Posts Tagged ‘ fast food ’

Does Fruit on the Menu Make Fast Food Healthful?

Monday, December 15th, 2014

This month, McDonald’s USA introduced fresh fruit—Cuties California Clementines—as a side option for their Happy Meal and Mighty Kids Meal options.

The cuties, which provide an excellent source of Vitamin C, will be available during their peak season through March 2015.

According to a press release by the company, adding Cuties to the menu as a kids’ meal option or a la carte purchase “supports McDonald’s ongoing dedication to children’s nutrition and well-being.”

Other nutritious options currently offered as sides for McDonald’s kids’ meals include apple slices and Go-GURT low fat Strawberry Yogurt (though the latter option has six grams of sugar, some of it added; sugar is listed as the second ingredient).

I applaud the effort by the company to include Cuties on the menu. Even though each Cutie counts as only one quarter of cup of fruit, most kids fall short on recommendations for daily fruit intake. According to the Centers for Disease Control and Prevention (CDC), recent national surveys reveal that although two- to five-year-olds met their recommended daily fruit intake goals (0.9 cup-equivalents* per 1,000 calories consumed), 60 percent of children don’t eat enough fruit.

I hope that efforts to provide more nutrient-rich options to kids and all consumers—especially fruits, vegetables, and whole grains—will continue to appear on fast food and restaurant menus. Such options can certainly provide alternatives to nutrient-poor, highly palatable fare that in excess can contribute to the development of unhealthy weight gain, obesity, and myriad diet-related diseases.

The problem is, even if nutrient-rich foods like Cuties are purchased by parents and their children, that’s no guarantee that they’ll be consumed in place of French fries or milkshakes—some of the very items most go to fast food for in the first place. And if parents and their kids don’t buy such items when offered at fast food outlets, it’s likely the companies will be less willing to offer similar items in the future.

As I’ve written about in a previous Scoop on Food post, I’m not sure fast food will ever truly be health food. Don’t get me wrong—I welcome any effort by McDonald’s or other chains/restaurants to enhance their nutritious offerings. But unless more dramatic changes are made e.g. offering smaller portions, and cutting added fats and sugars in entrees and sides, adding a piece of fruit to the menu isn’t going to have a dramatic impact when it comes to consumers’ health and nutrient intake. That’s because most fast food options including kids’ meals are packed with more calories, fat, saturated fat, and sodium than kids need.

Fortunately, providing calorie counts on menus and more comprehensive nutrition information upon request (and on company websites) potentially can help kids and parents make more mindful choices when eating out.

However, it’s prudent for all of us to limit the frequency of visits to fast food restaurants. And to make having a fast food meal or snack an occasional treat rather than a regular part of your routine. Studies suggest that children who eat more fast food tend to take in more calories and fewer nutrients than those who consume less or no fast food. Including fast food in the diet can also be a marker for less healthful habits overall. So, if you choose to go to fast food restaurants, I say do it infrequently and eat what you like (even if it’s a burger and fries). Such a strategy is likely better than eating fast food meals often.

If you and your kids find yourself eating fast food for whatever reason—you’re stranded at the airport, you’re on a road trip, you’re in a rush—choosing smaller portions and opting for the more nutrient-rich picks, like a Cutie, or something green and colorful (like a side salad with a small amount of oil-based salad dressing) and eating those first can help you eat better. They may even fill you up enough to leave over a few bites of that burger or a few French fries!

*One cup-equivalent of fruit is approximately one small apple, one cup applesauce or 100% juice.

What are your thoughts about adding fruit/produce to a fast food menu? Will it really make a difference in what kids and their parents choose/eat?

Image of Cuties via Elisa Zied.


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Will Calorie Counts on Menus Help Kids Eat Better?

Monday, December 1st, 2014

To help kids and their families make more informed choices when eating out, the U.S. Food and Drug Administration (FDA) has just finalized two rules for restaurant-type foods (foods usually eaten on the premises, while walking away, or soon after arriving at another location) and foods purchased from vending machines.

According to the new rules, chain restaurants, and similar retail food establishments such as pizza places, salad bars in grocery stores and delis, ice cream shops and movie theaters with 20 or more locations—are now required to post calorie information on menus and menu boards. Operators who own or operate 20 or more vending machines also are required to share calorie information with consumers.

