CSU's The Audit

INTRO: When you're a parent, one of the worst daily decisions you have to make is what's for dinner. When you are tired after a long day, that one question can feel overwhelming. What's healthy? What's available? What will my kids actually eat? So maybe you decide tonight, you're going out. Colorado State University researcher Megan Mueller studies the impact that restaurants and our food environment can have on our food choices and our health. An assistant professor in the Department of Food Science and Human Nutrition. Mueller recently published two studies looking at the impacts of dining out.

Today, I'm talking with her to find out more about how the food choices of parents influence their children, and where restaurant corporate social responsibility draws the line.

HOST: Your research found that while the majority of restaurants had some kind of corporate social responsibility statement on their webpage, most of those focused on philanthropic endeavors or sustainability measures, not health-related statements.

MUELLER: My colleagues and I were interested in understanding the landscape around corporate social responsibility in restaurants. The motivation for that was a study I had read in graduate school that was looking at how food industry professionals were talking about their responsibility in the obesity epidemic in news media and other sources of media. They found that basically the food industry shifted the conversation and how they'd been talking about their role in health and specifically in obesity to be focused more on wanting to be part of the solution.

Initially, in the early 2000s, a lot of interviews with food industry professionals, coverage of food in the media, and the way that those professionals or representatives were talking about the role was more, “it's not my problem. It's a personal responsibility. People just need to eat better and exercise more.” That shifted over the next decade. Around 2010 to 2015, the industry shifted in how they talked about their role to be more part of the solution. Instead of just blaming people for the outcomes that they were experiencing, they wanted to be a part of the solution. Who knows why, some of that could have been public pressure, could have been policy pressure, but that language shifted in how they represented themselves.

We wanted to understand, now that the food industry is saying they want to be part of the solution, what does that look like? Are they prioritizing things like health in their statements, or is it something that's just part of it, but not really a focus? That's essentially what we found, was that health was something that came up. About 50% of the restaurants that we surveyed had a health-related position. But when we looked at the actual content of the statements on their corporate social responsibility web pages, we found that the majority of those statements were not health related. And of those that were health-related, the majority of them weren't actionable. They weren't explicit. You couldn't point to that initiative five years later and say, “yes, they did what they said they were going to do.” There were pretty vague statements like, "we care about the health of our communities.”

HOST: “We care. We're not going to do anything, but we care.”

MUELLER: Right. “It's something that we think about.” But there wasn't a sodium reduction initiative, or we didn't find that many specific initiatives where they did things like reduce the sodium content of their menus. Some of that could be a function of the restaurants that we included in our study. Some of it could be a function of the time frame that we were specifically looking at.

Some restaurants did end up having some health-related initiatives. If you look at their web pages today, for example, McDonald's is a great example of a restaurant that actually does have some pretty explicit goals, especially for their children's menu. However, when we were looking, which was 2012 to 2018, those weren't necessarily explicitly put on their CSR pages.

HOST: What kind of restaurants were you looking at? Was it fast food? Was it chains?

MUELLER: We followed 96 of the top 100 restaurants based on system-wide sales. So that includes quick service restaurants, fast food restaurants like McDonald's or Taco Bell. It also includes restaurants that are fast casual. Chipotle falls into that category, as do Panera or St. Louis Bread Company. Those sorts of restaurants that are kind of in between a sit down and a fast food, maybe they have some more fresh ingredients, things like that. Then there were also some sit-down restaurants too, like Chili's, the larger chain, sit-down restaurants that you can think of.

HOST: Can you give me some examples of, and I hate to point people out, but who was good and who was not?

MUELLER: Yeah, so interestingly, the restaurants that had the most statements just in terms of number were those that were coffee-focused chains. Think about Starbucks and Tim Hortons. That was a little bit surprising. I would say there are some other chains that you would think of because maybe you've seen some of their initiatives; they're pretty good at advertising them. McDonald's is a great example of that. The ones that didn't do as well, I'm trying to think off the top of my head if there's anyone that stands out. It was surprising to me that of all these chain restaurants, a lot of them did have some kind of corporate social responsibility. I didn't necessarily expect to see that per se, so I'll just say that that was a surprise.

Some of the initiatives that were happening were things like sodium reduction initiatives. Some of the restaurants had calorie labeling on their menus before it was required by law, so that was another example. Other initiatives included things like offering healthier sides or beverages, things like that, especially on kids' menus. But yeah, a lot of them were just, “we care about the health of our communities.”

HOST: Your study concluded that there's a need for more actionable, health-focused initiatives in these social responsibility statements, particularly for chain restaurants. But some would say it's not the restaurant's responsibility; it's personal responsibility. It's your responsibility to take care of yourself – to make the right choices. It's the restaurant’s responsibility to serve food that people want to eat, and I think we all know that what we want to eat and what we should eat can be very far apart sometimes.

MUELLER: I think that it's fair to say that it is not the role of industry to be responsible for people's health. At the same time, we have companies publicly stating that that's something that they want to do. That to me indicated that there is this shift in how industry is talking about wanting to be part of the health of communities. So, if that is the case, what does that look like? If corporate social responsibility is the way that companies are committing to health, I think it's important to understand how. What does that mean and is that something that we can look to as an indicator of this restaurant actually offering healthier options? Or is this, as consumers something where we must be a little bit more, I guess “careful” might be the right word, of how much stake we put in those statements.

