Nutrition Environment Measures Study in restaurants (NEMS-R): development and evaluation

Area of Science:

• Nutrition science
• Public health
• Behavioral science

Background:

• Increasing rates of dining out in America.
• Limited understanding of restaurant nutrition environments.
• Need for a reliable tool to assess restaurant food environments.

Purpose of the Study:

• To develop and validate an observational measure to assess restaurant nutrition environments.
• To evaluate factors influencing food choices in restaurants.
• To provide a tool for research on eating patterns and obesity.

Main Methods:

• Developed the Nutrition Environment Measures Study-restaurant assessment (NEMS-R).
• Assessed inter-rater and test-retest reliability.
• Collected data in 217 sit-down and fast-food restaurants across four neighborhoods.
• Data collected in 2004 and 2005.

Main Results:

• NEMS-R demonstrated high inter-rater and test-retest reliability (kappa values >0.80).
• Significant differences found between sit-down and fast-food restaurant nutrition environments.
• Fast-food restaurants offered more healthy entrées/salads but encouraged larger portions and overeating.
• Sit-down restaurants had more healthy food/beverage items and a higher proportion of healthy main-dish salads.

Conclusions:

• The NEMS-R is a psychometrically sound and reliable tool for measuring restaurant nutrition environments.
• The NEMS-R can differentiate between restaurant types.
• This tool can be utilized in research and practice to characterize restaurant environments and inform public health strategies.