Prev Chronic Dis. 2014 Jul 17;11:E122. doi: 10.5888/pcd11.140026.

Impact of San Francisco's Toy Ordinance on Restaurants and Children's Food Purchases, 2011-2012.

Otten JJ1, Saelens BE2, Kapphahn KI3, Hekler EB4, Buman MP4, Goldstein BA3, Krukowski RA5, O'Donohue LS3, Gardner CD3, King AC3.

Author information

• 1University of Washington School of Public Health, Nutritional Sciences Program, Box 353410, Seattle, WA 98115. E-mail: jotten@uw.edu.
• 2University of Washington and Seattle Children's Research Institute, Seattle, Washington.
• 3Stanford University School of Medicine, Stanford, California.
• 4School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona.
• 5University of Tennessee Health Science Center, Memphis, Tennessee.

Abstract

INTRODUCTION:

In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children's menus), and the energy and nutrient content of all orders and children's-meal-only orders purchased for children aged 0 through 12 years.

METHODS:

Restaurant responses were examined from January 2010 through March 2012. Parent-caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012.

RESULTS:

Both restaurant chains responded to the ordinance by selling toys separately from children's meals, but neither changed their menus to meet ordinance-specified nutrition criteria. Among children for whom children's meals were purchased, significant decreases in kilocalories, sodium, and fat per order were likely due to changes in children's side dishes and beverages at Chain A.

CONCLUSION:

Although the changes at Chain A did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results underscore the importance of policy wording, support the concept that more healthful defaults may be a powerful approach for improving dietary intake, and suggest that public policies may contribute to positive restaurant changes.