The Fast-Casual Conundrum: Fast-Casual Restaurant Entrées Are Higher in Calories than Fast Food

RESEARCH

Original Research: Brief

The Fast-Casual Conundrum: Fast-Casual Restaurant Entrées Are Higher in Calories than Fast Food Danielle E. Schoffman; Charis R. Davidson, MPH; Sarah B. Hales, MSW; Anthony E. Crimarco, MS; Alicia A. Dahl, MS; Gabrielle M. Turner-McGrievy, PhD, MS, RD ARTICLE INFORMATION Article history: Submitted 23 July 2015 Accepted 21 March 2016 Available online 11 May 2016

Keywords: Fast food Restaurants Energy intake Dietary guidelines Consumer health 2212-2672/Copyright ª 2016 by the Academy of Nutrition and Dietetics. http://dx.doi.org/10.1016/j.jand.2016.03.020

ABSTRACT Background Frequently eating fast food has been associated with consuming a diet high in calories, and there is a public perception that fast-casual restaurants (eg, Chipotle) are healthier than traditional fast food (eg, McDonald’s). However, research has not examined whether fast-food entrées and fast-casual entrées differ in calorie content. Objective The purpose of this study was to determine whether the caloric content of entrées at fast-food restaurants differed from that found at fast-casual restaurants. Design This study was a cross-sectional analysis of secondary data. Calorie information from 2014 for lunch and dinner entrées for fast-food and fast-casual restaurants was downloaded from the MenuStat database. Outcome measures Mean calories per entrée between fast-food restaurants and fastcasual restaurants and the proportion of restaurant entrées that fell into different calorie ranges were assessed. Statistical analyses performed A t test was conducted to test the hypothesis that there was no difference between the average calories per entrée at fast-food and fastcasual restaurants. To examine the difference in distribution of entrées in different calorie ranges between fast-food and fast-casual restaurants, c2 tests were used. Results There were 34 fast-food and 28 fast-casual restaurants included in the analysis (n¼3,193 entrées). Fast-casual entrées had significantly more calories per entrée (760301 kcal) than fast-food entrées (561268; P<0.0001). A greater proportion of fast-casual entrées compared with fast-food entrées exceeded the median of 640 kcal per entrée (P<0.0001). Conclusions Although fast-casual entrées contained more calories than fast-food entrées in the study sample, future studies should compare actual purchasing patterns from these restaurants to determine whether the energy content or nutrient density of full meals (ie, entrées with sides and drinks) differs between fast-casual restaurants and fast-food restaurants. Calorie-conscious consumers should consider the calorie content of entrée items before purchase, regardless of restaurant type. J Acad Nutr Diet. 2016;116:1606-1612.

A

CCORDING TO 2010 DATA IN THE UNITED STATES, 68.8% of the adult population are categorized as overweight (body mass index between 25.0 and 29.9) or obese (body mass index >30.0).1 There has been a growing interest in public health efforts that target reducing fast-food consumption as a potential way to decrease intake of calories and fat.2 Recent statistics from the National Health and Nutrition Examination Survey indicate that US adults consume 11.3% of their daily caloric intake from fast food, with adults classified as obese consuming 13.1% of their calories from fast food.3 Frequent fast-food consumption has been found to be associated with a greater intake of calories and fat,4-6 and higher fat intake and consumption of fewer vegetables among African-American7 and non-Hispanic white adults.8 1606

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Fast-casual restaurants are a relatively new branch of quick-service restaurants gaining popularity because they are perceived as healthier and fresher alternatives to fast food.9,10 For the purposes of this study, fast-food restaurants are defined as restaurants with a typical meal price of $5 that offer minimal service, emphasize convenience and affordability in their advertising, and generally have drivethrus.9,11 In contrast, fast-casual restaurants are defined as restaurants with a typical meal price of $9 to $13 offering limited services that emphasize flavor and/or freshness in their advertising.9,11 Although fast-casual restaurants are becoming more popular in part due to their perceived freshness and healthy ingredients,12 there is no evidence at this time that fast-casual meals are healthier than fast food. Fast-casual restaurant chains have seen increased business ª 2016 by the Academy of Nutrition and Dietetics.

