Restaurant-based interventions: a new approach to promote healthier and allergy-adapted meals

Identifier:  TDX:3258

Handle: https://hdl.handle.net/20.500.11797/TDX3258

Authors:  Mandracchia, Floriana

Abstract:
Eating out increased, but healthy menu offerings and food allergen management remain a challenge. This thesis aimed to provide evidence about potential innovative strategies and technologies for restaurant-based interventions to improve healthy meal offerings and food allergen management. Studies conducted and obtained findings included: 1) A cross-sectional study assessed the Mediterranean diet adherence, healthiness, nutritional quality, and food allergen management at 44 restaurants in Tarragona Province. Restaurants partially met the Mediterranean-adherent diet and food allergen management criteria. Dishes’ nutritional content should be improved by increasing fibre and decreasing saturated fat. Considering food allergen management as a point to improve, staff training is needed. 2) A systematic review (35 Randomized Controlled Trials (RCTs) and 6 non-RCTs) and meta-analysis (16 RCTs) evaluated effective interventions in restaurants and canteens to improve healthy meals’ availability, purchase, and intake. Interventions implemented mainly in school canteens increased dietary intake and healthy food availability, and decreased fat intake. Purchase of healthy foods was partially effective. 3) A systematized review (8 RCTs) evaluated app-based (mHealth) interventions in increasing fruit and vegetable intake. Effective interventions lasted two to nine months, targeted population with healthy dietary goals, and include dietary feedback, self-monitoring, and remote coaching support strategies. 4) A systematic search of 14 apps about food allergy or intolerance assessed their quality by the Mobile App Rating Scale (MARS). Apps showed acceptable quality, although engagement should be improved for food product and restaurant purpose apps. 5) A study described the Healthy Meals web app (eHealth) development, usability, quality assessment, and validation. The app proved its usability, quality, and validity in dishes’ nutritional content assessment. In conclusion, effective strategies were identified and recommendations were designed for restaurants to improve healthy meal offerings and food allergen management. mHealth and eHealth are innovative technologies to support dishes’ food allergen and nutritional content assessments.