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At least 19 recordsLinked to original sources

Restaurant menu labeling: impact of nutrition information on entree sales and patron attitudes.

This study examined changes in sales of low fat/low cholesterol foods targeted in a restaurant menu labeling program. Sales of labeled items were tracked before and after the program was introduced, and a subsample of patrons were surveyed for information on visibility and comprehension of the menu labels. Two of the four restaurants had significant increases in the sales of targeted foods following labeling. Comparisons between patrons dining in restaurants which had an increase in sales (I--increase restaurants) to those dining in restaurants which had no overall shift in sales (NI--no increase restaurants) revealed no differences in patron awareness or comprehension of the menu labels. There were age and gender differences between I and NI restaurants, with I restaurants having proportionally more males, and a younger clientele. Taste was the primary reason given by patrons for their entree choice, regardless of whether or not it was labeled. In all four restaurants women and older patrons were more aware of the program and more responsive to its recommendations. These findings suggest that environmental strategies may be an effective method of encouraging dietary changes in the general population, but patron characteristics such as age and gender may influence receptivity to this type of intervention. Future studies aimed at developing effective point of purchase education programs should evaluate these patron characteristics and include more powerful behavior change strategies.

Age Factors

Marketing nutrition in restaurants: a survey of current practices and attitudes.

This study sought to determine attitudes toward nutrition, nutrition marketing practices, the relationship between attitudes toward nutrition and nutrition marketing practices, and nutrition training practices in restaurants. A written questionnaire was mailed to 200 research and development (R & D) directors in restaurant companies included in Restaurants & Institutions' list of top 400 foodservice organizations ranked by sales. Seventy (35%) responded. Most R & D directors did not think they were responsible for improving the health of their consumers. A positive relationship existed between attitudes toward nutrition and nutrition marketing practices (P = .013). Forty-four reported that they marketed nutrition and planned to add nutritious menu items in the future. Forty-six reported that nutritious meal options represented 0 to 10% of total sales. Nutrition information was provided to consumers by 27 restaurant companies but such information often had to be requested. The American Heart Association was a popular source of nutrition and menu-planning information. Twelve companies employed a registered dietitian, and 14 used registered dietitians as consultants. Nutrition-related training for restaurant employees was limited. These findings indicate that dietitians have opportunities to market their skills in developing nutritious menu items and providing staff training. Also, dietitians should encourage consumers (especially those with special dietary needs) to let restaurant managers know their menu and nutrition information needs.

Health Knowledge, Attitudes, Practice

Evaluation of a parent training programme for teaching mentally retarded children age-appropriate restaurant skills: a preliminary investigation.

A programme designed to train parents to teach their mentally retarded children age-appropriate restaurant skills was developed and evaluated. After participating in a brief training programme, three mothers attempted to facilitate greater independence in their developmentally delayed children during meals at a fast-food restaurant. The programme was evaluated by assessing the mothers' and children's performance in restaurants using a multiple-probe design. The results indicated that the parents' teaching interactions were influenced by the training programme and that their children's restaurant skills were enhanced. The results were discussed in the context of the normalization principle and deinstitutionalization movement.

Behavior Therapy

Involuntary smoking in Savannah's restaurants.

A survey of Savannah area restaurants was conducted to determine the frequency with which nonsmoking sections are provided. Only one in five restaurants in Savannah provide nonsmoking sections, and only one in 10 tables available for dining out are reserved for nonsmokers. Restaurants associated with a national corporation are more than four times as likely to reserve space for nonsmokers than those strictly locally owned. Pertinent attitudes of restaurant personnel are presented, as is a brief discussion of the issue of involuntary smoking.

Data Collection

Objectivity of food-symptomatology surveys. Questionnaire on the "Chinese restaurant syndrome".

The Chinese restaurant syndrome consists of a characteristic symptom complex, with limited times of onset and duration after eating in a Chinese restaurant. There is widespread belief that the C.R.S. is due to monosodium glutamate used in preparing food in Chinese restaurants and that as many as 25 per cent of the general population may be susceptible to the syndrome. Questionnaires were developed to determine the unpleasant symptoms which 530 subjects associated with specific foods, eating places, and "ethnic" styles of preparing food. Over 90 per cent of respondents associated unpleasant symptoms with specific foods, but only 6.6 per cent experienced an event which would "possibly" represent the characteristic C.R.S. Nevertheless, when the phrase "Chinese restaurant syndrome" was introduced in a second questionnaire, 31 per cent of respondents believed that they were personally susceptible to it. Many people do experience unpleasant symptoms after eating, and particularly after eating food associated with a different culture. Although the responses to food symptomatology questionnaires represent an important aspect of the sociology of eating behavior, this procedure should not be considered an objective data collecting system.

Adult

Restaurant-associated outbreak of giardiasis.