RESEARCH by promoting more “socially responsible practices,” such as only using “antibiotic-free” meat products (eg, Chipotle),13 with some offering sustainable and locally grown foods.11,14 Fast-casual restaurant sales have increased an average 6.5% each quarter for the past 5 years, largely driven by expansion of fast-casual chain locations.15 As a result of the growing popularity of fast-casual restaurants, fast-food restaurants are increasingly offering more fresh food and healthier options to stay competitive.11 A wide selection of different types of fast-food, fast-casual, and other restaurants are available to consumers. However, more research is needed to better understand the difference in calorie content of menu items offered at different types of restaurant chains so public health practitioners and consumers can be informed in recommending and choosing healthier dining choices away from home. A recent study used data from 2010 collected from restaurant websites (and directly from restaurants where necessary) to investigate the calorie content of food at a variety of restaurant chains.16 The results show that main entrées (not including salads) at fastfood restaurants have fewer calories than entrées at familystyle restaurants but more calories than entrées at upscale restaurants.16 However, the study focus was on the availability of nutrition information at chain restaurants, the way menu items compared with national nutrition standards, and the potential influence of menu labeling, as opposed to a controlled comparison between specific menu offerings at different restaurant types.16 The purpose of this study was to compare the calorie content of lunch and dinner entrées offered at US fast-food and fast-casual restaurants listed in the MenuStat database (New York City Department of Health and Mental Hygiene) to test the hypothesis that there was no significant difference in calorie content of entrées between fast-food and fast-casual restaurants.

METHODS Data Collection Energy content of menu items at fast-food and fast-casual restaurants for the most recent year available (2014) was obtained from the MenuStat database. This database contains nutrition information for menu items at the top-200 grossing restaurant chains and 90.0% of menu items in the database include the calorie content of a menu item.17 Nutrition information in the MenuStat database is collected from publicly available data listed on restaurant websites. MenuStat gathered the data in January 2014 and it was downloaded and analyzed in June 2015. The information downloaded for each restaurant included name of the menu item, description of the menu item, menu categories (eg, entrée, sandwich, and salad), and calories. The study protocol was exempt from institutional review board approval under federal regulation 45 46.101 (b) CFR.18

Classification of Restaurants Two coders independently reviewed and categorized the 150 restaurants in the MenuStat database as fast-food restaurants, fast-casual restaurants, coffee shops, sit-down restaurants, pizza restaurants, or “other” (ie, did not sell entrées). During the initial independent coding of restaurants, the coders reached consensus on 133 out of 150 restaurants (88.7%). The independent coders then worked with a third October 2016 Volume 116 Number 10

member of the research team to review discrepancies and reach consensus on restaurant classification. Only restaurants that had counter service (ie, were not sit-down restaurants) and offered single-serve (ie, not family style) lunch or dinner entrées were included in the analysis. This excluded coffee shops that did not serve lunch and dinner entrées, convenience stores, and pizza restaurants. Of the original 150 restaurants, 88 were excluded in the following categories: coffee shops (n¼3), sit-down restaurants (n¼59), pizza restaurants (n¼13), and establishments not serving entrées (ie, ice cream shops and convenience stores [n¼13]). A finalized list of 62 restaurants were included for analysis (34 fast-food restaurants and 28 fast-casual restaurants). The final list of restaurants represented all full-service fast-food and fast-casual restaurants in the top-200 grossing US chains that had published nutrition data available, thus representing a large market share of US casual dining.

Inclusion of Menu Items Full-size (ie, not “half” or “mini”) entrées, burgers, salads, and sandwiches were included in this analysis. Children’s menu items, desserts, baked goods, beverages, fried potatoes, soup, breakfast items, and beverages were excluded. Three restaurants did not provide standard menu items, but rather customizable menu options, where the consumer selects ingredients for his or her entrée. In these cases, the research team created standard entrées. For each individual menu option at these restaurants (eg, taco and burrito bowl) a standard entrée was created from the available ingredients with four different protein options: all-plant based protein (vegan; that is, no animal products), lacto-ovo-vegetarian (ie, contains dairy or eggs but no meat products, including seafood), white meat (eg, poultry), and red meat (eg, beef). The caloric values for the ingredients included in these standard entrées were added together and entered into the data set for analysis.

