scholarly journals Trends in energy and nutrient content of menu items served by large UK chain restaurants from 2018 to 2020: an observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054804
Author(s):  
Yuru Huang ◽  
Dolly R Z Theis ◽  
Thomas Burgoine ◽  
Jean Adams
Keyword(s):  
Observational Study ◽  
Fast Food ◽  
Sugar Content ◽  
Saturated Fat ◽  
Nutrient Content ◽  
Fat Content ◽  
Secondary Outcome ◽  
Nutritional Information ◽  
Sugar Reduction

ObjectiveThe objective of this study was to evaluate the change in energy and nutrient content of menu items sold in large UK chain restaurants (eg, fast food, full service) from 2018 to 2020.DesignObservational study.SettingEnergy and nutritional information of menu items served by 29 large UK chain restaurants that consistently provided this information online in all three years. Data were collected in 2018 (March–April), 2019 (April) and 2020 (October–November) from restaurant websites.Primary and secondary outcome measuresThe per-item energy and nutrient (saturated fat, sugar and salt) changes in all items available on menus (‘all menu items’) and recurring items that were consistently available on menus in all three years (‘core menu items’), overall and in 12 different food categories.ResultsOur study included 7770, 9213 and 6928 menu items served by 29 large UK chain restaurants in 2018, 2019 and 2020, respectively. Our results showed that sugar content declined from 2018 to 2020 among all menu items (per-item: −0.43 g/year, 95% CI −0.66 to –0.21). This reduction in sugar was evident in beverages, sandwiches and desserts. Among core menu items (N=1855), sugar content reduced significantly from 2018 to 2020 (per-item: −0.31 g/year, 95% CI −0.45 to –0.17), especially in beverages. Energy, salt and saturated fat content in menu items remained constant overall, in both all menu items and core menu items. Fewer food categories had significant changes in energy, sugar, salt and saturated fat content among core menu items than among all menu items.ConclusionsFrom 2018 to 2020, sugar content declined in restaurant menu items, which may reflect a response to the sugar reduction strategy and the effects of the soft drinks industry levy. In contrast, there was little change in other nutrients. Future policies addressing the overall nutritional quality of restaurant foods, rather than single nutrients, may help the restaurant sector move towards offering healthier foods.

scholarly journals The Effects of a Supermarket-Based Intervention on the Nutritional Quality of Private-Label Foods: A Prospective Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1692 ◽  
Author(s):  
Daisy H. Coyle ◽  
Jason HY Wu ◽  
Gian Luca Di Tanna ◽  
Maria Shahid ◽  
Fraser Taylor ◽  
...  
Keyword(s):  
Nutritional Quality ◽  
Energy Content ◽  
Sugar Content ◽  
Saturated Fat ◽  
Nutrient Content ◽  
Private Label ◽  
Relative Reduction ◽  
Star Rating ◽  
Private Label Products

Private-label products, products owned by supermarkets, are a growing area of the food supply. The aim of this study was to assess the effect of an intervention that provided an Australian supermarket (‘intervention supermarket’) with comparative nutrition data to improve the healthiness of their private-label range. Between 2015 and 2016, the intervention supermarket received reports that ranked the nutritional quality of their products against competitors. Changes in the nutrient content (sodium, sugar, saturated fat, energy and Health Star Rating) of products from the intervention supermarket between 2015 and 2018 were compared against changes achieved for three comparators (private-label products from two other supermarkets and branded products). The intervention supermarket achieved a significantly greater reduction in the sodium content of their products relative to all three comparators, which ranged between −104 and −52 mg/100 g (all p < 0.05). Conversely, the three comparators each achieved a greater relative reduction in the sugar content of their products by between −3.5 and −1.6 g/100 g (all p < 0.05). One of the comparators also had a greater relative reduction in the saturated fat and energy content of their products compared to the intervention supermarket (both p <0.05). There were negligible differences in the Health Star Rating of products between the intervention supermarket and comparators (all p > 0.05). Providing comparative nutrition information to a supermarket may be ineffective in improving the healthiness of their private-label products, likely due to competing factors that play a role in the decision-making process behind product reformulation and product discontinuation/innovation.

scholarly journals Reformulation and Priorities for Reducing Energy Density; Results from a Cross-Sectional Survey on Fat Content in Pre-Packed Cakes and Biscuits Sold in British Supermarkets

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1216 ◽  
Author(s):  
Roberta Alessandrini ◽  
Feng J. He ◽  
Kawther M. Hashem ◽  
Monique Tan ◽  
Graham A. MacGregor
Keyword(s):  
Energy Density ◽  
Energy Range ◽  
Sugar Content ◽  
Saturated Fat ◽  
Fat Content ◽  
Calorie Intake ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Mean ◽  
Total Fat

