Nutrient composition of Australian fast-food and fast-casual children\u27s meals available in 2016 and changes in fast-food meals between 2010 and 2016

Objective:A quarter of Australian children are overweight or obese. Research conducted in 2010 found that fast-food children\u27s meals were energy-dense and nutrient-poor. Since then, menu labelling and self-regulation of marketing have been introduced in Australia. The present study aimed to: (i) investigate the nutrient composition of children\u27s meals offered at fast-food chains; (ii) compare these with children\u27s daily requirements and recommendations and the food industry\u27s own criteria for healthier children\u27s meals; and (iii) determine whether results have changed since last investigated in 2010.Design:An audit of nutrition information for fast-food children\u27s meals was conducted. Meals were compared with 30 % (recommended contribution for a meal) and 100 % of children\u27s daily recommendations and requirements. A comparative analysis was conducted to determine if the proportion of meals that exceeded meal requirements and recommendations, and compliance with the food industry\u27s own criteria, changed between 2010 and 2016.Setting:Large Australian fast-food chains.Participants:All possible children\u27s meal combinations.Results:Overall, 289 children\u27s meals were included. Most exceeded 30 % of daily recommendations and requirements for a 4-year-old\u27s energy, saturated fat, sugars and Na. Results were also substantial for 8- and 13-year-olds, particularly for Na. When compared with mean energy and nutrient contents from 2010, there were minimal changes overall.Conclusions:Children\u27s meals can provide excess energy, saturated fat, sugar and Na to children\u27s diets. Systematic reformulation of energy, saturated fat, sugars and Na would improve the nutrient composition of the meals

Contribution of food prepared outside the home to diets of young adults

Increased consumption of foods prepared outside of home may contribute to rising obesity rates. Those aged 18-30 years are the largest consumers of these foods, and the group who gained weight at the fastest rate. This study measured the frequency, amount and purchase place of foods prepared outside of home by a population sample of 18-30 year-olds in NSW. A quantitative assessment of the contributions they make to nutrient intakes was conducted. A smartphone dietary data collection app, Eat and Track (EaT), was developed. The one-year development included compilation of an extensive database of foods and iterative phases of usability testing and redesign. Young adults from a range of geographic and socioeconomic areas were recruited through active and passive methods, including face-to-face (‘Relay For Life’ events), paid social media advertising and invitations using the electoral roll. Participants completed online screening and consent. Eligible participants recorded three consecutive days of dietary intake using the EaT app. Participants then completed an extensive demographic questionnaire. The study recruited 1,044 young adults from March 2017-November 2018; 1,001 completing the study. Twenty percent participated in a validation sub-study, where they completed three 24-hour recalls. While there was poor agreement between recalls and the EaT app for energy, the app was a valid way of measuring nutrient densities. Despite constituting a quarter of eating occasions, foods prepared outside the home contributed 40% of energy and deleterious nutrients. Males consumed more energy and nutrients outside home than females. Those with higher Body Mass Index consumed significantly more energy and proportion of total and saturated fat intakes from menu labelling chain outlets. A multi-strategy regulatory approach for improving fast food chain outlets and smaller-scale initiatives with independent outlets are needed to reduce the negative impact of foods prepared outside home

Health and nutrition content claims on Australian fast-food websites

Objective: To determine the extent that Australian fast-food websites contain nutrition content and health claims, and whether these claims are compliant with the new provisions of the Australia New Zealand Food Standards Code (\u27the Code\u27). Design: Systematic content analysis of all web pages to identify nutrition content and health claims. Nutrition information panels were used to determine whether products with claims met Nutrient Profiling Scoring Criteria (NPSC) and qualifying criteria, and to compare them with the Code to determine compliance. Setting: Australian websites of forty-four fast-food chains including meals, bakery, ice cream, beverage and salad chains. Subjects: Any products marketed on the websites using health or nutrition content claims. Results: Of the forty-four fast-food websites, twenty (45 %) had at least one claim. A total of 2094 claims were identified on 371 products, including 1515 nutrition content (72 %) and 579 health claims (28 %). Five fast-food products with health (5 %) and 157 products with nutrition content claims (43 %) did not meet the requirements of the Code to allow them to carry such claims. Conclusions: New provisions in the Code came into effect in January 2016 after a 3-year transition. Food regulatory agencies should review fast-food websites to ensure compliance with the qualifying criteria for nutrition content and health claim regulations. This would prevent consumers from viewing unhealthy foods as healthier choices. Healthy choices could be facilitated by applying NPSC to nutrition content claims. Fast-food chains should be educated on the requirements of the Code regarding claims

