Restaurant chains spend millions on toys to include in meals for children age 12 years and younger. Pairing energy-dense, nutrient-poor fast food with toys contributes to childhood obesity.
In August 2010, Santa Clara County, Calif., became the first U.S. jurisdiction to prohibit distributing toys with meals that do not meet minimal nutritional criteria regarding calories, fat, sodium and sugar. To determine if restaurants affected by the ordinance changed their menu offerings or toy distribution practices, researchers compared restaurants before the ordinance (July 2010), and after (November 2010) to matched, unaffected same-chain restaurants. They scored the restaurants by whether or not they offered side dishes that included non-fried vegetables or sides with no added sugar; offered 100 percent juice or low-fat milk beverages; included an unhealthy dessert; offered nutritional guidance; and had toy promotions and branded marketing.
After the ordinance, restaurants did not introduce more healthy meal items but did promote healthy meal choices and provide on-site nutritional guidance. Some restaurants changed toy marketing and distribution practices. Such changes did not occur in same-chain restaurants unaffected by the regulation.
When prompted to do so, restaurants were able to change marketing and advertising quickly (in less than 90 days). Changing food items, however, may require more time.