Adherence
Implementing healthful default options for children's meals (e.g., fruit/vegetables instead of fries, fat-free milk instead of low-fat) significantly reduces the caloric, fat, and sodium content of orders, even when the policy does not strictly enforce menu changes.
When ordering for children, look for restaurants that have made 'healthy' the default option (e.g., apples instead of fries, water instead of soda). You often do not need to actively request these changes; simply accepting the standard meal will likely result in lower calorie and sodium intake compared to chains where unhealthy items are the default.
We found a significant decrease in calories per order for children purchasing children’s meals... This decrease appeared to result from menu changes at Chain A from a less healthful to a more healthful default side dish. Additionally, because of the more healthful default side dish and the substitution of a fat-free beverage for a low-fat beverage, we found a significant decrease in total fat and sodium over time in children’s-meal–only orders.
Why this rating
Quasi-experimental pre-post design with large sample size (n=762 dyads) and objective nutritional analysis, though limited to two chains and one city.
Source
Impact of San Francisco’s Toy Ordinance on Restaurants and Children’s Food Purchases, 2011–2012
Jennifer J. Otten et al. · Preventing Chronic Disease · 2014
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