(OR10-02-24) Using the Nutrition Environment Measurement Survey for Restaurants To Describe the Independent Carryout Restaurant Environment in Baltimore, Maryland

Objectives: Consuming foods prepared away from home, including restaurants, has steadily increased in the American diet over the last 50 years and now accounts for over a third of daily calories. Much of this food, which is calorically dense and high in fat and sodium, comes from fast food and carryout restaurants (non-chain restaurants with limited to no seating). Despite the prevalence of carryouts in healthy food priority areas (HFPA) of Baltimore, MD – areas that also experience diet-related diseases at a higher rate than non-HFPAs – little is known about their consumer facing environment. This study sought to characterize the carryouts in Baltimore, MD using the Nutrition Environment Measurement Survey for Restaurants (NEMS-R) to better understand their potential impact on the diet.

Methods: 13 zipcodes in Baltimore City were identified by comparing census data to HFPA criteria. Within these zipcodes, 396 carryouts were identified and randomly assigned an order for visiting. Trained research assistants visited 190 carryouts to collect consent from the owner to conduct the NEMS-R, of which 41 provided consent. The overall score and three sub-scores were calculated in accordance with NEMS-R scoring guidelines with a higher score indicating a healthier environment.

Results: The average overall NEMS-R Score was 2.17 (-2 - 8) with a possible range of -5 to 21. Barriers to healthy eating had an average score of -0.27 (-2 - 0) out of a possible -5 to 0, which included such components as, unlimited soda, promotion materials related to larger portions, and not allowing substitutions for healthy sides. Facilitators to healthy eating awarded points for actions like reduced portion sizes, labeling of healthy items, or materials promoting healthy eating. The average score was 0.88 (range 0-4) out of a 0-8 possible range. Finally, the availability of healthy eating options subscore considers, the number of healthy entrees or salads, whole grain bread, and fruit availability, along with others. The average score was 1.56 (0-5) out of a 0-15 range.

Conclusions: Sampled carryout restaurants scored low on the NEMS-R, suggesting that their restaurant environment is not conducive to healthy eating. Future studies should explore potential interventions to increase facilitators to healthy eating, while decreasing potential barriers in those settings.

Funding Sources: BAHI Spark Award, NIMHD