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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Child and parent perspectives on healthier side dishes and beverages in restaurant kids’ meals: results from a national survey in the United States

Authors: Eleanor T. Shonkoff, Stephanie Anzman-Frasca, Vanessa M. Lynskey, Grace Chan, Meaghan E. Glenn, Christina D. Economos

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Children frequently consume foods from restaurants; considering the quick-service sector alone, 1/3 of children eat food from these restaurants on a given day, and among these consumers, 1/3 of their daily calories come from fast food. Restaurant foods and beverages are second only to grocery store foods and beverages in their contribution to total energy intake of U.S. 4- to 11-year-olds. Shifting their restaurant consumption in healthier directions could have a positive impact on child health. In 2014 this study examined self-reported child receptivity and parent awareness of child receptivity to ordering a fruit or vegetable side dish instead of French fries; and milk, water, or flavored water instead of soda/pop with a kids’ meal when eating out. Child receptivity to side dishes was compared between 2010 and 2014.

Methods

An online survey was administered by Nielsen via their Harris Poll Online to a national panel of 711 parents and their 8- to 12-year-old child, as part of a larger study. Frequencies, logistic regressions, t-tests, chi-square tests, and percent agreement were used to evaluate child likelihood of ordering certain side dishes; receptivity to healthier side dish and beverage alternatives; changes in receptivity to healthier sides across years; and parent awareness.

Results

A majority of children said they were likely to order a meal with a vegetable (60%), fruit (78%), or French fry (93%) side dish. They were receptive to receiving a fruit or vegetable (FV) side dish instead of French fries (68%); or milk, water, or flavored water instead of soda (81%) with their restaurant kids’ meal. Liking/taste was the most common reason for children’s feelings. Child receptivity to a FV side dish instead of French fries was high in both years and significantly higher in 2014 (t = −2.12, p = 0.034). The majority of parent and child reports of child receptivity were concordant (85%).