An outbreak of giardiasis occurred among staff of a job training center after a meeting at a restaurant. Twenty-seven (75%) of 36 attendees became ill compared with 1 (3%) of 31 staff members not attending (relative risk, 23.3; 95% confidence interval, 3.4-161.4). Because most attendees ate all items on a fixed menu, no individual food item could be conclusively associated with illness. Circumstantial evidence suggests, however, that ice contaminated by a food handler may have been the vehicle. The restaurant had multiple sanitary violations, and 2 employees, 1 with asymptomatic giardiasis and the other with a Giardia-infected, diapered child, served ice to the attendees. This outbreak demonstrates the potential for restaurant-based giardiasis outbreaks.

Adolescent

The response of restaurants to New Jersey's smoking control law.

The authors surveyed a representative sample of New Jersey restaurants to determine what provisions were made for patron smoking, and whether the restaurants were in compliance with the state law intended to restrict smoking in restaurants. The authors report the results of their recent study.

Humans

A restaurant-associated outbreak of E. coli O157 infection.

An outbreak of haemorrhagic colitis due to Escherichia coli O157 and associated with a restaurant in Lothian, occurred in September 1990. There were 16 symptomatic cases, four of whom (all children) required dialysis. Notable features of the outbreak were the wide range of incubation periods (1-14 days), the occurrence of secondary spread through asymptomatic carriers and the prolonged period (at least seven days) during which the restaurant appears to have been the source of infection. Despite careful investigation, no single source within the restaurant was identified. The implications for public health are discussed.

Adult

Community-based health promotion: a survey of churches, labor unions, supermarkets, and restaurants.

A telephone survey of randomly-sampled churches, labor unions, supermarkets and restaurants was conducted in San Diego, California to determine the level of health promotion activities offered for members and customers. Nearly two-thirds of the churches offered health promotion programs, the bulk of which were single educational sessions. A similar proportion of labor unions reported programs, and most of them consisted of the distribution of materials and single-session group meetings. About one-third of the supermarkets reported activities, with most of these being the distribution of brochures. Similarly, about one-third of restaurants reported programs, which primarily consisted of the enforcement of no-smoking regulations. Very few organizations evaluated programs or desired assistance from health professionals. It was concluded that while secular health promotion programs are common and are available to many people, their quality and effectiveness are unknown. These findings present a challenge for public health professionals and agencies.

California

An outbreak of Salmonella enteritidis infection at a fast-food restaurant: implications for foodhandler-associated transmission.

An outbreak of Salmonella enteritidis infection occurred in patrons and employees of a fast-food restaurant. Transmission took place over a 9-day period. A single employee (employee A) was identified who had onset of gastrointestinal illness 1 day before the first reported patron exposures and had S. enteritidis isolated from stool. A case-control study of 37 ill and 20 healthy patrons who ate during shifts worked by employee A demonstrated that curly-fried potatoes and ice (odds ratio [OR], 6.8; 95% confidence interval [CI], 1.5-33.7; P = .007), both food items handled bare-handed by employee A, were associated with illness. Employees who worked two or more shifts with employee A were more likely to be infected than those who did not work with employee A (OR, 4.4; CI, 1.0-19.5; P = .03). Foodhandlers who subsequently became infected apparently contaminated multiple food items with additional transmission to patrons. This outbreak illustrates the potential for foodhandlers in a fast-food restaurant setting who are infected with Salmonella to be a source of transmission.

Adolescent

Chlorpyrifos resistance in German cockroaches (Dictyoptera: Blatellidae) from restaurants.

Visual inspections and trapping revealed the presence of German cockroaches, Blattella germanica (L.) in 62 of 100 randomly selected commercial food-handling establishments. From live cockroaches trapped in 55 restaurants, 35 strains were established and tested for chlorpyrifos resistance. Poor sanitation and the likelihood of trapping cockroaches were associated. Twenty strains had resistance ratios (RR) as LD50 greater than 10-fold, a value exceeding the pest management threshold level for this insecticide. Resistance ratios were not associated with numbers of cockroaches trapped, the level of sanitation, numbers of different insecticide products used, or the number of treatments per month. Significantly more categories of insecticides (e.g., carbamate, organophosphate, inorganic) were used in restaurants with RR greater than 10 than in those with RR less than 10.

Animals

Foodborne hepatitis A infection: a report of two urban restaurant-associated outbreaks.

The cities of Portland, Oregon, and Buffalo, New York, each experienced a restaurant-associated foodborne outbreak of viral hepatitis type A during 1975. Although there were several food handlers ill with viral hepatitis A in each of the restaurants involved, each outbreak was the apparent result of food contamination by a single food handler. In the Buffalo outbreak, food contamination was documented to have occurred for a brief period of time six days prior to onset of any symptoms in the index case. These outbreaks point out the uncommon occurrence of food contamination by individuals ill with type A viral hepatitis, the usefulness of two types of food questionnaires in identifying the vehicle(s) of transmission, and the apparent lack of benefit of widespread immune serum globulin administration as a control measure in this setting.

