Quality Of Menus Research Articles

Nutritional quality and patterns of lunch menus at child care centers in South Korea and Japan.

This study aimed to investigate the nutritional quality and patterns of lunch menus provided by child care centers in South Korea and Japan. The weekly lunch menus from Monday to Saturday that child care centers provided in November 2014 in South Korea and Japan were analyzed. For Korea, a total of 72 meals provided by 12 centers in Seoul were analyzed by referring to the homepage of the Center for Children's Foodservice Management, which serviced menus for child care centers. For Japan, a total of 30 meals provided by 5 child care centers in Tokyo were analyzed. Nutrient content and pattern in lunch menus were evaluated. The lunch menus in Korea and Japan provided 359.5 kcal (25.7% of the estimated energy requirement) and 376.3 kcal (29.5% of the estimated energy requirement), respectively. 'Rice + Soup + Main dish + Side dish I + Side dish II' were provided in 66.7% of meals in Korea, while various patterns with rice and soup as their bases were provided in Japan. The lunch menus of child care centers in Korea and Japan provide similar amounts of energy, protein, carbohydrate, vitamin A, calcium, and other nutrients. However, there were significant differences in the lunch menu patterns in Korea and Japan. This study provides information about the nutritional content and pattern of lunch menus at child care centers in Asian countries with rice as a staple food.

Trends in Nutrient Content of Children's Menu Items in U.S. Chain Restaurants.

Restaurant food is widely consumed by children and is associated with poor diet quality. Although many restaurants have made voluntary commitments to improve the nutritional quality of children's menus, it is unclear whether this has led to meaningful changes. Nutrients in children's menu items (n=4,016) from 45 chain restaurants were extracted from the nutrition information database MenuStat. Bootstrapped mixed linear models estimated changes in mean calories, saturated fat, and sodium in children's menu items between 2012 and 2013, 2014, and 2015. Changes in nutrient content of these items over time were compared among restaurants participating in the Kids LiveWell initiative and non-participating restaurants. Types of available children's beverages were also examined. Data were analyzed in 2016. There was a significant increase in mean beverage calories from 2012 to 2013 (6, 95% CI=0.8, 10.6) and from 2012 to 2014 (11, 95% CI=3.7, 18.3), but no change between 2012 and 2015, and no differences in nutrient content of other items over time. Restaurants participating in Kids LiveWell reduced entrée calories between 2012 and 2013 (-24, 95% CI= -40.4, -7.2) and between 2012 and 2014 (-40, 95% CI= -68.1, -11.4) and increased side dish calories between 2012 and 2015 (49, 95% CI=4.6, 92.7) versus non-participating restaurants. Sugar-sweetened beverages consistently constituted 80% of children's beverages, with soda declining and flavored milks increasing between 2012 and 2015. Results suggest little progress toward improving nutrition in children's menu items. Efforts are needed to engage restaurants in offering healthful children's meals.

Evaluating the healthiness of chain-restaurant menu items using crowdsourcing: a new method.

To develop a technology-based method for evaluating the nutritional quality of chain-restaurant menus to increase the efficiency and lower the cost of large-scale data analysis of food items. Using a Modified Nutrient Profiling Index (MNPI), we assessed chain-restaurant items from the MenuStat database with a process involving three steps: (i) testing 'extreme' scores; (ii) crowdsourcing to analyse fruit, nut and vegetable (FNV) amounts; and (iii) analysis of the ambiguous items by a registered dietitian. In applying the approach to assess 22 422 foods, only 3566 could not be scored automatically based on MenuStat data and required further evaluation to determine healthiness. Items for which there was low agreement between trusted crowd workers, or where the FNV amount was estimated to be >40 %, were sent to a registered dietitian. Crowdsourcing was able to evaluate 3199, leaving only 367 to be reviewed by the registered dietitian. Overall, 7 % of items were categorized as healthy. The healthiest category was soups (26 % healthy), while desserts were the least healthy (2 % healthy). An algorithm incorporating crowdsourcing and a dietitian can quickly and efficiently analyse restaurant menus, allowing public health researchers to analyse the healthiness of menu items.

A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus.

Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada’s Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

Family farming products on menus in school feeding: a partnership for promoting healthy eating

The aim of this study was to characterize the process of buying Family Farming (FF) food for the Brazilian School Feeding Program (BSFP) and compare the quality of menus served to the schoolchildren before and after the implementation of Law n. 11,947/09. This is an observational cross-sectional study developed with application of semi-structured questionnaire and evaluating menus. Eighty-two cities from São Paulo and Rio de Janeiro in Brazil participated of the study. Of these cities reported, 74.1% performed the purchase of products of FF for BSFP. The lack of interest of farmers and the deficient hygienic and sanitary conditions were the main difficulties reported. The quality of the menus offered to the schoolchildren improved significantly after the implementation of FF purchases. The partnership between FF and BSFP can contribute greatly to the development of healthy eating habits, not only by offering better nutritional quality menus, but also by implementing of nutritional education activities guided by the sustainable production and consumption of food.

Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City’s Healthy Hospital Food Initiative

BackgroundMost hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City’s Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. ObjectiveThis study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. DesignThe study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Participants/settingEight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Main outcome measuresNutritional content of regular-diet menus were compared with the HHFI nutrition standards. Statistical analyses performedNutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. ResultsAt baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, P<0.01) and decreasing sodium (−19%, P<0.05), percentage of calories from fat (−24%, P<0.01), and percentage of calories from saturated fat (−21%, P<0.05). A significant increase was seen in fresh fruit servings (667%, P<0.05) and decreases in full-fat and reduced-fat milk servings (−100%, P<0.05), refined grain servings (−35%, P<0.05), and frequency of desserts (−92%, P<0.05). ConclusionsRegular diet menus did not comply with the HHFI nutrition standards at baseline. Using the HHFI framework, hospitals significantly improved the nutritional quality of regular-diet patient menus. The standards were applied across hospitals of varying sizes, locations, menu types, and food service operations, indicating feasibility of this framework in a range of hospital settings.

Evaluation of factors affecting plate waste of inpatients in different healthcare settings.

Satisfaction of inpatients with served food within a hospital care system still constitutes one of the main attempts to modernize food services. The impact of type of menu, food category, hospital centre and timetable on the meals wastage produced in different Spanish healthcare settings, was evaluated. Meal wastage was measured through a semiquantitative 5-point scale ("nothing on plate"; "¼ on plate"; "half on plate"; "¾ on plate" and "all on plate"). The study was carried out in two periods of three months each in 2010 and 2011. A trained person took charge of measuring plate waste classified into 726 servings belonging to 11 menus. In total 31,392 plates were served to 7,868 inpatients. A Kruskal-Wallis non-parametric test (p < 0.05) was applied to evaluate significant differences among the variables studied. The menus were satisfactorily consumed because more than 50% of the plates were classified as "nothing on plate". Regarding food categories, 26.78% of the plates corresponded to soups and purées, while pasta and rice, and prepared foods were only distributed in 4-5% of the servings. Desserts were mostly consumed, while cooked vegetables were less accepted by the inpatients evaluated. Other factors such as hospital centre influenced plate waste (p < 0.05) but timetable did not (p > 0.05). Visual inspections of plate waste might be useful to optimize type and quality of menus served. The type of menu served and the food category could have a great influence on food acceptability by the inpatients studied.

Fast-food menu offerings vary in dietary quality, but are consistently poor

To evaluate five popular fast-food chains' menus in relation to dietary guidance. Menus posted on chains' websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids' menus and sets of items promoted as healthy or nutritious were also assessed. Five popular fast-food chains in the USA. Not applicable. Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids' menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points. The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.

