title: Improving children's menus in community restaurants: best food for families, infants, and toddlers (Best Food FITS) intervention, South Central Texas, 2010-2014.
abstract: BACKGROUND
  Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children's menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children's access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus.
  
  
  OBJECTIVE
  San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos's population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level.
  
  
  METHODS
  This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children's menus in local restaurants, administering owner-manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention.
  
  
  RESULTS
  Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus.
  
  
  CONCLUSIONS
  Improving menus in restaurants can be a simple step toward changing children's food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition.
authors.affiliation: Professor, School of Family and Consumer Sciences, Nutrition and Foods, Texas State University, 601 University Drive, San Marcos, Texas 78666. Email: scrixell@txstate.edu.
authors.forename: Sylvia Hurd
authors.initials: SH
authors.lastname: Crixell
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, Texas.
authors.forename: Bj
authors.initials: B
authors.lastname: Friedman
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, Texas.
authors.forename: Deborah Torrey
authors.initials: DT
authors.lastname: Fisher
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, Texas.
authors.forename: Lesli
authors.initials: L
authors.lastname: Biediger-Friedman
mesh_terms: D000293:Adolescent; D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D018752:Diet, Fat-Restricted / Q000706:statistics & numerical data; D005192:Family Health / Q000208:ethnology; D005260:Female; D005502:Food / Q000592:standards*; D005515:Food Labeling / Q000592:standards*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008612:Menu Planning / Q000592:standards*; D052756:Nutritional Sciences / Q000193:education; D019982:Organizational Case Studies; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D063766:Pediatric Obesity / Q000208:ethnology / Q000517:prevention & control; D011203:Poverty / Q000706:statistics & numerical data; D012147:Restaurants / Q000592:standards*; D013781:Texas