Inclusion of Side Items with Entrées and Salad Dressings Some entrées in the database indicated that side items or sauces were to be included with the meal. In cases where it was undetermined whether side items were typically included with an entrée, the database and restaurant website menu were consulted to determine whether a side item should be included in the calories for the entrée. For these restaurants, a random number generator was used to select a side item(s) to be included with all entrées requiring sides. Nutrition information for the entrée and combined items were calculated together. The MenuStat database included salads with and without dressings, depending on how the individual restaurants provided nutrition information. Because salads are most often eaten with a dressing and dressing intake has been used as a proxy measure for salad intake, all salads were included with dressing.19 For salads listed in the database without dressing included, the suggested paired dressing was manually added by researchers to the salad’s nutrition information (eg, for McDonald’s the Newman’s Own Ranch dressing was included with the Bacon Ranch Salad). If the salad did not have a specified dressing, nutrition information for the restaurant’s ranch dressing was included because JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

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RESEARCH ranch has been reported to be the most commonly purchased dressing and is widely available.20 If a salad was listed as plain or with a protein option, only the item with the protein was included (eg, a salad with chicken was selected over the plain salad).

Statistical Analysis Descriptive statistics were conducted to assess the mean and median calories per entrée, across restaurant type. A t test was conducted to test the hypothesis that there was no difference between the average calories per entrée at fastfood and fast-casual restaurants. In addition, analyses were run, including and then excluding all entrées with sides included, to test for the possible bias of adding sides to some items (ie, fewer calories at fast-food restaurants, whether most whether fast-casual restaurants include side items with entrées). To further describe the distribution of calories per entrée at each type of restaurant, c2 tests were conducted to determine the number of entrées and any difference between fast-food and fast-casual restaurants above the overall median for calories per entrée, as well as differences in the following categories of calories per entrée: <250, 251 to 500, 501 to 750, 751 to 1,000, 1,001 to 1,250, 1,251 to 1,500, 1,501 to 1,750, 1,750 to 2,000, and >2,000 kcal. All analyses were conducted in SAS version 9.4 (2013, SAS Institute Inc). For all statistical analyses, P<0.05 was considered significant.

RESULTS There were 34 fast-food restaurants and 28 fast-casual restaurants included in the present analysis, with a total of 3,193 entrées. Average calories per entrée at a restaurant ranged from 308 to 1,034 kcal. The Table displays descriptive information about the number of entrées and calories per entrée at each of the fast-food and fast-casual restaurants. On average, fast-casual restaurant entrées had 200 more calories per entrée than fast-food restaurant entrées (P<0.0001). Overall, there were 125 entrées that included side items (fast-food: n¼51, fast-casual: n¼74). There was no significant difference in the number of entrées with and without sides included between the two types of restaurants (P¼0.71; data not shown). To ensure that the inclusion of sides did not bias the results of the overall analysis, the main analysis was also run excluding all entrées with sides. The exclusion of these items yielded similar results to the original analysis, in terms of mean calories per entrée at each restaurant type (fastcasual: 753297 kcal, fast-food: 549260 kcal), with a significant difference between mean calories (P<0.0001; data not shown). Thus entrées with sides were included in further analyses. The Figure shows the distribution of the number of entrées at fast-food and fast-casual restaurants within various ranges of caloric content (eg, 250, 251 to 500, and 501 to 750 kcal). The overall median calories per entrée was 640 and there were significantly more fast-casual than fast-food entrées with higher than the median number of calories per entrée (1,172 vs 413 kcal; P<0.0001; data not shown). Based on c2 test, there were significantly more fast-food than fast-casual entrées in lower calorie categories (250 kcal or 251 to 500 kcal), whereas there were significantly more fast-casual than fast-food entrées in higher calorie categories (751 to 1,000, 1608

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1,001 to 1,250, 1,251 to 1,500, and 1,501-1,750 kcal; see the Figure).

