Comparison of Children's Menu Items at Full- and Quick-Service Restaurants.

OBJECTIVES: The proportion of food consumed by children from restaurants tripled during the last 4 decades and that coincided with the increased rate of obesity. Despite the presence of data linking quick-service (QS) food consumption to poor diet quality, studies comparing the nutrition content of the children's menu items at QS restaurants (QSRs) with those at full-service restaurants (FSRs) are limited. The objectives of this study were to examine the nutrition content of common children's menu items at both QSRs and FSRs and compare these data with recommendations reported by the Dietary Guidelines for Americans 2015-2020, Eighth Edition. METHODS: Using the 2014 data of the MenuStat project, 10 food items that are on both QSR and FSR children's menus were selected. Data from each restaurant category were aggregated and the overall average of the nutritional content of each individual food item was calculated and compared between the two restaurant categories. RESULTS: The average of calories, fat, carbohydrates, and added sugar of most items on the children's menu of QSRs are lower than those of FSRs. Also, most food items on children's menus of FSRs, and to a lesser extent those of QSRs, exceeded the national recommended calories and fat content per meal. CONCLUSIONS: Although some children's menu items of QSRs have less fat and fewer calories compared with those of FSRs, most menu items in both FSRs and QSRs do not meet national dietary recommendations. Healthcare professionals may expand discussions with patients to include both restaurant categories when counseling them and their families on obesity prevention. Also, educating children and families about reading the nutritional content information of children's menu items when eating out to make an informed choice can be a tool in fighting childhood obesity.

Impact of a Pilot School-Based Nutrition Intervention on Fruit and Vegetable Waste at School Lunches.

OBJECTIVE: To determine the preliminary impact of the Brighter Bites nutrition intervention on decreasing fruit and vegetable (F&V) waste at school lunches among fourth- and fifth-grade children. METHOD: This was a nonrandomized pre-post-controlled study in Houston and Dallas, TX. Two schools received the Brighter Bites intervention (n = 76), and 1 comparison school (n = 39), during the 2017-2018 school year. Brighter Bites is a 16-week school-based nutrition intervention providing weekly distribution of fresh F&V plus nutrition education. Main outcome measures were direct observation and weights to measure the number of F&V dishes selected at school lunches, amount of F&V wasted (gm), and related nutrient waste (4 time points/child). Mixed-effects linear regression analysis was used to determine change in F&V selection and waste over time. RESULTS: There was a significant decrease over time in proportion of F&V selected among those in the comparison school, but not the intervention schools (P < .001). Compared with children in the comparison group, those receiving Brighter Bites showed a significant decrease in the amount of F&V wasted at each meal (P < .001) and per item (P < .05) at the end of both 8 and 16 weeks of intervention. There were significant decreases in waste of energy (kcal); dietary fiber (gm); vitamins B1, B3, and B6 (mg); total folate (µg); and B12 (µg) among those receiving Brighter Bites (P < .05). CONCLUSIONS AND IMPLICATIONS: Although absolute food or nutrient changes were small even when significant, programs such as Brighter Bites may contribute to a healthy intake. Future studies are warranted that include a larger sample size with a stringent, cluster-randomized control trial design and consideration for other covariates.