Strategies to Improve Children’s Menu Offerings in Restaurant Settings: A Literature Review

Food eaten out of the home makes up an increasing proportion of people’s dietary intakes. Research by the Food Standards Agency (FSA) has shown that children’s menus in restaurants in Northern Ireland are limited in choice and offer few healthy options. The aim of this literature review is to investigate the effectiveness of restaurant initiatives to improve the nutritional content of children’s meals, and to promote positive behaviour change in consumers (i.e. parents and children) when choosing meals for children. Studies from 2014 to 2024 were searched using SCOPUS, PubMed and Cochrane Library. A total of 39 studies were included in the review and analysed by research objective and intervention type. For objective 1, this included: mandatory legislation (n=7); voluntary recognition schemes (n=4); community initiatives (n=2). For objective 2, this included: calorie labelling (n=6); optimal defaults (n=10); signposting initiatives (n=4); incentives (n=3) and social marketing (n=2). Very little evidence was found about motivators and barriers to restaurants participating in children’s menu reformulation initiatives (objective 3), or the impacts of such initiatives on profitability (objective 4). No evidence was found relating to impacts on food waste. Community initiatives involving restaurant owners and intervention teams working closely together, were found to help encourage restaurants to reformulate their children’s menus. Similarly, toy incentives and optimal defaults were shown to be effective at influencing parents and children to order healthier meals in restaurants. Mandatory legislation, voluntary standards, strategies based on guiding consumers (signposting; social marketing), or providing information (calorie labelling) were found to be of limited effectiveness at getting businesses to make menus healthier and influencing consumers to order healthier meals. Overall the quality of the evidence base is limited, and further research is needed on specific strategies and initiatives, especially in the UK context. An infographic summary of the report can be found here (https://science.food.gov.uk/article/143909-strategies-to-improve-children-s-menu-offerings-in-restaurant-settings-a-literature-review/attachment/300603.pdf?auth_token=iwtB22N6Jq9BncbiURng).