In an effort to reduce the incidence of obesity and improve nutritional intake—and offerings—to Americans, menu labeling was originally spearheaded by the consumer advocacy group, Center for Science in the Public Interest, in 2003. But it wasn’t until 2008 that menu labeling was mandated for the first time in the U.S. in New York City. Supported by dozens of consumer and professional groups including the Academy of Nutrition and Dietetics, several cities have since adopted similar measures. And in 2010, the national health care reform bill that included a menu labeling provision was passed. Although final menu labeling regulations were expected within a year, they weren’t finalized until recently, at the end of 2014. (Better late than never, I guess!)

Chain restaurants and other retail establishments have one year, and vending machines have two years, to comply with the new federal rules that, incidentally, trump local laws. Although many chain restaurants have already implemented menu labeling laws, following the new rules will be costly for grocery stores and other establishments that before now weren’t required by law to post calorie information.

It’s unclear at this time how menu labeling will impact kids’ overall calorie and nutrient intake. Still, it’s important to pay attention to calories and other nutrients such as fat and sodium derived from foods purchased away from home since they make up a large part of the daily diet. In the press release announcing the new rules, FDA commissioner, Margaret A. Hamburg, M.D. says, “Americans eat and drink about one-third of their calories away from home.” The question is, will knowing how many calories are in different foods help consumers—including kids—purchase and subsequently consume fewer calories?

Although we need a lot more data before drawing conclusions about the effectiveness of menu labeling (the few studies on its impact on adults and teenagers have thus far yielded mixed results), a recent report by the Robert Wood Johnson Foundation concludes that “menu labeling will likely cause small, but meaningful, reductions in calories purchased at chain restaurants and cafeterias overall, and particularly for patrons who see and use the labels.” It also suggests that the full impact of menu labeling won’t be apparent until chains throughout the country comply with federal menu labeling regulations.

Many experts support the new rules requiring calorie information for fast food and other restaurants and food sold at movie theaters and other venues and in vending machines. Registered and licensed dietitian Joan Salge Blake, a Clinical Associate Professor at Boston University, says, “The new, and long overdue, labeling guidelines will allow families to better understand the amount of calories in their choices at restaurants, and then, balance those decisions among the other family meal options for the week.”

Lisa Young, R.D., PhD., author of The Portion Teller Plan, says, “It’s good that people will now know how many calories are in the foods they eat. They may even see some surprises that may help them make better choices.” David Katz, M.D., Editor in Chief of the journal Childhood Obesity, agrees. He says, “I support the measures because more informed decisions are better than uninformed decisions.” But he also says we have to be very careful not to conflate calories with nutritional quality. “Being cognizant of calories is important and potentially useful to both adults and children, but only if it is in the context of also thinking about the importance of food quality,” Katz says.

Although I would never recommend that parents teach kids to obsess over or focus solely on calories in each and every item that passes their lips, it’s important for parents to model healthier eating by making mindful choices themselves and offering small portions to their children when eating out. Having calorie counts available provides parents and kids with an opportunity to have a conversation about how a favorite fast food meal, slice of pizza, scoop of ice cream or muffin or cookie measures up compared to different foods or portion sizes of those foods. Choosing more healthful (or at least, less caloric) options in appropriate portions for young kids when dining out can be a first step. But as kids age, it’s important to empower them so that when they’re older, they can make their own healthful choices when eating away from home (e.g. at school, or at a friend’s house). Also, showing kids how the foods they eat fit into their total daily calorie and nutrient needs can really be eye opening. Modeling healthier eating habits and showing kids how they can fit in treats (e.g. high calorie, nutrient poor foods like French fries and cookies) as occasional indulgences rather than staple items can also be a valuable lesson.

Although higher calorie foods like nuts can pack in nutrients, many of the items kids grab when they’re on the go are often loaded not only with calories but with added sugar, fat, and sodium—things that should be limited in kids’ diets. Showing kids how the choices they make and the portions they choose when they’re eating out fit into the rest of the day can be a good lesson, especially when kids need to try to make room for many of the nutritious foods they tend to skimp on like fruits and vegetables and whole grains.

According to the new rules, the statement, “2,000 calories a day is used for general nutrition advice, but calorie needs vary” will appear on menus and menu boards to show consumers how the calories in different foods fit into their daily needs and in the context of their entire diet. Although some older kids calorie needs may be on par with that of some adults, younger kids typically require less. According to the new rules, the following may also be used on menus and menu boards targeted to children:

“1,200 to 1,400 calories a day is used for general nutrition advice for children ages 4 to 8 years, but calorie needs vary.”


“1,200 to 1,400 calories a day is used for general nutrition advice for children ages 4 to 8 years and 1,400 to 2,000 calories a day for children 9 to 13 years, but calorie needs vary.”

