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Problem Eating out is associated with enjoyment, but not healthy meals. The number of families that consume their daily calories from away-from-home foods is increasing. Most restaurants (90%) offer kids meals that are lacking vegetables and are high in calories, sodium and saturated fat. Additionally, families are exposed to many advertisements promoting unhealthy foods and only 3% is aimed at healthy choices. Description The local health authority of the city Nijmegen in the Netherlands started a program (January-June 2019) in collaboration with the local hospital, university, city council, restaurants, primary schools and children’s council to promote healthy kids meals in restaurants. Chef-cooks, a dietician and culinary advisor visited the schools they were paired to in their neighborhood to co-create new kids menus. In parallel, students conducted focus groups at schools that could not be visited by the chef-cooks. Information was gathered about which healthy foods children like, and how to present and promote the meals in an attractive way. Next, the children were invited to the restaurants to taste and rate three kids meals created by the input of the children. The winning meals stayed on the restaurant menus for at least a month, while promoting the meals with marketing techniques that were suggested by the children and tested in two experiments: online and in the restaurants. Results During the co-creation lessons at schools, children became more aware of the primarily unhealthy food options in restaurants. Preliminary findings suggest that although most parents would choose unhealthy kids menus in restaurants, healthy meals can be promoted to families by use of characters. Lessons Restaurants are willing to offer and promote healthy kids menus. Co-creation with the target audience and a collaboration between different parties may increase the effect of an environment-level intervention to achieve individual and family-level behavior change. Key messages Involving children and local parties to increase the availability of healthy kids meals in restaurants and promoting these meals can be an effective way to make eating out a healthy experience. A collaboration between different local public and private parties may increase the effect of an environment-level intervention to achieve individual and family-level behavior change.

Placing healthy kids meals on the restaurant menu by co-creation between chef-cooks and children