The Healthfulness of Eateries at the University of Waterloo: A Comparison across 2 Time Points

Publication: Canadian Journal of Dietetic Practice and Research
18 November 2019

Abstract

Purpose: The aim of this study was to assess the healthfulness of a sample of campus eateries at 2 time points, 2 years apart.
Methods: Five eateries at the University of Waterloo were audited using the Nutrition Environment Measures Survey adapted for university campuses (NEMS-UC) in 2015 and late 2017–early 2018. Based on the availability of healthy options and facilitators of and barriers to healthy eating, possible NEMS-UC scores ranged from −5 to 23 points.
Results: Scores were low, ranging from 7 to 14 (mean = 10.8, SD = 2.59) points in 2015 and 7 to 13 (mean = 9.6, SD = 2.19) points in 2017–2018. For all eateries except 1 residence cafeteria, scores at time 2 were the same or lower than scores at time 1. All venues carried whole fruit and vegetable options and lower-fat milks, and most offered whole-wheat options. However, healthier items were often located in low-traffic areas, priced higher than less healthy options, and sometimes limited to prepackaged items. Misleading health messaging was also evident.
Conclusions: Increased availability, accessibility, and visibility of healthy offerings is needed to enhance campus food environments and support healthy eating patterns, while barriers such as contradictory messaging should be minimized.

Résumé

Objectif. Cette étude visait à évaluer la qualité nutritionnelle d’un échantillon de restaurants de campus à deux points dans le temps, à deux ans d’intervalle.
Méthodes. Cinq restaurants de l’Université de Waterloo ont été analysés au moyen de l’enquête Nutrition Environment Measures Survey [Enquête sur les mesures de l’environnement nutritionnel] adaptée pour les campus universitaires (NEMS-UC) en 2015 et à la fin 2017, début 2018. Selon la disponibilité d’options saines et les facteurs facilitant la saine alimentation et y nuisant, les scores NEMS-UC pouvaient varier de —5 à 23 points.
Résultats. Les scores se sont avérés faibles, variant de 7 à 14 points (moyenne = 10,8; écart-type = 2,59) en 2015 et de 7 à 13 points (moyenne = 9,6; écart-type = 2,19) en 2017–2018. Pour tous les restaurants, à l’exception d’une cafétéria de résidence, les scores sont restés les mêmes ou ont diminué lors de la deuxième évaluation. Tous les restaurants offraient des fruits et des légumes entiers et du lait à faible teneur en gras, et la plupart offraient des options à base de blé entier. Cependant, les aliments plus sains étaient souvent situés dans les zones moins passantes, leur prix était plus élevé que celui des options moins santé, et ils étaient parfois limités à des aliments préemballés. Des messages santé trompeurs étaient également évidents.
Conclusions. Il est nécessaire d’accroître la disponibilité, l’accessibilité et la visibilité des options santé pour améliorer les environnements alimentaires des campus et favoriser des modèles alimentaires sains. De plus, les obstacles à la saine alimentation comme les messages contradictoires devraient être limités.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: KML is supported by an Ontario Graduate Scholarship. LMM gratefully acknowledges a Canadian Cancer Society Career Development Award (award #704744).
Conflicts of interest: The authors have no conflicts of interest to disclose.

