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The Fixed Environment and Collegiate Health. RESEARCH MENTOR: DR. JANE JUE JOHN-PAUL JULIEN UNIVERSITY OF PENNSYLVANIA [email protected] Primary goal: Perform an exploratory examination of the food environment around the University of Pennsylvania’s campus. Background.

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The fixed environment and collegiate health

The Fixed Environment and Collegiate Health

RESEARCH MENTOR: DR. JANE JUE

JOHN-PAUL JULIEN

UNIVERSITY OF PENNSYLVANIA

[email protected]


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


Background
Background

US Health Trends and Nutrition


Going up
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
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
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
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



A brief description
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 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


Results
Results

Graphical Analysis


Restaurant Type

SD Sit-Down Restaurant 21%

FC Fast Casual Restaurant 20%

FF Fast Food 41%

SP Specialty 18%


Nutritional information
Nutritional Information

Restaurants

Yes (5) 5%

No (89) 95%

Food Trucks

Yes (0) 0%

No (36) 100%


Healthy entrees
Healthy Entrees

Restaurants

No (81) 86%

Yes (13) 14%

Food Trucks

No (35) 97%

Yes (1) 3%


Minimum delivery charge restaurants
MinimumDelivery Charge (Restaurants)

No (69)73%

Yes (25) 27%


Scoring
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


Scoring continued
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



The difficulty with eating healthy
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
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



Lessons learned
Lessons Learned

  • Personal - Time Management

  • Project- It’s not easy being healthy

  • SUMR- Health services research is a field

  • Career – Many doors


Special thanks
SpecialThanks

Dr. Jane Jue

To LDI, Joanne Levy, Kelly Johnson, Shanta Layton

SUMR scholars


References
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.


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