No Financial Disincentive for Choosing More Healthful Entrées on Children’s Menus in Full-Service Restaurants

Krukowski, Rebecca A.; West, Delia Smith

doi:10.5888/pcd10.120266

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…Regardless of restaurant type, the healthy-food availability scores for the children’s menu were low (mean, 1.9; SD, 2.9; range −3 to 11) on a 21 point scale. Similar to findings of Kurkowski et al, the overall CMA scores in this study were within the lower third of the range (24,25). Furthermore, one-third of the restaurants for both studies listed soda as a drink option on their children’s menu, and even fewer offered 100% juice.…”

Section: Discussionsupporting

confidence: 91%

“…This study provides additional information to support the use of CMA in evaluating an aspect of the food environment, children’s menus (24,25,29). It would also be advantageous to investigate the purchasing behavior of adults and children to see whether the food on children’s menus is what is typically purchased.…”

Section: Discussionmentioning

confidence: 94%

“…To focus on foods for children, all restaurants with children’s menus (n = 137) were further audited with the Children’s Menu Assessment (CMA) tool and are included in this study (24). Details of enumeration methods and data collection process are provided elsewhere (25). In 2013 research staff members visited each restaurant with a children’s menu and reviewed the menu on site.…”

Section: Methodsmentioning

confidence: 99%

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Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

Hill¹,

Olive²,

Waters³

et al. 2015

Prev. Chronic Dis.

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IntroductionInterest has increased in understanding the types and healthfulness of restaurant foods for children, particularly in disadvantaged areas. The purpose of this community-based participatory research study was to describe the quality of restaurant food offered to children in a health-disparate region in Virginia and North Carolina and to determine if the availability of healthy foods differed by location (rural, urban) or by the predominant race (black, white, mixed race) of an area’s population.MethodsRestaurants offering a children’s menu in the 3 counties in Virginia and North Carolina that make up the Dan River Region were identified by using state health department records. Research assistants reviewed menus using the Children’s Menu Assessment (CMA), a tool consisting of 29 scored items (possible score range, −4 to 21). Scores were calculated for each restaurant. We obtained information on the predominant race of the population at the block group level for all counties from 2010 US Census data.ResultsFor the 137 restaurants studied, mean CMA scores were low (mean, 1.6; standard deviation [SD], 2.7), ranging from −4 to 9 of 21 possible points. Scores were lowest for restaurants in the predominantly black block groups (mean, 0.2; SD, 0.4) and significantly different from the scores for restaurants in the predominantly white (mean, 1.4; SD, 1.6) and mixed-race block groups (mean, 2.6; SD, 2.4) (F = 4.3; P < .05).ConclusionChildren’s menus available in the Dan River Region lack healthy food options, particularly in predominantly black block groups. These study findings can contribute to regional efforts in policy development or environmental interventions for children’s food quality by the community-based participatory research partnership and help local stakeholders to determine possible strategies and solutions for improving local food options for children.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

Hill¹,

Olive²,

Waters³

et al. 2015

Prev. Chronic Dis.

View full text Add to dashboard Cite

show abstract

“…Finally, these changes highlight some of the many menu adjustments made by national restaurant chains , though some may still question the nutritional quality of the new CMB. Evidence reported by the Centers for Disease Control and Prevention indicates fast food contributes less than 12% of a child's total caloric intake .…”

Section: Discussionmentioning

confidence: 99%

“…Despite the usefulness of de-identified transaction records in measuring product demand, intake remains unmeasured, limiting the ability of this study to measure the overall impact on diet. In addition, while it is perfectly plausible that some children over-compensated for the calorie decrease in later snacks or meals, calorie compensation is highly variable among children (18) and systematic increases may be difficult to detect. Additionally, without customer-specific information, demographic controls cannot be utilized and specific customers cannot be tracked over time, and furthermore we have no indication of whether these diners knew of the changes.…”

Section: Discussionmentioning

confidence: 99%

Calorie reductions and within‐meal calorie compensation in children's meal combos

Wansink

Hanks

2013

Obesity

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Objective: What happens if a fast-food restaurant chain lowers the calories in a children's meal bundle (CMB), mainly by reducing the portion size of French fries? This study examines how such changes may influence within-meal selections. Specifically, do lower-calorie changes lead to within-meal calorie compensation? Methods: Item-level anonymous transaction data were collected for thirty chain-owned representative US restaurants during June, July, and August of 2011 (pre-changes) and 2012 (post-changes) with a focus on transaction records that included a CMB. Mixed-effects, repeated measures estimation techniques were used for the analysis. Outcome measures were the percentage and caloric profile of specific entree items, side items, and beverages purchased in all children selecting meals. Results: The new CMB resulted in selected children's meals that had an average of 18.8% fewer calories (P < 0.001). Additionally, a greater percentage of meals had milk (P < 0.001) compared to the prior year. Conclusion: Small changes in the automatic-or default-foods offered or promoted in children's meals can reduce calorie intake and improve the overall nutrition from selected foods as long as there is still an indulgence. Importantly, balancing a meal with smaller portions of favored foods might avoid reactance and overeating. Just as managers have done this in restaurants, parents can do this at home.

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Food ordering for children in restaurants: multiple sources of influence on decision making

Castro

Williams

Madanat

et al. 2016

Public Health Nutr.

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Objective Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. Design A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making. Setting Ten independent, table-service restaurants in San Diego, CA, USA participated. Subjects Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years). Results Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu. Conclusions Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.

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No Financial Disincentive for Choosing More Healthful Entrées on Children’s Menus in Full-Service Restaurants

Cited by 7 publications

References 6 publications

Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

Calorie reductions and within‐meal calorie compensation in children's meal combos

Food ordering for children in restaurants: multiple sources of influence on decision making

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