References

1
Office of Disease Prevention and Health Promotion. 2015–2020 dietary guidelines. Chapter 3: Everyone has a role in supporting healthy eating patterns; c2015 [cited 2019 Aug 19]. Available from: https://health.gov/dietaryguidelines/2015/.
2
Health Canada. Measuring the food environment in Canada; c2013 [cited 2018 Oct 20]. Available from: www.hc-sc.gc.ca/fn-an/nutrition/pol/index-eng.php/.
3
McKinnon RA, Reedy J, Morrissette MA, Lytle LA, and Yaroch AL. Measures of the food environment: a compilation of the literature, 1990–2007. Am J Prev Med. 2009;36(4 Suppl):S124–33.
4
Minaker L, Fisher P, Raine KD, and Frank LD. Measuring the food environment: from theory to planning practice. J Agric Food Syst Community Dev. 2011;2(1):65–82.
5
Minaker LM, Raine KD, and Cash SB. Measuring the food service environment: development and implementation of assessment tools. Can J Public Health. 2009;100(6):421–6.
6
Glanz K, Sallis JF, Saelens BE, and Frank LD. Healthy nutrition environments: concepts and measures. Am J Health Promot. 2005;19(5):330–3.
7
Glanz K, Sallis JF, Saelens BE, and Frank LD. Nutrition Environment Measures Survey in stores (NEMS-S): development and evaluation. Am J Prev Med. 2007;32(4):282–9.
8
Larson NI, Story MT, and Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36(1):74–81.e10.
9
Story M, Nanney MS, and Schwartz MB. Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q. 2009;87(1):71–100.
10
Driessen CE, Cameron AJ, Thornton LE, Lai SK, and Barnett LM. Effect of changes to the school food environment on eating behaviours and/or body weight in children: a systematic review. Obes Rev. 2014;15(12):968–82.
11
Ontario Ministry of Education. Healthy schools: new school food and beverage policy; c2010 [cited 2018 Oct 20]. Available from: http://www.edu.gov.on.ca/eng/healthyschools/policy.html/.
12
Deshpande S, Basil MD, and Basil DZ. Factors influencing healthy eating habits among college students: an application of the health belief model. Health Mark Q. 2009;26(2):145–64.
13
Nelson MC, Story M, Larson NI, Neumark-Sztainer D, and Lytle LA. Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity. 2008 Oct;16(10):2205–11.
14
Arnett JJ. Emerging adulthood: the winding road from the late teens through the twenties. 2nd ed. New York, NY: Oxford Press; 2014.
15
Schwartz SJ, Côté JE, and Arnett JJ. Identity and agency in emerging adulthood: two developmental routes in the individualization process. Youth & Society. 2005 Dec;37(2):201–29.
16
Lo BKC, Minaker L, Chan ANT, Hrgetic J, and Mah CL. Adaptation and validation of a Nutrition Environment Measures Survey for university grab-and-go establishments. Can J Diet Pract Res. 2016;77(1):17–24.
17
Horacek TM, Erdman MB, Byrd-Bredbenner C, Careg G, Colby SM, Greene GW, et al. Assessment of the dining environment on and near the campuses of fifteen post-secondary institutions. Public Health Nutr. 2013 Jul;16(7):1186–96.
18
Tseng M, DeGreef K, Fishler M, Gipson R, Koyano K, and Neill DB. Assessment of a university campus food environment, California, 2015. Prev Chronic Dis. 2016;13:150455.
19
Statistics Canada. Table 37-10-0103-01 Participation rate in education, population aged 18 to 34, by age group and type of institution attended, 2019 [cited 2019 Aug 19]. Available from: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3710010301.
20
Horacek TM, Erdman MB, Reznar MM, Olfert M, Brown-Esters ON, Kattelmann KK, et al. Evaluation of the food store environment on and near the campus of 15 postsecondary institutions. Am J Health Promot. 2013 Mar;27(4):e81–90.
21
Roy R, Hebden L, Kelly B, De Gois T, Ferrone EM, Samrout M, et al. Description, measurement and evaluation of tertiary-education food environments. Br J Nutr. 2016 May;115(9):1598–606.
22
Health Canada. Healthy eating strategy; c2018 [cited 2019 Jan 31]. Available from: https://www.canada.ca/en/services/health/campaigns/vision-healthy-canada/healthy-eating.html/.
23
University of Waterloo. Waterloo facts; c2018 [cited 2018 Jun 23]. Available from: https://uwaterloo.ca/about/who-we-are/waterloo-facts.
24
University of Waterloo. University of Waterloo food services eateries; c2018 [cited 2019 May 9]. Available from: https://uwaterloo.ca/food-services/locations-and-hours/see-eateries/.
25
University of Waterloo. UW food services; c2016 [cited 2016 Jun 23]. Available from: https://uwaterloo.ca/food-services/.
26
Honeycutt S, Davis E, Clawson M, and Glanz K. Training for and dissemination of the Nutrition Environment Measures Surveys (NEMS). Prev Chronic Dis. 2010;7(6):A126.
27
Voss C, Klein S, Glanz K, and Clawson M. Nutrition Environment Measures Survey-Vending: development, dissemination, and reliability. Health Promot Pract. 2012;13(4):425–30.
28
Saelens BE, Glanz K, Sallis JF, and Frank LD. Nutrition Environment Measures Study in restaurants (NEMS-R): development and evaluation. Am J Prev Med. 2007;32(4):273–81.
29
Pelletier JE, Laska MN, Neumark-Sztainer D, and Story M. Positive attitudes toward organic, local, and sustainable foods are associated with higher dietary quality among young adults. J Acad Nutr Diet. 2013;113(1):127–32.
30
University of Pennsylvania. Philadelphia, PA: Nutrition Environment Measures Survey; no date [cited 2018 Oct 27]. Available from: www.med.upenn.edu/nems/.
31
