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Du W, Zhang P, Zhang J, Li Y, He FJ, Zhang X, Su C, Jia X, Li L, Song J, Zhang B, Wang H. Sodium Reduction in Restaurant Food: A Randomized Controlled Trial in China. Nutrients 2022; 14:nu14245313. [PMID: 36558472 PMCID: PMC9781955 DOI: 10.3390/nu14245313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/02/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
Restaurant food is one of the important sources of sodium intake in China. We aimed to determine whether a restaurant-based comprehensive intervention program may induce lower sodium content in restaurant food. A randomized controlled trial was implemented between 2019 and 2020 in 192 restaurants in China. After baseline assessment, the restaurants were randomly assigned to either an intervention or a control group (1:1). Comprehensive activities designed for intervention restaurants were conducted for one year. The primary outcome was the difference in change of sodium content estimated by the mean values of five best-selling dishes for each restaurant, from baseline to the end of the trial between groups. In total, 66 control restaurants and 80 intervention restaurants completed the follow-up assessment. The average sodium content of dishes at baseline was 540.9 ± 176.8 mg/100 g in control and 551.9 ± 149.0 mg/100 g in intervention restaurants. The mean effect of intervention after adjusting for confounding factors was -43.63 mg/100 g (95% CI: from -92.94 to 5.66, p = 0.08), representing an 8% reduction in sodium content. The restaurant-based intervention led to a modest but not significant reduction in the sodium content of restaurant food. There is great urgency for implementing effective and sustainable salt reduction programs, due to the rapid increase in the consumption of restaurant food in China.
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Affiliation(s)
- Wenwen Du
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Puhong Zhang
- George Institute for Global Health, Peking University Health Science Center, Beijing 100600, China
- Faculty of Medicine, University of New South Wales, Sydney, NSW 1466, Australia
| | - Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Yuan Li
- George Institute for Global Health, Peking University Health Science Center, Beijing 100600, China
- Faculty of Medicine, University of New South Wales, Sydney, NSW 1466, Australia
| | - Feng J. He
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Xiaofan Zhang
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Li Li
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Jing Song
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-66237089
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Rothpletz-Puglia P, Fredericks L, Dreker MR, Patusco R, Ziegler J. Position of the Society for Nutrition Education and Behavior: Healthful Food for Children is the Same as Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:4-11. [PMID: 35000680 DOI: 10.1016/j.jneb.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | | | - Margaret Rush Dreker
- Hackensack Meridian School of Medicine, Interprofessional Health Sciences Library, Nutley, NJ
| | | | - Jane Ziegler
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ
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Mandracchia F, Tarro L, Llauradó E, Valls RM, Solà R. Interventions to Promote Healthy Meals in Full-Service Restaurants and Canteens: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:1350. [PMID: 33919552 PMCID: PMC8073122 DOI: 10.3390/nu13041350] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Out-of-home eating is increasing, but evidence about its healthiness is limited. The present systematic review and meta-analysis aimed to elucidate the effectiveness of full-service restaurant and canteen-based interventions in increasing the dietary intake, food availability, and food purchase of healthy meals. Studies from 2000-2020 were searched in Medline, Scopus, and Cochrane Library using the PRISMA checklist. A total of 35 randomized controlled trials (RCTs) and 6 non-RCTs were included in the systematic review and analyzed by outcome, intervention strategies, and settings (school, community, workplace). The meta-analysis included 16 RCTs (excluding non-RCTs for higher quality). For dietary intake, the included RCTs increased healthy foods (+0.20 servings/day; 0.12 to 0.29; p < 0.001) and decreased fat intake (-9.90 g/day; -12.61 to -7.19; p < 0.001), favoring the intervention group. For food availability, intervention schools reduced the risk of offering unhealthy menu items by 47% (RR 0.53; 0.34 to 0.85; p = 0.008). For food purchases, a systematic review showed that interventions could be partially effective in improving healthy foods. Lastly, restaurant- and canteen-based interventions improved the dietary intake of healthy foods, reduced fat intake, and increased the availability of healthy menus, mainly in schools. Higher-quality RCTs are needed to strengthen the results. Moreover, from our results, intervention strategy recommendations are provided.
