Stephanie Anzman-Frasca1, Abbey C Braun2, Sarah Ehrenberg3, Leonard H Epstein4, April Gampp5, Lucia A Leone6, Anita Singh7, Sara Tauriello8. 1. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: safrasca@buffalo.edu. 2. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: abbeybra@buffalo.edu. 3. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: sarahehr@buffalo.edu. 4. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: lhenet@buffalo.edu. 5. Independent Health Foundation, 511 Farber Lakes Drive, Buffalo 14221, NY, USA. Electronic address: april.gampp@independenthealth.com. 6. Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, 333 Kimball Tower, South Campus, Buffalo 14214, NY, USA. Electronic address: lucialeo@buffalo.edu. 7. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: asingh11@buffalo.edu. 8. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo 14214, NY, USA. Electronic address: sarataur@buffalo.edu.
Abstract
BACKGROUND: Children's consumption of restaurant foods is associated with higher energy intake and lower nutritional quality compared to foods prepared at home. The aim of this pilot study was to test whether an in-restaurant intervention promoting healthy children's meals (i.e. two meals that met nutrition recommendations and were thus healthier than typical children's meal offerings across leading restaurants) affected children's meal selection and intake. METHODS:Families with 4-to-8-year-old children were recruited from one location of Anderson's Frozen Custard, a regional quick-service restaurant chain. Families were randomly assigned to return to the restaurant during an intervention or control period and were blinded to group assignment. All families received free meals. During the intervention period families also received placemats featuring two healthy "Kids' Meals of the Day" upon restaurant entry. After families finished dining, researchers recorded children's orders and collected leftovers for quantifying dietary intake via weighed plate waste. Poisson regression and chi-square tests were used to compare children's orders between study groups, and t-tests were used to test for differences in dietary intake among children ordering a promoted healthy entrée (main dish) versus those who did not. RESULTS:Fifty-eight families participated. Children who were exposed to the study placemats prior to ordering ordered a significantly greater number of healthy food components compared to controls (p = 0.03). Overall, in the intervention group, 21% of children ordered a healthy entrée or side dish, versus 7% of controls. Children who ordered one of the promoted healthy entrées consumed less saturated fat across the total meal compared to those who did not (p = 0.04). CONCLUSIONS: Manipulating the prominence of healthy choices in restaurants may shift children's meal selections. Future research should build on these initial promising results, aiming to increase the potency of the intervention to achieve more widespread effects.
RCT Entities:
BACKGROUND:Children's consumption of restaurant foods is associated with higher energy intake and lower nutritional quality compared to foods prepared at home. The aim of this pilot study was to test whether an in-restaurant intervention promoting healthy children's meals (i.e. two meals that met nutrition recommendations and were thus healthier than typical children's meal offerings across leading restaurants) affected children's meal selection and intake. METHODS: Families with 4-to-8-year-old children were recruited from one location of Anderson's Frozen Custard, a regional quick-service restaurant chain. Families were randomly assigned to return to the restaurant during an intervention or control period and were blinded to group assignment. All families received free meals. During the intervention period families also received placemats featuring two healthy "Kids' Meals of the Day" upon restaurant entry. After families finished dining, researchers recorded children's orders and collected leftovers for quantifying dietary intake via weighed plate waste. Poisson regression and chi-square tests were used to compare children's orders between study groups, and t-tests were used to test for differences in dietary intake among children ordering a promoted healthy entrée (main dish) versus those who did not. RESULTS: Fifty-eight families participated. Children who were exposed to the study placemats prior to ordering ordered a significantly greater number of healthy food components compared to controls (p = 0.03). Overall, in the intervention group, 21% of children ordered a healthy entrée or side dish, versus 7% of controls. Children who ordered one of the promoted healthy entrées consumed less saturated fat across the total meal compared to those who did not (p = 0.04). CONCLUSIONS: Manipulating the prominence of healthy choices in restaurants may shift children's meal selections. Future research should build on these initial promising results, aiming to increase the potency of the intervention to achieve more widespread effects.
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Flora Tzelepis; Rebecca J Wyse; Kate M Bartlem; Rachel Sutherland; Erica L James; Courtney Barnes; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2019-11-07
Authors: Amanda N Spitzer; Katrina Oselinsky; Rachel G Lucas-Thompson; Dan J Graham Journal: Int J Environ Res Public Health Date: 2022-02-08 Impact factor: 3.390
Authors: Megan P Mueller; Eleanor T Shonkoff; Sara C Folta; Stephanie Anzman-Frasca; Christina D Economos Journal: Nutrients Date: 2020-10-23 Impact factor: 5.717