# Evaluating A Healthy Restaurant Kids Meals Policy

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $674,783

## Abstract

PROJECT SUMMARY
More than a dozen municipalities have passed healthy restaurant kids’ meals policies. These policies seek to
reduce child consumption of sugar-sweetened beverages (SSBs) by requiring that restaurants serve only
healthy beverages (water, milk, or 100% juice) instead of SSBs as the default choice with children’s meals in
restaurants. These policies have potential to meaningfully reduce child SSB consumption; 10% of child calories
from SSBs come from restaurant sources. Restaurants that have voluntarily removed SSBs from children’s
menus (but still allow SSBs by request) have found significant reductions in SSBs and total calories in
children’s meal orders. However, there are significant gaps in our knowledge of the effects of healthy kids’
meals policies on children’s health; to date, these policies have not been evaluated for their short-term effects
on children’s meal orders or total dietary intake, or for their long-term effects on childhood obesity. This study
makes a significant contribution by combining a natural experiment with restaurant manager and City official
interviews and cost-effectiveness modeling to evaluate the implementation and health effects of a healthy
restaurant kids’ meals policy in Washington DC, the largest City to implement this policy to date. Our study
uses a mixed-methods approach incorporating quasi-experimental difference-in-differences analyses;
qualitative interviews with restaurant managers and City officials; and cost-effectiveness modeling. We will
collect receipts from and survey 2,000 adults and children aged 2-10 years dining at fast-food restaurants in
one intervention City with a healthy kids’ meals policy (Washington DC) and one comparison City without a
policy (Philadelphia, PA) to assess changes in SSBs and calories purchased before and 12 months following
implementation of a healthy kids’ meals policy (Aim 1). We will also conduct next-day telephone dietary recalls
to assess changes in children’s SSB consumption, diet quality, and total caloric intake on the day of the
restaurant meal (Aim 2). We will conduct implementation surveys in restaurants, collect local food safety
inspection data from the DC Department of Public Health, and conduct interviews with restaurant managers
and City officials to estimate costs, compliance, and reach of the policy in Washington DC and to model the 10-
year health impact, population reach, implementation cost, healthcare cost savings, and cost-effectiveness if
the policy were implemented nationwide (Aim 3). A healthy kids’ meals bill was introduced in Washington DC in
September 2018 and is expected to be reintroduced this month (March 2019). Advocates are confident that the
bill will pass this legislative session, and implementation deadlines are typically 90 days from passage. Thus,
time-sensitive funding is critical for ensuring adequate time for baseline data collection. The proposal’s
significance lies in our ability to provide the first empirical e...

## Key facts

- **NIH application ID:** 9978080
- **Project number:** 5R01HD100983-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Angie Cradock
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $674,783
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9978080

## Citation

> US National Institutes of Health, RePORTER application 9978080, Evaluating A Healthy Restaurant Kids Meals Policy (5R01HD100983-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9978080. Licensed CC0.

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