Residential summer camp: a new venue for nutrition education and physical activity promotion

BackgroundMillions of children attend residential summer camps each year. However, few studies have examined the potential of camps for obesity prevention efforts. Research in the domain of positive youth development has shown that camp programs as short as one week have both short- and long-term positive effects on self-esteem, self-efficacy and other youth outcomes. The objective of the present study was to highlight the potential of resident camps as promising venues for the promotion of healthy eating and physical activity behaviors in the children who attend.MethodsData for this study came from the American Camp Association 2007 Emerging Issues Survey. This survey assessed camp professionals’ perspectives on a diverse array of issues, including the healthy eating and physical activity of children. Data analysis focused on responses from 247 camp professionals whose camps offered resident camp programs.ResultsDescriptive and Chi-square statistics were calculated. Ninety-two percent of camp professionals reported that the healthy eating and physical activity of campers was an “important” or “very important” issue for camps. The majority of camps reported offering vegetarian options, healthy snacks and salad bars, and allergen-free options. Additionally, 86% of camp professionals indicated that they had implemented one or more strategies to address concerns related to the unhealthy eating behaviors of children, with top strategies including increasing the availability of fruits and vegetables, increasing the availability of healthy drink options, and improving the nutritional quality of menus. Fewer camp professionals (50%) indicated they had implemented strategies to increase children’s physical activity levels, but many professionals indicated that their camp programs were inherently active and additional strategies to promote physical activity were not necessary. Associations were found between camp affiliation and food options available to campers.ConclusionsThe majority of camp professionals believe the healthy eating and physical activity of children are important issues for camps and have implemented strategies to address these issues. An important question for future research is to examine whether these strategies are effective in promoting healthy eating and physical activity behaviors in children, as well as ways that camp programs could be improved.

Improving nutrition in home child care: are food costs a barrier?

Child-care providers have a key role to play in promoting child nutrition, but the higher cost of nutritious foods may pose a barrier. The present study tested the hypothesis that higher nutritional quality of foods served was associated with higher food expenditures in child care homes participating in the Child and Adult Care Food Program (CACFP). In this cross-sectional study, nutritional quality of foods served to children and food expenditures were analysed based on 5 d menus and food shopping receipts. Nutritional quality was based on servings of whole grains, fresh whole fruits and vegetables, energy density (kJ/g) and mean nutrient adequacy (mean percentage of dietary reference intake) for seven nutrients of concern for child health. Food expenditures were calculated by linking receipt and menu data. Associations between food expenditures and menu quality were examined using bivariate statistics and multiple linear regression models. USA in 2008-2009. Sixty child-care providers participating in CACFP in King County, Washington State. In bivariate analyses, higher daily food expenditures were associated with higher total food energy and higher nutritional quality of menus. Controlling for energy and other covariates, higher food expenditures were strongly and positively associated with number of portions of whole grains and fresh produce served (P = 0·001 and 0·005, respectively), with lower energy density and with higher mean nutrient adequacy of menus overall (P = 0·003 and 0·032, respectively). The results indicate that improving the nutritional quality of foods in child care may require higher food spending.

Evaluating the nutritional quality of menus by using software in professional kitchens

PurposeThe purpose of this paper is to explore evaluating the nutritional quality of menus by using software in professional kitchens.Design/methodology/approachNutritional quality and the core factors used when evaluating the nutritional quality of menus are discussed. The empirical data were collected in 2008 by theme interviewing nine municipal food service employees. The data were analysed by a thematic analysis.FindingsThe results indicated that both positive and contributing factors emerged as follows: productisation of menu; using a plate model; length of a control period concerning the nutritional quality of the menu; checking the nutrition content when making changes in menus, dishes and food items; dealing with the results of the evaluation in the meetings; including the results in the service agreements; employers' positive attitude displayed towards software suppliers' training; including nutritional quality as a part of service quality; and implementing nutritional quality according to the job descriptions.Practical implicationsA variety of courses should be offered for the students concerning the guidance of food production by using software in professional kitchens; integrating working life into the curriculum; continuous training of the food service personnel; and cooperation with the professional kitchen's software suppliers. Moreover, further implications could involve, for example, developing and diffusing the national model for the nutritional quality follow‐up; and taking the Sinfos‐product information data bank into use.Originality/valueActive updating of the software and training of the employees are needed in order to ensure the nutritional quality of menus.

