<?xml version="1.0" encoding="utf-8"?>
<recommendedContent xmlns="http://api.mspoke.com">
    <recommendedItem id="20100101_19_265"
                     title="How Many Calories in that Happy Meal? (CME/CE)"
                     score="0.004"
                     href="http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/18099?impressionId=1265752027717"
                     
      Putting nutrition labels on fast food may lead parents to pick lower-calorie meals for their children, researchers say.&lt;br&gt;
&lt;br&gt;In a small waiting room study, parents ordered about 20% fewer calories for their kids when they chose from a menu with nutrition information on it, Pooja Tandon, MD, of the University of Washington, and colleagues reported online in &lt;em&gt;Pediatrics&lt;/em&gt;.&lt;br&gt;
&lt;br&gt;&quot;One hundred calories over time and at a population level is actually a significant amount in terms of being able to avert weight gain,&quot; Tandon told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;br&gt;
&lt;br&gt;Many fast-food restaurants don&apos;t provide nutrition information at the point of purchase. In a recent study, just about half  --  54%  --  of the largest chains made some nutritional information available on site. The majority  --  86%  --  provided it only through their Web sites, leaving consumers clueless while ordering.&lt;br&gt;
&lt;br&gt;Labels have long been advocated as a means of lowering calorie consumption. So to determine whether nutrition labeling specifically on fast-food menus would lead to lower-calorie choices for children, the researchers conducted a randomized, controlled experiment in a primary care pediatric clinic in Seattle.&lt;p&gt;&lt;/p&gt;
&lt;p&gt;Parents of children ages 3 to 6 were given a McDonald&apos;s menu, and then asked to pick out meals anonymously&lt;strong&gt; &lt;/strong&gt;for themselves and their child.&lt;/p&gt;
&lt;p&gt;The menus were identical, with one exception: those given to parents in the intervention group included nutrition information, while the menus given to parents in the control group had none. The menus did include prices for both groups.&lt;/p&gt;
&lt;p&gt;A total of 99 parents participated between October 2008 and January 2009. Some 62% reported eating fast food one to four times over the previous month, mostly because it was quick, cheap, or fun.&lt;/p&gt;
&lt;p&gt;The researchers found that parents who were given nutritional information ordered an average of 102 fewer calories for their kids than did controls (567.1 cal versus 671.5 cal, &lt;em&gt;P&lt;/em&gt;=0.04).&lt;/p&gt;
&lt;p&gt;On average, the nutrition-labeled menu reduced total calories ordered by 20%, the researchers wrote.&lt;/p&gt;
&lt;p&gt;The difference remained significant after adjustment for gender, race, education, BMI, fast-food frequency, and child&apos;s BMI z-score (&lt;em&gt;P&lt;/em&gt;=0.004).&lt;/p&gt;
&lt;p&gt;&quot;We know that fast food consumption is rising alongside alarming rates of child obesity in this country,&quot; Tandon said. &quot;These results make me optimistic that if parents are given nutritional information at the point of ordering  --  and not on a Web site or tray liner  --  they will have the tools to make healthier, lower-calorie choices for their children.&quot;&lt;/p&gt;
&lt;p&gt;Research has suggested that even small changes in behavior that affect energy balance by about 100 calories per day could avert weight gain in most adults.&lt;/p&gt;
&lt;p&gt;Interestingly, Tandon said, there were no differences between the groups when it came to parents&apos; choices for themselves. Both ordered about the same number of calories.&lt;/p&gt;
&lt;p&gt;&quot;I&apos;m not sure exactly what&apos;s going on with this group of parents, but this is a trend we&apos;ve seen,&quot; Tandon said. &quot;I would hypothesize that there are some other factors at play when people are choosing for themselves and their children in terms of wanting children to eat healthier than they might for themselves.&quot;&lt;/p&gt;
&lt;p&gt;There was also a positive correlation between how many calories the parent ordered and how many calories he or she ordered for the child (&lt;em&gt;P&lt;/em&gt;=0.02).&lt;/p&gt;
&lt;p&gt;&quot;We do know that if a child has one or two parents who are overweight, that increases their chance of being overweight, so [obesity] probably is a combination of genetic and environmental factors,&quot; Tandon said.&lt;/p&gt;
&lt;p&gt;Tandon noted that a growing number of local and state governments have adopted restaurant menu labeling regulations, and legislation for federal labeling standards has been introduced in both the House and the Senate.&lt;/p&gt;