Adult

Grease burns at fast-food restaurants. Adolescents at risk.

Intermountain Burn Center and Utah State Insurance Fund industrial records were reviewed to determine the incidence and consequences of grease burns among teenagers employed at fast-food restaurants. Burn center records reveal that 10 patients were admitted between 1977 and 1985, and that nine patients required surgery with mean burn care costs of $7389 per patient. State Insurance Fund records demonstrate that 81 grease-burn injuries were reported from 1982 through 1985, at an average burn care cost of $660 per patient. Causes of burn wounds included adding, filtering, or removing hot grease, dropping objects into hot grease, slipping on the floor, cleaning the grill or fryer, and splashing hot grease during cooking. Those treated as outpatients were off from work for as long as 10 days. These data identify an adolescent population at risk for work-related burn injury in fast-food restaurants.

Accidents, Occupational

100 percent smokefree New Jersey restaurants.

The overwhelming majority of New Jerseyans are not smokers and they want and deserve protection. Smokefree policies benefit restaurants. Smokers, too, support controls. Legal action, education, and public demand will make New Jersey restaurants smokefree.

Humans

A low-cholesterol menu in a steak restaurant.

A twelve-month pilot project was conducted to test public reaction to a special restaurant menu identifying food choices low in cholesterol and saturated fat. The Houston steak house in which the "Help Your Heart" menu was tested prepared foods according to guidelines from dietitians of the Diet Modification Clinic, Baylor College of Medicine. Two newspaper articles, a brief magazine feature, and regularly scheduled radio advertising spots publicized the special menu. At the end of each month of the test period, the number of orders from the special menu was tallied for fourteen randomly selected days. Monthly sales from the special menu ranged from 2.5 to 5.1 per cent, with an overall average of 3.4 per cent. There was no statistically significant change from the mean of the percentage of total sales from the special menu over the months. Despite the relatively low percentage of total sales, restaurant executives were pleased with the results of the study and planned to offer the low-cholesterol menu indefinitely, eventually in an expanded form.

Behavior Therapy

Development of standardized inspections in restaurants using visual assessments and microbiological sampling to quantify the risks.

The relationship between visual inspections carried out by environmental health officers and microbiological examination was studied in 89 restaurants. Using 30 variables a standardized inspection procedure was developed and each of the premises was assessed in six main areas-structure and design, cleaning and cleanliness, personal hygiene, risk of contamination, temperature control, and training and knowledge about food hygiene. Selected foods and specimens from hands, surfaces, and wiping cloths were examined. There were significant associations between all six areas of the inspections. The structure and design were significantly related to the combined score from all the other areas (P less than 0.001). There were no highly significant associations between microbiological examination and visual assessments. The microbial contamination of wiping cloths, however, was related to the cleaning and cleanliness (P = 0.005). Microbial sampling provided additional information to inspections and was a valuable aid. Further development of this risk-assessment approach could provide an effective system for monitoring potential health risks in high-risk food premises.

Education

Bacterial growth in seafoood on restaurant premises.

Operational guidelines for a chain of the newer type of seafood restaurants and take-out stores were derived from plots of bacteriological and trimethylamine changes during the preparation and storage of cod fillets, shrimp, and clams. If fish is to be defrosted at room temperature it should be washed and portioned within 14 h. Subsequent storage at 5 degrees C should not exceed 72 h and once removed from the refrigerator it should be fried within 3 h. New stores should consider improved methods of defrosting. Trimethylamine content was a more sensitive measure of quality loss than bacterial growth. Shrimp quality can be improved by emphasizing the way shells are removed because most of the contamination was external. Shrimp shelled while still frozen had the best potential keeping quality. Clam meat is handled less and is always held at 5 degrees C; but bacterial growth indicated that it should not be held on the premises for more than 3 days including the time necessary for defrosting. Batter prepared fresh daily can be feft at room temperature. Frying can obliterate poor handling procedures, but adequate cooking is essential under any conditions. Clams are a gourmet item but the practice of cooking them lightly at customer request proved inadvisable.

Bacteria

[Evaluation of results of a nutritional marketing intervention in Montreal restaurants].

This article reviews two major questions examined in conjunction with the evaluation of the feasibility of a nutritional marketing program in restaurants. The first question focuses on the acceptance by restaurateurs of this type of initiative and the second, on the receptiveness of consumers. The evaluation allows us to render a positive judgement regarding the project while recognizing its limitations. The evaluation also points to a number of ways in which the program should be changed if it is expanded.

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