Sponsorship of junior sport development programs in Australia

Abstract Objective: This study investigated the nature and extent of unhealthy food, beverage, alcohol and gambling sponsors of children's sport development programs. Methods: Websites of junior development sport programs (n=56) associated with sporting organisations that received funding from the Australian Sporting Commission were analysed. Sponsors were considered unhealthy if they were alcohol or gambling companies or sold food and/or beverages that failed independent nutrition criteria. The websites of the sport development programs were also analysed for types of promotion. Results: There were 246 sponsors identified. Eleven (4.5%) sponsors were food, beverage, alcohol or gambling companies of which 10 (91%) were unhealthy. Surf Lifesaving (n=4) and athletics (n=3) websites had the highest number of unhealthy sponsors. Promotions associated with unhealthy sponsorship included logo placement on homepages (100%), naming rights (31%), logo on sport uniforms (27%) and branded participant packs (31%). Conclusions: The majority of food and beverage company sponsors in sport development programs are companies associated with unhealthy products. Two websites hosting junior development program information included an alcohol company sponsor and a gambling company sponsor. Implications: Unhealthy product sponsorship of children's sport should be addressed as part of a comprehensive regulation designed to reduce exposure to marketing of unhealthy foods

Support for food policy initiatives is associated with knowledge of obesity-related cancer risk factors

Objectives: To investigate community support for government-led policy initiatives to positively influence the food environment, and to identify whether there is a relationship between support for food policy initiatives and awareness of the link between obesity-related lifestyle risk factors and cancer. Methods: An online survey of knowledge of cancer risk factors and attitudes to policy initiatives that influence the food environment was completed by 2474 adults from New South Wales, Australia. The proportion of participants in support of seven food policy initiatives was quantified in relation to awareness of the link between obesity, poor diet, insufficient fruit and vegetable consumption, and physical inactivity with cancer and other health conditions. Results: Overall, policies that involved taxing unhealthy foods received the least support (41.5%). Support was highest for introducing a colour-coded food labelling system (85.9%), restricting claims being made about the health benefits of foods which are, overall, unhealthy (82.6%), displaying health warning labels on unhealthy foods (78.7%) and banning unhealthy food advertising that targets children (72.6%). Participants who were aware that obesity-related lifestyle factors are related to cancer were significantly more likely to support food policy initiatives than those who were unaware. Only 17.5% of participants were aware that obesity, poor diet, insufficient fruit and vegetable consumption, and physical inactivity are linked to cancer. Conclusions: There is strong support for all policies related to food labelling and a policy banning unhealthy food advertising to children. Support for food policy initiatives that positively influence the food environment was higher among those who were aware of the link between cancer and obesity-related lifestyle factors than among those who were unaware of this link. Increasing awareness of the link between obesity-related lifestyle factors and cancer could increase community support for food policy initiatives, which, in turn, support the population to maintain a healthy weight

Energy‐dense fast food products cost less: an observational study of the energy density and energy cost of Australian fast foods

Abstract Objective: To examine the association between energy cost and energy density of fast food products. Methods: Twenty Sydney outlets of the five largest fast food chains were surveyed four times. Price and kilojoule data were collected for all limited‐time‐only menu items (n=54) and a sample of standard items (n=67). Energy cost ($/kilojoule) and energy density (kilojoules/gram) of menu items were calculated. Results: There was a significant inverse relationship between menu item energy density and energy cost (p<0.001). Salads had the highest energy cost, while value items, meals that included a dessert and family meals had the lowest. Conclusions: Fast food chains could provide a wider range of affordable, lower‐energy foods, use proportional pricing of larger serve sizes, or change defaults in meals to healthier options. More research is required to determine the most effective strategy to reduce the negative impact of fast food on the population's diet. Implications: Current pricing in the fast food environment may encourage unhealthier purchases

