Lack of Healthy Food Options on Children’s Menus of Restaurants in the Health-Disparate Dan River Region of Virginia and North Carolina, 2013

Abstract

IntroductionInterest has increased in understanding the types and healthfulness of restaurant foods for children, particularly in disadvantaged areas. The purpose of this community-based participatory research study was to describe the quality of restaurant food offered to children in a health-disparate region in Virginia and North Carolina and to determine if the availability of healthy foods differed by location (rural, urban) or by the predominant race (black, white, mixed race) of an area’s population.MethodsRestaurants offering a children’s menu in the 3 counties in Virginia and North Carolina that make up the Dan River Region were identified by using state health department records. Research assistants reviewed menus using the Children’s Menu Assessment (CMA), a tool consisting of 29 scored items (possible score range, −4 to 21). Scores were calculated for each restaurant. We obtained information on the predominant race of the population at the block group level for all counties from 2010 US Census data.ResultsFor the 137 restaurants studied, mean CMA scores were low (mean, 1.6; standard deviation [SD], 2.7), ranging from −4 to 9 of 21 possible points. Scores were lowest for restaurants in the predominantly black block groups (mean, 0.2; SD, 0.4) and significantly different from the scores for restaurants in the predominantly white (mean, 1.4; SD, 1.6) and mixed-race block groups (mean, 2.6; SD, 2.4) (F = 4.3; P < .05).ConclusionChildren’s menus available in the Dan River Region lack healthy food options, particularly in predominantly black block groups. These study findings can contribute to regional efforts in policy development or environmental interventions for children’s food quality by the community-based participatory research partnership and help local stakeholders to determine possible strategies and solutions for improving local food options for children.

A comparative analysis of the restaurant consumer food environment in Rochester (NY, USA) and London (ON, Canada): assessing children’s menus by neighbourhood socio-economic characteristics

“…To our knowledge, the present study is the first to investigate the children's restaurant FE in two cities on either side of the Canada-US border, and the first to develop and implement an index for neighbourhood restaurant quality in children (NRQI-C). Several studies have employed the CMA in various settings to examine the restaurant FE for children (11,22,(38)(39)(40)(41)(42)(43) , but virtually none go beyond descriptive results to analyse the relationship between FE and neighbourhood socio-economic characteristics. An exception is Hill et al (38) , who explored how children's menu scores differ in urban and rural areas, as well as by block group race/ethnicity.…”

Association between home and school food environments and dietary patterns among 9–11-year-old children in 12 countries

“…28 These findings are not surprising, as foods marketed to children at restaurants are often high in energy density and low in micronutrient density. 29 It would be important to develop healthier eating-out alternatives for children and adolescents, but to combine health and attractiveness is obviously a great challenge. We did not find any associations between school lunch availability and dietary patterns.…”

Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006–2017

“…Nine studies [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] revealed that between one and 13 percent of meals sold to children, adolescent and their parents met healthy criteria recommended by authoritative bodies. Kirkpatrick et al [ 53 ] ( n = 5 QSR chains) found that in 2006 children’s menu items scored higher than adult items, and those labeled “healthy or nutritious” had a higher HEI-2005 score than the full-menu items.…”

“…Krukowski et al [ 58 ] ( n = 130 local QSR chains and non-chains) found that only 13 percent of children′s menus provided healthy options between 2009 and 2010. Between 2012 and 2013, three studies [ 59 , 60 , 61 ] revealed that between one and 11 percent of children’s meals met recommended nutrition criteria.…”