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Do American children use calorie information at fast food or chain restaurants?

By Dr. Holly Wethington

Federal law in the United States requires restaurants with at least 20 locations nationally to list calorie information next to menu items on menus or menu boards. This law includes the prominent placement of a statement concerning suggested daily caloric intake on the menu. While national menu labeling has not been implemented, some fast food and chain restaurants have begun to post this information voluntarily. Thus, we wanted to know if kids actually use calorie information when it is available and we wanted to know what sociodemographic and behavioral characteristics were associated with using this information.

How was the study conducted?

American youth 9-18 years old were asked in an online survey whether they used calorie information when ordering at fast food or chain restaurants and how frequently they visited a fast food or chain restaurant each week. Youth were also asked to report their height and weight from which we calculated weight status (e.g. healthy weight and obesity). The youth’s parents were questioned in a similar survey to see if their race/ethnicity, household income, marital status, and geographical region of residence were associated with youth’s use of calorie information. The study included 721 kids and excluded those who said that they never eat at fast food or chain restaurants (about 8%) and those who said they never noticed calorie information (about 20%).

What were the findings of this study?

We found that of kids who visited fast food or chain restaurants, over 40% reported using calorie information at least sometimes, when it was available. We also found that girls were more likely than boys and youth who were obese were more likely than those of a healthy weight to use calorie information. We also found that youth who eat at a fast food or chain restaurant twice a week or more were about half as likely to report using calorie compared to kids who go once a week or less. This adds to other information about kid’s eating habits.

Why are these findings important for healthy weight in youth?

Our findings are important given the prevalence of obesity among youth and the adverse health effects associated with obesity. We are encouraged that a large number of youth, particularly those who are obese, are using the calorie information to inform their ordering selections. This finding implies that calorie labeling on menus and menu boards may potentially to lead to improved food choices as a way for obese youth to manage weight. More research is needed to assess whether youth know how many calories they should consume in a day given their activity level. Further research is also needed to understand the differences in motivation to use calorie labeling between boys and girls. Public health practitioners, school nutrition services, retailers, and other interested groups can implement education programs in various venues to assist development of this understanding as a way to improve health literacy.

Holly Wethington, PhD, is a Behavioral Scientist in the Division of Nutrition, Physical Activity, and Obesity at the U.S. Centers for Disease Control and Prevention. Her work focuses on evaluating public health interventions and researching health behaviors related to obesity. She is the author of the article, “Use of calorie information at fast food and chain restaurants among US youth aged 9–18 years, 2010” which is available to read for free for a limited time.

The Journal of Public Health invites submission of papers on any aspect of public health research and practice. We welcome papers on the theory and practice of the whole spectrum of public health across the domains of health improvement, health protection and service improvement, with a particular focus on the translation of science into action. Papers on the role of public health ethics and law are welcome.

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Image credit: Image courtesy of the Center for Disease Control via thinkstock.com.

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