A comparative analysis of the restaurant consumer food environment in Rochester (NY, USA) and London (ON, Canada): assessing children’s menus by neighbourhood socio-economic characteristics

Abstract

Objective: To assess restaurant children's menus for content and nutritional quality; and to investigate the relationship between the restaurant consumer food environment for children and neighbourhood-level socio-economic characteristics within and between one Canadian city and one US city. Design: Cross-sectional observational study. Setting: London, ON, Canada and Rochester, NY, USA. Participants: Restaurant children's menus were assessed, scored and compared using the Children's Menu Assessment tool. We quantified neighbourhood accessibility to restaurants by calculating 800 m road-network buffers around the centroid of each city census block and created a new Neighbourhood Restaurant Quality Index for Children (NRQI-C) comprising the sum of restaurant menu scores divided by the total number of restaurants within each area. After weighting by population, we examined associations between NRQI-C and neighbourhood socio-economic characteristics using correlations and multiple regression analyses. Results: Nutritional quality of children's menus was greater, on average, in Rochester compared with London. Only one variable remained significant in the regression analyses for both cities: proportion of visible minorities had a positive effect on neighbourhood NRQI-C scores in London, whereas the reverse was true in Rochester. Conclusions: Results suggest the presence of a socio-economic disparity within Rochester, where children in more disadvantaged areas have poorer access to better nutritional quality restaurant choices. In London, results suggest an inverse relationship across the city where children in more disadvantaged areas have better access to better nutritional quality restaurant choices. Given these disparate results, research on restaurant nutritional quality for children requires additional consideration.

Area Characteristics and Consumer Nutrition Environments in Restaurants: an Examination of Hispanic Caribbean Restaurants in New York City

“…To our knowledge, the present analysis is the first to examine the association between consumer food environment in HC restaurants and neighborhood characteristics. The few studies that have examined restaurants adjusting for neighborhood characteristics showed that low area income and high proportion of minority populations were significantly associated with lower healthy food availability [ 16 , 17 , 19 , 20 ]. Our research did not find significant differences in the healthfulness of the consumer food environment in HC restaurants by area Hispanic composition, as measured by the NEMS-R.…”

“…The total score of the adapted NEMS-R (NEMS-HCR) has the potential to range of –7 to 22, where higher scores denote healthier consumer nutrition environments. As the score has not been divided into meaningful evidence-based categories [ 10 ], we used natural breaks (also known as “Jenks”) to categorize the consumer nutrition environment scores in HC restaurants into three categories (low, medium, high) to be able to compare restaurants [ 17 ]. This approach was used, as opposed to the more commonly used tertiles.…”

“…We delineated local neighborhoods around each restaurant as the 800-meter street network buffer that radiates in all walking directions from each restaurant, since 800 meters represent the approximate distance a person could walk in 10–15 minutes. The distance was selected following approaches followed in other food access research [ 17 , 29 ]. This buffering technique took into consideration the actual street network available for traveling by foot when calculating buffer distances, rather than just straight-line Euclidean distances.…”

“…For example, Dubreck et al 2019 examined the association between visible minority residents and the healthfulness of children’s consumer food environments in neighborhoods in Canada and the USA. Their findings suggest a negative correlation between the visible minority population in the area and restaurant healthfulness in the USA, while the inverse was found in Canada [ 17 ]. The US-based disparities by minority population have been echoed in other research addressing fast-food proximity to schools by area racial composition [ 16 , 18 ].…”

Development of a Teen-Informed Coding Tool to Measure the Power of Food Advertisements

“…The nutritional health of adolescents is a growing public health concern in many developed countries, as an estimated one-quarter to one-third of teenagers in high-income countries such as Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States, are currently living with overweight or obesity [5,6,7]. An increasing body of literature recognizes the health impacts of food environments (FEs) [8,9,10], which are defined as the surroundings and conditions affecting one’s dietary patterns and nutritional health outcomes [11]. Studies have shown that youth’s FEs can be highly obesogenic, as they tend to lack easily accessible, nutritious food options, and expose teens to a wide selection of energy-dense, nutrient-poor foods [12,13].…”