Cakes and biscuits contribute to energy, total and saturated fat and sugar in British diets. So far, the UK government has prompted manufacturers to reduce energy density in these products through a reduction of their sugar content. We conducted a cross-sectional survey of the fat content of cakes and biscuits available in nine UK supermarket chains. In cakes (n = 381), the mean total fat content was 17.9 ± 5.2 g/100 g (39% of the overall energy); range (1.4–35.6 g/100 g) and the average saturated fat content in cakes was 5.9 ± 3.4 g/100 g (13% of the overall energy); range (0.3–20 g/100 g). In biscuits (n = 481), the mean total fat content was 21.8 g ± 6.3 g/100 g (40% of the overall energy); range (0.7–38.9 g/100 g) and the average saturated fat content was 11.4 ± 4.9 g/100 g (23% of the overall energy); range (0.3–22.3 g/100 g). In both cakes and biscuits, total and saturated fat content was positively correlated with energy density. Our results show that cakes and biscuits sold in UK supermarkets are high in total and saturated fat, and that fat content contributes substantially to product energy density. Fat reformulation in these products would effectively reduce energy density, calorie intake and help prevent obesity. Fat reformulation should be implemented simultaneously with sugar reformulation and be focused on saturated fat, as this will have the additional effect of lowering LDL cholesterol.

scholarly journals Yoghurt and dairy snacks presented for sale to an Australian consumer: are they becoming less healthy?

2009 ◽  
Vol 13 (7) ◽  
pp. 1036-1041 ◽  
Author(s):  
Karen Z Walker ◽  
Julie Woods ◽  
Jamie Ross ◽  
Rachel Hechtman
Keyword(s):  
Energy Content ◽  
Sugar Content ◽  
Saturated Fat ◽  
Nutrition Information ◽  
High Fat ◽  
Nutrient Quality ◽  
Traffic Lights ◽  
Nutrient Profiling ◽  
Total Fat

AbstractObjectiveTo assess the nutrient profile of yoghurts and dairy desserts.DesignNutrition information panels and product labels on yoghurts and dairy desserts offered for sale were surveyed in 2005 and 2008 and nutrients analysed by two nutrient profiling systems.SettingA large supermarket in metropolitan Melbourne, Australia.ResultsIn total, 248 and 140 dairy snacks (yoghurt, fromage frais or dairy desserts) were surveyed in 2005 and 2008, respectively. Over this time, median packet size rose significantly (P≤ 0·001). In yoghurts, median energy and total fat content also increased while protein decreased (allP< 0·05). The proportion of ‘full-fat’ products rose from 36 % to 46 %. Because of the addition of sugar, most ‘reduced-fat’ yoghurts had energy content similar to many ‘full-fat’ yoghurts. Overall, the proportion of yoghurts and dairy desserts that were ‘less healthy’ (i.e. displaying one or more ‘red traffic lights’ for high fat, saturated fat, salt and sugar content) rose from 12 % in 2005 to 23 % in 2008. Only 1–2 % could be deemed ‘healthy’ by the most stringent criterion (displaying four ‘green traffic lights’), while 21 % (2005) or 28 % (2008) were ‘healthy’ by a nutrient profiling system that included a score for protein. Sucrose, the most common sweetener, was found in levels up to 29 g/100 g. Claims on packaging mainly related to Ca, fat or protein content. Few labels referred to sugar content.ConclusionsThe deterioration in nutrient quality of yoghurts needs to be redressed.

The Risks of Everyday Life: Fat content of chips, quality of frying fat and deep-frying practices in New Zealand fast food outlets

2002 ◽  
Vol 26 (2) ◽  
pp. 101-107 ◽  
Author(s):  
Judith Morley-John ◽  
Boyd A. Swinburn ◽  
Patricia A. Metcalf ◽  
Fezeela Raza ◽  
Heather Wright
Keyword(s):  
New Zealand ◽  
Everyday Life ◽  
Fast Food ◽  
Fat Content ◽  
Deep Frying ◽  
Food Outlets ◽  
Frying Fat

scholarly journals Trends in Quality and Quantity of Dietary Intake from Full-Service Restaurants and Fast Food Restaurants Among US Adults, 2003–2016 (P04-147-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Junxiu Liu ◽  
Colin Rehm ◽  
Renata Micha ◽  
Dariush Mozaffarian
Keyword(s):  
Diet Quality ◽  
Fast Food ◽  
Saturated Fat ◽  
Heart Association ◽  
Poor Quality ◽  
Processed Meat ◽  
Challenges And Opportunities ◽  
Fast Food Restaurants ◽  
Over Time

