Abstract
BackgroundApproximately 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 ContextSan 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. MethodsThis 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.OutcomeBest 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.InterpretationImproving 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.
Highlights
32% of US children are overweight or obese
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions
Children and adolescents aged 2 to 18 obtain 34% of daily calories from food consumed outside the home, 18% of which comes from fast food and fullservice restaurants [3]
Summary
We chose 3 obesity-prevention focus areas identified by the Texas Nutrition, Physical Activity, and Obesity Prevention Program for the Best Foods FITS intervention: increasing intake of fruits and vegetables, decreasing intake of sugar-sweetened beverages, and decreasing intake of energy-dense foods [16]. Most respondents agreed that sugar-sweetened beverages were bad for health and agreed that restaurants should serve healthy foods and provide alternatives to sugar-sweetened beverages This community intervention provides insight into how to engage restaurant owners and managers to voluntarily change their menus. Best Food FITS developed a work-around by requiring that sugar-sweetened beverages not appear on children’s menus at participating restaurants www.cdc.gov/pcd/issues/2014/14_0361.htm Centers for Disease Control and Prevention 5. Despite a few challenges, including the absence of a city restaurant association to serve as a point of contact, 24% of nonchain restaurant owners and managers proved to be valuable partners in improving their children’s menus Their participation demonstrated concern for their community and for the children who live in it. Improving the usual menu options, such as including fruit and vegetable sides, can be an important step in changing restaurant norms and in building a less obesogenic community for children [5]
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