Conclusions

These national survey results indicate that children are receptive to FV side dishes and healthier beverage options with their restaurant meals. Their receptivity has remained high in the recent past, and parents are aware of child receptivity. An opportunity exists for restaurants to leverage child receptivity to healthier sides and beverages by providing and promoting healthy options.
Literature
1.
go back to reference Vikraman S, Fryar CD, Ogden CL. Caloric intake from fast food among children and adolescents in the United States, 2011-2012. NCHS Data Brief. 2015;213:1–8. Vikraman S, Fryar CD, Ogden CL. Caloric intake from fast food among children and adolescents in the United States, 2011-2012. NCHS Data Brief. 2015;213:1–8.
2.
go back to reference Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. JAMA Pediatr. 2013;167(1):14–20.CrossRefPubMedPubMedCentral Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. JAMA Pediatr. 2013;167(1):14–20.CrossRefPubMedPubMedCentral
4.
go back to reference Deierlein AL, Peat K, Claudio L. Comparison of the nutrient content of children's menu items at US restaurant chains, 2010-2014. Nutr J. 2015;14 Deierlein AL, Peat K, Claudio L. Comparison of the nutrient content of children's menu items at US restaurant chains, 2010-2014. Nutr J. 2015;14
5.
go back to reference USDHHS, 2015–2020 Dietary Guidelines for Americans. US Government Printing Office Washington, DC: 2015. USDHHS, 2015–2020 Dietary Guidelines for Americans. US Government Printing Office Washington, DC: 2015.
6.
go back to reference Batada A, Bruening M, Marchlewicz EH, Story M, Wootan MG. Poor nutrition on the menu: children’s meals at America’s top chain restaurants. Childhood Obesity (Formerly Obesity and Weight Management). 2012;8(3):251–4. Batada A, Bruening M, Marchlewicz EH, Story M, Wootan MG. Poor nutrition on the menu: children’s meals at America’s top chain restaurants. Childhood Obesity (Formerly Obesity and Weight Management). 2012;8(3):251–4.
7.
go back to reference Powell ES, Smith-Taillie LP, Popkin BM. Added sugars intake across the distribution of US children and adult consumers: 1977-2012. J Acad Nutr Diet. 2016;116(10):1543–50.CrossRefPubMed Powell ES, Smith-Taillie LP, Popkin BM. Added sugars intake across the distribution of US children and adult consumers: 1977-2012. J Acad Nutr Diet. 2016;116(10):1543–50.CrossRefPubMed
8.
go back to reference Wu HW, Sturm R. What's on the menu? A review of the energy and nutritional content of US chain restaurant menus. Public Health Nutr. 2013;16(1):87–96.CrossRefPubMed Wu HW, Sturm R. What's on the menu? A review of the energy and nutritional content of US chain restaurant menus. Public Health Nutr. 2013;16(1):87–96.CrossRefPubMed
9.
go back to reference Cantor J, Breck A, Elbel B. Correlates of sugar-sweetened beverages purchased for children at fast-food restaurants. Am J Public Health. 2016;106(11):2038–41.CrossRefPubMed Cantor J, Breck A, Elbel B. Correlates of sugar-sweetened beverages purchased for children at fast-food restaurants. Am J Public Health. 2016;106(11):2038–41.CrossRefPubMed
10.
go back to reference Sharpe KM, Staelin R. Consumption effects of bundling: consumer perceptions, firm actions, and public policy implications. J Public Policy Mark. 2010;29(2):170–88.CrossRef Sharpe KM, Staelin R. Consumption effects of bundling: consumer perceptions, firm actions, and public policy implications. J Public Policy Mark. 2010;29(2):170–88.CrossRef
11.
go back to reference Anzman-Frasca S, et al. Healthier side dishes at restaurants: an analysis of children's perspectives, menu content, and energy impacts. Int J Behav Nutr Phys Act. 2014;11:81.CrossRefPubMedPubMedCentral Anzman-Frasca S, et al. Healthier side dishes at restaurants: an analysis of children's perspectives, menu content, and energy impacts. Int J Behav Nutr Phys Act. 2014;11:81.CrossRefPubMedPubMedCentral
12.
go back to reference Sliwa S, et al. Assessing the availability of healthier Children's meals at leading quick-service and full-service restaurants. J Nutr Educ Behav. 2016;48(4):242–9.CrossRefPubMed Sliwa S, et al. Assessing the availability of healthier Children's meals at leading quick-service and full-service restaurants. J Nutr Educ Behav. 2016;48(4):242–9.CrossRefPubMed
13.
go back to reference Bleich SN, Wolfson JA, Jarlenski MP. Calorie changes in large chain restaurants declines in new menu items but room for improvement. Am J Prev Med. 2016;50(1):E1–8.CrossRefPubMed Bleich SN, Wolfson JA, Jarlenski MP. Calorie changes in large chain restaurants declines in new menu items but room for improvement. Am J Prev Med. 2016;50(1):E1–8.CrossRefPubMed
14.
go back to reference Anzman-Frasca S, et al. Changes in Children's meal orders following healthy menu modifications at a regional US restaurant chain. Obesity. 2015;23(5):1055–62.CrossRefPubMed Anzman-Frasca S, et al. Changes in Children's meal orders following healthy menu modifications at a regional US restaurant chain. Obesity. 2015;23(5):1055–62.CrossRefPubMed
15.
go back to reference Anzman-Frasca S, et al. Orders of healthier Children's items remain high more than two years after menu changes at a regional restaurant chain. Health Aff (Project Hope). 2015;34(11):1885–92.CrossRef Anzman-Frasca S, et al. Orders of healthier Children's items remain high more than two years after menu changes at a regional restaurant chain. Health Aff (Project Hope). 2015;34(11):1885–92.CrossRef
17.
18.
go back to reference Wolnicka K, et al. Factors within the family environment such as parents' dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by polish children. Public Health Nutr. 2015;18(15):2705–11.CrossRefPubMed Wolnicka K, et al. Factors within the family environment such as parents' dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by polish children. Public Health Nutr. 2015;18(15):2705–11.CrossRefPubMed
19.
go back to reference Wellard L, et al. Who is responsible for selecting children's fast food meals, and what impact does this have on energy content of the selected meals? Nutr Diet. 2014;71(3):172–7.CrossRef Wellard L, et al. Who is responsible for selecting children's fast food meals, and what impact does this have on energy content of the selected meals? Nutr Diet. 2014;71(3):172–7.CrossRef
20.
