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Food ordering for children in restaurants: multiple sources of influence on decision making

  • Iana A Castro (a1) (a2), Christine B Williams (a3), Hala Madanat (a2) (a4), Julie L Pickrel (a2), Hee-Jin Jun (a2), Michelle Zive (a3), Sheila Gahagan (a3) and Guadalupe X Ayala (a2) (a4)...



Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants.


A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making.


Ten independent, table-service restaurants in San Diego, CA, USA participated.


Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years).


Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu.


Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.

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1. Howarth, NC, Murphy, SP, Wilkens, LR et al. (2006) Dietary energy density is associated with overweight status among 5 ethnic groups in the multiethnic cohort study. J Nutr 136, 22432248.
2. Food Marketing Institute (2014) US Grocery Shopper Trends 2014. (accessed August 2015).
3. Poti, JM & Popkin, BM (2011) Trends in energy intake among US children by eating location and food source, 1977–2006. J Am Diet Assoc 111, 11561164.
4. White House Task Force on Childhood Obesity (2010) Report to the President. Solving the Problem of Childhood Obesity within a Generation. (accessed April 2016).
5. Krukowski, RA & West, D (2013) No financial disincentive for choosing more healthful entrées on children’s menus in full-service restaurants. Prev Chronic Dis 10, E94.
6. Anzman-Frasca, S, Dawes, F, Sliwa, S et al. (2014) Healthier side dishes at restaurants: an analysis of children’s perspectives, menu content, and energy impacts. Int J Behav Nutr Phys Act 11, 81.
7. Batada, A, Bruening, M, Marchlewicz, EH et al. (2012) Poor nutrition on the menu: children’s meals at America’s top chain restaurants. Child Obes 8, 251254.
8. Center for Science in the Public Interest (2013) Kids’ meals II: Obesity and poor nutrition on the menu. (accessed April 2016).
9. National Restaurant Association (n.d.) Kids LiveWell Criteria. (accessed April 2016).
10. Dodds, P, Wolfenden, L, Chapman, K et al. (2014) The effect of energy and traffic light labeling on parent and child fast food selection: a randomised controlled trial. Appetite 73, 2330.
11. Elbel, B, Gyamfi, J, Kersh, R et al. (2011) Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. Int J Obes (Lond) 35, 493500.
12. Harnack, LJ & French, SA (2008) Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: a review of the literature. Int J Behav Nutr Phys Act 5, 51.
13. Forster-Coull, L & Gillis, D (1988) A nutrition education program for restaurant patrons. J Nutr Educ 20, 22B23B.
14. Papies, EK & Veling, H (2013) Healthy dining. Subtle diet reminders at the point of purchase increase low-calorie food choices among both chronic and current dieters. Appetite 61, 17.
15. Blair, AM, Drass, JA, Stone, M et al. (2011) Restaurant challenge offers healthful meal options and builds diabetes awareness. Diabetes Educ 37, 581588.
16. Hanni, KD, Garcia, E, Ellemberg, C et al. (2009) Targeting the taqueria: implementing healthy food options at Mexican American restaurants. Health Promot Pract 10, 2 Suppl., 91S99S.
17. Fitzpatrick, PM, Chapman, GE & Barr, SI (1997) Lower-fat menu items in restaurants satisfy customers. J Am Diet Assoc 97, 510514.
18. Richard, L, O’Loughlin, J, Masson, P et al. (1999) Healthy menu intervention in restaurants in low-income neighbourhoods: a field experience. J Nutr Educ 31, 5459.
19. van Kleef, E, van den Broek, O & van Trijp, HC (2015) Exploiting the spur of the moment to enhance healthy consumption: verbal prompting to increase fruit choices in a self-service restaurant. Appl Psychol Health Well Being 7, 149166.
20. Acharya, RN, Patterson, PM, Hill, EP et al. (2006) An evaluation of the ‘TrEAT Yourself Well’ restaurant nutrition campaign. Health Educ Behav 33, 309324.
21. Fitzgerald, CM, Kannan, S, Sheldon, S et al. (2004) Effect of a promotional campaign on heart-healthy menu choices in community restaurants. J Am Diet Assoc 104, 429432.
22. Nothwehr, FK, Snetselaar, L, Dawson, J et al. (2013) Promoting healthy choices in non-chain restaurants: effects of a simple cue to customers. Health Promot Pract 14, 132138.
23. Anzman-Frasca, S, Mueller, M, Sliwa, S et al. (2015) Changes in children’s meal orders following healthy menu modifications at a regional US restaurant chain. Obesity (Silver Spring) 23, 10551062.
24. Bernhardt, AM, Wilking, C, Gottlieb, M et al. (2014) Children’s reaction to depictions of healthy foods in fast-food television advertisements. JAMA Pediatr 168, 422426.
25. Wansink, B & Hanks, AS (2014) Calorie reductions and within-meal calorie compensation in children’s meal combos. Obesity (Silver Spring) 22, 630632.
26. Wootan, M (2012) Children’s meals in restaurants: families need more help to make healthy choices. Child Obes 8, 3133.
27. Bandura, A (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.
28. Stokols, D (1996) Translating social ecological theory into guidelines for community health promotion. Am J Health Promot 10, 282298.
29. Valkenburg, PM & Cantor, J (2001) The development of a child into a consumer. J Appl Dev Psychol 22, 6172.
30. John, DR (1999) Consumer socialization of children: a retrospective look at 25 years of research. J Consum Res 26, 183213.
31. Piaget, J & Inhelder, B (1969) The Psychology of the Child. New York, NY: Basic Books.
32. Mata, J, Scheibehenne, B & Todd, PM (2008) Predicting children’s meal preferences: how much do parents know? Appetite 50, 367375.
33. Libotte, E, Siegrist, M & Bucher, T (2014) The influence of plate size on meal composition: literature review and experiment. Appetite 82, 9196.
34. Ohri-Vachaspati, P, Isgor, Z, Rimkus, L et al. (2015) Child-directed marketing inside and on the exterior of fast food restaurants. Am J Prev Med 48, 2230.
35. Ayala, GX, Castro, IA, Pickrel, JL et al. (2016) A restaurant-based intervention to promote sales of healthy children's menu items: the Kids’ Choice Restaurant Program cluster randomized trial. BMC Public Health 16, 250.
36. Ayala, GX, Mueller, K, Lopez-Madurga, E et al. (2005) Restaurant and food shopping selections among Latino women in Southern California. J Am Diet Assoc 105, 3845.
37. McKenzie, T, Marshall, S, Sallis, J et al. (2000) Leisure-time physical activity in school environments: an observational study using SOPLAY. Prev Med 30, 7077.
38. McKenzie, TL, Cohen, DA, Sehgal, A et al. (2006) System for Observing Play and Recreation in Communities (SOPARC): reliability and feasibility measures. J Phys Act Health 3, Suppl. 1, S208S222.



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