I hope that menu labeling will be an empowering wake-up call to kids and parents alike about what’s really in their food. With obesity and diet-related diseases at high levels, it’s critical that we find solutions to help create a more healthful environment that supports making better food choices. This one federal effort may not be THE solution, but it can certainly be part of the solution, especially if it leads restaurants and any venues that serve food to offer smaller portions and/or more nutrient-rich foods. Hopefully, future studies will show that menu labeling can make a dent in our collective calorie intake to help all of us maintain healthy body weights and avert diet-related health problems down the road.

To learn more about the new calorie labeling rules, check out the FDA website.

Also, check my previous Scoop on Food blogs: How Kids Can Eat Better When They Eat Out and New Nutrition Guidance for 2 to 11-Year-Olds.

Do you think providing calorie counts will help kids eat better?

How to Eat Healthy: Raising Nutrition-Smart Kids
How to Eat Healthy: Raising Nutrition-Smart Kids
How to Eat Healthy: Raising Nutrition-Smart Kids

Image of pizza nutrition facts via shutterstock.

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Are Parents to Blame for Their Kids’ Obesity?

Monday, August 18th, 2014

A public service announcement (PSA) called “Rewind the Future,” launched as part of the Children’s Healthcare of Atlanta’s Strong4Life campaign, has garnered a lot of media attention—and considerable criticism—from health experts and parents alike. Although the PSA first surfaced in April 2012, it recently blew up on the internet, garnering an estimated six million views so far.

The PSA begins with a 32-year-old man named Jim who at 5’9” and 300 pounds is wheeled into a hospital while having a heart attack. After the doctor asks, “How the hell does this happen,” the video flashes backwards through the man’s life, attempting to illustrate how he got there. At various stages of Jim’s life, he’s shown eating ice cream and pancakes, being out of breath while playing with his kids or walking on a treadmill, hiding food in his room, playing video games, being rewarded candy by a teacher for earning good grades, being exposed to fast food by his parents (his dad orders pizza and his mom goes through a drive-thru), and acting up at meal time—and being pacified with French fries by his mother. The video ends with the message, “There’s still time to reverse the unhealthy habits our kids take into adulthood” and a link to the Strong4Life  website.

While the PSA has certainly sparked conversation, I was surprised when a Good Morning America poll inspired by the PSA revealed that eighty-one percent of viewers believe parents are to blame if their kids are obese. Only nineteen percent believe they are not. Although parents certainly play a major role in their children’s eating habits, I don’t believe pointing fingers and playing the blame game are the way to inspire meaningful change and better physical or psychological health in children. And while I appreciate the idea of prevention of obesity and its consequences, I don’t feel that blame and shame as suggested in this video are the answer.

Several experts have also spoken out against the PSA. In his recent blog post about the PSA, Yoni Freedhoff, MD, a family doctor and Assistant Professor at the University of Ottawa refers to the PSA as “…everything that’s ugly about society’s attitudes towards weight boiled into a two-minute video treatise on how gluttony and sloth are to blame for obesity….oh, and add in lazy parents.” Although he agrees that parents have a role to play in all of this, he believes that fear and shame aren’t likely to get them there. He writes, “If guilt or shame had any lasting impact on weight or behavior, the world would be skinny, as guilt and shame are the two things that the world bends over backwards to ensure that people with weight never run short of.” Freedhoff also says that shaming the symptom without tackling the cause is likely only to add to the belief that fat shaming has a role to play in fixing the environment.

In another blog post, California-based registered dietitian nutritionist Aaron Flores wrote, “Just like many other ads, the sensational tone shames both parents and kids. It says nothing of the fact that health comes in different shapes and sizes. It makes it seem as if a parent makes one mistake feeding a child at an early age, they’ve doomed their child to an early death. Nothing could be further from the truth. It’s this black and white thinking that leads us to think of foods as “good” or “bad” and lead to a life of dieting and binging.” Flores goes on to suggest that what parents need is to learn how to help children feel comfortable with all different kinds of foods and to nurture children’s self confidence with food and their body. He adds, “The last thing we need is to create environment that leads our children to hate their bodies, seek diets and (develop) unhealthy relationships with food.” Terrific points, no?

Although obesity, especially among children, is certainly something we all need to be concerned about and address, the findings of a recent study from the Rudd Center for Food Policy and Obesity at Yale University and published in American Journal of Preventive Medicine suggest that this video and others like it may not be the answer. The study found that stigmatizing obesity-related public health campaigns were no more likely to instill motivation for improving lifestyle behaviors among participants than campaigns that were more neutral.

