Fast Food Menus with Calorie Information Lead to Lower Calorie Selections

Pooja Tandon, MD, of the University of Washington, and colleagues reported online in Pediatrics, in a small waiting room study, parents ordered about 20% fewer calories for their kids when they chose from a menu with nutrition information on it.

Many fast-food restaurants don't provide nutrition information at the point of purchase. In a recent study, just about half (54%) of the largest chains made some nutritional information available on site. The majority (86%) provided it only through their websites, leaving consumers clueless while ordering.

Labels have long been advocated as a means of lowering calorie consumption. So to determine whether nutrition labeling specifically on fast-food menus would lead to lower-calorie choices for children, the researchers conducted a randomized, controlled experiment in a primary care pediatric clinic in Seattle.

Parents of children ages 3 to 6 were given a McDonald's menu, and then asked to pick out meals anonymouslyfor themselves and their child. The menus were identical, with one exception: those given to parents in the intervention group included nutrition information, while the menus given to parents in the control group had none. The menus did include prices for both groups.

A total of 99 parents participated between October 2008 and January 2009. Some 62% reported eating fast food one to four times over the previous month, mostly because it was quick, cheap, or fun. The researchers found that parents who were given nutritional information ordered an average of 102 fewer calories for their kids than did controls (567.1 cal versus 671.5 cal, P=0.04).

On average, the nutrition-labeled menu reduced total calories ordered by 20%, the researchers wrote.

Research has suggested that even small changes in behavior that affect energy balance by about 100 calories per day could avert weight gain in most adults.

Interestingly, Tandon said, there were no differences between the groups when it came to parents' choices for themselves. Both ordered about the same number of calories.

"I'm not sure exactly what's going on with this group of parents, but this is a trend we've seen," Tandon said. "I would hypothesize that there are some other factors at play when people are choosing for themselves and their children in terms of wanting children to eat healthier than they might for themselves."

There was also a positive correlation between how many calories the parent ordered and how many calories he or she ordered for the child (P=0.02).

"We do know that if a child has one or two parents who are overweight, that increases their chance of being overweight, so [obesity] probably is a combination of genetic and environmental factors," Tandon said.

Tandon noted that a growing number of local and state governments have adopted restaurant menu labeling regulations, and legislation for federal labeling standards has been introduced in both the House and the Senate.

"At a time when menu labeling is being discussed throughout the country at the national level, I think these results support theidea that an informed parent will be able to make smarter healthier choices for their child," she added.