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The Fixed Environment and Collegiate Health. RESEARCH MENTOR: DR. JANE JUE JOHN-PAUL JULIEN UNIVERSITY OF PENNSYLVANIA JJULIEN89@GMAIL.COM. 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





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

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

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


Yes (5) 5%

No (89) 95%

Food Trucks

Yes (0) 0%

No (36) 100%

healthy entrees
Healthy Entrees


No (81) 86%

Yes (13) 14%

Food Trucks

No (35) 97%

Yes (1) 3%


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


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
  • 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

Dr. Jane Jue

To LDI, Joanne Levy, Kelly Johnson, Shanta Layton

SUMR scholars

  • 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.