Abstract Objectives Meals from full-service restaurants (FS) and fast-food restaurants (FF) are major contributors to US diets. Yet, their overall healthfulness, trends, and disparities are unknown. We sought to evaluate trends in FS and FF diet quality in US adults, and disparities by key subgroups. Methods We used data from 7 NHANES cycles 2003–2016, totaling 35,015 adults aged 20 + y. Percent of energy (%E) and meal settings (breakfast, etc.) from FS and FF were examined. Diet quality was based on the validated American Heart Association (AHA) 2020 primary diet score (components: fruits/vegetables, whole grains, fish/shellfish, sugar-sweetened beverages, sodium; range 0–50) and secondary score (adding nuts/seeds/legumes (NSL), processed meat, saturated fat; range 0–80). Analyses utilized survey-weight with energy adjusted to 2000 kcal/d. Results Between 2003–16, US adults consumed ∼9%E from FS (8.5% in 2003–04; 9.5% in 2015–16, p trend = 0.38) and ∼12%E from FF (10.5%; 13.4%; p trend = 0.31). Over this period, increasing FF meals were eaten for breakfast (4.4% to 7.6%) (p trend < 0.001). In 2015–16, diet quality of both FS and FF were low: mean primary AHA score of 17.3 and 14.7 (out of 50), respectively; and secondary AHA score of 31.6 and 27.6 (out of 80). Between 2003–16, diet quality of FS was unchanged; while FF quality was unchanged per the primary score and modestly improved per the secondary score (improvement of 4.2%; p trend < 0.001), largely due to changes in NSL and saturated fat. The % of FF meals with poor quality (<40% adherence to the AHA secondary score) declined from 74.6% to 69.8%, while the % with intermediate quality (40–79.9% adherence) increased from 25.4% to 30.2% (both p trend < 0.001) (Figure). FS meals with poor (∼50%) and intermediate (∼50%) quality were stable over time. Notably, < 0.1% of consumed FS or FF meals met ideal quality ( > 80% adherence). Disparities in FS and FF meal quality were observed by race/ethnicity, income, and education, which generally worsened over time. Conclusions FF and FS meals provide 1 in 5 calories in US adults. Modest improvements in quality were observed in FF, but not FS; average quality for both remained low, with growing disparities. These findings highlight specific challenges and opportunities for improving quality of restaurant meals in the US. Funding Sources AHA, NIH/NHLBI. Supporting Tables, Images and/or Graphs

scholarly journals Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment

PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003714
Author(s):  
Joshua Petimar ◽  
Fang Zhang ◽  
Eric B. Rimm ◽  
Denise Simon ◽  
Lauren P. Cleveland ◽  
...  
Keyword(s):  
Fast Food ◽  
Saturated Fat ◽  
Nutrient Content ◽  
The United States ◽  
Nutrition Information ◽  
Menu Labeling ◽  
Sales Data ◽  
Calorie Labeling ◽  
The Relationship ◽  
Nationwide Implementation

Background Calorie menu labeling is a policy that requires food establishments to post the calories on menu offerings to encourage healthy food choice. Calorie labeling has been implemented in the United States since May 2018 per the Affordable Care Act, but to the best of our knowledge, no studies have evaluated the relationship between calorie labeling and meal purchases since nationwide implementation of this policy. Our objective was to investigate the relationship between calorie labeling and the calorie and nutrient content of purchased meals after a fast food franchise began labeling in April 2017, prior to the required nationwide implementation, and after nationwide implementation of labeling in May 2018, when all large US chain restaurants were required to label their menus. Methods and findings We obtained weekly aggregated sales data from 104 restaurants that are part of a fast food franchise for 3 national chains in 3 US states: Louisiana, Mississippi, and Texas. The franchise provided all sales data from April 2015 until April 2019. The franchise labeled menus in April 2017, 1 year prior to the required nationwide implementation date of May 2018 set by the US Food and Drug Administration. We obtained nutrition information for items sold (calories, fat, carbohydrates, protein, saturated fat, sugar, dietary fiber, and sodium) from Menustat, a publicly available database with nutrition information for items offered at the top revenue-generating US restaurant chains. We used an interrupted time series to find level and trend changes in mean weekly calorie and nutrient content per transaction after franchise and nationwide labeling. The analytic sample represented 331,776,445 items purchased across 67,112,342 transactions. Franchise labeling was associated with a level change of −54 calories/transaction (95% confidence interval [CI]: −67, −42, p < 0.0001) and a subsequent 3.3 calories/transaction increase per 4-week period (95% CI: 2.5, 4.1, p < 0.0001). Nationwide implementation was associated with a level decrease of −82 calories/transaction (95% CI: −88, −76, p < 0.0001) and a subsequent −2.1 calories/transaction decrease per 4-week period (95% CI: −2.9, −1.3, p < 0.0001). At the end of the study, the model-based predicted mean calories/transaction was 4.7% lower (change = −73 calories/transaction, 95% CI: −81, −65), and nutrients/transaction ranged from 1.8% lower (saturated fat) to 7.0% lower (sugar) than what we would expect had labeling not been implemented. The main limitations were potential residual time-varying confounding and lack of individual-level transaction data. Conclusions In this study, we observed that calorie labeling was associated with small decreases in mean calorie and nutrient content of fast food meals 2 years after franchise labeling and nearly 1 year after implementation of labeling nationwide. These changes imply that calorie labeling was associated with small improvements in purchased meal quality in US chain restaurants.

