Healthy menu items for kids a hit, UB research finds

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 in 2012 to encourage healthier eating among its youngest patrons. 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 the new, healthy children’s menu found that it was a success. After its introduction, orders of healthier children’s items increased.  

And according to new research published Nov. 2 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 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, assistant professor in the Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, and first author on the paper.

Anzman-Frasca, who joined the UB faculty this fall, conducted the research while a postdoctoral 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,” Anzman-Frasca explains. “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 says, 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 says. The restaurant would provide them if diners asked, but they weren’t listed on the menu.

She notes that whereas 20 or 30 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, Anzman-Frasca will continue her work 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 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 at Tufts; 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 at Tufts.

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