Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina.
The University of North Carolina at Greensboro, 319 College Ave, 318 Stone Building, Greensboro, NC 27412. Email:
Prev Chronic Dis. 2019 Oct 17;16:E142. doi: 10.5888/pcd16.190129.
Each year, millions of people purchase food at highway rest areas. Rest areas are potential sites for health promotion because they are operated by the public sector; they are frequently visited by professional truck drivers, who have a disproportionate burden of chronic disease; and they are easily accessible. To our knowledge, no research has systematically examined the healthfulness of food offerings at rest areas. The objective of this study was to determine the accessibility and healthfulness of food and beverages offered at highway rest areas in North Carolina using a mixed-methods audit and geospatial approach.
We conducted a cross-sectional audit of all rest areas offering foods and beverages in North Carolina (N = 30) in summer 2018. We used the Nutrition Environment Measures Survey-Vending (NEMS-V) to record the 1) type, price, and size of all foods and beverages and 2) healthfulness of items offered (based on NEMS-V categorization). Two researchers independently double coded NEMS-V data. We used geospatial analysis to examine proximity of rest areas to food stores. We analyzed data by using univariate and bivariate analysis.
The mean number of vending machines per site was 8.0 (range, 2-12, standard deviation, 2.8). The healthfulness of offerings varied across sites. Most food items (88.1%; 2,922 of 3,315) and beverage items (63.7%; 1,567 of 2,459) were classified as least healthful. Cold beverage machines had a greater percentage of healthful items (38.2%; 778 of 2,036) than snack machines (11.4%; 374 of 3,270) (P < .001), mainly because of water and diet soda in beverage machines.
Policy changes are needed to increase the number and presentation of healthful food options at highway rest areas. Policy changes could provide travelers with more healthful options conveniently located along their travel route.
每年都有数百万人在高速公路休息区购买食品。休息区是促进健康的潜在场所，因为它们由公共部门运营；它们经常被职业卡车司机光顾，而这些司机患有慢性疾病的比例过高；而且它们很容易到达。据我们所知，没有研究系统地检查过休息区提供的食品的健康状况。本研究的目的是使用混合方法审计和地理空间方法确定北卡罗来纳州高速公路休息区提供的食品和饮料的可及性和健康程度。
我们在 2018 年夏天对北卡罗来纳州所有提供食品和饮料的休息区（N = 30）进行了横断面审计。我们使用营养环境测量工具-销售（NEMS-V）记录 1）所有食品和饮料的类型、价格和大小，以及 2）提供的项目的健康程度（根据 NEMS-V 分类）。两名研究人员独立对 NEMS-V 数据进行了双重编码。我们使用地理空间分析来检查休息区与食品店的距离。我们使用单变量和双变量分析来分析数据。
每个地点的自动售货机平均数量为 8.0（范围，2-12，标准差，2.8）。供应品的健康程度在各个地点有所不同。大多数食品（88.1%；3,315 个中的 2,922 个）和饮料（63.7%；2,459 个中的 1,567 个）被归类为最不健康。冷饮机的健康食品比例（38.2%；2,036 个中的 778 个）高于零食机（11.4%；3,270 个中的 374 个）（P <.001），这主要是因为饮料机中有水和无糖苏打水。
需要改变政策，增加高速公路休息区健康食品的数量和种类。政策的改变可以为旅行者提供更多的健康选择，这些选择可以方便地位于他们的旅行路线上。