scholarly journals Nutritional quality of food items on fast-food ‘kids’ menus’: comparisons across countries and companies

2013 ◽  
Vol 17 (10) ◽  
pp. 2263-2269 ◽  
Author(s):  
Erin Hobin ◽  
Christine White ◽  
Ye Li ◽  
Maria Chiu ◽  
Mary Fodor O'Brien ◽  
...  
Keyword(s):  
Fast Food ◽  
Nutritional Quality ◽  
Saturated Fat ◽  
Food Chains ◽  
Food Items ◽  
The Usa ◽  
English Speaking ◽  
Total Fat ◽  
The Uk

AbstractObjectiveTo compare energy (calories), total and saturated fats, and Na levels for ‘kids’ menu’ food items offered by four leading multinational fast-food chains across five countries.DesignA content analysis was used to create a profile of the nutritional content of food items on kids’ menus available for lunch and dinner in four leading fast-food chains in Australia, Canada, New Zealand, the UK and the USA.SettingFood items from kids’ menus were included from four fast-food companies: Burger King, Kentucky Fried Chicken (KFC), McDonald's and Subway. These fast-food chains were selected because they are among the top ten largest multinational fast-food chains for sales in 2010, operate in high-income English-speaking countries, and have a specific section of their restaurant menus labelled ‘kids’ menus’.ResultsThe results by country indicate that kids’ menu foods contain less energy (fewer calories) in restaurants in the USA and lower Na in restaurants in the UK. The results across companies suggest that kids’ menu foods offered at Subway restaurants are lower in total fat than food items offered at Burger King and KFC, and food items offered at KFC are lower in saturated fat than items offered at Burger King.ConclusionsAlthough the reasons for the variation in the nutritional quality of foods on kids’ menus are not clear, it is likely that fast-food companies could substantially improve the nutritional quality of their kids’ menu food products, translating to large gains for population health.

scholarly journals Sodium and Saturated Fat Content of Children's Foods at Top-selling U.S. Chain Restaurants in 2017 (P04-150-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Paula-Dene Nesbeth ◽  
Yuru Huang ◽  
Kasey Heintz
Keyword(s):  
Saturated Fat ◽  
Nutrient Content ◽  
Fat Content ◽  
Dietary Guidelines ◽  
Department Of Energy ◽  
Nutrition Information ◽  
Oak Ridge ◽  
Nutrient Density ◽  
Serving Size ◽  
Limited Service

Abstract Objectives To understand the nutritional landscape of restaurant meals targeted to children, the nutrient content of common menu categories, such as sandwiches, were collected from top U.S. chain restaurants. Median sodium and saturated fat content of restaurant entrees, sandwiches (including burgers), and pizzas were compared to U.S. dietary recommendations. Mean sodium and saturated fat per 100 kilocalories were also compared by menu category and restaurant type (limited service and full service). Methods Nutrient data was obtained from publicly available menu and nutrition information collected in 2017 from websites of top-selling U.S. chain restaurants. Foods were categorized using menu category definitions in MenuStat, a restaurant nutrition database created by the New York City Department of Health and Mental Hygiene. Linear regression was used to identify differences in nutrient density by menu category and restaurant type. Results The dataset contained 356 entrees, 28 pizzas, 162 sandwiches and burgers from 64 top U.S. chain restaurants that have online nutrition information with menu items aimed for children. Median (Q1, Q3) milligrams of sodium were 780 (500, 1150) for entrees, 1000 (797.5, 1272.5) for pizzas, and 850 (613, 1160) for sandwiches and burgers respectively. Median (Q1, Q3) grams of saturated fat were 4.25 (2, 8) for entrees, 8 (6, 11.25) for pizzas, and 6 (3.5, 10.75) for sandwiches and burgers. Fifty-one % of entrees, 89% of pizzas, and 73% of sandwiches have >10% of calories from saturated fat, whereas the 2015–2020 Dietary Guidelines for Americans recommended consuming <10% of calories per day from saturated fat. Predicted mean saturated fat in grams per 100 kcal for sandwiches and burgers was lower in limited service (1.51, 95% CI: 1.37, 1.65) compared to full service restaurants (2.08, 95% CI: 1.88, 2.29). However, this difference may be related to serving size which was not available for 83% of menu items. Conclusions With more Americans purchasing meals outside the home and the availability of restaurant nutrition information, examination of nutrient content and serving size for restaurant foods can help to identify areas for nutritional improvement for meals targeted to children. Funding Sources U.S. Food and Drug Administration and an appointment to FDA administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and FDA.