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Affiliation(s)
- Floriana Mandracchia
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Lucia Tarro
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
- Institut d’Investigació Sanitaria Pere Virgili, 43204 Reus, Spain
| | - Elisabet Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Rosa Maria Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Rosa Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
- Institut d’Investigació Sanitaria Pere Virgili, 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
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Tauriello S, McGovern L, Bartholomew B, Epstein LH, Leone LA, Goldsmith J, Kubiniec E, Anzman-Frasca S. Taste Ratings of Healthier Main and Side Dishes among 4-to-8-Year-Old Children in a Quick-Service Restaurant Chain. Nutrients 2021; 13:nu13020673. [PMID: 33669768 PMCID: PMC7922908 DOI: 10.3390/nu13020673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/16/2022] Open
Abstract
Restaurants are regular eating environments for many families. Children's consumption of restaurant foods has been linked with poorer diet quality, prompting emerging research examining strategies to encourage healthier eating among children in restaurants. Although taste is a primary determinant of restaurant meal choices, there is a lack of research considering children's perspectives on the taste of different healthier kids' meal options. The current study sought to examine, via objective taste testing, children's liking of and preference for healthier kids' meal options at a quick-service restaurant (QSR) and to describe bundled kids' meals with evidence of both taste acceptability and consistency with nutrition guidelines. Thirty-seven 4-to-8-year-old children completed taste tests of ten healthier main and side dish options. Liking and preference were assessed using standard methods after children tasted each food. Children also reported their ideal kids' meal. Results show the majority of children liked and preferred three main (turkey sandwich, chicken strips, peanut butter/banana sandwich) and side dishes (yogurt, applesauce, broccoli), with rank order differing slightly by age group. Accepted foods were combined into 11 bundles meeting nutritional criteria. Results highlight healthier kids' meals with evidence of appeal among children in a QSR. Findings can inform future research and may increase the success of healthy eating interventions in these settings.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
| | - Lily McGovern
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
| | | | - Leonard H. Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY 14214, USA;
| | - Lucia A. Leone
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY 14214, USA;
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Juliana Goldsmith
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA; (S.T.); (L.M.); (L.H.E.); (J.G.); (E.K.)
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY 14214, USA;
- Correspondence:
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Fuster M, Handley MA, Alam T, Fullington LA, Elbel B, Ray K, Huang TTK. Facilitating Healthier Eating at Restaurants: A Multidisciplinary Scoping Review Comparing Strategies, Barriers, Motivators, and Outcomes by Restaurant Type and Initiator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041479. [PMID: 33557280 PMCID: PMC7915132 DOI: 10.3390/ijerph18041479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022]
Abstract
Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated by investigators and associated with independently owned restaurants. Aside from those associated with revenue, motivations and barriers for healthy eating promoting strategies varied by restaurant type. While corporate restaurants were also motivated by public health criticism, independently owned restaurants were motivated by interests to improve community health. Revenue concerns were followed by food sourcing issues in corporate restaurants and lack of interest among independently owned restaurants. Among reporting sources, most outcomes were revenue positive. This study shows the need for practice-based evidence and accounting for restaurant business models to tailor interventions and policies for sustained positive changes in these establishments.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
- Correspondence:
| | - Margaret A. Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94158, USA;
| | - Tamara Alam
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
| | - Lee Ann Fullington
- Library, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY 10016, USA;
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
| | - Terry T-K Huang
- Department of Community Health and Social Sciences and Center for Systems and Community Design, City University of New York Graduate School of Public Health and Health Policy, New York, NY 10027, USA;
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Gutierrez-Salcedo M, Parras-Rosa M, Torres-Ruiz FJ, Vega-Zamora M. Do Chefs Value Health in Their Olive Oil Purchasing Decisions? Nutrients 2021; 13:nu13020445. [PMID: 33572879 PMCID: PMC7912701 DOI: 10.3390/nu13020445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022] Open
Abstract
Amidst the public’s growing preoccupation with healthy eating, both inside and outside the home; an increase in people eating out; and the importance that olive oil has acquired in the markets due to its health benefits, the aim of this study is to find out whether health is also a relevant criterion for chefs in their olive oil purchase decisions. To this end, a survey was conducted of 400 chefs in Spain belonging to the international chefs’ association Euro-Toques. The results show that only 2% of the sample consider health to be a relevant criterion in the purchase of olive oils and that the attribute of “health” is not used by restaurants as an element of differentiation by which to position themselves in the market. These results lead us to conclude that the consumer demand for healthy foods (in this case, olive oils) is not being met by the restaurant sector. Moreover, this raises the question as to whether chefs actually make good opinion leaders, with all that this social role implies.
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Affiliation(s)
- María Gutierrez-Salcedo
- Department of Business Management, Marketing and Sociology, Faculty of Social Sciences and Law, University of Jaén, 23071 Jaén, Spain; (M.P.-R.); (F.J.T.-R.); (M.V.-Z.)
