Facilitating Healthier Eating at Restaurants: A Multidisciplinary Scoping Review Comparing Strategies, Barriers, Motivators, and Outcomes by Restaurant Type and Initiator

Abstract

Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated by investigators and associated with independently owned restaurants. Aside from those associated with revenue, motivations and barriers for healthy eating promoting strategies varied by restaurant type. While corporate restaurants were also motivated by public health criticism, independently owned restaurants were motivated by interests to improve community health. Revenue concerns were followed by food sourcing issues in corporate restaurants and lack of interest among independently owned restaurants. Among reporting sources, most outcomes were revenue positive. This study shows the need for practice-based evidence and accounting for restaurant business models to tailor interventions and policies for sustained positive changes in these establishments.

Promoting healthy eating in Latin American restaurants: a qualitative survey of views held by owners and staff

“…The interviews took place in English or Spanish, depending on participant preference. We developed a semi-structured interview guide informed by an extensive review of the literature, including relevant articles and reports on industry perspectives and practices concerning HEPS [ 5 ]. The guide included four sections: (1) initial questions, asking respondents to share their experience in the restaurant industry and, for owners, the restaurant concept and opening process; (2) experience with COVID-19, including past and potential future modifications to the business model; (3) experience with and perception of HEPS, including pre-defined HEPS (i.e.…”

“…Member checks included incorporating an expert in restaurant management as part of the research team and sharing emerging results with participants for verification during the data collection period. Triangulation was used by examining findings against findings gathered through a scoping review of the literature, examining restaurant engagement in healthy eating promotion strategies, including barriers and facilitators [ 5 ].…”

“…Restaurants are starting to implement changes that can potentially facilitate healthier eating, including adding nutrition information to menus, increasing the availability of healthier options, and promoting them. However, these efforts mostly occur in corporate restaurants; less activity has been observed in independently-owned restaurants, especially those serving ethnic cuisines [ 5 ], such as Latin American restaurants (LARs). This omission is pertinent because LARs comprise an increasingly important sector within the larger restaurant landscape in the United States (US).…”

Evaluating Mediterranean Diet-Adherent, Healthy and Allergen-Free Meals Offered in Tarragona Province Restaurants (Catalonia, Spain): A Cross-Sectional Study

“…Based on the present cross-sectional analysis, several recommendations could be proposed to restaurants to increase Mediterranean menu offerings and improve food allergen management ( Table S4 ). In particular, when limited resources can be invested in the development of new offerings, as is the case for most independent restaurants that operate with narrower profit margins [ 13 ], restaurants should improve the promotion of existing healthy options and encourage consumers to select such offerings through symbols and indicators on menus.…”

“…On the other hand, one of the main concerns for restaurateurs in the implementation of healthier meals and nutrient information is the loss of profit that could result from it; thus, changes in community nutritional policies and norms could support restaurants through the provision of more incentives [ 12 ] for the improvement of menus offering to include meals with better nutritional quality [ 7 ]. However, the value that restaurateurs place on community health is the most important driver to encourage healthy improvements since the lack of interest by restaurants has been found to be a major barrier in the effectiveness of interventions to promote healthy eating [ 13 ].…”