Extra-large portions served at restaurants put consumers at risk of overweight and obesity, including children. Developing standards for portions sizes for kids' menus could reduce the risk that children will be served more food than they need for normal growth. We reviewed the calorie content of foods offered on kids' menus at franchised restaurants and US Department of Agriculture published recipes for use in schools. Using an expert panel, we developed recommendations for portion sizes for different food categories at restaurants that would reduce the likelihood that children would be served too much when they dine out. We found that portions of a la carte items offered on kids' menus averaged 147% more calories than the portions recommended by the panel, with hundreds of single servings exceeding 600 calories, the amount recommended as a maximum for an entire children's meal. Expert panel members recommended that single servings of entrees not exceed 300 calories, fried potatoes not exceed 100 calories, and desserts not exceed 150 calories on kids' menus. Restaurants should revise their portions for children and downsize them to match with recommendations that will reduce the risk that children will be served too much. The current kid's menu offerings are likely to be partly responsible for childhood obesity. New guidelines offer reasonable benchmarks for food service to children.
Deborah A. Cohen, MD, MPH, is a senior scientist at the RAND Corporation, Santa Monica, California.
Lenard I. Lesser, MD, MSHS, is a family physician and clinical research lead at One Medical in San Francisco, California.
Cameron Wright, MBA, is a doctoral candidate in Policy Analysis at the Pardee RAND Graduate School, Santa Monica, California.
Mary Story, PhD, is a professor and associate director of Academic Programs, Community and Family Medicine, at Duke University and the Duke Global Health Institute in Durham, North Carolina.
Christina D. Economos, PhD, is the director of ChildObesity180, the New Balance Chair in Childhood Nutrition, and a professor at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Tufts University, Boston, Massachusetts.
The following persons contributed to the expert panel: Margo Wootan, Ariane Corbett, Suzanne Murphy, Catherine Champagne, Melissa Laska, Lynn Silver, Lorrene Ritchie, Marlene Schwartz, Linda Van Horn, Megan Lott, Guadalupe Ayala, and the authors of the paper.
Support for this work was funded in part by a grant from the JPB Foundation.
The authors have no conflicts of interest to disclose.
Correspondence: Deborah A. Cohen, MD, MPH, RAND Corporation, 1776 Main St, Santa Monica, CA 90407 (firstname.lastname@example.org).