Restaurants
GOAL: To encourage people’s food choices to shift to healthier items by providing more nutrition information. In order to offset the increase in the availability of fast food, policy-makers can help consumers make healthier choices by encouraging restaurants to offer healthier menu items, decrease portion sizes and post nutritional information on their menus.
1. Encourage Restaurants to Offer Reasonably Sized Portions and Low-Fat and Low-Calorie Menus
The Issues and the Research: Americans’ average daily caloric intake increased from 2,000 to 3,000 calories between 1971 and 2000.1,2,3 Representing about 74 percent of
all restaurant traffic nationally, fast food has more per-serving calories than food prepared
in the home,4,5,6 and three analyses show a direct association between fast-food
availability and obesity rates.7,8,9 Furthermore, fast-food restaurants often promote
larger sizes as selling points and chain restaurants also promote large-size items on their
menus.10 This situation is especially problematic for children who, according to one
study, can often find clusters of fast-food restaurants within walking distance of schools,11
particularly in lower-income areas. For example, one study found that twice as many
fast-food restaurants were located in racially-mixed neighborhoods in Mississippi, North
Carolina, Maryland and Minnesota, compared with white neighborhoods in those
states.12 In addition, restaurants that offer the most low-nutrient, energy dense foods and
the least amount of healthy menu items, according to researchers, are located in lower-income
areas.13,14 For example, only 27 percent of restaurants in lower-income areas
offered five or more healthy options compared to 40 percent of restaurants in affluent
neighborhoods.15
Potential Stakeholders
Policy-makers
State and local elected and appointed officials
Other Government and Community Stakeholders
County and city health officials
Restaurants
Policy and Program Options
Healthy food promotional campaigns
State
and local policy-makers can create programs and policies to help
restaurants promote healthier foods and beverages and reasonably-sized
portions. For example, local officials can offer a “healthy eating”
designation or stamp of approval. They can publicize specific
restaurants on Web pages and also describe the government’s own
programs to promote healthy eating and active living. They can support
public service announcements and provide prompts that display nutrition
information and healthy messaging and, through financial or other
incentives, they can encourage restaurants to offer healthier foods and
provide price reductions for such offerings.
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2. Encourage Restaurant Menu Labeling
The Issues and the Research: Marketing research has shown that providing
nutrition information affects consumer attitudes and purchasing behavior. Researchers
have determined that consumers consistently underestimate the nutrient levels in food
items and overestimate the healthfulness of restaurant items.16 Yet, when consumers
are made aware of nutrition information at point-of-purchase, there is an increase in
their perception of disease risk, and their intent to buy unhealthy foods decreases.17,18
Studies have also indicated that nutrition information on restaurant menus empowers
consumers and influences food choices.19 Furthermore, research indicates that consumers
want this information. Six nationally-representative polls have found that between 62
and 87 percent of Americans support the idea of requiring restaurants to list nutrition
information.20,21 In summary, increased awareness about nutrition information may
change consumer purchasing decisions and lead to fewer calories consumed. At the same
time, restaurants may then have a greater incentive to reformulate their menus based on
changes in consumer preference for healthy foods.22
Potential Stakeholders
Policy-makers
State and local elected and appointed officials
Other Government and Community Stakeholders
Restaurants
County and city health officials
Policy and Program Options
Nutrition and/or calorie information
Local policy-makers can consider adopting policies to require fast-food and chain restaurants to provide calorie or nutrition information on their menus or menu boards.
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1 Lin B, Guthrie J and Frazao E. “Nutrient Contribution of Food Away from Home.” America’s Eating Habits: Changes and Consequences, Frazao (ed). Washington: U.S. Department of Agriculture, 1999.
2 Putnam J, Allshouse J and Kantor L. “U.S. Per Capita Food Supply Trends: More Calories, Carbohydrates and Fats.” Food Review, 25: 2–15, Winter 2002.
3 Wright J, Kennedy-Stephenson J, Wang C, et al. “Trends in Intake of Energy and Macronutrients: United States, 1971–2000.” CDC Morbidity and Mortality Weekly Report, 53(4): 80–82, February 2004.
4 Lin et al.
5 Bowman S and Vinyard B. “Fast Food Consumption of U.S. Adults: Impact on Energy and Nutrient Intakes and Overweight Status.” Journal of the American College of Nutrition, 23:163–168, April 2004.
6 Bowman S, Gortmaker S, Ebbeling C, et al. “Effects of Fast Food Consumption on Energy Intake and Diet Quality among Children in a National Household Survey.” Pediatrics, 113(1 Pt 1): 112–118, January 2004.
7 Chou S, Rashad I and Grossman M. “Fast-Food Restaurant Advertising on Television and its Influence on Childhood Obesity.” Journal of Law and Economics, 51(4): 599-618, November 2008.
8 Maddock J. “The Relationship Between Obesity and the Prevalence of Fast-Food Restaurants: State-Level Analysis.” American Journal of Health Promotion, 9(2): 137–143, November 2004.
9 Mehta N and Chang V. “Weight Status and Restaurant Availability: A Multilevel Analysis.” American Journal of Preventive Medicine, 34(2): 127–133, February 2008.
10 Young L and Nestle M. “The Contribution of Expanding Portion Sizes to the U.S. Obesity Epidemic.” American Journal of Public Health, 92(2): 246-249, February 2002. Available at http://steinhardt.nyu.edu/nutrition.olde/PDFS/young-nestle.pdf.
11 Austin S, Melly S, Sanchez B, et al. “Clustering of Fast-food Restaurants around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments.” American Journal of Public Health, 95(9): 1575-1581, September 2005.
12 Morland K, Wing S, Diez Roux A, et al. “Neighborhood Characteristics Associated with the Location of Food Stores and Food Service Places.” American Journal of Preventive Medicine, 22(1): 23–29, January 2002.
13 Lewis L, Sloane D, Nascimento L, et al. “African Americans’ Access to Healthy Food Options in South Los Angeles Restaurants.” American Journal of Public Health, 95(4): 668–673, April 2005.
14 Baker E, Schootman M, Barnidge E, et al. “The Role of Race and Poverty in Access to Foods that Enable Individuals to Adhere to Dietary Guidelines.” Preventing Chronic Disease, 3(3), July 2006.
15 Lewis et. al.
16 Burton S and Creyer E. “What Consumers Don’t Know Can Hurt Them: Consumer Evaluations and Disease Risk Perceptions of Restaurant Menu Items.” The Journal of Consumer Affairs. 38(1):121-145, Summer 2004.
17 Ibid.
18 Kozup J, Creyer E and Burton S. “Making Healthful Food Choices: The Influence of Health Claims and Nutrition Information on Consumers’ Evaluations of Packaged Food Products and Restaurant Menu Items.” Journal of Marketing, 67: (2): 19-34, April 2003.
19 Burton and Creyer.
20 Anyone’s Guess: The Need for Nutrition Labeling at Fast-Food and Other Chain Restaurants. Washington: Center for Science in the Public Interest, November 2003. Available at www.cspinet.org/restaurantreport.pdf.
21 Obesity as a Public Health Issue: A Look at Solutions. Results From A National Poll. Cambridge, MA: Lake Snell Perry & Associates, June 2003. Available at www.phsi.harvard.edu/health_reform/poll_results.pdf.
22 Berman M and Lavizzo-Mourey R. “Obesity Prevention in the Information Age: Caloric Information at the Point of Purchase. Journal of the American Medical Association, 300 (4): 433-435, July 2008.
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