Nutrition Menu Labeling May Lead to Lower-calorie Restaurant Meal Choices for Children

Objective: Our aim was to determine whether nutrition labeling on menus would lead to lower-calorie choices for children.

Methods: We performed a randomized, controlled experiment in a primary care pediatric clinic in Seattle, Washington. Parents of children 3 to 6 years of age presenting for an appointment were eligible. Parents were ineligible if they never ate fast food, if they were not English speaking, if their child was too sick, or if they had already participated. This was a convenience sample, with randomization performed in blocks of 6. Parents were presented with a McDonald's menu and were asked to select meals for themselves and their child. The menus were identical for both groups except for the presence of nutrition information for the intervention group.

Results: There were 99 participants, for a participation rate of 82%. There were no significant differences in demographic characteristics between the groups. Parents in the intervention arm ordered an average of 102 fewer calories for their children than did control subjects (567.1 cal vs 671.5 cal; P = .04). With adjustment for parent's gender, race, education, and BMI, fast food frequency, and child's BMI z score, the difference remained significant (P = .004). There was no difference in energy between the 2 groups in the parents' choices for themselves.

Conclusion: This study is the first to suggest that labeled menus may lead to significantly lower calorie content in restaurant meals purchased for children.