How Many Calories in that Kids Meal?

Jan. 25, 2010— -- Putting nutrition labels on fast food may lead parents to pick lower-calorie meals for their children, researchers say.

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

"One hundred calories over time and at a population level is actually a significant amount in terms of being able to avert weight gain," Tandon told MedPage Today.

Many fast-food restaurants don't provide nutrition information at the point of purchase. In a recent study, just about half -- 54 percent -- of the largest chains made some nutritional information available on site.

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 for 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 percent 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 calories for those who saw calorie counts, compared to 671.5 calories for those who did not.

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

"We know that fast food consumption is rising alongside alarming rates of child obesity in this country," Tandon said. "These results make me optimistic that if parents are given nutritional information at the point of ordering -- and not on a Web site or tray liner -- they will have the tools to make healthier, lower-calorie choices for their children."

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."

Researchers also found that the more calories the parent ordered for themselves, the more calories he or she tended to order for the child.

"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 country at the national level, I think these results support the idea that an informed parent will be able to make smarter healthier choices for their child," he added.

The study was limited because it was not conducted in a real restaurant setting. Food choices are made within social and environmental contexts, Tandon said, and the results of a mock menu survey in a clinic may not fully represent that reality. He added that a randomized experiment in a real restaurant setting would be an ideal follow-up.