Rüsing Lisa, Hilger-Kolb Jennifer, Schneider Sven
Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Mannheim Institute for Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany.
Cent Eur J Public Health. 2020 Jun;28(2):87-93. doi: 10.21101/cejph.a5878.
Prevalence of obesity and overweight among children is rising worldwide. Thus, the importance of restaurants as food environments is also growing. Considering these developments, the present study describes and evaluates menus and meals offered to children in German full-service restaurants.
Using quota sampling procedure, a representative sample of German full-service restaurants was identified. The individual meals were then assessed, using the Children's Menu Assessment tool (CMA). A total of 500 restaurants and 1,877 individual meals were analyzed.
On average, every menu included 3.76 ± 1.31 meals for children. The arithmetic mean of the CMA score was 0.73 ± 0.85. Around 80% of all offered meals were limited to eight typical dishes and over 50% included French fries or another form of fried potatoes. Not one of the meals included any nutritional information. Healthy entrees were never marked (e.g. by an optional qualitative information such as healthy food symbol or a healthier choice tag). Eighty-one percent of all the main components in the meals were rated as unhealthy and none of the meals used wholegrain products. The automatic inclusion of a drink and free refill options are both rather unusual in Germany, as well as the use of cartoon characters and product logos or giving away promotional toys. A positive correlation was found between the price of the food and its quality. The majority of dishes feature a high energy density while simultaneously having a low nutrient density.
Overall, the range of food on offer for children in German restaurants is unhealthy and lacking in variety. There is an urgent need for improvement of both the menus themselves as well as the offered meals. Our study is not only by far the most comprehensive study, but also the study with the worst CMA score values worldwide.
全球儿童肥胖和超重的患病率正在上升。因此，餐厅作为食物环境的重要性也在增加。考虑到这些发展情况，本研究描述并评估了德国全方位服务餐厅提供给儿童的菜单和餐食。
采用配额抽样程序，确定了德国全方位服务餐厅的代表性样本。然后使用儿童菜单评估工具（CMA）对各份餐食进行评估。共分析了500家餐厅的1877份餐食。
平均而言，每份菜单包含3.76±1.31份儿童餐。CMA评分的算术平均值为0.73±0.85。所有提供的餐食中，约80%局限于八种典型菜品，超过50%包含薯条或其他形式的炸土豆。所有餐食均未包含任何营养信息。健康主菜从未被标记（例如通过健康食品标志或更健康选择标签等定性信息）。餐食中所有主要成分的81%被评为不健康，且没有一份餐食使用全谷物产品。自动包含饮品和免费续杯选项在德国相当少见，使用卡通人物和产品标志或赠送促销玩具的情况也不多见。食物价格与其质量之间存在正相关。大多数菜品能量密度高，而营养密度低。
总体而言，德国餐厅提供给儿童的食物种类不健康且缺乏多样性。菜单本身以及提供的餐食都迫切需要改进。我们的研究不仅是迄今为止最全面的研究，也是全球CMA评分值最差的研究。