- University Institute for Olive Grove and Olive Oil Research, University of Jaen, Campus las Lagunillas s/n, 23071 Jaén, Spain
- Agri-Food Campus of International Excellence (ceiA3), 14071 Córdoba, Spain
- Correspondence:
| | - Manuel Parras-Rosa
- Department of Business Management, Marketing and Sociology, Faculty of Social Sciences and Law, University of Jaén, 23071 Jaén, Spain; (M.P.-R.); (F.J.T.-R.); (M.V.-Z.)
- University Institute for Olive Grove and Olive Oil Research, University of Jaen, Campus las Lagunillas s/n, 23071 Jaén, Spain
- Agri-Food Campus of International Excellence (ceiA3), 14071 Córdoba, Spain
| | - Francisco José Torres-Ruiz
- Department of Business Management, Marketing and Sociology, Faculty of Social Sciences and Law, University of Jaén, 23071 Jaén, Spain; (M.P.-R.); (F.J.T.-R.); (M.V.-Z.)
- University Institute for Olive Grove and Olive Oil Research, University of Jaen, Campus las Lagunillas s/n, 23071 Jaén, Spain
- Agri-Food Campus of International Excellence (ceiA3), 14071 Córdoba, Spain
| | - Manuela Vega-Zamora
- Department of Business Management, Marketing and Sociology, Faculty of Social Sciences and Law, University of Jaén, 23071 Jaén, Spain; (M.P.-R.); (F.J.T.-R.); (M.V.-Z.)
- University Institute for Olive Grove and Olive Oil Research, University of Jaen, Campus las Lagunillas s/n, 23071 Jaén, Spain
- Agri-Food Campus of International Excellence (ceiA3), 14071 Córdoba, Spain
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Downs S, Demmler KM. Food environment interventions targeting children and adolescents: A scoping review. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2020.100403] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Food Marketing as a Special Ingredient in Consumer Choices: The Main Insights from Existing Literature. Foods 2020; 9:foods9111651. [PMID: 33198136 PMCID: PMC7698179 DOI: 10.3390/foods9111651] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
The choices and preferences of food consumers are influenced by several factors, from those related to the socioeconomic, cultural, and health dimensions to marketing strategies. In fact, marketing is a determinant ingredient in the choices related to food consumption. Nonetheless, for an effective implementation of any marketing approach, the brands play a crucial role. Creating new brands in the food sector is not always easy, considering the relevant amount of these goods produced within the agricultural sector and in small food industries. The small dimension of the production units in these sectors hinders both brand creation and respective branding. In this context, it would seem important to analyse the relationships between food marketing and consumer choice, highlighting the role of brands in these frameworks. For this purpose, a literature review was carried out considering 147 documents from Scopus database for the topics of search “food marketing” and “choices” (search performed on 16 October 2020). As main insights, it is worth highlighting that the main issues addressed by the literature, concerning food marketing and consumer choices, are the following: economic theory; label and packaging; marketing strategies; agriculture and food industry; market segments; social dimensions; brand and branding. In turn, food marketing heavily conditions consumer choices; however, these related instruments are better manipulated by larger companies. In addition, this review highlights that bigger companies have dominant positions in these markets which are not always beneficial to the consumers’ objectives.
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Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children's Menu. Nutrients 2020; 12:nu12113253. [PMID: 33114155 PMCID: PMC7690819 DOI: 10.3390/nu12113253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022] Open
Abstract
This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children’s menu in April 2012. Orders of adult menu items were abstracted from before (September 2011–March 2012; PRE; n = 1,801,647) and after (September 2012–March 2013; POST; n = 1,793,582) the healthier children’s menu was introduced. Entrées, appetizers, and sides listed as healthier options on the menu were coded as healthier. PRE to POST changes in the percentage of orders of healthier items, soda, and dessert were evaluated using McNemar tests of paired proportions. Orders of healthier entrées, appetizers, and sides on the adult menu increased PRE to POST (8.9% to 10.4%, 25.5% to 27.5%, and 7.3% to 9.3%, respectively), and soda and dessert orders decreased (23.2% to 21.7% and 29.0% to 28.3%, respectively). All shifts were statistically significant (p < 0.0001). Our findings demonstrate improvements in orders of healthier adult menu options during the same time frame as a healthy children’s menu change. Future research can help elucidate mechanisms to inform future health promotion efforts in restaurants in ways that have the potential to impact both adults and children.
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