This initial study showed that there's not a lot of teeth to these corporate social responsibility statements, at least the ones that we looked at. As consumers, we can't just use that as a rule of thumb when choosing where to eat out. But there's a lot of literature that suggests that people do use some of that information to make decisions about where to go to eat or what to eat and that in some ways those could be a little bit misleading.

HOST: In the paper, you mentioned public health initiatives engaging with industry. What might that look like?

MUELLER: There are some public health initiatives out there that have industry partnerships, and sometimes the industry will partner with public health organizations to be part of their corporate social responsibility initiatives. One example is the Partnership for Healthier America. They do a lot of public-private partnerships to try and improve food environments. It's a great starting point, I think.

The point of this work isn't necessarily to vilify the industry. The point is just to point out where we can do more or where there might be gaps. That's really the biggest take home is that there appears to be some gaps, at least in terms of what they say they care about and then the actual initiatives that are happening.

HOST: Another study that came out just late last year was a look at restaurant choices, but it's from the patron's side. Specifically, you looked at how parents' food choice values at home can influence their children's eating behaviors and choices in restaurants. Tell me a little bit more about this.

MUELLER: This was done during the COVID-19 pandemic. We wanted to know, among frequent fast-food consumers or restaurant consumers, how much did their restaurant eating change during the pandemic? We were also interested in parental food choice values and how that was related to both their children's eating behaviors in restaurants and around restaurant frequency of eating. These were specifically low-income families.

What we found, at least among these parents during this time, was that there were three distinct classes or subgroups of parents based on their values. We looked at things like convenience, cost, taste -- sort of the big three that everyone thinks about when they think of food choices. But we also looked at things like nutrition, whether they wanted to support their local businesses, and whether food safety concerns were something that they were concerned about. What we found basically was that there were three different classes or groups of parents. All of them prioritized convenience. The indulgent class of parents also prioritized taste. We had a hassle-free group of parents that prioritized not wanting to cook at home. We've all been there, right? And then there was the multifaceted parent class who prioritized a lot of things, like they really valued nutrition, wanting to socialize with friends, et cetera.

Within these groups of parents, we saw differences in how their kids ate. For the hassle-free group, those that prioritize convenience and do not want to cook at home actually had kids that were more likely to choose a less healthy entree. For our parents that prioritized a lot of different things and had values around almost everything with their restaurant eating, they were more likely to eat out more frequently. But they also had higher rates of food insecurity and lower rates of high stress.

HOST: You also found that children of parents who prioritize convenience and dislike cooking, as you said, were significantly less likely to order healthy entrees when dining out compared to others. Do you have any idea why?

MUELLER: It's a cross-sectional study, so we can't really say much about the underlying mechanisms. But we could posit that there might be some other things underlying some of that. There could be differences in food parenting practices. That's another way of asking some of these same things. There could also be differences within these parent groups based on kids' taste preferences and what they're exposed to. It's possible that all of these parents had kids that were also not likely to order healthy entrees, so it's also possible that it's just a representation of the menu.

HOST: What kind of conclusions can we draw from this study? What does it tell us about our influence on our children's eating habits?

MUELLER: It's a great question. I think the conclusions from the study are that at least from this context with this sample of parents, it seems that value systems have some relationship to child eating behavior. We don't know, again, if that's causally related but we can at least see that there are some observational differences in how these children eat in the context of their parents' values. That being said, there are other bigger picture things to consider here.

We have, again, low-income parents during COVID-19. We all remember what that was like. It was incredibly stressful, especially if you're doing school at home while trying to work. If you have a job where you have to be in the office, it can be even more complicated. It was, in some ways, a unique time. We still have within the sample a fairly high rate of eating out, on average about two times per week, which is less than they did prior to the pandemic.

Considering that a lot of people shifted to not eating out at all, it's somewhat telling of the parents we were sampling. The fact that there is this higher rate of less healthy entree consumption among children whose parents are in that hassle-free group, there's something that could be done at the restaurant level to reach those families. However, all three of the classes still had a high rate of choosing less healthy entrees. In part, that's a function of just what's available on restaurant menus. That goes back to some of these questions that we were talking about earlier about what the role of the industry is.

My personal motivation for doing this work is that there's a lot of reasons why families eat out. My family had to eat out a lot when I was a kid because I had two working parents and very active kids. That was just part of what we had to do as a family to make it. And in this group of parents, when you're experiencing low income, you are going to prioritize things that your kids will eat that might be cheaper in terms of calories per dollar. If you think, “oh, I can go get a burger from the dollar menu, or I can get a pear.” Obviously, you're going to choose the burger from the dollar menu. It's more satiating, it's more substantive, and that'll feed your child, right? And you know they'll eat it. Given all that, I think it's important to really consider what we can do in the public health setting to help empower families to eat healthier when they do eat out. In part, that's maybe thinking about how restaurants can prioritize things like health when they say that's something that they want to prioritize.