As someone who always thinks you can attract more bees with honey, I, too, believe that rather than shocking or shaming parents, emphasizing what they can do more of—for example, offering more produce and cooking more at home, and choosing choose smaller portions while dining out—can empower them to feed their children better and help children actually eat better. It can also have a wonderful side effect of helping kids develop more healthful food, fitness and lifestyle behaviors they’ll carry with them as they increasingly make more decisions about what and how much to eat and move. Over time, this can help prevent many of the diet-related diseases many children, including those who are overweight, can develop as adults.

When asked about the rationale for the PSA, Stephanie Walsh, M.D., Medical Director, Strong4Life at Children’s Healthcare of Atlanta wrote in an email, “The video was designed as part of a larger movement to empower parents” and to “remind parents of the power they have to influence their child’s health and help them to consider making small steps towards lifestyle change.” In response to criticisms that the video unfairly blames and shames parents, Dr. Walsh added, “This video was not designed to place the blame on parents or make people change; it was designed to make people consider making a change.” She also suggests that people must first realize the importance of changing a behavior before they actually make a change. Although she concedes that the video dramatizes the problem, she notes that the scenes depicting unhealthy habits are real examples of the struggles many of their patients and families face— reigning in screen time, motivating kids to be active and decreasing the amount of sugar their kids drink. She adds, “The video was designed to focus on behaviors that we, as parents, can control.”

What are your thoughts? Does this video go too far, or do you think it will inspire parents to help their kids eat and live better?

Image of mother and kids having a snack at a fast food restaurant via shutterstock.

Kids and Chronic Health Concerns
Kids and Chronic Health Concerns
Kids and Chronic Health Concerns

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Fast Food and Kids: How to Fit It In

Sunday, July 13th, 2014

If you and your kids frequent fast food restaurants—especially while traveling over the summer—Consumer Reports just released its latest fast food survey. In an update to its 2011 survey, Consumer Reports had more than half of its 32,405 subscribers rate 96,208 meals at 65 fast-food chains in America on variables including food quality and freshness and value. One of the key findings of the survey was that while consumers talk thin, they eat fat.

According to Consumer Reports, despite the fact that some fast food restaurants have made some strides when it comes to nutritious offerings, many aren’t biting. It’s true that many chains now offer nutritious options like salads and soups, have reduced sodium in their offerings (for example, Subway reports it has reduced sodium in some core menu items including low-fat sandwiches and subs by 15 to 28%), have added grilled choices, and now offer fruit and yogurt (instead of French fries and cookies) in kids’ meals. Some chains including Chipotle, Culver’s, and Panera have even begun to offer poultry raised without antibiotics. But despite an increase in nutritious fast food fare—64% of those surveyed said that the restaurant they ate at most recently offered enough healthy alternatives—only 1 in 5 said they think about the availability of healthy menu options when choosing a restaurant. That’s no real surprise, but troubling nonetheless since higher fast food intake seems to be associated with higher calorie intake and a less nutritious diet overall. And according to Consumer Reports, Americans spend more than more ever before—in excess of $680 billion—dining out.

But there’s some good news: while only 19% of those surveyed reported ordering a healthy meal during their most recent dining experience, 42% of women and 28% of men reported they ordered lower calorie fare when calorie and nutrition information was conspicuous at such restaurants.

While I agree that some healthy steps have been taken in recent years to improve the nutritional and overall quality of fast-food, healthy pickings remain slim. And unless parents and their children who frequent such restaurants demand or at the very least buy more healthful fare when it’s made available, little is likely to change. So as I inferred in a previous Scoop on Food post, fast food probably won’t be considered health food any time soon.

If you know fast food is and will continue to be part of your family’s diet, I’m not going to be the food police and tell you to forgo it altogether. But if you and your kids have fast food more than once-in-a-while, it’s important to at least become familiar with the menus at some of your favorite fast food outlets (fortunately, many are available online). Planning ahead and making mindful choices in moderate portions can help you and your kids fit in fast food without derailing an otherwise healthful diet.