&lt;p&gt;&quot;At a time when menu labeling is being discussed throughout country at the national level, I think these results support the&lt;strong&gt; &lt;/strong&gt;idea that an informed parent will be able to make smarter healthier choices for their child,&quot; she added.&lt;/p&gt;
&lt;p&gt;The study was limited because it was not conducted in a real restaurant setting. Food choices are made within social and environmental contexts, Tandon said, and the results of a mock menu survey in a clinic may not fully represent that reality. A randomized experiment in a real restaurant setting would be an ideal follow-up.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The researchers reported no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_95"
                     title="School Lunches Healthier than Brown-Bagging It (CME/CE)"
                     score="-0.005"
                     href="http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/17900?impressionId=1265752027717"
                     
      &lt;p&gt;Only about 1% of lunches that school children brought from home met the nutritional standards set for school meals, English researchers found.&lt;/p&gt;
&lt;p&gt;&quot;Children were provided with packed lunches low in fruit and vegetables,&quot; the researchers wrote. &quot;The majority . . . included savory snacks, confectionery, or both,&quot; Charlotte Evans, PhD, of the University of Leeds, and colleagues reported online in the &lt;em&gt;Journal of Epidemiology and Community Health&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;The U.K. introduced standards for school meals in 2006  --  including requirements for protein-rich and low-fat foods, fruits and vegetables, and minimum amounts of vitamins and minerals  --  but about half of students bring a brown-bag lunch to school.&lt;/p&gt;
&lt;p&gt;Packed lunches aren&apos;t subject to the nutritional regulations.&lt;/p&gt;
&lt;p&gt;So to investigate their healthfulness, the researchers conducted a survey of 1,294 children ages 8 and 9 who attended 89 English primary schools. Nearly the same number  --  87  --  declined to participate in the survey.&lt;/p&gt;
&lt;p&gt;For brown-bag lunches, the researchers assessed the weight of the foods and their nutrient content. They also assessed whether the foods met school meal standards set by the government.&lt;/p&gt;
&lt;p&gt;Only 14 of the packed lunches, or 1.1%, met all of the government standards, and only 5.1% met five healthy standards, which included a sandwich with protein filling, vegetables, fruit, and a dairy product.&lt;/p&gt;
&lt;p&gt;Instead, the median number of healthy food groups in a child&apos;s lunchbox was three.&lt;/p&gt;
&lt;p&gt;The vast majority of children  --  85%  --  did have a sandwich, while 54% had fruit, 44% had a milk-based dessert, 19% had vegetables, and 17% had cheese.&lt;/p&gt;
&lt;p&gt;However, 82% had restricted snacks and 61% had a sweetened drink.&lt;/p&gt;
&lt;p&gt;Overall, the foods least likely to be found in lunchboxes were vegetables or permitted savory foods such as pasta.&lt;/p&gt;
&lt;p&gt;The researchers said that the nutrient standards most likely to be met were those for protein and vitamin C; those most likely to be missed were non-milk extrinsic sugars and sodium.&lt;/p&gt;
&lt;p&gt;Girls had more fruit, vegetables, and milk-based desserts in their lunchboxes, while boys had more savory snacks.&lt;/p&gt;
&lt;p&gt;The researchers noted that there is &quot;some indication&quot; that the number of savory snacks and other sweets has decreased since a previous survey in 2004, although overall levels haven&apos;t changed.&lt;/p&gt;
&lt;p&gt;&quot;More than three-quarters of children continue to be provided with snacks restricted in school meals, with boys consuming higher levels of confectionery on average,&quot; the researchers wrote.&lt;/p&gt;
&lt;p&gt;Levels of saturated and total fat have also decreased since 2004, but this is likely the result of efforts by industry to reduce the content of these nutrients in their products, the researchers noted. It is certainly not that the snacks have decreased in popularity.&lt;/p&gt;
&lt;p&gt;The researchers concluded that future research should address policy, interventions, and programs to educate parents about the nutritional content of packed lunches.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was funded by the Food Standards Agency.&lt;/p&gt;&lt;p&gt;The researchers reported no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_1_61"
                     title="Students Navigate Minefield of Lunch Time Temptations"
                     score="-0.005"
                     href="