The health of the city of Cleveland is directly correlated to the health of its people. That is the premise underlying a new policy proposal aimed at improving health outcomes for Cleveland’s youth by mandating healthy options on restaurant kids’ menus. Spearheaded by the American Heart Association, it is the latest salvo in the city’s war to combat chronic disease in high-risk communities.
The Coalition is composed of more than 20 community and healthcare organizations, medical professionals, and culinary leaders. Many of its members were part of the team that successfully lobbied City Council to enact a kids’ healthy beverage ordinance in 2020. That legislation ensured that the only default beverages to be offered on kid’s menus are water, low-fat milk, and 100% juice (vs. sugary, high-calorie sodas).
Why the focus on restaurant meals? “Twenty-five percent of kids get nutrition from restaurant meals,” explained James Meerdink, Community Advocacy Director, American Heart Association. “If you call something a kids’ meal in the City of Cleveland, that should mean healthy.”
Under the proposed ordinance, restaurants that offer “kids’ meals” must provide healthy options – fruit, vegetables, whole grains – while also scaling portions to reduce the high salt, fat, sugar, and calorie content that are baked into most kids’ menus at restaurants across the city.
Restaurants meals as part of public health
Yvonka Hall, a Healthy Kids’ Meals Coalition member and Executive Director of Northeast Ohio Black Health Coalition, links the proposed policy to City Council’s 2020 resolution naming racism as a public health crisis.
At that time, Ward 6 councilman Blaine Griffin defined the crisis during a press conference: “Racism exists in all of the systems we have across this city. It has caused health disparities. It has caused economic disparities….and it is a public health crisis.”
Picking up that thread, Hall noted that the issue is one of nutrition and health equity. “Health disparities are everyone’s problem. If Cleveland is looking at racism as a public health crisis, this is part of that. We’re dying before our parents,” she observed, pointing to the drop in African American life expectancy from 75 to 72 since 2016.
The good news, says Hall, is that if given a choice, folks will choose to eat healthy food.
As a preemptive response to the expected outcry from those who would say that kids’ meal standards reduce choice, the proposed standards apply only to bundled kids’ meals in restaurants that offer a separate kids’ menu. If enacted as proposed, the policy would not remove food choices from the regular menu in restaurants with kids’ menus. Additionally, there are no restrictions against children ordering from the regular menu.
Instead, the proposed standard would require healthier options for kids’ menus. Instead of a burger on a white bread bun, for example, a substitute of a whole grain bun raises the healthy quotient of that entree. Instead of chicken fingers and fries, a healthy side might be a salad or carrot sticks, with a fruit cup for dessert. The policy is also cuisine-neutral and could be applied across all restaurant genres.
“Choice is medicine,” asserted chef Ben Bebenroth, speaking in favor of the new options. Bebenroth is a Coalition member and the founder of Spice Hospitality Group, which includes a nonprofit arm that implemented an innovative STEM curriculum for grades 1-4 about five years ago. He uses his farm as an edible classroom and applies growing principles to academic learning.
“This region is facing some of the highest rates of dietary disease amongst the young than anywhere else in the country,” he noted, “and we are the epicenter of medical research.”
Mandate would come with challenges
Bebenroth, as a restaurateur, cautions against seeing the proposed standards as a panacea and says any policy enacted should avoid “overburdening of restaurants with the demise of community health.” He pointed to other sources of less-nutritious food for kids, including school cafeterias and corner stores.
When asked if he expects major pushback from the restaurant operators in Cleveland, especially the fast-food eateries, Meerdink of the American Heart Association offered that “The Big 6” fast food chains have voluntarily been developing and adapting their kids’ meals nutrition policies since 2015. “This is a commonsense approach,” he said.
Likewise, the National Restaurant Association promotes healthier nutrition standards through its Kids Live Well initiative, whose goal is to make it easier for restaurant operators to make healthy changes based on the latest science.
Bebenroth is not quite as optimistic when it comes to the fast-food chains. “Large corporate interests, they do not care about the health of [that] community,” he said. He expects more from local owners, though, adding that “it’s an easy lift for independent operators who give a shit about their community.”
Committee members overall were supportive of the initiative. Councilman Joe Jones noted that it represents “a small step today.” He did urge the Coalition to “..go deeper; cause an uproar” like the one raised by Cleveland’s controversial ban on the usage of oils containing trans fats that passed in 2011 and was later upheld by the courts in 2012.
Committee Chair Kevin Conwell pointed to the business realities of marketing budgets being spent to promote what sells. Businesses survive based on their profit and loss statements: a healthier community is not a factor until and unless it is profitable.
By way of seconding that notion, councilman Joe Jones later admitted to having a conditioned response when a slide of a burger and fries was shown during the Coalition’s presentation: “Aah, I’m hungry! I wish the burgers and fries was here to eat.”
First-term councilwoman Rebecca Maurer expressed concern about unintended consequences of problematic language around eating. She recounted the messaging she got as early as the fifth grade that led to her tracking calories on a school trip out of town.
Noting that there is a movement away from language that promotes disordered eating in adults, she cautioned the presenters to “think about how we present this to parents, and also how they talk to their kids about the food that they eat.”
The Coalition hopes to have the proposed ordinance before the full council by the end of the year.
Michelle B. Jackson was a participant in The Land’s community journalism program.