LAUSR

Background Children in the US are eating frequently in restaurants, which is associated with poor dietary quality, including decreased vegetable intake. Behavioral economic strategies, such as optimal defaults, have increased children's orders of healthful sides, but it is unknown what children consume when healthful sides are presented. Objective To investigate whether restructuring the children's menu in restaurants using behavioral economic strategies can alter children's ordering and consumption of vegetable sides. Study Design, Setting, Participants A convenience sample of families with a child between 4-8 years old attended 3 dinners at a university-based, sit-down restaurant. Children's meals included 2 entree choices (macaroni-and-cheese or chicken tenders) and a default side: all carrots (150g; Meal-1), small fries (50g)/large carrots (100g; Meal-2), and small carrots (50g)/large fries (100g; Meal-3). Participants could opt-out of the default side and instead choose: only fries (Meal-1), or only fries or carrots (Meals-2/3). Foods offered were weighed pre- and post-meal to determine consumption. Measurable Outcome/Analysis Descriptive statistics examined children's ordering behavior. Repeated measures analysis of covariance examined the effects on fries and carrot consumption (g) controlling for child weight (lbs). Results Forty-eight children (6.2 ± 1.3 years; 25 male) participated. Most children remained with the default side (Meal-1: 90.2%; Meal-2: 97.6%; Meal-3: 87.8%). A small percentage of children who remained with the default ordered additional fries after receiving their meal (Meal-1, n = 4, 9.8%; Meal-2, n = 3, 7.3%; Meal-3, n = 1, 2.4%). After controlling for child body weight, no significant effect was noted of Meal condition on carrot (P = .39) or french fry consumption (P ≤ .99). Conclusion Use of optimal defaults leads to increased orders of healthful sides, however vegetable and french fry consumption were unchanged. Further investigation of optimal default use on children's menus is warranted. Funding USDA, Colorado State University.