DISCUSSION This study found that, on average, lunch and dinner entrées from fast-casual restaurants were higher in calories than entrées from fast-food restaurants in 2014. This was contrary to our hypothesis that energy content would be similar, and to the popular notion that fast-casual restaurants may offer healthier options than fast-food restaurants.12 In addition, significantly more entrées from fast-casual restaurants contained the median of 640 kcal or greater compared with fastfood restaurants. Two previous studies21,22 that used MenuStat data examined changes in energy content of chain restaurant menus (from 2012-2013 and then 2012-2014) indicated mean calories did not decline, but that new menu items tended to be lower in energy content than stable menu items. Our analysis focused on the most recent data available in the MenuStat database—2014—during which time people in the United States spent $30 billion at fast-casual restaurants.10 During the past decade, fast-casual restaurants have seen remarkable growth, whereas fast-food restaurant growth has remained relatively stable.9 Whereas several studies have found that frequent fast-food consumption is associated with poor diet quality (eg, low fruits, vegetables, and fiber and high total and saturated fat) and greater body weight,4-7,23-25 not all studies have found that frequent consumption of fast food is associated with greater caloric intake.26 With the passing of the Affordable Care Act, the energy content of menu items will be posted in all large restaurant chains (ie, >20 locations), allowing consumers to make more informed choices about their meal selections.27,28 However, preliminary research has demonstrated that simply providing calorie information may not be sufficient to change eating behaviors. One study29 examined the influence of menu labeling before and after menu label policy changes in New York City, through customer receipt audits and surveys. Comparing pre- and postlabeling, there was no significant overall reduction of total calories ordered.29 Of note, some restaurants did see a significant decrease in the number of calories ordered following labeling, but one restaurant saw an increase in the number of calories ordered, resulting in overall null findings.29 Although consumers may not adjust their caloric intake in response to the labeling, another study examined whether consumers are even paying attention to these labels. Past research has found that only about 36% of consumers report seeing posted calorie information in chain restaurants.30,31 In addition, customers who report seeing and using posted calorie information purchased significantly fewer calories than customers seeing but not using the information as well as those customers not seeing the calorie information.31 Further, a recent systematic review of menu labeling initiatives in North American restaurants and foodservice establishments found that the provision of calorie information alone did not reduce calories consumed.32 However, providing calorie information along with contextual and interpretive information may be an approach to help consumers select and consume fewer calories.32 Although there have been no research studies examining purchases specifically at fast-casual restaurants, one previous October 2016 Volume 116 Number 10

RESEARCH Table. Mean calories per entrée by restaurant type at US chain restaurants in the MenuStat database,a 2014 Fast-food restaurants

Entrées

Calories per entrée

n

meanstandard deviation

Fast-casual restaurants

Entrées

Calories per entrée

n

meanstandard deviation

White Castle

18

308127

Panda Express

Krystal

20

316183

Steak ’N Shake

66

505235

Subway

48

394145

Einstein Brothers

44

510158

Wienerschnitzel

57

414151

Bruegger’s Bagels

31

533113

Taco Bell

66

414210

Five Guys

27

534168

In-N-Out Burger

20

327126

9

437140

Au Bon Pain

50

574121

A&W

17

445157

Panera Bread

49

583197

Del Taco

35

448239

Noodles & Company

54

588260

McDonald’s

46

454122

Cosi

47

600168

Chick-Fil-A

17

455129

Qdoba

19

602330

Taco Bueno

34

475250

Schlotzsky’s

Arby’s

43

485151

Potbelly’s Sandwich Works

117

603164

51

625224

Taco John’s

36

486168

Chipotle

20

644193

Burger King

56

495199

Corner Bakery Cafe

35

693206

Hardee’s

59

508264

Pollo Tropical

22

695500

Wendy’s

31

510206

Culver’s

86

714337

Charley’s Grilled Subs

16

52948

McAlister’s Deli

59

736163

Tropical Smoothie Cafe

21

537100

Jason’s Deli

54

753312

27

783210

261

810165

Jack in the Box

50

549215

Moe’s Southwest Grill

Dairy Queen

52

555218

Smashburger

KFC

45

558210

Dickey’s Barbecue Pit

50

81854

El Pollo Loco

40

562310

Togo’s Eatery/Sandwiches

81

820253

Checker’s Drive-In/Rally’s

44

565166

Baja Fresh

83

839332

Sonic

50

628239

Zaxby’s

26

856400

Church’s Chicken

14

636400

Firehouse Subs

131

877311

Carl’s Jr.

