Can a Healthy Food Ordinance Improve Child Nutrition?

Abstract

Research Article| October 01 2014 Can a Healthy Food Ordinance Improve Child Nutrition? AAP Grand Rounds (2014) 32 (4): 37. https://doi.org/10.1542/gr.32-4-37 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Can a Healthy Food Ordinance Improve Child Nutrition?. AAP Grand Rounds October 2014; 32 (4): 37. https://doi.org/10.1542/gr.32-4-37 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: child nutrition, food, calories, restaurants, science of nutrition Source: Otten J, Saelens B, Kapphahn K, et al. Impact of San Francisco’s toy ordinance on restaurants and children’s food purchases, 2011–2012. Prev Chron Dis. 2014; 11: 140026; doi: https://doi.org/10.5888/pcd11.140026Google Scholar Researchers from multiple institutions conducted a study to assess the impact of legislation in San Francisco banning restaurants from including “free” toys in children’s meals that did not meet nutritional standards. The ordinance was enacted on December 1, 2011. For the study, adult/child (aged 0–12 years) dyads exiting 1 of 2 major fast-food-chain restaurants in the San Francisco area were surveyed. Three separate surveys were completed. The timing of the surveys coincided with the enactment of the citywide ordinance. Investigators conducted “pre-ordinance” surveys of restaurant customers during the period January–March 2011 and again during October–November 2011. A “post-enactment” survey was conducted January–March 2012. Surveys addressed meal purchasing priorities, habits and preferences relating to children’s meals and toys, awareness of the toy ordinance and calorie labels, foods and beverages ordered, and demographic/anthropometric data. Data calculated on ordered items included calories, total fat, saturated fat, trans fat, sodium, sugar, fiber, and protein. Outcomes of interest were differences across time in mean calorie content per purchase for all children, and for those ordering only children’s meals over the time period that surveys were conducted. In addition, changes in the nutritional content of children’s meals made by the restaurant chains over the study period were tracked. Data were analyzed on surveys completed by 762 dyads during the 3 survey periods. Both restaurant chains chose to comply with the ordinance by offering toys with the children’s meals for an extra $0.10 (which was not prohibited by the explicit language in the legislation). In the post-enactment survey, 88% of those surveyed purchased the toy. Investigators found that no child’s meal at either restaurant met the ordinance’s nutritional requirements during the study period. Both restaurant chains independently implemented positive nutritional changes in the children’s meals between the first and second survey periods. Although no changes in calories for all children’s orders over time were detected, calories in children’s meals did decrease across the study period (P < .001), likely due to changes in side dishes and beverages. Awareness of the toy ordinance among parents was highest immediately following its passage (45.2%), falling to 29.4% and finally 17.7% post-ordinance. The authors conclude that although the changes in nutritional content of children’s meals were not directly related to the legislation, they were consistent with the intent of the ordinance. Dr Springer has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. The CDC estimates that the proportion of children aged 6–11 years in the United States who are obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who are obese increased from 5% to nearly 21% over the same period.1,2 In... You do not currently have access to this content.