Viera AJ and Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360–3.
32
Landis JR and Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.
33
University of Waterloo. UW food services product information search; c2018 [cited 2018 Jun 23]. Available from: https://uwaterloo.ca/food-services/menu/search/.
34
Ministry of Ontario. Healthy Menu Choices Act, 2015, S.O. 2015, c. 7, Sched. 1; c2016 [cited 2018 Feb 22]. Available from: https://www.ontario.ca/laws/statute/15h07.
35
Kroese FM, Marchiori DR, and de Ridder DTD. Nudging healthy food choices: a field experiment at the train station. J Public Health. 2016;38(2):e133–7.
36
Pulz IS, Martins PA, Feldman C, and Veiros MB. Are campus food environments healthy? A novel perspective for qualitatively evaluating the nutritional quality of food sold at foodservice facilities at a Brazilian university. Perspect Public Health. 2017 Mar;137(2):122–35.
37
Maynard MS, Perlman CM, and Kirkpatrick SI. Food insecurity and perceived anxiety among adolescents: an analysis of data from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). J Hunger Environ Nutr. 2017 Dec;14(3):339–51.
38
Maynard M, Meyer SB, Perlman CM, and Kirkpatrick SI. Experiences of food insecurity among undergraduate students: “You Can’t Starve Yourself Through School”. Can J Higher Educ. 2018;48(2):130–48.
39
Olauson C, Engler-Stringer R, Vatanparast H, and Hanoski R. Student food insecurity: examining barriers to higher education at the University of Saskatchewan. J Hunger Environ Nutr. 2018 Jan;13(1):19–27.
40
Henry L. Understanding food insecurity among college students: experience, motivation, and local solutions. Ann Anthropol Pract. 2017 May;41(1):6–19.
41
Health Canada. Canada’s dietary guidelines for health professionals and policy makers; c2019 [cited 2019 May 30]. Available from: https://food-guide.canada.ca/en/guidelines/section-2-foods-and-beverages-that-undermine-healthy-eating/.
42
Roy R, Hebden L, Kelly B, De Gois T, Ferrone EM, Samrout M, et al. Description, measurement and evaluation of tertiary-education food environments. Br J Nutr. 2016 May;115(9):1598–606.
43
Biden CR, Matthews JI, Laframboise NA, Zok A, Dworatzek PDN, and Seabrook JA. Point-of-purchase labels and reward cards improve sales of healthy foods in university dining halls. Can J Diet Pract Res. 2018;79(3):92–8.
44
Hawkes C, Jewell J, and Allen K. A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: the NOURISHING framework. Obes Rev. 2013;14(Suppl. 2):159–68.
45
Swinburn B, Kraak V, Rutter H, Vandevijvere S, Lobstein T, Sacks G, et al. Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet. 2015 Jun;385(9986):2534–45.
46
International Network for Food and Obesity/Non-Communicable Disease Research Research, Monitoring and Action Support. Informas modules; c2018 [cited 2018 Oct 27]. Available from: https://www.informas.org/.
47
Olstad DL and Raine KD. Profit versus public health: the need to improve the food environment in recreational facilities. Can J Public Health. 2013;104(2):e167–9.
48
Laroche HH, Ford C, Hansen K, Cai X, Just DR, Hanks AS, et al. Concession stand makeovers: a pilot study of offering healthy foods at high school concession stands. J Public Health. 2015;37(1):116–24.
49
Treviño RP, Pham T, Mobley C, Hartstein J, El Ghormli L, and Songer T. HEALTHY study school food service revenue and expense report. J Sch Health. 2012 Sept;82(9):417–23.
50
Health Canada. Canada’s Food Guide; c2019 [cited 2019 May 30]. Available from: https://food-guide.canada.ca/en/.
51
Association for the Advancement of Sustainability in Higher Education. The sustainability tracking, assessment & rating system; c2018 [cited 2019 Jan 16]. Available from: https://stars.aashe.org/.
52
People and Planet. How sustainable is your university?—methodology; c2016 [cited 2019 Jan 16]. Available from: https://peopleandplanet.org/university-league-methodology/.
53
University of Waterloo. Environmental sustainability report; c2018 [cited 2019 Jan 16]. Available from: https://uwaterloo.ca/sustainability-report/.
54
Marsh K and Bugusu B. Food packaging—roles, materials, and environmental issues. J Food Sci. 2007 Apr;72(3):R39–55.

Supplementary Material

File (cjdpr-2019-031suppla.docx)
File (cjdpr-2019-031supplb.docx)
File (cjdpr-2019-031supplc.docx)

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 81Number 2June 2020
Pages: 72 - 79

History

Version of record online: 18 November 2019

Authors

Affiliations

Kirsten M. Lee BSc
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON
Michelle L. Marcinow PhD
Institute for Better Health, Trillium Health Partners, Mississauga, ON
Leia M. Minaker PhD
School of Planning, University of Waterloo, Waterloo, ON
Sharon I. Kirkpatrick PhD
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON

Notes

A correction was made to the e-First version of this paper on 25 November 2019 prior to the final issue publication. The current online version contains the correction.

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Food Security Status in Relation to Co-operative Enrolment Among University of Waterloo Undergraduate Students: A Cross-Sectional Analysis
2. Re: The Healthfulness of Eateries at the University of Waterloo: a Comparison across 2 Time Points

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media