HOST: When you talk about items that are “less healthy,” what do we mean?

MUELLER: We used a previously published study that utilized data from a national survey where they categorized entrees as “less healthy” based on whether they were something like a burger, pizza, or fried fish or fried chicken. So that's...

HOST: The staple kids' diet.

MUELLER: Exactly. Unfortunately. I always joke that, why in America is kids’ food chicken fingers, grilled cheese, pizza and burgers? Why is that what our kids eat instead of a lot of other countries where, even school meals, you see these beautiful pictures of these gorgeous school lunches that look like a full complete meal. Even here in Colorado, Boulder County does a lot of farm-to-school stuff. They have beautiful school lunches. It's very impressive what some schools can do if they have the resources.

But for some reason, in the U.S., kids' food has just become the things that we see, not only in restaurants, but that are marketed to us on television shows, that we see in the grocery aisle. That's just what we're told is kids' food. That's something that I hope that we, as engaged citizens, challenge a little bit. Why is that the only thing that's kid food? Why can't we also have a small version of grilled chicken or salmon or tofu even as a kid's meal?

HOST: I wanted to circle back on something you mentioned. Again, the study was done during the pandemic when people were less likely to go out to restaurants, and it also focused on low-income families. Why focus on that timeframe and that group specifically?

MUELLER: I really wanted to understand, in this group of parents and families, how much did their restaurant eating behavior change during the pandemic. It was a goal of mine to reach those families with some of my work doing intervention studies. I had a panic moment when the pandemic happened because I've done all this work in the restaurant space and I wondered if people are even eating out anymore? Am I suddenly not doing something that's really meaningful?

It's also an important population to study. Low-income families, as we see in our sample, experience a lot of stress. They have other stressors in their lives like food insecurity and access issues. The food environments in low-income communities are historically and currently not great.

HOST: Like living in a place where there are several fast-food places, but maybe not a grocery store.

MUELLER: Exactly, and you'll see this in the literature deemed a “food swamp,” and I think that's a pretty accurate term for it. These communities are disproportionately often marketed to by companies. That's another type of corporate social responsibility, should we be marketing to historically marginalized communities.

HOST: Yeah, I think this is a little bit of an aside, but I was thinking about the fact that – as you mentioned earlier, a burger is $1, and a fruit or vegetable is also $1. The healthier options are often quite a bit more expensive. If you go to a restaurant, the healthier choice costs extra. Switching fries for a salad can be extra. It becomes harder to make healthier choices.

MUELLER: Yeah, it can, especially if you are low income. What I've seen in my work is that for a lot of restaurants - and not every child will order from the kids’ menu, especially if they're older - but for a of restaurants, the children's menu is a loss leader. They're not making a ton of money on the kids' food. But they are making a lot of money for the whole family coming in. That's the goal, to bring the whole family in. Some of the restaurants that I've partnered with in the past have made those health changes. They have automatically bundled their kids' entrees with healthier sides or beverages. And we've seen shifts in what children order. And from a business perspective, the restaurants actually continued to have revenue growth. They continued to make just as much money as other comparable restaurants. That indicates that it didn't negatively hurt their bottom line. And we saw these positive shifts for kids. So, it can be done in a chain restaurant. It's a great business case study, essentially, an example of where it worked, and it didn't hurt their business.

HOST: Parents hearing this data, myself included I'll admit, may hear all this and think, “oh my gosh, I take my kids out to eat fairly frequently. I'm teaching them bad habits. I'm a bad parent.” What should the parent takeaway be?

MUELLER: There are so many reasons why families need to eat out or want to eat. The last thing I hope to do is to contribute to the guilt that we all feel. Parenting is the hardest job. You feel guilty all the time. I'm just speaking as a person now, but I think that's the last thing I want to do with this work.

I hope what it does instead is highlight how hard it is to navigate food environments, especially in restaurants. It's a challenge that we all must deal with, unfortunately. Hopefully that takes some of the pressure off us as individuals. It's just hard to navigate the food environments for ourselves and also for our children. Also, I hope that it highlights instead what changes could happen that might help us.

There are all these sorts of subconscious things that we're exposed to on a daily basis that affect our choices, including where products are placed, when we're marketed to, how we're marketed to, and at what time of day we're making these choices. Are we stressed out? Are we not stressed? Just knowing that about ourselves, that context matters. Environment matters. Our mental state matters. Our daily experiences matter. I don’t want people to feel bad about the decisions that they make, but instead to know that there's things that could happen that could make this easier.

What are those things? Prioritizing some of those convenient healthy things on the dollar menu, for example, could be one type of a change that a restaurant could make to make it easier for families to eat a little bit healthier when they eat out. Or to market healthier options, and to provide more healthy options. To also make those things accessible and hopefully affordable for families is something that hopefully is a shift that we start to see in the industry.

HOST: Thank you so much for your time. I really appreciate you being here.

MUELLER: Thank you so much. It was great to be here.

OUTRO: That was CSU Assistant Professor Megan Mueller talking about her research into the impacts of dining out. I'm your host, Stacy Nick, and you're listening to CSU's The Audit.