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All Aboard Meal Train: Can Child-Friendly Menu Labeling Promote Healthier Choices in Hospitals?
Sanjukta Basak1, Alissa Steinberg2, Alison Campbell2
1Department of Pediatrics, The Scarborough and Rouge Hospital, Toronto, ON, Canada.
Insights
Child-friendly menu labeling in hospitals encouraged healthier food choices initially. This strategy effectively increased healthy meal orders among pediatric patients, though the impact diminished over time.
Area of Science:
- Pediatric Nutrition
- Hospital Foodservice Management
- Behavioral Economics in Health
Background:
- Hospitalized children often have limited food choices, impacting nutritional intake.
- Menu design can influence patient food selection and dietary habits.
- Child-friendly labeling strategies are being explored to promote healthier eating in pediatric populations.
Purpose of the Study:
- To evaluate the impact of revised, child-friendly menu labeling on meal orders and consumption among hospitalized children.
- To assess whether specific labeling techniques can encourage healthier food choices in a pediatric inpatient setting.
Main Methods:
- A randomized controlled trial was conducted over one month comparing standard menus with intervention menus featuring child-friendly, healthy eating labels.
- 163 hospitalized children (mean age 9.9 years) were included, excluding those with specialized diets or younger than two.
- Analysis focused on meal orders, food item selection (categorized as 'green-light' or 'red-light'), and consumption trends.
Main Results:
- Children receiving the intervention menu ordered significantly more 'green-light' (healthy) items and fewer 'red-light' (less healthy) items, particularly at the first meal.
- Odds of selecting a 'red-light' item decreased by 0.65, while odds of selecting a 'green-light' item increased by 1.75.
- Trends showed increased fruit and vegetable intake and decreased consumption of 'foods to limit,' but no significant impact on sugar-sweetened beverage intake. Meal consumption proportions remained similar between groups.
Conclusions:
- Child-targeted menu labeling in hospitals is an effective short-term strategy for promoting healthier food selections among pediatric patients.
- The positive effects of menu labeling on food choices were observed to wane over time, suggesting a need for sustained or varied interventions.
- Further research may explore long-term impacts and optimal strategies for maintaining healthier eating habits in hospitalized children.
Objective:
To evaluate patient meal orders and consumption with a revised menu design that includes child-friendly labeling.
Study Design:
A randomized controlled trial among hospitalized children was performed over a 1-month period comparing the control menu layout and the intervention menu. The intervention menu contained the same choices but was labeled to encourage healthy eating. Children on a specialized diet, receiving parenteral nutrition, or age <2 years were excluded.
Results:
A total of 163 patients (81 males) were included, with a mean age of 9.9 ± 5.1 year, and a mean weight z-score of -0.08 ± 1.3. Children receiving the intervention ordered more "green-light" healthy choices and fewer "red-light" items, with 0.65 lower odds of selecting a red-light item (95% CI, 0.55-0.76) and 1.75 higher odds of selecting a green-light item (95% CI, 1.49-2.04), both at the first meal, but with effects waning over time. There were trends toward increased intake of fruits and vegetables and decreased intake of "foods to limit", but no impact on the consumption of sugar-sweetened beverages. Both intervention and control group consumed their meals in equal proportions.
Conclusions:
The combination of menu labeling techniques targeted to children in the inpatient hospital setting was an effective short-term tool for increasing the intake of healthier foods, although the effect of labeling waned over time.
Trial Registration:
ClinicalTrials.gov: NCT02692001.
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