Restaurant placemats can help promote healthy eating among children

Placemats can be used to encourage children to eat healthier food in restaurants, according to a new study by UB and the Independent Health Foundation.

Researchers used the dining accessory, known mostly for quirky games and local business advertisements, as a tool to promote healthier menu options in fun and engaging ways.

While hot dogs and chicken tenders remained the meal of choice for most of the 4 to 8 year olds who participated in the study, the placemats helped convince some children to choose healthier options, such as turkey on whole wheat bread (Gobble-Me-Up Turkey Sandwich) or a peanut butter and banana sandwich (The Nutty Monkey). Children exposed to the placemats prior to ordering were more likely to choose healthier food options compared to a control group.

“Many families eat food from restaurants on a regular basis, with research suggesting that children tend to consume less healthy foods in these settings compared to home,” says the study’s lead author Stephanie Anzman-Frasca. “In this study, our goal was to feature healthier children’s meal options prominently to see whether this could affect children’s orders and intake.”

Anzman-Frasca, assistant professor in the Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, presented the findings this week at the Society for the Study of Ingestive Behavior conference in Montreal.

Anzman-Frasca and fellow researchers recruited 58 children — and their parents — within one location of Anderson’s Frozen Custard, a quick-service restaurant chain in the Buffalo Niagara region, in the fall of 2016. Families were each given a voucher to return to the restaurant once during a randomly assigned two-week period. Upon returning to the restaurant, half of the children were given a placemat promoting two healthier children’s meals as “Meals of the Day.” The meals were listed alongside fun names and images, as well as activities such as a word search. The rest of the children were in a control group and received no placemats.

Children who were exposed to the placemats before ordering were significantly more likely to order healthier food options. Eighteen percent of the children in the placemat group ordered one of the featured healthier entrées, compared to 7 percent in the control group.

The groups did not differ in the likelihood of ordering dessert or healthier beverages.

Children who ordered the healthier entrées consumed less saturated fat across the total meal compared to those who did not.

“These results suggest that restaurants can help promote healthier eating among children by featuring healthier items more prominently on materials that are viewed prior to ordering,” Anzman-Frasca says. “Making healthy options appealing and easy to choose offers the potential to increase children’s acceptance of them in restaurants. At the same time, there is room for future efforts to build on the current results, aiming to normalize healthy options in restaurants further and nudge even more children toward healthier choices.”

Co-authors of the study from UB are Abbey Braun, Sarah Ehrenberg, Lucia Leone, Anita Singh, Sara Tauriello and Leonard Epstein; April Gampp is a co-author from Independent Health Foundation.