Evaluating the nutritional quality of menus by using software in professional kitchens

Evaluating the nutritional quality of menus by using software in professional kitchens

Menu Planning for Childcare Centres: Practices and Needs

Childcare menu planners' relevant knowledge, attitudes, and practices were determined, as were the menu planning guidelines or tools needed and the nutritional adequacy and quality of menus in licensed full-day childcare centres in Nova Scotia. An ethics committee-approved questionnaire was mailed to a stratified random sample of 101 licensed childcare centres across the province. Respondents were instructed to forward a copy of their current four-week menu for nutrient analysis and menu quality evaluation. Descriptive statistical data analysis from the returned questionnaires (n=35) indicated that fewer than 50% of the menu planners had relevant training and knowledge. Discrepancies exist between attitudes about good menu planning and practices. A positive finding was that most respondents used reliable resources for menu planning and expressed a desire for updated resources and ongoing training in child nutrition/ menu planning. A number of nutrient and menu quality deficiencies were identified from the menus submitted (n=28). A significant statistical correlation was found between menu planning training and higher menu quality scores. The results will be relevant to nutritionists in the development of effective resources and training for childcare centre menu planners.

Are green caterers more likely to serve healthy meals than non-green caterers? Results from a quantitative study in Danish worksite catering

The present study aimed to investigate whether organic conversion in catering has positive effects on the nutritional quality of menus offered. The methodology was based on a self-administered questionnaire. The self-declared priority given to the use of organic foods was measured as the basis for assigning catering managers to one of two groups: 'green' or 'non-green' caterers. These groups were then compared with regard to the relative nutritional quality of the menu options offered to customers. The study was carried out among randomly selected Danish worksite catering outlets. The subjects participating in the study comprised 526 Danish worksite catering managers. The results showed a strong correlation between caterers' 'green-ness' and the nutritional quality of the menu options offered. Green caters had more healthy options in their menus than non-green caters, which is likely to result in improved nutritional quality of the diets of end consumers. The reason for this may partly be the increased service training efforts that green caterers practise in order to be able to implement organic foods successfully. It may also be associated with the fact that the price premiums and availability of the organic products forces caterers to serve menus with higher amounts of root and non-green leafy vegetables, pulses and seasonal vegetables. The present findings suggest that organic conversion of public canteens may be a good opportunity to promote healthier eating in public catering.

How to analyse and develop healthy menus in foodservice

AbstractIn addition to playing a pivotal role in assessing customer satisfaction, menus play an important role in the foodservice production process. Additionally, the type and quality of foods offered on menus may have a direct correlation with health promotion. To verify the nutritional quality of menus, a qualitative assessment method – the Qualitative Evaluation of Menu Components (QEMC) – is being proposed. The method is derived from the Standard QEMC and offers variations such as the Buffet QEMC and the Portugal QEMC. Menu items can be improved during the planning stage when using this assessment, which allows for corrections prior to production. These changes can lead to a healthier and more attractive menu from the sensory point of view, fulfilling the role of relieving hunger and feeding with quality, thus promoting health through the foods offered.

A method for implementation of nutritional therapy in hospitals

Many barriers make implementation of nutritional therapy difficult in hospitals. In this study we investigated whether, a targeted plan made by the staff in different departments could improve nutritional treatment within selected quality goals based on the ESPEN screening guidelines. The project was carried out as a continuous quality improvement project. Four different specialities participated in the study with a nutrition team of both doctors, nurses, and a dietician, and included the following methods: (1) Pre-measurement: assessment of quality goals prior to study including the use of screening of nutritional risk (NRS-2002), whether a nutrition plan was made, and monitoring was documented in the records. (2) INTERVENTION: multidisciplinary meeting for the ward staff using a PC-based meeting system for detecting barriers in the department concerning nutrition, elaboration of an action plan and implementation of the plan. (3) Re-measurement: as in (1) based on information from records and patient interviews, and an evaluation based on focus group interview with the staff. Patients who gave informed consent to participate in the study (>14 years) were included consecutively. Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson chi(2) test for nominative data. P values <0.05 were considered significant. The study was performed in accordance with the Research Ethics Committee. In this study 141/122 patients were included before/after the implementation period with a mean weight loss within the last 3 months of 6.2 and 5.2 kg, respectively. Before the study we found that BMI was not measured. More than half of the patients had a weight loss within the last 3 months, and 40% had a weight loss during hospitalization, and this was not documented in the records. About 75% had a food intake less than normal within the last week, and nearly one-third were at a severe nutritional risk, and only 33% of these had a nutrition plan, and 18% a plan for monitoring. Barriers concerning nutrition included low priority, no focus, no routine or established procedures, and insufficient knowledge, lack of quality and choice of menus, and lack of support from general manager of the hospital. The staff introduced individually targeted procedures including assigning of responsibility, a nutrition record, electronic calculator of energy intake, upgrading of the dieticians and special diets, communication, and educational programs. A great consistency existed between barriers for targeted nutrition effort and ideas for improvement of the quality goals between the different departments. Quality assessment after study showed an overall significant improvement of the selected quality goals. The introduction of a new method for implementation of nutritional therapy according to ESPEN screening guidelines seems to improve nutritional therapy in hospitals. The method included assessment of quality goals, identification of barriers and individual targeted plans for each department followed by an evaluation process. The model has to be refined further with relevant clinical endpoints.