go back to reference Daniel C. Economic constraints on taste formation and the true cost of healthy eating. Soc Sci Med. 2016;148:34–41.CrossRefPubMed Daniel C. Economic constraints on taste formation and the true cost of healthy eating. Soc Sci Med. 2016;148:34–41.CrossRefPubMed
21.
go back to reference O'Dougherty M, Story M, Stang J. Observations of parent-child co-shoppers in supermarkets: Children's involvement in food selections, parental yielding, and refusal strategies. J Nutr Educ Behav. 2006;38(3):183–8.CrossRefPubMed O'Dougherty M, Story M, Stang J. Observations of parent-child co-shoppers in supermarkets: Children's involvement in food selections, parental yielding, and refusal strategies. J Nutr Educ Behav. 2006;38(3):183–8.CrossRefPubMed
22.
go back to reference Sondergaard HA, Edelenbos M. What parents prefer and children like - investigating choice of vegetable-based food for children. Food Quality Preference. 2007;18(7):949–62.CrossRef Sondergaard HA, Edelenbos M. What parents prefer and children like - investigating choice of vegetable-based food for children. Food Quality Preference. 2007;18(7):949–62.CrossRef
24.
go back to reference Strom, S. McDonald’s alters happy meals and shrinks fries. New York: The New York Times; 2011. Strom, S. McDonald’s alters happy meals and shrinks fries. New York: The New York Times; 2011.
26.
go back to reference Ding D, et al. Community food environment, home food environment, and fruit and vegetable intake of children and adolescents. J Nutr Educ Behav. 2012;44(6):634–8.CrossRefPubMed Ding D, et al. Community food environment, home food environment, and fruit and vegetable intake of children and adolescents. J Nutr Educ Behav. 2012;44(6):634–8.CrossRefPubMed
28.
go back to reference Lumley T. Analysis of complex survey samples. J Stat Softw. 2004;9(1):1–19. Lumley T. Analysis of complex survey samples. J Stat Softw. 2004;9(1):1–19.
30.
go back to reference Anzman-Frasca S, et al. Repeated exposure and associative conditioning promote preschool children’s liking of vegetables. Appetite. 2012;58(2):543–53.CrossRefPubMed Anzman-Frasca S, et al. Repeated exposure and associative conditioning promote preschool children’s liking of vegetables. Appetite. 2012;58(2):543–53.CrossRefPubMed
31.
go back to reference Cooke L. The importance of exposure for healthy eating in childhood: a review. J Hum Nutr Diet. 2007;20(4):294–301.CrossRefPubMed Cooke L. The importance of exposure for healthy eating in childhood: a review. J Hum Nutr Diet. 2007;20(4):294–301.CrossRefPubMed
32.
go back to reference Mesirow MSC, Welsh JA. Changing beverage consumption patterns have resulted in fewer liquid calories in the diets of US children: National Health and nutrition examination survey 2001-2010. J Acad Nutr Diet. 2015;115(4):559–U320.CrossRefPubMed Mesirow MSC, Welsh JA. Changing beverage consumption patterns have resulted in fewer liquid calories in the diets of US children: National Health and nutrition examination survey 2001-2010. J Acad Nutr Diet. 2015;115(4):559–U320.CrossRefPubMed
33.
go back to reference Rosinger A, et al. Sugar-sweetened beverage consumption among US youth, 2011–2014. NCHS Data Brief. 2017;271:1. Rosinger A, et al. Sugar-sweetened beverage consumption among US youth, 2011–2014. NCHS Data Brief. 2017;271:1.
35.
go back to reference Wansink B, Hanks AS. Calorie reductions and within-meal calorie compensation in Children’s meal combos. Obesity. 2014;22(3):630–2.CrossRefPubMed Wansink B, Hanks AS. Calorie reductions and within-meal calorie compensation in Children’s meal combos. Obesity. 2014;22(3):630–2.CrossRefPubMed
36.
go back to reference Taylor JP, Evers S, McKenna M. Determinants of healthy eating in children and youth. Can J Public Health Rev Canadienne De Sante Publique. 2005;96:S20–6. Taylor JP, Evers S, McKenna M. Determinants of healthy eating in children and youth. Can J Public Health Rev Canadienne De Sante Publique. 2005;96:S20–6.
37.
go back to reference Rasmussen M, et al. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies. Int J Behav Nutr Phys Act. 2006;3(1):1.CrossRef Rasmussen M, et al. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies. Int J Behav Nutr Phys Act. 2006;3(1):1.CrossRef
38.
go back to reference Levy PS, Lemeshow S. Sampling of populations: methods and applications. Hoboken: John Wiley & Sons; 2013. Levy PS, Lemeshow S. Sampling of populations: methods and applications. Hoboken: John Wiley & Sons; 2013.
39.
go back to reference Morwitz VG, Steckel JH, Gupta A. When do purchase intentions predict sales? Int J Forecasting. 2007;23(3):347–64.CrossRef Morwitz VG, Steckel JH, Gupta A. When do purchase intentions predict sales? Int J Forecasting. 2007;23(3):347–64.CrossRef
40.
go back to reference Peters J, et al. Using healthy defaults in Walt Disney world restaurants to improve nutritional choices. J Assoc Consum Res. 2016;1(1):92–103.CrossRef Peters J, et al. Using healthy defaults in Walt Disney world restaurants to improve nutritional choices. J Assoc Consum Res. 2016;1(1):92–103.CrossRef
41.
go back to reference Anzman-Frasca S, et al. Healthier children’s meals in restaurants: an exploratory study to inform approaches that are acceptable across stakeholders. J Nutr Educ Behav. 2017;49(4):285–295.e1.CrossRefPubMed Anzman-Frasca S, et al. Healthier children’s meals in restaurants: an exploratory study to inform approaches that are acceptable across stakeholders. J Nutr Educ Behav. 2017;49(4):285–295.e1.CrossRefPubMed
42.
go back to reference Laurent J, et al. A measure of positive and negative affect for children: scale development and preliminary validation. Psychol Assess. 1999;11(3):326–38.CrossRef Laurent J, et al. A measure of positive and negative affect for children: scale development and preliminary validation. Psychol Assess. 1999;11(3):326–38.CrossRef
43.
go back to reference Holder MD, Klassen A. Temperament and happiness in children. J Happiness Stud. 2010;11(4):419–39.CrossRef Holder MD, Klassen A. Temperament and happiness in children. J Happiness Stud. 2010;11(4):419–39.CrossRef
Metadata
Title
Child and parent perspectives on healthier side dishes and beverages in restaurant kids’ meals: results from a national survey in the United States
Authors
Eleanor T. Shonkoff
Stephanie Anzman-Frasca
Vanessa M. Lynskey
Grace Chan
Meaghan E. Glenn
Christina D. Economos
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4610-3

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