domingo, 7 de junio de 2015

Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review


Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review

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Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review

Jennifer N. Valdivia Espino, BS; Natalie Guerrero, BA; Natalie Rhoads, MPH; Norma-Jean Simon, MPH, MPA; Anne L. Escaron, PhD, MPH; Amy Meinen, MPH, RD; F. Javier Nieto, MD, MPH, PhD; Ana P. Martinez-Donate, PhD

Suggested citation for this article: Valdivia Espino JN, Guerrero N, Rhoads N, Simon N, Escaron AL, Meinen A, et al. Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review. Prev Chronic Dis 2015;12:140455. DOI:


Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions.
We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category.
This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes.
Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes.


This work was supported in part by the University of Wisconsin School of Medicine and Public Health Wisconsin Partnership Program. Jennifer N. Valdivia Espino was supported by the National Institute of General Medical Sciences of the National Institutes of Health under award no. R25GM083252. The content of the publication is the sole responsibility of the authors and does not necessarily represent the official views of the University of Wisconsin or the National Institutes of Health.

Author Information

Corresponding Author: Ana P. Martinez-Donate, PhD, 610 Walnut St, 605 WARF, Madison, WI 53705, Telephone: 608-261-1380. Email:
Author Affiliations: Jennifer N. Valdivia Espino, Natalie Guerrero, Natalie Rhoads, Norma-Jean Simon, F. Javier Nieto, University of Wisconsin–Madison, Madison, Wisconsin; Anne L. Escaron, University of California, Los Angeles, California; Amy Meinen, University of Wisconsin–Madison and Wisconsin Obesity Prevention Network, Madison, Wisconsin.


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