Fast-food menu offerings vary in dietary quality, but are consistently poor

1 Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, EPN 4005, Bethesda, MD 20892, USA.
Public Health Nutrition (Impact Factor: 2.48). 01/2013; 17(4):1-8. DOI: 10.1017/S1368980012005563
Source: PubMed

ABSTRACT OBJECTIVE: To evaluate five popular fast-food chains' menus in relation to dietary guidance. DESIGN: Menus posted on chains' websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids' menus and sets of items promoted as healthy or nutritious were also assessed. SETTING: Five popular fast-food chains in the USA. SUBJECTS: Not applicable. RESULTS: Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids' menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points. CONCLUSIONS: The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Healthier meal selections at restaurants and canteens are often limited and not actively promoted. In this Danish study the effectiveness of a healthy labelling certification program in improving dietary intake and influencing edible plate waste was evaluated in a quasi-experimental study design. Employees from an intervention worksite canteen and a matched control canteen were included in the study at baseline (February 2012), after completing the certification process (end-point) and six month from end-point (follow-up) (total n=270). In order to estimate nutrient composition of the consumed lunch meals and plate waste a validated digital photographic method was used combining estimation of food intake with food nutrient composition data. Food satisfaction was rated by participants using a questionnaire. Several significant positive nutritional effects were observed at the intervention canteen including a mean decrease in energy density in the consumed meals from 561 KJ/100 g at baseline to 368 and 407 KJ/100 g at end-point and follow-up, respectively (P<0.001). No significant changes were seen with regard to food satisfaction and plate waste. In the control canteen no positive nutritional effects were observed. The results of the study highlight the potential of using healthy labelling certification programs as a possible driver for increasing both the availability and awareness of healthy meal choices, thereby improving dietary intake when eating out.
    Appetite 12/2013; 75. DOI:10.1016/j.appet.2013.12.005 · 2.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although fast food consumption has been linked to adverse health outcomes, the relative contribution of fast food itself compared with the rest of the diet to these associations remains unclear. Our objective was to compare the independent associations with overweight/obesity or dietary outcomes for fast food consumption compared with dietary pattern for the remainder of intake. This cross-sectional analysis studied 4466 US children aged 2-18 y from NHANES 2007-2010. Cluster analysis identified 2 dietary patterns for the non-fast food remainder of intake: Western (50.3%) and Prudent. Multivariable-adjusted linear and logistic regression models examined the association between fast food consumption and dietary pattern for the remainder of intake and estimated their independent associations with overweight/obesity and dietary outcomes. Half of US children consumed fast food: 39.5% low-consumers (≤30% of energy from fast food) and 10.5% high-consumers (>30% of energy). Consuming a Western dietary pattern for the remainder of intake was more likely among fast food low-consumers (OR: 1.51; 95% CI: 1.24, 1.85) and high-consumers (OR: 2.21; 95% CI: 1.60, 3.05) than among nonconsumers. The remainder of diet was independently associated with overweight/obesity (β: 5.9; 95% CI: 1.3, 10.5), whereas fast food consumption was not, and the remainder of diet had stronger associations with poor total intake than did fast food consumption. Outside the fast food restaurant, fast food consumers ate Western diets, which might have stronger associations with overweight/obesity and poor dietary outcomes than fast food consumption itself. Our findings support the need for prospective studies and randomized trials to confirm these hypotheses.
    American Journal of Clinical Nutrition 10/2013; 99(1). DOI:10.3945/ajcn.113.071928 · 6.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about the role of location in U.S. children's excess intake of energy from solid fat and added sugar, collectively referred to as SoFAS. The goal of this study was to compare the SoFAS content of foods consumed by children from stores, schools, and fast-food restaurants and to determine whether trends from 1994 to 2010 differ across these locations. Children aged 2-18 years (N=22,103) from five nationally representative surveys of dietary intake from 1994 to 2010 were studied. SoFAS content was compared across locations for total intake and key foods. Regression models were used to test and compare linear trends across locations. Data were analyzed in 2012. The mean percentage of total energy intake consumed from each location that was provided by SoFAS remained above recommendations, despite significant improvements between 1994 and 2010 at stores (1994, 38.3%; 2004, 33.2%); schools (1994, 38.7%; 2004, 31.2%); and fast-food restaurants (1994, 34.6%; 2004, 34.6%). For each key food, SoFAS content decreased significantly at stores and schools, yet progress at schools was comparatively slower. Milk was higher in SoFAS at schools compared to stores because of shifts toward flavored milk at schools. Schools provided french fries that were higher in solid fat than store-bought versions and pizza that was not significantly different in SoFAS content than fast-food pizza. However, schools made significantly greater progress for sugar-sweetened beverages, as lower-sugar beverages replaced regular sodas. Key fast foods showed little improvement. These findings can inform future strategies targeted to the specific locations and foods where continued progress is needed to reduce children's SoFAS consumption.
    American journal of preventive medicine 11/2013; 45(5):551-9. DOI:10.1016/j.amepre.2013.06.013 · 4.28 Impact Factor