Ordering patterns following the implementation of a healthier children's restaurant menu: A latent class analysis

Mueller, Megan P.; Anzman‐Frasca, Stephanie; Blakeley, Caitlin E.; Folta, Sara C.; Wilde, Parke; Economos, Christina D.

doi:10.1002/oby.21708

Cited by 7 publications

(13 citation statements)

References 34 publications

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“…For example, child meals were often identified on sales reports by the entrée name only; thus, we could not examine variations in meal composition. Unhealthy add-ons and substitutions (i.e., asking to remove vegetables from quesadilla) to a new healthy child meal can negate the impact of the new menu item [ 39 ]. Second, restaurants were reluctant to remove unhealthy child menu items, such as grilled cheese sandwiches and fried chicken tenders from their menus; workarounds such as those enacted by other researchers and practitioners may be warranted (e.g., continued encouragement to remove from printed menu but make available upon request; [ 20 , 26 , 40 ]).…”

Section: Discussionmentioning

confidence: 99%

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program

Ayala

Castro

Pickrel

et al. 2017

IJERPH

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Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants.

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Section: Discussionmentioning

confidence: 99%

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program

Ayala

Castro

Pickrel

et al. 2017

IJERPH

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“…Restaurants could make menu changes by adding new healthy items and changing existing items to have a broader impact to improve the dietary quality of children’s restaurant meals [ 133 ]. Through the Kids LiveWell Program, the NRA should show leadership to incentivize members to reduce and standardize portions for à la carte components of children′s “bundled meals” to meet 100 percent of their own nutrient criteria.…”

Section: Discussionmentioning

confidence: 99%

Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006–2017

Kraak

Englund

Misyak

et al. 2017

IJERPH

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Consumption of restaurant food and beverage products high in fat, sugar and sodium contribute to obesity and non-communicable diseases. We evaluated restaurant-sector progress to promote healthy food environments for Americans. We conducted a desk review of seven electronic databases (January 2006–January 2017) to examine restaurant strategies used to promote healthful options in the United States (U.S.). Evidence selection (n = 84) was guided by the LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) and verified by data and investigator triangulation. A marketing-mix and choice-architecture framework was used to examine eight voluntary strategies (i.e., place, profile, portion, pricing, promotion, healthy default picks, priming or prompting and proximity) to evaluate progress (i.e., no, limited, some or extensive) toward 12 performance metrics based on available published evidence. The U.S. restaurant sector has made limited progress to use pricing, profile (reformulation), healthy default picks (choices), promotion (responsible marketing) and priming and prompting (information and labeling); and some progress to reduce portions. No evidence was available to assess progress for place (ambience) and proximity (positioning) to promote healthy choices during the 10-year review period. Chain and non-chain restaurants can apply comprehensive marketing-mix and nudge strategies to promote healthy food environments for customers.

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“…This repeated cross-sectional study follows previous research evaluating child meal orders after the implementation of a healthier children’s menu [ 5 , 6 , 7 ]. We conducted a secondary analysis of adult menu order data from 13 outlets of the Silver Diner, a full-service restaurant chain located in the mid-Atlantic region of the US that serves >4 million customers annually.…”

Section: Methodsmentioning

confidence: 99%

“…The restaurant introduced the new, healthier children’s menu in April 2012. Additional information about the restaurant and the children’s menu changes have been published elsewhere [ 5 , 6 , 7 ]. Briefly, this new menu included more entrées that met Kids LiveWell nutrition criteria [ 1 ], all meals automatically bundled with fruit and non-fried vegetable sides, and the removal of French Fries and soda.…”

Section: Methodsmentioning

confidence: 99%

“…Previously, we examined children’s menu orders before (September 2011–March 2012; PRE) to after (September 2012–March 2013; POST) these healthy children’s menu changes. This study revealed significant, lasting increases in the healthfulness of children’s menu orders after the healthy children’s menu changes which persisted at 2 year follow up [ 5 , 6 , 7 ]. More specifically, orders of nutrient-poor items such as French fries and soda decreased (from 57.0 to 22.0% and from 34.7 to 29.7%, respectively); orders of fruit and vegetable sides, milk, and 100% fruit juices increased (from 29.1 to 63.0%, from 5.5 to 6.9%, from 37.0 to 39.5%, and from 28.3 to 30.8%, respectively) [ 5 ].…”

Section: Introductionmentioning

confidence: 96%

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Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children’s Menu

et al. 2020

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This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children’s menu in April 2012. Orders of adult menu items were abstracted from before (September 2011–March 2012; PRE; n = 1,801,647) and after (September 2012–March 2013; POST; n = 1,793,582) the healthier children’s menu was introduced. Entrées, appetizers, and sides listed as healthier options on the menu were coded as healthier. PRE to POST changes in the percentage of orders of healthier items, soda, and dessert were evaluated using McNemar tests of paired proportions. Orders of healthier entrées, appetizers, and sides on the adult menu increased PRE to POST (8.9% to 10.4%, 25.5% to 27.5%, and 7.3% to 9.3%, respectively), and soda and dessert orders decreased (23.2% to 21.7% and 29.0% to 28.3%, respectively). All shifts were statistically significant (p < 0.0001). Our findings demonstrate improvements in orders of healthier adult menu options during the same time frame as a healthy children’s menu change. Future research can help elucidate mechanisms to inform future health promotion efforts in restaurants in ways that have the potential to impact both adults and children.

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Ordering patterns following the implementation of a healthier children's restaurant menu: A latent class analysis

Cited by 7 publications

References 34 publications

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program

Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006–2017

Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children’s Menu

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