Abstract
BackgroundRestaurants are ideal settings for implementing food interventions targeted at children. Studies with adults suggest that changes to the physical menu can lead to healthier food choices; online studies with parents indicate that specific menu designs facilitate healthier choices. However, it is unknown whether applying well-established nudging and boosting methods to children’s menus also increases their choice of healthier meals in a real-world restaurant setting.MethodsThe effects of two versions of a restaurant menu on the frequency of choosing a healthy meal (newly created, healthy target dish) were tested in a blinded quasi-randomized controlled trial. The menu in the control condition contained all dishes (including the healthy target dish) in a standardized format. The intervention menu included nudging (e.g. comic character, fun attractive name for the dish) and boosting elements (e.g. information on low calorie density) next to the healthy target dish. Over five months, the control and intervention menus were switched every two weeks and records were made of how often the healthy target dish was ordered.ResultsIn total, 607 orders were made from the children’s restaurant menu (57% from the intervention menu). During the intervention phase, 4.2% of all ordered dishes from the children’s menu were the healthy target dish, during the control phase, 4.4% of orders were for the target dish (p=.896).ConclusionsContrary to our hypothesis, a modified children’s menu did not lead to a significant increase in the number of orders for a healthy dish compared with a neutral control menu. Importantly, given that parents and children often choose the child’s dish together, particularly boosting methods that focus on social processes and joint decision making could be promising to increase children’s frequency of healthy food choices in restaurants.Trial registrationDRKS00027039, registered on 11/22/2021, (Retrospectively registered).
Highlights
Restaurants are ideal settings for implementing food interventions targeted at children
Throughout the study period, a total of 607 orders were made from the children’s menu, of which, 585 were made during the experiment phase
A children’s menu that had been modified to include boosting and various well-established nudging and elements did not lead to a significant increase in the number of orders for the intervention dish compared with a neutral control menu
Summary
Restaurants are ideal settings for implementing food interventions targeted at children. Studies with adults suggest that changes to the physical menu can lead to healthier food choices; online studies with parents indicate that specific menu designs facilitate healthier choices. It is unknown whether applying well-established nudging and boosting methods to children’s menus increases their choice of healthier meals in a real-world restaurant setting. [2], that is, environmental factors that promote obesity through inactivity and unbalanced nutrition. In this context, targeting children’s food environments is an innovative and promising field of prevention [3]. Children’s menus in restaurants could serve as an innovative and potentially significant approach for improving children’s food environments [4, 5]
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