Nutr Res Pract.  2018 Jun;12(3):243-250. 10.4162/nrp.2018.12.3.243.

Parents' meal choices for their children at fast food and family restaurants with different menu labeling presentations

• Lee K
• Lee Y

• KMID: 2442298
• DOI: http://doi.org/10.4162/nrp.2018.12.3.243

Abstract

BACKGROUND/OBJECTIVES
This study examined the effect of nutrition labeling formats on parents' food choices for their children at different restaurant types.
SUBJECTS/METHODS
An online survey was conducted with 1,980 parents of children aged 3-12 years. Participants were randomly assigned to fast food or family restaurant scenarios, and one of four menu stimuli conditions: no labeling, low-calorie symbol (symbol), numeric value (numeric), and both low-calorie symbol and numeric value (symbol + numeric). Participants selected menu items for their children. Menu choices and total calories were compared by nutrition labeling formats in each type of the restaurant.
RESULTS
Low-calorie item selections were scored and a two-way analysis of variance (ANOVA) was conducted for an interaction effect between restaurant and labeling type. In the fast food restaurant group, parents presented with low-calorie symbols selected the lowest calorie items more often than those not presented with the format. Parents in the symbol + numeric condition selected significantly fewer calories (653 kcal) than those in the no labeling (677 kcal) or numeric conditions (674 kcal) (P = 0.006). In the family restaurant group, no significant difference were observed among different labeling conditions. A significant interaction between restaurant and labeling type on low-calorie selection score (F = 6.03, P < 0.01) suggests that the effect of nutrition labeling format interplays with restaurant type to jointly affect parents' food choices for their children.
CONCLUSIONS
The provision of easily interpretable nutritional information format at fast food restaurants may encourage healthier food choices of parents for their children; however, the effects were negligible at family restaurants.

Keyword

Nutrition labeling; labeling formats; food choice; fast food restaurant; family restaurant

MeSH Terms

Child*
Fast Foods*
Food Labeling
Humans
Meals*
Parents
Restaurants*

Figure

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  Fig. 1 Low calorie selection scores

Reference

1. Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. JAMA Pediatr. 2013; 167:14–20.

2. Mancino L, Todd JE, Guthrie J, Lin BH. Food away from home and childhood obesity. Curr Obes Rep. 2014; 3:459–469.

3. Altman M, Holland JC, Lundeen D, Kolko RP, Stein RI, Saelens BE, Welch R, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Reduction in food away from home is associated with improved child relative weight and body composition outcomes and this relation is mediated by changes in diet quality. J Acad Nutr Diet. 2015; 115:1400–1407.

4. Seguin RA, Aggarwal A, Vermeylen F, Drewnowski A. Consumption frequency of foods away from home linked with higher body mass index and lower fruit and vegetable intake among adults: a cross-sectional study. J Environ Public Health. 2016; 2016:3074241.

5. Bhutani S, Schoeller DA, Walsh MC, McWilliams C. Frequency of eating out at both fast-food and sit-down restaurants was associated with high body mass index in non-large metropolitan communities in midwest. Am J Health Promot. 2018; 32:75–83.

6. Ministry of Food and Drug Safety (KR). The special act on safety management of children's dietary life of food and drug safety [Internet]. Cheongju: Ministry of Food and Drug Safety;2014. cited 2017 November 27. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=154149&efYd=20140521#AJ.

7. Yang JH, Heo YR. Perception of university students on nutrition information according to food & nutrition labeling systems in family restaurant. J Korean Soc Food Sci Nutr. 2013; 42:2068–2075.

8. Ham S, Jeong JY, Kim YS. Relationships among customer attitudes, behavioral intention and health-consciousness toward menu labeling in restaurants. J Tourism Leis Res. 2016; 28:365–384.

9. Lee JH. Structural relationship among consumer attitude, usage motive, health-consciousness, satisfaction, and revisit intent pursuant to foodservice nutrition information labeling system. Culin Sci Hosp Res. 2017; 23:129–139.

10. Roberto CA, Larsen PD, Agnew H, Baik J, Brownell KD. Evaluating the impact of menu labeling on food choices and intake. Am J Public Health. 2010; 100:312–318.

11. Tandon PS, Wright J, Zhou C, Rogers CB, Christakis DA. Nutrition menu labeling may lead to lower-calorie restaurant meal choices for children. Pediatrics. 2010; 125:244–248.

12. Wisdom J, Downs JS, Loewenstein G. Promoting healthy choices: information versus convenience. Am Econ J Appl Econ. 2010; 2:164–178.

13. Auchincloss AH, Mallya GG, Leonberg BL, Ricchezza A, Glanz K, Schwarz DF. Customer responses to mandatory menu labeling at full-service restaurants. Am J Prev Med. 2013; 45:710–719.

14. Elbel B, Kersh R, Brescoll VL, Dixon LB. Calorie labeling and food choices: a first look at the effects on low-income people in New York City. Health Aff (Millwood). 2009; 28:w1110–w1121.

15. Dumanovsky T, Huang CY, Nonas CA, Matte TD, Bassett MT, Silver LD. Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys. BMJ. 2011; 343:d4464.

