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Improving children's menus in community restaurants: best food for families, infants, and toddlers (Best Food FITS) intervention, South Central Texas, 2010-2014.

Crixell SH, Friedman B, Fisher DT, Biediger-Friedman L - Prev Chronic Dis (2014)

Bottom Line: Improving menus in restaurants can be a simple step toward changing children's food habits.The approach taken in this case study can be adapted to other communities.Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

View Article: PubMed Central - PubMed

Affiliation: Professor, School of Family and Consumer Sciences, Nutrition and Foods, Texas State University, 601 University Drive, San Marcos, Texas 78666. Email: scrixell@txstate.edu.

ABSTRACT

Background: Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children's menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children's access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus.

Community context: San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos's population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level.

Methods: This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children's menus in local restaurants, administering owner-manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention.

Outcome: Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus.

Interpretation: Improving menus in restaurants can be a simple step toward changing children's food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

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Related in: MedlinePlus

Timeline for the Best Food for Families, Infants and Toddlers (Best Food FITS) Restaurant Intervention, San Marcos, Texas, 2010–2014. Excluded establishments were a) food stores, bars, bowling alleys and b) coffee shops and restaurants going out of business. In 2014, c) 2 Best Food FITS restaurants had gone out of business and 3 had withdrawn.
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Figure 2: Timeline for the Best Food for Families, Infants and Toddlers (Best Food FITS) Restaurant Intervention, San Marcos, Texas, 2010–2014. Excluded establishments were a) food stores, bars, bowling alleys and b) coffee shops and restaurants going out of business. In 2014, c) 2 Best Food FITS restaurants had gone out of business and 3 had withdrawn.

Mentions: In summer 2010, the city’s environmental health department provided a list of local establishments that served food. After eliminating food stores and restaurants that did not serve children, we visited the remaining 157 restaurants (or accessed fast food menus online) to collect available children’s menus. We then eliminated coffee shops and restaurants that were going out of business, yielding a final list of 135 restaurants, 85 of which had children’s menus (Figure 2). We asked the restaurant staff to clarify beverage and side options that were not clearly described, and 3 registered dietitians then classified menu items as follows: beverages as sugar-sweetened (eg, sodas, flavored milk, specialty drinks), nonnutritive (eg, diet sodas, unsweetened tea), or healthy (eg, milk, 100% juice); entrées as unhealthy (fried, cheesy, greasy, or fatty) or healthy, depending on content and preparation; and sides as unhealthy (fried, fatty, or starchy) or healthy vegetables, or as fruit. Desserts were classified as healthy if they were fruit; otherwise, they were classified as unhealthy (Table 1). Children’s menus were also scored using the Children’s Menu Assessment system, which scores 21 items, such as availability of healthy entrées, free refills on sugar-sweetened beverages, healthy fruit and vegetable offerings, and the practice of brand marketing on menus (17).


Improving children's menus in community restaurants: best food for families, infants, and toddlers (Best Food FITS) intervention, South Central Texas, 2010-2014.

Crixell SH, Friedman B, Fisher DT, Biediger-Friedman L - Prev Chronic Dis (2014)

Timeline for the Best Food for Families, Infants and Toddlers (Best Food FITS) Restaurant Intervention, San Marcos, Texas, 2010–2014. Excluded establishments were a) food stores, bars, bowling alleys and b) coffee shops and restaurants going out of business. In 2014, c) 2 Best Food FITS restaurants had gone out of business and 3 had withdrawn.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4279868&req=5

Figure 2: Timeline for the Best Food for Families, Infants and Toddlers (Best Food FITS) Restaurant Intervention, San Marcos, Texas, 2010–2014. Excluded establishments were a) food stores, bars, bowling alleys and b) coffee shops and restaurants going out of business. In 2014, c) 2 Best Food FITS restaurants had gone out of business and 3 had withdrawn.
Mentions: In summer 2010, the city’s environmental health department provided a list of local establishments that served food. After eliminating food stores and restaurants that did not serve children, we visited the remaining 157 restaurants (or accessed fast food menus online) to collect available children’s menus. We then eliminated coffee shops and restaurants that were going out of business, yielding a final list of 135 restaurants, 85 of which had children’s menus (Figure 2). We asked the restaurant staff to clarify beverage and side options that were not clearly described, and 3 registered dietitians then classified menu items as follows: beverages as sugar-sweetened (eg, sodas, flavored milk, specialty drinks), nonnutritive (eg, diet sodas, unsweetened tea), or healthy (eg, milk, 100% juice); entrées as unhealthy (fried, cheesy, greasy, or fatty) or healthy, depending on content and preparation; and sides as unhealthy (fried, fatty, or starchy) or healthy vegetables, or as fruit. Desserts were classified as healthy if they were fruit; otherwise, they were classified as unhealthy (Table 1). Children’s menus were also scored using the Children’s Menu Assessment system, which scores 21 items, such as availability of healthy entrées, free refills on sugar-sweetened beverages, healthy fruit and vegetable offerings, and the practice of brand marketing on menus (17).

Bottom Line: Improving menus in restaurants can be a simple step toward changing children's food habits.The approach taken in this case study can be adapted to other communities.Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

View Article: PubMed Central - PubMed

Affiliation: Professor, School of Family and Consumer Sciences, Nutrition and Foods, Texas State University, 601 University Drive, San Marcos, Texas 78666. Email: scrixell@txstate.edu.

ABSTRACT

Background: Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children's menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children's access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus.

Community context: San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos's population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level.

Methods: This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children's menus in local restaurants, administering owner-manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention.

Outcome: Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus.

Interpretation: Improving menus in restaurants can be a simple step toward changing children's food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

Show MeSH
Related in: MedlinePlus