Trend to better nutrition on Australian hospital menus 1986-2001 and the impact of cook-chill food service systems.

To assess trends in the nutritional quality of hospital menus and examine differences between menus used in hospitals with cook-chill or cook-fresh food services. Standard patient menus were analysed against 28 criteria to assess nutritional standards and compared with results from similar studies in 1986 and 1993. Menus were collected from 80 hospitals in New South Wales (NSW), Australia, including 36 using cook-chill food service systems. Chi-squared analysis was used to assess differences between the proportions of hospitals meeting the criteria in 1993 and 2001, and between different types of hospitals. In 2001, compared with 1993, significantly many hospitals offered more than one hot choice at the evening meal, more menus highlighted low fat items and more calcium-rich foods were available. More than 90% of hospitals allowed patients to select their own menu, offered wholemeal breads and high-fibre breakfast cereals, fresh fruit, polyunsaturated margarine, a milk dessert at least once a day and two or more hot options at the midday meal. Hospitals with cook-chill food services had menus that were more likely to meet nutritional recommendations, although they were less likely to offer a choice of serving size. A high proportion of unpopular choices were offered in menus, especially meat dishes and desserts. Since 1986, NSW hospital menus have improved to offer choices that conform better to dietary guidelines. Cook-chill food services may have positive and negative impacts on meal choices. The assessment criteria are useful in hospitals to assess their menus.

Identification of factors that influence the menu at child care centers: A grounded theory approach

Objective This study was conducted to identify factors that influence what is on the menu at child care centers. Design Quantitative and qualitative data on menus, food preparation, and foodservice were collected during site visits to child care centers. Grounded theory methods were used to develop an explanation of child care menu planning that is “grounded” in data. Sample and setting Three child care centers were selected in each of three communities representing different ethnic cultures in Texas. Main outcome measure Quality of child care menus, as measured by nutrient content and variety and amount of food served, constituted the core category or main phenomenon. Analyses Open and axial coding of the qualitative data were performed to identify significant themes and concepts and to explore their interrelationships in order to produce an explanation of the quality of child care menus. Results The patterns of strenghts and weaknesses in the menus were similar in all three ethnic/geographic regions that were visited and were similar to findings in other states. The factors that have the most direct influence on the menus are food program requirements, staff perceptions of children's food preferences, history of the food program at the center, and cost. Applications/conclusions The data and theory support three broad conclusions: (a) child care menus need to be improved; (b) training for child care staff needs to be sensitive to the missions and cultures of different kinds of child care centers; and (c) because lack of staff knowledge has only an indirect influence on the menus, changes in program requirements and strategies for assisting and monitoring food programs in child care centers may also be needed.

Quantity vegetarian meal patterns

Production and service of quantity vegetarian meals requires skills that are used in most quantity food kitchens around the world. Menu planning with the vegetarian in mind requires the substitution of meat, fish, and poultry entrees with vegetable sources of protein. Variety of available alternatives is good in many locations; creativity in selecting alternatives contributes to excitement in meals and improved nutrition. Specific protein sources appropriate for quantity feeding include many ethnic foods as well as standard North American and Western European favorites that may require slight modifications. The computer plays a role in monitoring nutritional quality of menus served to customers. Other computer applications provide feedback for cost analysis and control of menu, inventory, and production planning. Research in production times of vegetarian entrees provides a basis for comparison of production times of menu items for cost analysis.