The availability and accessibility of nutrition information in fast food outlets in five states post‐menu labelling legislation in New South Wales

Abstract Objectives: 1) Explore the availability and accessibility of fast food energy and nutrient information post‐NSW menu labelling legislation in states with and without menu labelling legislation. 2) Determine whether availability and accessibility differed compared with pre‐menu labelling legislation in NSW. Methods: We visited 210 outlets of the five largest fast food chains in five Australian states to observe the availability and accessibility of energy and nutrient information. Results were compared with 197 outlets surveyed pre‐menu labelling. Results: Most outlets (95%) provided energy values, half provided nutrient values and 3% provided information for all menu items. The total amount of information available increased post‐NSW menu labelling implementation (473 versus 178 pre‐implementation, p<0.001); however, fewer outlets provided nutrient values (26% versus 97% pre‐implementation, p<0.001). Conclusions: Fast food chains surveyed had voluntarily introduced menu labelling nationally. However, more nutrient information was available in‐store in 2010, showing that fast food chains are able to provide comprehensive nutrition information, yet they have stopped doing so. Implications: Menu labelling legislation should compel fast food chains to provide accessible nutrition information including nutrient values in addition to energy for all menu items in‐store. Additionally, public education campaigns are needed to ensure customers can use menu labelling

Who is responsible for selecting children's fast food meals, and what impact does this have on energy content of the selected meals?

Aim: The present study aimed to: (i) document the role of parents in children's fast food meal selection; (ii) determine whether parental demographics, weight status or fast food consumption frequency were associated with who selects children's fast food meals; and (iii) determine whether the total energy content of children's meals selected from a hypothetical fast food menu was associated with selection responsibility. Methods: A cross-sectional survey of 477 parents of children aged 3-12 years in New South Wales, Australia, was conducted. Participants completed two computer-assisted telephone interviews. The first collected demographic and anthropometric data including height and weight. Participants were subsequently mailed a hypothetical fast food menu. The second interview asked who was responsible for selecting their children's fast food meals, and what items would be chosen. Energy content of the selections was examined. Results: Most parents (60%) stated that they shared meal selection responsibility with their children. Parents with higher education levels (P < 0.01) or younger children (P < 0.01) were more likely to take responsibility for meal selection. When parents stated that children were responsible, they chose fast food meals with significantly higher energy content than when responsibility was shared (P < 0.01). Conclusions: The present study shows that parents are influential in children's fast food intake. Parents should be encouraged to play an active role in assisting children to make healthier fast food choices, to reduce the impact of high-energy meals on their overall diets

The effect of energy and traffic light labelling on parent and child fast food selection: a randomised controlled trial

Objectives: Labelling of food from fast food restaurants at point-of-purchase has been suggested as one strategy to reduce population energy consumption and contribute to reductions in obesity prevalence. The aim of this study was to examine the effects of energy and single traffic light labelling systems on the energy content of child and adult intended food purchases. Participants and methods: The study employed a randomised controlled trial design. English speaking parents of children aged between three and 12 years were recruited from an existing research cohort. Participants were mailed one of three hypothetical fast food menus. Menus differed in their labelling technique – either energy labels, single traffic light labels, or a no-label control. Participants then completed a telephone survey which assessed intended food purchases for both adult and child. The primary trial outcome was total energy of intended food purchase. Results: A total of 329 participants completed the follow-up telephone interview. Eighty-two percent of the energy labelling group and 96% of the single traffic light labelling group reported noticing labelling information on their menu. There were no significant differences in total energy of intended purchases of parents, or intended purchases made by parents for children, between the menu labelling groups, or between menu labelling groups by socio-demographic subgroups. Conclusions: This study provided no evidence to suggest that energy labelling or single traffic light labelling alone were effective in reducing the energy of fast food items selected from hypothetical fast food menus for purchase. Additional complementary public health initiatives promoting the consumption of healthier foods identified by labelling, and which target other key drivers of menu item selection in this setting may be required