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Changes to kids' menu items could help curb childhood obesity

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Most kids' menu items offered by the nation's top 200 restaurant chains exceed the calorie counts recommended by nutrition experts, a new RAND Corporation study has found.

The findings highlight the importance of the upcoming rollout of calorie labeling on most restaurant menus, providing operators with an opportunity to reduce portion sizes so they are more appropriate to meet children's needs, according to researchers.

A panel convened to create guidelines for the calorie content of menus that cater to children's tastes found room for improvement. For example, a la carte items averaged 147% more calories than recommended by the expert panel.

The menu item that most often exceeded the calorie guidelines was fried potatoes. The study found that the average calorie count for the popular side dish was 287, nearly triple the recommended amount. McDonald's was the only chain in the study that served fried potatoes in the recommended 100-calorie portions. The findings are published online by the journal Nutrition Today.

"It's important to examine the caloric value of what kids are served because the chances are they will eat all or most of what they are served," said lead author Deborah Cohen, a senior natural scientist at RAND, a nonprofit research organization. "Overeating — consuming more calories than are needed for normal growth and maintenance — is a very common problem and a key contributing factor to childhood obesity."

A consensus of 15 child nutrition experts convened for the study recommended a maximum of 300 calories from main dishes for kids' meals. Other recommendations include 100 calories for a serving of fried potatoes, 150 calories for soups, appetizers and snacks and 150 calories for vegetables and salads that included added sauces and dressings. No recommended limit was made for vegetables and fruits that have no added oils or sauces. Kids' meals also should include no more than 110 calories of unflavored milk. The entire meal should not exceed 600 calories.

Using the expert guidelines, a burger or a serving of macaroni and cheese should have no more than 300 calories, but the study found that the average calorie content for those items in restaurants was 465 and 442, respectively.

What restaurants offer children is important because they eat out often. According to a study by the U.S. Centers for Disease Control and Prevention, on any given day 1 of 3 children and 41% of teenagers eat at fast-food outlets. The Economic Research Service of the U.S. Department of Agriculture reports that 50% of all food dollars are spent on meals away from home.

The study pointed out that appropriate calorie intake is challenging even when restaurants list the calorie counts for each menu item. Many adult consumers ignore or misunderstand the calorie information, and it is "unrealistic to expect that, if served too much, children younger than 12 years will be able to limit what they consume," the study said.

Furthermore, the average customer is ill-equipped to calculate how much of an oversized portion to leave behind or take home unless he or she has "a fluid knowledge of geometry" and brings a measuring cup or other tools, the study noted.

"The public may want to consider how they are at a disadvantage to prevent childhood obesity when so many food outlets serve foods in quantities that put their children at risk," Cohen said. "It is too difficult for children and their parents to limit consumption when they are served too much."

Cohen said the restaurant industry has an opportunity to embrace these calorie guidelines established by child nutrition experts by adjusting kids' menu offerings accordingly in support of promoting children's health and reducing childhood obesity. "Ultimately," she said, "this could mean good business for restaurants."

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