Objective: Nutritionally promoted foods are now available at fast-food establishments. Little is known about their popularity, who is purchasing them, or their impact on dietary intake. Our study aimed to determine: how often nutritionally promoted fast foods were purchased; the demographic characteristics of people purchasing these foods; and if purchasing these foods resulted in reduced energy, and increased vegetable, content of lunches compared with those who purchased traditional fast foods. Design: A survey collecting lunchtime fast-food purchases and demographic details was administered over two months. Nutritionally promoted products included the McDonalds' 'Heart Foundation Tick Approved' range and Subway's 'Six grams of fat or less' range. Energy and vegetable contents were estimated using information from fast-food companies' websites. Differences in demographics, energy and vegetable contents between individuals purchasing nutritionally promoted and traditional lunches were assessed using x 2 and t tests. Setting: Queensland, Australia. Subjects: Lunchtime diners aged over 16 years at Subway and McDonalds. Results: Surveys were collected from 927 respondents (58 % male, median age 25 (range 16-84) years; 73 % response rate). Only 3 % (n 24/910) of respondents who ordered a main option had purchased a nutritionally promoted item. Purchasers of nutritionally promoted foods were ,13 years older, predominantly female (79 %), and more often reported involvement in a health-related profession (29 % v. 11 %) than purchasers of traditional foods (P , 0?05). Purchasers of nutritionally promoted foods ordered 1?5 fewer megajoules and 0?6 more vegetable servings than purchasers of traditional foods (P , 0?05). Conclusions: Nutritionally promoted fast foods may reduce lunchtime energy content, however these foods were infrequently chosen. Keywords Take-away McDonalds Subway VegetablesOne in three Australians consumes food prepared outside the home every 24 h, with these foods contributing over one-third of total 24 h energy intake (1) . Fast foods tend to be high in energy, and a poor source of fibre and micronutrients (2)(3)(4)(5) . The significant contribution of energy-dense fast foods to the average diet has prompted concern that fast foods contribute to an obesogenic environment (4,(6)(7)(8)(9) .Fast-food establishments may have introduced nutritionally promoted fast foods (NPFF) to respond to public demand, address public concern regarding the limited health value of fast foods, or to demonstrate corporate responsibility (10)(11)(12) . NPFF include the 'Tick Approved' options endorsed by the National Heart Foundation at McDonalds, and a range of sandwiches bearing a 'Six grams of fat or less' claim at Subway (11,13) .Actual purchase rates of NPFF have not been independently reported. Media articles and company reports suggest 15 % of revenue from these options (14) with 19 % of customers reporting purchasing these options at McDonalds (15) . However, these purchase rates were reported soon after th...
Aim The aim of the study was to compare sodium and saturated fat contents of lunchtime fast food orders containing regular items with those containing items promoted for nutritional attributes (e.g. Subway sandwiches containing 6 g fat or less, McDonald's Heart Foundation Tick approved range). Methods In March–April 2010, 907 McDonald's and Subway lunchtime customers (aged 25(16–84) years, 59% M, 73% response rate) in Queensland, Australia were surveyed. Sodium and saturated fat contents of orders were calculated using information from company websites. Independent samples t‐ and chi‐squared tests were used to assess whether orders including nutritionally promoted fast foods contained less sodium and saturated fat, and a chi‐squared test to compare the proportion of customers at each store whose orders exceeded the daily sodium upper limit (2300 mg). Results Proportionately more customers ordering nutritionally promoted fast foods (n = 24) ordered meals containing ≤1300 mg sodium and ≤6 g saturated fat (83% and 92%, respectively) than those ordering regular fast foods (n = 883, 33% and 24%, respectively, P < 0.02). One‐quarter (24%) of orders—all selected from the regular menu—exceeded the daily sodium upper limit. Proportionately more orders from Subway (40%) exceeded the daily sodium upper limit than from McDonald's (5%, P < 0.001). Conclusions Lunchtime fast food orders may contain less sodium and saturated fat when nutritionally promoted foods are selected. Reformulating all fast foods may be warranted given that fast foods contain high levels of sodium and saturated fat, and nutritionally promoted fast foods may represent only a small proportion of lunchtime choices.
BackgroundTherapists and counsellors increasingly use online video applications to offer treatment in place of face‐to‐face delivery. In the alcohol treatment sector, this offers a range of potential benefits for treatment providers. However, the impact of working remotely via video on the therapeutic relationship remains unclear and under‐researched.AimsThis study aimed to explore how alcohol treatment clients make sense of the relational aspects of therapy delivered remotely, and to examine how the use of remote therapy might disrupt existing ideas around the therapeutic relationship.MethodologyThis study utilised a qualitative design using thematic analysis, with 15 participant interviews with adult service users from a single treatment provider. All participants had previously undertaken at least four 1‐h online therapy sessions.FindingsThe themes that were identified highlighted the significance of the participants' own homes as the site of therapy, with emphasis on the comfort of the home, and the presence of family members and pets. Participants stressed the importance of viewing the face of the therapist, the establishment of a therapeutic bond and specific therapist qualities. Participants also reflected on issues around denial and avoidance associated with self‐image and identity.DiscussionThere are nuanced and potentially unforeseen consequences of undertaking therapy for alcohol problems via video, relating to the significance of the therapy environment and relationship between client and therapist. This may include issues of shame, denial and avoidance, which are of particular significance for clients experiencing difficulties associated with alcohol.
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