(Nielsen et al., 2002b). Trends in the calorie intakes of children and adolescents ages 2–18 years by selected eating locations showed a substantial increase in away-from-home calories obtained from restaurants, especially QSRs, from 5 percent in 1977–1978 to 15 percent in 1994–1996 (Nielsen et al., 2002a). Data for more recent trends in young peoples’ calorie intake from foods and beverages obtained at restaurants are not available. A review of the available literature finds that nearly one-half of away-from-home calories obtained at full serve restaurants and QSRs were higher in fat content (IOM, 2006). Although healthier menu options are gaining attention, most QSRs continue to offer choices that are predominantly high in total calories, saturated fat, sugar, and salt. Many QSRs indicate that sustained consumer demand is inextricably related to a broader sustained societal effort focused on promoting healthier choices (IOM, 2006).

Restaurants are important venues for increasing fruit and vegetable consumption. A recent survey, combined with menu trend research, found that although 67 percent of consumers reported visiting a QSR at least once every 2 weeks, only 18 percent reported regularly consuming fruits or vegetables from such restaurants. Additionally, whereas 13 percent of all meals are eaten at or carried out from a commercial restaurant (including casual dining and QSRs), only 7 percent of total fruit and vegetable servings were consumed at restaurants. Many opportunities exist to use plate presentation, promote convenience, and use limited-time offers and incentives to promote produce consumption when consumers eat out at restaurants (PBH, 2005b).

The growing public concern about obesity presents certain marketing risks—such as increased costs associated with developing, reformulating, packaging, test marketing, and promoting food and beverage products, as well as uncertainty related to creating and sustaining consumer demand for these new products. However, the public’s interest and concern also present potentially profitable marketing opportunities not yet fully explored: food and beverage manufacturers can compete for and expand their market share for healthier food and beverage product categories, serve as role models for the industry by substantially shifting overall product portfolios toward healthier products, and engage in socially responsible corporate behaviors in the response to the childhood obesity epidemic. Despite the challenges of market forces and the marketplace, companies can make positive changes that expand consumers’ selection of healthier products, as well as to reduce the risks of government regulation or litigation (Mello et al., 2006).

Physical Activity Opportunities

The Health in the Balance report recommended that the leisure, entertainment, and recreation industries develop products and opportunities



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