Changing the children's menu default: A Best Food for Families, Infants, and Toddlers (Best Food FITS) community intervention

Abstract

Children in San Marcos, TX, are disproportionately overweight. 50% of 8th graders have a body mass index (BMI) ≥ the 85th percentile, compared to 39% of 8th graders in Texas and 31.7% of children in the US. Improving children's menus may help combat excess weight gain. We obtained all children's menus in San Marcos restaurants and invited owners to improve menus in collaboration with Best Food for Families, Infants, and Toddlers, a community organization dedicated to combatting child obesity. 85/135 restaurants had children's menus. We characterized menu items in beverage, dessert, entree, and side categories. 80/85 (94%) offered sugar‐sweetened beverages (SSBs), 26/85 (31%) offered fruit and 60/85 (71%) offered vegetable sides (including French fries). 78/85 (92%) offered at least one high‐energy dense (HED) entree, and 70/85 (82%) offered ≥ 2. While 24/85 agreed to (1) add more fruits/vegetables, (2) replace SSBs, and (3) replace HED entrees, only 11 complied. However, 6 restaurants with no previous menu added one. All 17 new menus reduced/removed HED entrees, offered no SSBs or French fries, and included at least 1 fruit or vegetable. Incentives included free ads and promotional items. Barriers were concerns about profits/cost, and perceptions that restaurant foods are not obesogenic. This study met all Institutional Review Board guidelines and was funded by the Texas Department of State Health Services.