73

637295

Captain D’s

32

976242

Fazoli’s

32

668260

Pei Wei

Quiznos

166

687282

Boston Market

Jimmy John’s

25

697178

Whataburger

26

700272

Bojangles’

15

786371

Popeyes

22

803235

Taco Cabana

60

810431

Long John Silver’s

11

851219

262

1,002243

35

1,034294

P valueb All fast-food

1,354

561268

All fast-casual

1,839

760301

<0.0001

a

New York City Department of Health and Mental Hygiene. P value of t test comparing mean calories per entrée at fast-food vs fast-casual restaurants overall. Statistical significance was set at P<0.05.

b

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1000 a

418

Number of Entrées

800

b

600

179

533

Fast-food Fast-casual

400 597 200

b

536

72

a

b

317 125

0

215

47

22

b

101

4 21

1 3

0 2

Calories Per Entrée Figure. Distribution of calories per entrée by restaurant type at US chain restaurants in the MenuStat database (New York City Department of Health and Mental Hygiene), 2014. aSignificantly more fast-food entrées in this category (P<0.0001). bSignificantly more fast-casual entrées in this category (P<0.0001). study33 examined receipts from fast-food purchases, including one fast-casual restaurant (Au Bon Pain). Examining calories from purchased foods, Au Bon Pain had significantly fewer calories per purchase compared with fastfood hamburger, pizza, or Tex-Mex restaurants.33 In our study, only entrée calorie content, and not nutritional quality, was assessed. Other research has found that items from fastfood restaurants have low nutritional quality, particularly in the area of fruit, whole grains, and sodium.34 Many fastcasual restaurants typically offer a choice of whole grains (eg, whole-grain tortilla, bread, and rice), so it is possible that fast-casual restaurants may score better on nutritional quality indexes than do fast-food restaurants. Given the wide distribution of fast-food and fast-casual restaurants, the availability of calorie-dense foods at these restaurants, and the potential health influences of consuming excess energy, public health recommendations should focus on assisting consumers with choosing healthier menu items when offered at these types of restaurants and making caloric content of items more readily accessible.16,33,35 A recent study found that providing healthy sides as the default option and removing unhealthy sides (eg, sugar-sweetened beverages and french fries) from the children’s menu of a full-service 1610

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chain restaurant resulted in a significant decrease in the caloric content of meals ordered without a reduction in consumer choice or reduced revenue.36 Strategies for promoting healthy menu items at restaurants include shifting attention to the healthier items on menus, promoting positive expectations about the desirable taste of these items, and enhancing the consumers’ perceptions of the greater value gained from ordering healthy menu items.37 There are several strengths of this investigation. Caloric intake of menu items was collected using the MenuStat database, which includes a large sample of nationally representative chains. In addition, the study synthesized publicly available data and categorized it into two common quickservice restaurant types—fast food and fast casual—that allowed for the first study examining the difference in caloric content from these two different restaurant types. In addition, there is growing focus on healthy food items at fast-casual restaurants, including new chains in development.13,38,39 These newer restaurant chains generally have limited locations, but it is possible that future comparisons between the energy content of fast-food and fast-casual restaurant entrées could change as more health-centered fast-casual restaurants enter the market. October 2016 Volume 116 Number 10

RESEARCH dietary intake in overweight and obese women recruited from financially disadvantaged neighborhoods. Nutr Res. 2013;33(8): 636-646.

Limitations Several limitations are acknowledged. The MenuStat database draws from publicly available nutrient data (that are not verified through an outside testing agency), and only contains the top-200 grossing restaurant chains in the United States. The results of this investigation may have been different if smaller or local chains were included. In addition, MenuStat collects data in January of each year so menu items appearing after January 2014, such as seasonal items, were not included. Only lunch and dinner entrées were included and side items (such as french fries) were only included if they automatically came with the entrée. At fast-food restaurants, the majority of purchases by consumers are for multiple items, including multiple items from the dollar or value menu or in combination meals, that include french fries or other fried side items.33 In a study examining receipts from fast-food purchases, less than one-quarter of purchases were for single items.33 Of note, a typical side at a fast-food restaurant—a medium order of french fries—contains approximately 400 kcal at the top-three grossing fast-food restaurants40 (McDonald’s: 380 kcal, Burger King: 410 kcal, and Wendy’s: 410 kcal, according to the MenuStat database). In addition, at hamburger fast-food restaurants, purchases containing two or more dollar- or value-menu items accounted for more than half the purchases at Wendy’s, 40% at McDonalds, and 34% at Burger King, with a mean of 800 kcal for these purchases.33 Based on these findings and the findings of our study, it is possible that although mean calories per entrée are lower at fast-food restaurants, calorie consumption may potentially be higher than at fast-casual restaurants due to purchasing more than one entrée or routinely purchasing side items at fastfood restaurants.

7.

