Field Notes

Restaurant Kids’ Meals Make Nutrition Strides
but Leave Room for Improvement

Eating meals from restaurants has become routine for many American children, often contributing excess calories, solid fats, sodium, and added sugar to diets already lacking in fruit, vegetables, and low-fat dairy. Many restaurants have made voluntary changes to their kids’ menus, including reducing the calories in new items, in advance of menu-labeling legislation that will mandate printed calorie counts. However, many kids’ menu items are still high in fat and sodium, leading researchers to question how well children’s meals at top restaurants match national nutrition recommendations.

Using the 2014 Nation's Restaurant News Top 100 Report, researchers identified the top 10 quick-service restaurants (QSRs) and full-service restaurants (FSRs) that offered a kids’ menu, made nutrition information publicly available, and provided calorie information for all children’s entrées. Using this information, researchers compared calories, fat, saturated fat, and sodium from children’s meal combinations with national dietary recommendations to understand the nutritional value of these offerings. They found that many meals met calorie recommendations but failed to meet recommendations for fat, saturated fat, and sodium levels.

“Improving the availability of healthier kids’ meals is a critical step toward increasing children's exposure to healthier foods, but that alone is not enough,” says lead author Sarah Sliwa, PhD, an instructor at Tufts University Friedman School of Nutrition. “We encourage restaurants to look holistically at the nutritional value of their children’s meals and to market healthier options in ways that emphasize taste and appeal to parents and children alike.”

Although 72% of the meal combinations researchers studied at QSRs and 63% at FSRs met nutritional recommendations for calories, less than one-third of children’s meal combinations at QSRs and one-quarter at FSRs met the recommendations for fat, saturated fat, and sodium as well as calories. Most meals exceeded the sodium recommendation, but there are reasons to be optimistic. At two of the QSRs included in the study, more than 90% of meal combinations had less than 770 mg of sodium; this demonstrates that large, successful restaurant chains can meet this recommendation.

Based on the nutritional values from QSRs and FSRs, the researchers concluded that improvements in children’s meals are feasible. Calorie counts are expected to be published on menus at many FSRs and QSRs nationwide by December 2016, potentially spurring additional calorie decreases. It’s unclear whether menu labeling will encourage improvements in other areas, such as sodium content.

“Restaurants should be commended for their progress to date, but no single step will reverse the childhood obesity epidemic and there’s still much work to do,” says Christina Economos, PhD, vice chair and director of ChildObesity180, who’s the senior author on the study. “Everyone has a role to play in providing healthier meals for kids. Restaurants can make healthful, appealing options more prevalent and prominent. Parents can educate and guide their children toward healthful choices and speak up to demand healthful meals where they don’t exist. We need to combine more nutritious children’s meal offerings with stronger education to drive both supply and demand to support healthier choices.”

— Source: Society for Nutrition Education and Behavior


Cancer Link Offers a Reason to Avoid Highly Processed Carbs

Recent years have brought more attention to the role of carbohydrates in our diets and the differences between healthful and unhealthful carbs, most often in the context of weight control. A new study highlights one more reason to avoid sugary beverages, processed foods, and other energy-dense carbohydrate-containing foods: Cutting them may help reduce your risk of cancer.

In the new study, regular consumption of sugary beverages was associated with a threefold greater risk of prostate cancer, and higher intake of processed lunch foods such as pizza, burgers, and meat sandwiches doubled prostate cancer risk. By contrast, healthful carbohydrate-containing foods like legumes, nonstarchy vegetables, fruits, and whole grains were collectively associated with a 67% lower risk of breast cancer.

“One of the most important findings here is that the type of carbohydrate-containing foods you consume can impact your cancer risk,” says Nour Makarem, a PhD student at New York University and the study’s lead author. “It appears that healthful carbohydrate sources, such as legumes, tend to protect us from cancer, but nonhealthful ones, such as fast foods and sugary beverages, seem to increase the risk of these cancers.”

The study is based on the health records of 3,100 volunteers tracked since the early 1970s. Researchers began tracking participants’ diets through detailed food frequency questionnaires starting in 1991. For the new study, Makarem and her colleagues categorized all of the study participants’ food sources by glycemic index (a measure of dietary carbohydrate quality based on an item’s relative impact on blood sugar levels as compared with a reference food) and glycemic load (a measure of both the quantity and quality of carbohydrates in a given food item). They then analyzed the results in relation to volunteers’ cancer rates.

After taking into account multiple cancer risk factors, the study found that eating foods with a higher glycemic load was associated with an 88% higher prostate cancer risk. Prostate cancer is one of the most common types of cancer and the second leading cause of cancer-related death in men.

“Our study showed very strong associations between certain foods and cancer, in particular with prostate cancer,” Makarem says. “There hadn’t been very many studies on food sources and prostate cancer previously.”

The risk increase was most pronounced for people who regularly consumed processed lunch foods or sugary beverages, a category that includes sugar-sweetened soft drinks in addition to fruit juices, which can be naturally high in sugar and often contain added sugars.

“Americans consume almost one-half of their added sugars in beverages,” Makarem says. “Sugar-sweetened beverages have been shown to increase the risk of obesity and diabetes, and our study documents that they may also have a detrimental impact on cancer risk.”

By contrast, consuming low-glycemic index foods such as legumes, nonstarchy vegetables, most fruits, and whole grains was associated with a 67% lower breast cancer risk. Breast cancer risk also was reduced among women who had a higher level of carbohydrate intake overall as a proportion of their total calories. However, in this study, participants within the highest level of carbohydrate intake also had higher intakes of fruits and vegetables, whole grains, and legumes. These findings underscore the idea that the type of carbohydrates matters more than the total amount of carbohydrates, Makarem says.

Among individual foods, legumes such as beans, lentils, and peas were associated with a 32% lower risk of all overweight- and obesity-related cancers, including breast, prostate, and colorectal cancers.

By nature of the study design, the results point only to associations, not necessarily to cause and effect. Nonetheless, the findings are in line with previous studies, which have shown that malignant cancer cells seem to feed on sugar, and that diets high in refined carbohydrates may lead to a range of adverse health effects primarily due to their impacts on body fatness and on the dysregulation of insulin and glucose, both of which are factors that may increase cancer risk.

“Current cancer prevention guidelines recommend avoiding sugary drinks and limiting the consumption of energy-dense foods, which tend to be high in refined carbohydrates,” Makarem says. “I think our findings add to the body of evidence behind this recommendation and strengthen the associations between these types of food and cancer.”

One caveat that Makarem noted is that the volunteers involved in the study were 99% Caucasian. Further study is needed to determine if these associations hold true in more ethnically diverse groups.

— Source: Federation of American Societies for Experimental Biology