Across New York and Newark, before and after labeling, a total of 427 children and adolescents were sampled. We excluded 78 respondents (18%) who indicted that they shared food listed on the receipt, as it was difficult to ascertain the relative amount of food eaten. Children and adolescents who came to the restaurant with a caretaker/parent comprised 69% of the study sample, with 31% visiting the restaurant alone. By design, 76% of our sample was drawn from NYC (see ). Conditional on providing data on at least one child, parents/caregivers provided data on 1.4 children.
Descriptions of children and adolescents and their parent/caregiver
Approximately 47% of the respondents were male. Adolescents aged 13–17 years made up 54% of our sample. In total, 66% of the participants identified themselves as Black, 24% were Latino and the remaining 11% were of mixed race or White. These demographic characteristics remained consistent across our two data collection periods, except that the Newark post-labeling sample included a higher proportion of Black respondents (94%). We also provide data on the parents/caretakers of the children in our sample. Only 13% were male, and approximately one-third were between the ages of 18 and 29 years.
describes differences in the total amount of calories purchased, and whether this changed as a result of labeling. Overall, the 349 children and adolescents in our sample purchased an average of 645 calories; those without a caregiver tended to be older and purchased a higher amount of calories. We did not observe any differences before or after labeling in NYC or Newark. The same was true for male and female participants of various age groups. We did occasionally see a nonsignificant decrease (females <13 years old) as well as a nonsignificant increase (males ≥13 years) in calories consumed, but no consistent patterns emerged. Again, we note our limited sample size.
Mean calorie intake of children and adolescents from fast food
Next, we examined whether adolescents noticed and/or indicated that they responded to calorie labels (). No adolescent respondent said that they noticed the calorie labels in NYC and Newark before labeling began. After labeling began in NYC, 57% of the same group in NYC (and 18% in Newark) reported noticing calorie information. A total of 9% indicated that the labels influenced their meal choice; 9% also claimed that they purchased fewer calories as a result. In other words, of adolescents who reported noticing the labels, 16% reported that the information influenced their food choice.
Adolescents noticing and indicating responses to calorie labels.
We next turned to the factors that adolescents described as influencing their fast-food choice, and examined whether these differences correlated with the amount of calories purchased (). Of the factors we examined, ‘ease’ mattered ‘some’ or ‘a lot’ for 57% of respondents. After this, location was the most important factor, with 48% of respondents falling into one of the categories (of course, these characteristics are likely correlated). Adolescents who indicated that these factors mattered purchased somewhat fewer calories.
Additional factors influencing adolescent fast-food choices, and their correlation with calories consumed
Turning to the characteristics that adolescents used to determine which food to eat, taste was rated as most important by 72% of respondents, but these consumers did not appear to purchase more calories. As for price, 46% of consumers said this was not at all a factor in their choice. Finally, just over a quarter of adolescent consumers reported that they often, or always, limited the amount of food they ate in an attempt to control their weight, with an almost equal number never limiting food for this reason. This was not correlated with any difference in the number of calories purchased.
More accurate calorie information is a key benefit claimed for calorie labeling. As indicates, a majority of adolescents underestimated the calorie counts for the meals that they purchased. In New York, 63% underestimated the total calories they purchased before labeling, and 59% did so afterward (n.s.). Of those who underestimated, the mean underestimate was 466 calories before labeling and 494 after labeling in NYC (n.s.). In response to the question determining the amount of calories an adult should consume to maintain a normal weight (), approximately a quarter of adolescents provided a number between 1500 and 2500. The vast majority of consumers underestimated the recommended calories, 63% before labeling in NYC and 61% after labeling.
Adolescents estimate of calories purchased vs actual calories purchased
NYC, adolescent estimates of calories that should be consumed by adults to maintain healthy weight
Finally, another little understood aspect of child obesity concerns parental influence on food decisions in general, and fast-food decisions in particular. Approximately 30% of parents/caregivers indicated that the child chose what to eat that day, whereas 57% indicated that they chose for the child. For adolescents, in most cases (61%), no caregiver was present; the adolescents almost always chose what they ate by themselves. Only 30% of adolescents said that their parents had no influence on their food choice, with an almost equal number saying that they influenced their decisions ‘some’ or ‘a lot.’ Half of the adolescents reported that they decided what to eat at home, 24% indicated that their parent decided and the remaining (17%) reported that the decision was made jointly. There was no apparent trend toward greater parental involvement being associated with lower fast-food calorie consumption in our sample ().
Fast-food intake and decision making among families