scholarly journals Regional differences in the care and outcomes of acute stroke patients in Australia: an observational study using evidence from the Australian Stroke Clinical Registry (AuSCR)

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e040418
Author(s):  
Mitchell Dwyer ◽  
Karen Francis ◽  
Gregory M Peterson ◽  
Karen Ford ◽  
Seana Gall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Acute Stroke ◽  
Rural Areas ◽  
Regional Differences ◽  
Rural Hospitals ◽  
Care Plan ◽  
Secondary Outcome ◽  
Clinical Registry

ObjectiveTo compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia.DesignObservational study using data from a multicentre national registry.SettingData from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Registry during the period 2010–2015.ParticipantsPatients were divided into two groups (urban, rural) according to the Australian Standard Geographical Classification Remoteness Area classification. Data pertaining to 28 115 patients who had a stroke were analysed, of whom 8159 (29%) were admitted to hospitals located within rural areas.Primary and secondary outcome measuresRegional differences in processes of care (admission to a stroke unit, thrombolysis for ischaemic stroke, discharge on antihypertensive medication and provision of a care plan), and survival analyses up to 180 days and health-related quality of life at 90–180 days.ResultsCompared with those admitted to urban hospitals, patients in rural hospitals less often received thrombolysis (urban 12.7% vs rural 7.5%, p<0.001) or received treatment in stroke units (urban 82.2% vs rural 76.5%, p<0.001), and fewer were discharged with a care plan (urban 61.3% vs rural 44.7%, p<0.001). No significant differences were found in terms of survival or overall self-reported quality of life.ConclusionsRural access to recommended components of acute stroke care was comparatively poorer; however, this did not appear to impact health outcomes at approximately 6 months.

scholarly journals The impact of ultrasonography on quality of cardiopulmonary resuscitation: a retrospective observational study

2019 ◽  
Author(s):  
Wan-Ching Lien ◽  
Kah-Meng Chong ◽  
Herman Chih-Heng Chang ◽  
Su-Fen Cheng ◽  
Wei-Tien Chang ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Observational Study ◽  
Pause Duration ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Secondary Outcome ◽  
Chest Compressions ◽  
Traumatic Cardiac Arrest ◽  
The Impact

Abstract Background: This study aims to evaluate the effect of ultrasonography (US) on quality of cardiopulmonary resuscitation (CPR), and US-related pause duration of pulse-checks.Methods: This retrospective observational study was conducted at the emergency department of National Taiwan University Hospital between April 2017 and May 2018. Video recordings for adult patients with non-traumatic cardiac arrest in designated resuscitation rooms were collected. The primary outcome was chest compression fraction (CCF) in the CPR with US group. The secondary outcome was pause duration of pulse checks with introduction of US or not. US-related pulse-checks were stratified into US during hands-off periods only (hands-off US), and US performing from hands-off to hands-on periods (continuous US). Results: A total of 153 patients were enrolled. Continuous US was performed in 116 patients. CCF was similar (92%) between the CPR with and without US groups. In the CPR with US group, pause duration was significantly longer in US-related pulse-checks than that without US (9.3±8.0 v.s. 7.3±4.7s, p<0.0001). Notably, longer pause was noted in the hands-off US, as comparing with that in the continuous US (18.3±16.4 v.s. 7.7±3.5s, p<0.0001). Conclusions: The introduction of US during CPR did not impact on CCF. Individual pause would not be lengthened if continuous US was performed while allowing chest compressions to be resumed. In addition, structured training, adequate facilities and manpower, and a timer reminding resumption of chest compressions would help sophisticated integration of US into CPR process.

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