Nutritional Quality of Children’s Menus Offered by Fast-Food and Traditional-Food Chain Restaurants in Costa Rica

Introduction: This study characterizes foods offered by children’s menus at chain restaurants and determines whether differences exist in the nutritional quality between fast-food and traditional restaurants. Methodology: this is a cross-sectional study. After evaluating its inter-observer reliability, the Kids Menu Healthy Score (KIMEHS) was used to determine the nutritional quality of children’s menus. Setting: Chain restaurants located within major shopping centers in the Greater Metropolitan Area (GMA) of Costa Rica in 2023. Participants: 74 unique chain restaurants were included. Outcomes: Availability of children´s menus, KIMEHS individual categories (presence/absence) and overall KIMEHS score. Results: Of all restaurants, 41.9% offered a children’s menu. According to KIMEHS, 97% of these menus were considered unhealthy. There were no significant differences between fast food and traditional restaurants. The most frequent main dishes were chicken nuggets (83.9%), hamburgers (54.8%) and pasta (41.9%). Most restaurants (83.9%) included French fries as a side dish, while only 6.4% offered fruit in their menus. Conclusion: The children’s menus offered had poor nutritional quality, with limited variety and availability of healthy options. There is a need for policies and practices that promote better nutritional quality of food available to children when they eat outside the home in the restaurant setting.