, Shanta Layton SUMR scholars

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

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