16. Tandon PS, Zhou C, Chan NL, Lozano P, Couch SC, Glanz K, Krieger J, Saelens BE. The impact of menu labeling on fast-food purchases for children and parents. Am J Prev Med. 2011; 41:434–438.

17. Elbel B, Mijanovich T, Dixon LB, Abrams C, Weitzman B, Kersh R, Auchincloss AH, Ogedegbe G. Calorie labeling, fast food purchasing and restaurant visits. Obesity (Silver Spring). 2013; 21:2172–2179.

18. Downs JS, Wisdom J, Wansink B, Loewenstein G. Supplementing menu labeling with calorie recommendations to test for facilitation effects. Am J Public Health. 2013; 103:1604–1609.

19. Kiszko KM, Martinez OD, Abrams C, Elbel B. The influence of calorie labeling on food orders and consumption: a review of the literature. J Community Health. 2014; 39:1248–1269.

20. Long MW, Tobias DK, Cradock AL, Batchelder H, Gortmaker SL. Systematic review and meta-analysis of the impact of restaurant menu calorie labeling. Am J Public Health. 2015; 105:e11–e24.

21. VanEpps EM, Roberto CA, Park S, Economos CD, Bleich SN. Restaurant menu labeling policy: Review of evidence and controversies. Curr Obes Rep. 2016; 5:72–80.

22. Arora R, Singer J. Cognitive and affective service marketing strategies for fine dining restaurant managers. J Small Bus Strategy. 2006; 17:51–61.

23. Maclnnis DJ, Jaworski BJ. Information processing from advertisements: toward an integrative framework. J Mark. 1989; 53:1–23.

24. Burton S, Creyer EH, Kees J, Huggins K. Attacking the obesity epidemic: the potential health benefits of providing nutrition information in restaurants. Am J Public Health. 2006; 96:1669–1675.

25. Chandon P, Wansink B. The biasing health halos of fast-food restaurant health claims: lower calorie estimates and higher side-dish consumption intentions. J Consum Res. 2007; 34:301–314.

26. Wei W, Miao L. Effects of calorie information disclosure on consumers' food choices at restaurants. Int J Hosp Manag. 2013; 33:106–117.

27. Liu PJ, Roberto CA, Liu LJ, Brownell KD. A test of different menu labeling presentations. Appetite. 2012; 59:770–777.

28. Holmes AS, Serrano EL, Machin JE, Duetsch T, Davis GC. Effect of different children's menu labeling designs on family purchases. Appetite. 2013; 62:198–202.

29. Morley B, Scully M, Martin J, Niven P, Dixon H, Wakefield M. What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study. Appetite. 2013; 67:8–15.

30. Ventura AK, Birch LL. Does parenting affect children's eating and weight status? Int J Behav Nutr Phys Act. 2008; 5:15.

31. Castro IA, Williams CB, Madanat H, Pickrel J, Jun HJ, Zive M, Gahagan S, Ayala GX. Food ordering for children in restaurants: multiple sources of influence on decision making. Public Health Nutr. 2016; 19:2404–2409.

32. Bobrow DG, Norman DA. Some principles of memory schemata. In : Bobrow DG, Collins AM, editors. Representation and Understanding: Studies in Cognitive Science. New York (NY): Academic Press;1975. p. 131–149.

33. Hoch SJ, Ha YW. Consumer learning: advertising and the ambiguity of product experience. J Consum Res. 1986; 13:221–233.

34. Seenivasan S, Thomas D. Negative consequences of nutrition information disclosure on consumption behavior in quick-casual restaurants. J Econ Psychol. 2016; 55:51–60.

35. Burton S, Howlett E, Tangari AH. Food for thought: how will the nutrition labeling of quick service restaurant menu items influence consumers' product evaluations, purchase intentions, and choices? J Retail. 2009; 85:258–273.

36. Elbel B. Consumer estimation of recommended and actual calories at fast food restaurants. Obesity (Silver Spring). 2011; 19:1971–1978.

37. Block JP, Condon SK, Kleinman K, Mullen J, Linakis S, Rifas-Shiman S, Gillman MW. Consumers' estimation of calorie content at fast food restaurants: cross sectional observational study. BMJ. 2013; 346:f2907.

38. Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev. 2008; 9:535–547.

39. Choe JS, Chun HK, Hwang DY, Nam HJ. Consumer perceptions of food-related hazards and correlates of degree of concerns about food. J Korean Soc Food Sci Nutr. 2005; 34:66–74.

40. Lee JY, Kim KD. A study on the perception of and concern for food safety among urban housewives. Korean J Food Preserv. 2009; 16:999–1007.

41. Hawley KL, Roberto CA, Bragg MA, Liu PJ, Schwartz MB, Brownell KD. The science on front-of-package food labels. Public Health Nutr. 2013; 16:430–439.

42. Ellison B, Lusk JL, Davis D. Looking at the label and beyond: the effects of calorie labels, health consciousness, and demographics on caloric intake in restaurants. Int J Behav Nutr Phys Act. 2013; 10:21.

43. Viera AJ, Antonelli R. Potential effect of physical activity calorie equivalent labeling on parent fast food decisions. Pediatrics. 2015; 135:e376–e382.

44. Sah JY, Yeo JS. Efficacy and accuracy of consumer responses for four different nutrition label formats. Consum Policy Educ Rev. 2014; 10:217–245.