Moran Alyssa J, Block Jason P, Goshev Simo G, Bleich Sara N, Roberto Christina A
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, Massachusetts.
Am J Prev Med. 2017 Mar;52(3):284-291. doi: 10.1016/j.amepre.2016.11.007. Epub 2017 Jan 11.
Restaurant food is widely consumed by children and is associated with poor diet quality. Although many restaurants have made voluntary commitments to improve the nutritional quality of children's menus, it is unclear whether this has led to meaningful changes.
Nutrients in children's menu items (n=4,016) from 45 chain restaurants were extracted from the nutrition information database MenuStat. Bootstrapped mixed linear models estimated changes in mean calories, saturated fat, and sodium in children's menu items between 2012 and 2013, 2014, and 2015. Changes in nutrient content of these items over time were compared among restaurants participating in the Kids LiveWell initiative and non-participating restaurants. Types of available children's beverages were also examined. Data were analyzed in 2016.
There was a significant increase in mean beverage calories from 2012 to 2013 (6, 95% CI=0.8, 10.6) and from 2012 to 2014 (11, 95% CI=3.7, 18.3), but no change between 2012 and 2015, and no differences in nutrient content of other items over time. Restaurants participating in Kids LiveWell reduced entrée calories between 2012 and 2013 (-24, 95% CI= -40.4, -7.2) and between 2012 and 2014 (-40, 95% CI= -68.1, -11.4) and increased side dish calories between 2012 and 2015 (49, 95% CI=4.6, 92.7) versus non-participating restaurants. Sugar-sweetened beverages consistently constituted 80% of children's beverages, with soda declining and flavored milks increasing between 2012 and 2015.
Results suggest little progress toward improving nutrition in children's menu items. Efforts are needed to engage restaurants in offering healthful children's meals.
儿童广泛食用餐厅食物，且这与不良饮食质量相关。尽管许多餐厅已自愿承诺改善儿童菜单的营养质量，但尚不清楚这是否带来了有意义的改变。
从营养信息数据库MenuStat中提取45家连锁餐厅儿童菜单项（n = 4016）中的营养成分。通过自抽样混合线性模型估计2012年至2013年、2014年和2015年儿童菜单项中平均卡路里、饱和脂肪和钠的变化。比较参与“儿童健康生活”倡议的餐厅和未参与餐厅这些菜单项营养成分随时间的变化。还对现有的儿童饮料类型进行了研究。数据于2016年进行分析。
从2012年到2013年（6，95%可信区间=0.8，10.6）以及从2012年到2014年（11，95%可信区间=3.7，18.3），饮料平均卡路里显著增加，但2012年到2015年无变化，其他菜单项的营养成分随时间也无差异。与未参与餐厅相比，参与“儿童健康生活”倡议的餐厅在2012年到2013年（-24，95%可信区间=-40.4，-7.2）以及2012年到2014年（-40，95%可信区间=-68.1，-11.4）减少了主菜卡路里，在2012年到2015年增加了配菜卡路里（49，95%可信区间=4.6，92.7）。含糖饮料一直占儿童饮料的80%，2012年到2015年汽水减少，调味牛奶增加。
结果表明在改善儿童菜单项营养方面进展甚微。需要努力促使餐厅提供健康的儿童餐。
