Original Article

Comparison of Children’s Menu Items at Full- and Quick-Service Restaurants

Authors: Mona A. Eissa, MD, PhD, Katherine Hearne, MPH, RDN, Nora Saavedra, MD


Objectives: The proportion of food consumed by children from restaurants tripled during the last 4 decades and that coincided with the increased rate of obesity. Despite the presence of data linking quick-service (QS) food consumption to poor diet quality, studies comparing the nutrition content of the children’s menu items at QS restaurants (QSRs) with those at full-service restaurants (FSRs) are limited. The objectives of this study were to examine the nutrition content of common children’s menu items at both QSRs and FSRs and compare these data with recommendations reported by the Dietary Guidelines for Americans 2015–2020, Eighth Edition.

Methods: Using the 2014 data of the MenuStat project, 10 food items that are on both QSR and FSR children’s menus were selected. Data from each restaurant category were aggregated and the overall average of the nutritional content of each individual food item was calculated and compared between the two restaurant categories.

Results: The average of calories, fat, carbohydrates, and added sugar of most items on the children’s menu of QSRs are lower than those of FSRs. Also, most food items on children’s menus of FSRs, and to a lesser extent those of QSRs, exceeded the national recommended calories and fat content per meal.

Conclusions: Although some children’s menu items of QSRs have less fat and fewer calories compared with those of FSRs, most menu items in both FSRs and QSRs do not meet national dietary recommendations. Healthcare professionals may expand discussions with patients to include both restaurant categories when counseling them and their families on obesity prevention. Also, educating children and families about reading the nutritional content information of children’s menu items when eating out to make an informed choice can be a tool in fighting childhood obesity.

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1. Ogden CL, Carroll MD, Fryar CD, et al. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief 2015;219:1-8.
2. Paeratakul S, Ferdinand DP, Champagne CM, et al. Fast-food consumption among US adults and children: dietary and nutrient intake profile. J Am Diet Assoc 2003;103:1332-1338.
3. Vikraman S, Fryar CD, Ogden CL. Caloric intake from fast food among children and adolescents in the United States, 2011-2012. NCHS Data Brief 2015;213:1-8.
4. St-Onge MP, Keller KL, Heymsfield SB. Changes in childhood food consumption patterns: a cause for concern in light of increasing body weights. Am J Clin Nutr 2003;78:1068-1073.
5. Poti JM, Slining MM, Popkin BM. Where are kids getting their empty calories? Stores, schools, and fast-food restaurants each played an important role in empty calorie intake among US children during 2009-2010. J Acad Nutr Diet 2014;114:908-917.
6. US Department of Health and Human Services., US Department of Agriculture. Dietary Guidelines for Americans 2015-2020, Eighth Edition. http://health.gov/dietaryguidelines/2015/guidelines. Published December 2015. Accessed May 5, 2016.
7. Wu HW, Sturm R. What’s on the menu? A review of the energy and nutritional content of US chain restaurant menus. Public Health Nutr 2013;16:87-96.
8. US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. https://health.gov/dietaryguidelines/2010. Published December 2010. Accessed January 21, 2018.
9. Serrano EL, Jedda VB. Comparison of fast-food and non-fast-food children’ menu items. J Nutr Educ Behav 2009;41:132-137.
10. O'Donnell SI, Hoerr SL, Mendoza JA, et al. Nutrient quality of fast food kids meals. Am J Clin Nutr 2008;88:1388-1395.
11. Kirkpatrick SI, Reedy J, Kahle LL, et al. Fast-food menu offerings vary in dietary quality, but are consistently poor. Public Health Nutr 2014;17:924-931.
12. Auchincloss AH, Leonberg BL, Glanz K, et al. Nutritional value of meals at full-service restaurant chains. J Nutr Educ Behav 2014;46:75-81.
13. US Food and Drug Administration. Food labeling nutrition labeling of standard menu items in restaurants and similar retail food establishments. A rule by the Food and Drug Administration on 12/01/2014. https://www.federalregister.gov/articles/2014/12/01/2014-27833/food-labeling-nutrition-labeling-of-standard-menu-items-in-restaurants-and-similar-retail-food. Published December 2014. Accessed May 5, 2015.
14. New York City Department of Health and Mental Hygiene. MenuStat methods. http://menustat.org/methods-for-researchers. Published December 2014. Accessed May 1, 2015.
15. Nation’s Restaurant News 2012. Top 100 chains: US sales. http://nrn.com/us-top-100/top-100-chains-us-sales. Published November 17, 2012. Accessed May 5, 2015.
16. Center for Science in the Public Interest. Kids’ meals II: obesity and poor Nutrition on the menu. https://cspinet.org/new/pdf/cspi-kids-meals-2013.pdf. Published March 28, 2013. Accessed May 14, 2017.
17. Gidding SS, Dennison BA, Birch LL, et al. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics 2006;117:544-559.
18. Batada A, Breuning M, Marchlewicz EH, et al. Poor nutrition on the menu: children’s meals at America’s top chain restaurants. Child Obes 2012;8:251-524.