Satia JA, Galanko JA, Siega-Riz AM. Eating at fast-food restaurants is associated with dietary intake, demographic, psychosocial and behavioural factors among African Americans in North Carolina. Public Health Nutr. 2004;7(8):1089-1096.

8.

Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005;365(9453):36-42.

9.

Fast casual is only restaurant segment to see traffic growth in 2013, reports NPD. https://www.npd.com/wps/portal/npd/us/news/pressreleases/fast-casual-is-only-restaurant-segment-to-see-traffic-growthin-2013-reports-npd/. Published February 5, 2014. Accessed March 5, 2016.

10.

Fast casual fuels Technomic Top 500 growth once again. https:// www.technomic.com/Pressroom/Releases/dynRelease_Detail.php? rUID¼362. Published April 28, 2015. Accessed March 8, 2016.

11.

Roberto F. The Chipotle effect: Why America is obsessed with fast casual food. http://www.washingtonpost.com/blogs/wonkblog/wp/ 2015/02/02/the-chipotle-effect-why-america-is-obsessed-with-fastcasual-food/. Published February 2, 2015. Accessed March 1, 2016.

12.

Five consumer trends shaping the future of the food and foodservice industries. https://www.npd.com/wps/portal/npd/us/news/pressreleases/2015/five-consumer-trends-shaping-the-future-of-the-foodand-foodservice-industries/. Published May 7, 2015. Accessed March 1, 2016.

13.

Food with integrity. https://www.chipotle.com/food-with-integrity. Published 2015. Accessed March 1, 2016.

14.

Panera Bread’s food policy statement. https://www.panerabread. com/content/dam/panerabread/documents/nutrition/panera-breadfood-policy.pdf. Published June 3, 2014. Accessed March 1, 2016.

15.

General Electric Company. Category segments. http://gerestaurant review.com/category-segments/. Published 2015. Accessed March 8, 2016.

16.

Wu HW, Sturm R. What’s on the menu? A review of the energy and nutritional content of US chain restaurant menus. Public Health Nutr. 2013;16(1):87-96.

17.

New York City Department of Health and Mental Hygiene. Menustat methods. http://menustat.org/methods-for-researchers/. Published 2015. Accessed March 1, 2016.

18.

Code of Federal Regulations. Title 45, Public Welfare, Department of Health and Human Services, Part 46: Protection of Human Subjects; 2009. http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46. html#46.101. Accessed March 5, 2016.

19.

Su LJ, Arab L. Salad and raw vegetable consumption and nutritional status in the adult US population: Results from the Third National Health and Nutrition Examination Survey. J Am Diet Assoc. 2006;106(9):1394-1404.

20.

Ranch number one dressing flavor shipped to u.s. foodservice outlets, Reports SupplyTrack. https://www.npd.com/wps/portal/npd/us/ news/press-releases/ranch-number-one-dressing-flavor-shipped-tous-foodservice-outlets-reports-supplytrack/. Published April 1, 2014. Accessed March 5, 2016.

21.

Bleich SN, Wolfson JA, Jarlenski MP. Calorie changes in chain restaurant menu items: Implications for obesity and evaluations of menu labeling. Am J Prev Med. 2015;48(1):70-75.

22.

Bleich SN, Wolfson JA, Jarlenski MP. Calorie changes in large chain restaurants: Declines in New menu items but room for improvement. Am J Prev Med. 2016;50(1):e1-e8.

CONCLUSIONS Although energy content was higher in fast-casual restaurants in this analysis, it is possible that nutrient density (eg, fiber, potassium, or magnesium) may be higher, as well. Future studies should examine whether the nutrient content and meal quality of fast-food or fast-casual menus items differ. Based on the present results, calorie-conscious consumers should consider the calorie content of entrée items before purchase, regardless of restaurant type.

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https://www.thelittlebeet.com/about/.

AUTHOR INFORMATION D. E. Schoffman, C. R. Davidson, S. B. Hales, A. E. Crimarco, and A. A. Dahl are doctoral students, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia. G. M. Turner-McGrievy is an assistant professor, Department of Health Promotion, Education, and Behavior, an affiliate, Center for Research in Nutrition and Health Disparities, and an affiliate, Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia. Address correspondence to: Danielle E. Schoffman, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene St, Room 529, Columbia, SC 29208. E-mail: [email protected]

STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

FUNDING/SUPPORT There is no funding to disclose.

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JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

October 2016 Volume 116 Number 10