Healthy menu items for kids are a hit, research finds

BUFFALO, N.Y. – Imagine a kids’ menu with no French fries or soda that offers healthy entrees with side dishes like salads and strawberries.  

This is the type of menu that Silver Diner, an East coast restaurant chain, introduced to encourage healthier eating among their youngest patrons in 2012. It’s also the kind of change that more restaurants may try starting in 2017, after the Affordable Care Act requires calorie counts on menus.

The restaurant and researchers who studied it found that the new, healthy children’s menu was a success. After its introduction, orders of healthier children’s items increased.  

And according to new research published Nov. 2, 2015 in Health Affairs, more than two years after the healthier menu was introduced, three-quarters of children’s meal orders included a healthy side dish, and three-quarters included a healthy beverage, demonstrating that the spike in healthier ordering patterns seen just after the introduction of the healthy menu had been sustained long-term.

“The data suggest that this menu was working for families,” says Stephanie Anzman-Frasca, PhD, assistant professor in the Department of Pediatrics in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo and first author on the paper.

Anzman-Frasca, who became a UB faculty member this fall, conducted the research while a post-doctoral research associate at ChildObesity180 in the Friedman School of Nutrition Science and Policy at Tufts University.

According to the new study, orders of French fries made up less than a quarter of side dishes ordered with children’s meals, and soda only comprised a third of children’s beverages ordered.

The researchers note that this finding is not only gratifying for parents and public health policymakers, but also for restaurant owners concerned about how such changes would affect revenue.

 “Our findings say to restaurants that this is something they might want to try,” explains Anzman-Frasca. “They show parents that many kids will accept healthier foods in restaurants. Research has shown that repeated exposure to healthy foods will increase the likelihood of children eventually accepting them, and healthier kids’ menus are another way to get kids exposed to these foods.”

The foods selected for the menu were determined to be healthy according to nutrition standards from the National Restaurant Association’s Kids LiveWell Program.

One of the important aspects of this children’s menu, she points out, is that it completely eliminated any mention of French fries or soda. Instead, the healthier options automatically came with the children’s meals.

That’s important, Anzman-Frasca said, because other studies have repeatedly shown that people who are faced with a choice tend to pick the default option – in a restaurant setting that might be something like a hamburger being automatically bundled with a fried side dish and a sweet drink, with the defaults traditionally being less-healthy options.

“But on this menu, those options weren’t there,” she said. The restaurant would provide them if diners asked, but they weren’t listed on the menu.

She notes that whereas twenty or thirty years ago, families may have dined out mostly for a special occasion, today, it is estimated that one-third of all children are eating fast food on a daily basis.

As a researcher in the Behavioral Medicine Division in the Department of Pediatrics in the Jacobs School of Medicine and Biomedical Sciences, Anzman-Frasca will continue her research on what aspects of menus might be most effective in getting children to try healthier options. Her work at UB will involve laboratory-based research as well as, in the future, collaborations with the Buffalo community, including local restaurants.

Co-authors with Anzman-Frasca on the Health Affairs publication are Christina D. Economos, director of ChildObesity180 and associate professor in the Friedman School of Nutrition Science and Policy, Tufts University; Linda Harelick, director of operations and communications at ChildObesity 180; Vanessa M. Lynskey, program manager at ChildObesity 180 and Megan P. Mueller, a doctoral candidate in the Friedman School of Nutrition Science and Policy, Tufts University.

The research was funded by the Robert Wood Johnson Foundation and The JPB Foundation.