Here are some tips adapted from Consumer Reports to help you move in a more healthful direction when you eat fast food:

  • If eating healthfully is a priority when you eat out, choose more often from sandwich shops, Asian, and Mexican restaurants instead of from pizza and burger chains.
  • Have it your way. Many chains will hold the mayonnaise or cheese, go easy on sauces, substitute skim milk for whole milk, or serve dressings on the side. This is especially true at sandwich shops.
  • Beware of certain words. Instead of buying foods that are battered, creamy, crispy, crusted, sautéed, or stuffed, choose items that are roasted, broiled, baked, grilled, charbroiled, steamed, poached, or blackened.
  • Don’t supersize unless you plan to feed your whole family. For example, choose a single patty instead of a double or triple, and choose small instead of medium or large items (especially for high calorie items like French fries).
  • Drink smart. Instead of soda, choose plain water or low- or nonfat milk.

How do you help your family fit in fast food without sabotaging your diets?

How to Eat Healthy: Raising Nutrition-Smart Kids
How to Eat Healthy: Raising Nutrition-Smart Kids
How to Eat Healthy: Raising Nutrition-Smart Kids

Image of cheeseburger and french fries via shutterstock.



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Do Fast-Food Ads Fail When it Comes to Healthy Foods?

Friday, April 4th, 2014

For many, it might seem that having fast food outlets offer—and then promote—more nutritious items are steps in a more healthful direction. As I covered in a recent Scoop on Food post, fast-food chains are increasingly (albeit sparingly) offering more healthful options. And McDonald’s recently agreed to promote and market water, milk, and juice instead of soda as the beverage in Happy Meals and to include fun messages about nutrition or well-being in all its advertising aimed at children. Despite these initiatives, there’s evidence that fast food giants are falling short when it comes to advertisements for healthy meals aimed at children.

In a new study published in JAMA Pediatrics, Dartmouth researchers sought to determine how children depicted images of healthy foods in television advertisements for kids’ meals by McDonald’s and Burger King restaurants. Ninety-nine kids between the ages of 3 and 7 were shown in sequence two still images of the milk and apple slices and were asked, “What do you see in this picture?”

Researchers found that only 52% and 70% of the children (mostly older children) correctly identified milk from the McDonald’s and Burger King images, respectively. Eighty percent of children correctly identified apples from the McDonald’s image while only 10% correctly identified apples from the Burger King image. Although French fries weren’t shown in either image, 80% of the children thought they saw French fries in the Burger King ad, while only 4% thought they saw French fries in the McDonald’s ad. The researchers concluded that of the 4 healthy food images shown to the children, only the depiction of apples by McDonald’s was communicated adequately. Younger kids had a harder time identifying milk and Burger King’s depiction of apple slices misled the children, although no federal or regulatory actions were taken to correct this.

According to “Fast Food FACTS 2013,” a report by the Yale Rudd Center for Food Policy & Obesity, while most restaurants offer healthier sides and beverages in their kids’ meals, they still have a long way to go to promote only healthier fast-food options to kids. The report encouraged fast food restaurants to stop marketing directly to children and teens to encourage consumption of unhealthy fast food. It also recommended that fast food companies limit advertising on children’s TV networks and third party kids’ websites to healthy kids’ meals only.

When asked if he supports marketing of healthy foods to children, James D. Sargent, co-author of the JAMA Pediatrics study, said, “Personally and professionally, as a pediatrician, I am against any marketing to children under the age of 12 years. Many children in that age range are unable to even grasp the concept that marketing is someone trying to sell them something. It is only at about age 12 that children are developmentally capable of understanding that companies pay marketing firms to design ads aimed at persuading them to buy a product, a message that they should view with a certain amount of skepticism. Prior to that age, any message aimed at selling products seems unethical to me.”

Although Sargent doubts that limits on food marketing aimed at children will be established in the near future, he believes that companies that decide to market to young children should be held to very high communications standards. At the very least, Sargent says they should “design and test their messages to ensure that they mainly communicate information about the product (not the premium) and that most children are receiving that message.” He adds, “If Burger King and McDonald’s agree to promote messages about healthy food, we should be able to show that children come away from the advertisements saying they saw healthy food.”

Some think children should not be targets when it comes to food marketing, period. In their post, The Dark Side of Marketing Healthy Foods to Children, Susan Linn, Director of the Campaign for a Commercial-Free Childhood, and Michele Simon, a public health attorney, argue against marketing food—healthy or not—to children to best protect them. They say, “By begging and pleading with the food industry to improve how it markets to children, instead of working to end food marketing to children entirely, we are continuing to endorse a failed system in which industry gets to set the rules, break them whenever it pleases, and then take credit for doing the right thing.”

What’s your opinion?

Image of McDonalds Drive-Thru via shutterstock.

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