SOURCES: Anthony Viera, M.D., M.P.H., director, health care and prevention, and associate professor, family medicine, University of North Carolina Gillings School of Global Public Health, Chapel Hill, N.C.; Lisa Powell, Ph.D., professor, health policy and administration, and director, Illinois Prevention Research Center, University of Illinois at Chicago School of Public Health; February 2015, Pediatrics
MONDAY, Jan. 26, 2015 (HealthDay News) -- Parents might order fewer calories for their children if menus included calorie counts or information on how much walking would be required to burn off the calories in foods, a new study suggests.
The new research also found that mothers and fathers were more likely to say they would encourage their kids to exercise if they saw menus that detailed how many minutes or miles it takes to burn off the calories consumed.
"Our research so far suggests that we may be on to something," said study lead author Dr. Anthony Viera, director of health care and prevention at the University of North Carolina Gillings School of Global Public Health. New calorie labels "may help adults make meal choices with fewer calories, and the effect may transfer from parent to child."
Findings from the study were published online Jan. 26 and in the February print issue of the journal Pediatrics.
As many as one in three children and teens in the United States is overweight or obese, according to background information in the study. And, past research has shown that overweight children tend to grow up to be overweight adults. Preventing excess weight in childhood might be a helpful way to prevent weight problems in adults.
Calories from fast-food restaurants comprise about one-third of U.S. diets, the researchers noted. So adding caloric information to fast-food menus is one possible prevention strategy. Later this year, the federal government will require restaurants with 20 or more locations to post calorie information on menus.
The hope behind including calorie-count information is that if people know how many calories are in their food, it will convince them to make healthier choices. But "the problem with this approach is there is not much convincing data that calorie labeling actually changes ordering behavior," Viera said.
This prompted the investigators to launch their study to better understand the role played by calorie counts on menus.
The researchers surveyed 1,000 parents of children aged 2 to 17 years. The average age of the children was about 10 years. The parents were asked to look at mock menus and make choices about food they would order for their kids.
Some menus had no calorie or exercise information. Another group of menus only had calorie information. A third group included calories and details about how many minutes a typical adult would have to walk to burn off the calories.
The fourth group of menus included information about calories and how many miles it would take to walk them off.
The information about a generic double burger, for instance, noted that it had 390 calories and would require 4.1 miles of walking to be burned off, Viera explained. "Some examples of other menu items were grilled chicken salad (220 calories and 2.3 miles), large french fries (500 calories and 5.2 miles), small chocolate milk shake (440 calories and 4.6 miles), and a large regular cola (310 calories and 3.2 miles)," Viera said.
The researchers found that parents mock-ordered slightly less food, calorie-wise, when their menus included the extra information. With no calorie numbers, they ordered an average of 1,294 calories worth of food for their kids. When calorie or exercise information was included, parents ordered 1,060 to 1,099 calories per meal for their kids, according to the study.
Meanwhile, about 38 percent of parents said they'd be "very likely" to encourage their kids to exercise if they saw labels with information about minutes or miles of activity required to burn off calories. Only 20 percent said they'd be moved to encourage exercise if they just saw calorie numbers alone.
While the study findings suggest that including calorie counts or exercise amounts might prompt parents to order fewer calories per meal for their children, the study has limitations. For one thing, no one actually ordered anything; the study scenario was hypothetical. Also, kids weren't part of the study, so it didn't reflect their food preferences and requests.
"There are many factors that come into play such as cost, time pressure, marketing and the child's preferences," Viera said. The hope is that labels with extra information will "provide a simple-to-understand snapshot of calorie content that will make it easier for parents to make healthier choices for themselves and their children in the context of all of these competing factors."
Lisa Powell is a health researcher and director of the Illinois Prevention Research Center at the University of Illinois at Chicago School of Public Health. She pointed to previous research that found younger children and teens typically consume 126 and 309 extra calories, respectively, on days when they eat fast food.
"Therefore, the results from this study are encouraging," she said.
"They suggest that menu labeling in physical activity calories equivalents may be a helpful tool to guide parents to order smaller portion sizes or less-energy dense food items in fast-food restaurants for their kids. It is important to extend this research to test whether the menu labeling would similarly impact adolescents' choices since they order and purchase a significant amount of fast food on their own," she said.
More research is already planned. "Next, we will start examining the effects of this kind of labeling on real-world food purchasing and physical activity," said Viera.
Researchers also want to understand why the most overweight parents appeared to respond more to the labels and order less food for their kids than other parents. "We're not sure why this is, and it merits further investigation," Viera said.
Learn more about fast-food marketing to children from the Prevention Institute.