Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet

Abstract Background The Mediterranean diet (MD) has been considered one of the healthiest dietary patterns, and an excellent model of sustainability. Higher Education food services present an excellent scenario to encourage students healthy eating habits and modulate food choices. The purpose of thi...

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Main Authors: S. S. Silva, A. Rocha, L. Ferreira, B. Neto, D. Dikmen, S. Vidacek Filipec, Z. Satalic, C. Viegas
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Nutrition
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Online Access:https://doi.org/10.1186/s40795-024-00975-2
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author S. S. Silva
A. Rocha
L. Ferreira
B. Neto
D. Dikmen
S. Vidacek Filipec
Z. Satalic
C. Viegas
author_facet S. S. Silva
A. Rocha
L. Ferreira
B. Neto
D. Dikmen
S. Vidacek Filipec
Z. Satalic
C. Viegas
author_sort S. S. Silva
collection DOAJ
description Abstract Background The Mediterranean diet (MD) has been considered one of the healthiest dietary patterns, and an excellent model of sustainability. Higher Education food services present an excellent scenario to encourage students healthy eating habits and modulate food choices. The purpose of this work was to develop an index to evaluate MD compliance with cafeteria menus. Methods Three major axes were considered: MD key points, existing indexes on individual adherence to the MD and, existing indexes on menu assessment. The index includes four levels: (I) assesses the availability (IA), variety and frequency (IB) of food; (II) evaluates menu’s nutritional quality; (III) assesses the menu’s quality through information provided in the dishes’ technical specifications and (IV) allows a more detailed evaluation through on-site visits and documentation consultation. The components receive a score between − 2 and 3, according to the given answers. The final score may vary between − 33.5 and 41.5 points depending on the degree of compliance with the MD key points. The index was applied to 60 menus from different contexts using complete assessments of each menu, performed independently by 3 researchers, using the same pre-prepared Microsoft Excel® spreadsheet. Inter-rater reliability was assessed using Cohen’s Kappa and internal consistency with Cronbach’s alpha. Results Assessment for level I) returned a Cohen’s Kappa coefficient of 0.92 (p < 0.05) and a Cronbach’s alpha coefficient of 0.88. Dimension I is mostly influenced by subdimension IB (r = 0,97). The availability of non-starchy vegetables and fresh fruits has a stronger correlation with IA (availability of foods), and higher availability of fish, pulses and fruit has a strong positive correlation with IB (variety and frequency of foods). Conclusion Researchers believe that the index is a useful tool to assess compliance of menus to the MD and help identify the key points that need to be addressed and improved in cafeterias.
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spelling doaj-art-ce31387e3b574ff4a4c652b8fe79f9f62025-08-20T02:31:44ZengBMCBMC Nutrition2055-09282024-12-0110111210.1186/s40795-024-00975-2Development of a tool to assess the compliance of cafeteria menus with the Mediterranean DietS. S. Silva0A. Rocha1L. Ferreira2B. Neto3D. Dikmen4S. Vidacek Filipec5Z. Satalic6C. Viegas7GreenUPorto/Inov4Agro, Faculdade de Ciências da Nutrição e Alimentação da Universidade do PortoGreenUPorto/Inov4Agro, Faculdade de Ciências da Nutrição e Alimentação da Universidade do PortoGreenUPorto/Inov4Agro, Faculdade de Ciências da Nutrição e Alimentação da Universidade do PortoEscola Superior de Tecnologia da Saúde, Instituto Politécnico de LisboaFaculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Türkiye Hacettepe UniversityFaculty of Food Technology and Biotechnology, University of ZagrebFaculty of Food Technology and Biotechnology, University of ZagrebH&TRC - Health & Technology Research Center, ESTeSL—Escola Superior de Tecnologia da Saúde, Instituto Politécnico de LisboaAbstract Background The Mediterranean diet (MD) has been considered one of the healthiest dietary patterns, and an excellent model of sustainability. Higher Education food services present an excellent scenario to encourage students healthy eating habits and modulate food choices. The purpose of this work was to develop an index to evaluate MD compliance with cafeteria menus. Methods Three major axes were considered: MD key points, existing indexes on individual adherence to the MD and, existing indexes on menu assessment. The index includes four levels: (I) assesses the availability (IA), variety and frequency (IB) of food; (II) evaluates menu’s nutritional quality; (III) assesses the menu’s quality through information provided in the dishes’ technical specifications and (IV) allows a more detailed evaluation through on-site visits and documentation consultation. The components receive a score between − 2 and 3, according to the given answers. The final score may vary between − 33.5 and 41.5 points depending on the degree of compliance with the MD key points. The index was applied to 60 menus from different contexts using complete assessments of each menu, performed independently by 3 researchers, using the same pre-prepared Microsoft Excel® spreadsheet. Inter-rater reliability was assessed using Cohen’s Kappa and internal consistency with Cronbach’s alpha. Results Assessment for level I) returned a Cohen’s Kappa coefficient of 0.92 (p < 0.05) and a Cronbach’s alpha coefficient of 0.88. Dimension I is mostly influenced by subdimension IB (r = 0,97). The availability of non-starchy vegetables and fresh fruits has a stronger correlation with IA (availability of foods), and higher availability of fish, pulses and fruit has a strong positive correlation with IB (variety and frequency of foods). Conclusion Researchers believe that the index is a useful tool to assess compliance of menus to the MD and help identify the key points that need to be addressed and improved in cafeterias.https://doi.org/10.1186/s40795-024-00975-2IndexMenusEvaluationMediterranean Diet
spellingShingle S. S. Silva
A. Rocha
L. Ferreira
B. Neto
D. Dikmen
S. Vidacek Filipec
Z. Satalic
C. Viegas
Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
BMC Nutrition
Index
Menus
Evaluation
Mediterranean Diet
title Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
title_full Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
title_fullStr Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
title_full_unstemmed Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
title_short Development of a tool to assess the compliance of cafeteria menus with the Mediterranean Diet
title_sort development of a tool to assess the compliance of cafeteria menus with the mediterranean diet
topic Index
Menus
Evaluation
Mediterranean Diet
url https://doi.org/10.1186/s40795-024-00975-2
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