Differences in the sugar content of fast-food products across three countries

Abstract

Objective: To compare the sugar content of items at four multinational fast-food chains, across three countries. Design: Total sugar (g)/per serving was extracted from online nutrition information, and sugar/100 g serving was calculated. Foods were categorised as: breakfast sandwiches, burgers, sandwiches, desserts and condiments. Beverages were categorised as fountain, frozen or pre-packaged. Sugar (g) was compared across countries using linear mixed-effects models. Pairwise comparisons were performed with Tukey–Kramer adjustments. Setting: USA, Germany and Australia. Participants: Burger King™ (Hungry Jack’s™), Kentucky Fried Chicken™, McDonald’s™ and Subway™. Results: Differences in total sugar/100 g or ml were observed across countries for burgers (n 104), desserts (n 110), sandwiches (n 178), pre-packaged beverages (n 36) and frozen beverages (n 72). Comparing identical items across countries (e.g. BigMacTM from McDonalds in USA, Germany and Australia), burgers (n 10 available in all three countries) had lower sugar content in Australia (3·4 g/100 g) compared with the USA (4·7 g/100 g, P = 0·02) or Germany (4·6 g/100 g, P = 0·04), yet no differences were observed in other food categories. Comparing the same beverages across countries (e.g. chocolate shake from Burger King), frozen beverages (n 4 available in all three countries) had lower sugar content in Australia (14·2 g/100 ml), compared with the USA (20·3 g/100 ml, P = 0·0005) or Germany (17·8 g/100 ml, P = 0·0148), yet no differences were observed in other beverage categories. Conclusions: Heterogeneity in fast-food sugar content across countries suggests that reductions are possible and should be implemented to reduce health risks associated with excess added sugar intake.

Food Safety and Quality in Connection with the Change of Consumer Choice in Czechia (a Case Study)

“…To the best of the authors' knowledge, there are only a few studies that use data containing multiple versions of the same branded food products offered across countries. For example, Lewis et al [37] discovered heterogeneity in fast-food sugar content across three countries (USA, Germany, and Australia) and suggest that reductions are possible and should be implemented to reduce health risks associated with excess added sugar intake.…”

Fast food consumption and its relationship with oral health among US adults: A cross-sectional NHANES-based study

“…The link between dental caries and fast-food consumption identified in this study invites us to reflect on the types of beverages and food items available at fast-food outlets. According to Lewis et al (2020) and Mackay et al (2021) , fast-food outlets offer a variety of options, such as desserts, burgers, condiments, sandwiches, breakfast sandwiches, and beverages ranging from sugary soft drinks to sugar-free soft drinks and hot drinks. Of the abovementioned items, the high sugar content of desserts and soft drinks is likely to contribute most significantly to the association between the development of dental caries and fast-food consumption.…”

Front-of-Pack Nutrition Labelling: are Health Policy Decisions Reconcilable with the WTO Disciplines?

“…35 Fast food follows suit. 36 Further on, sugar and fats contents ensure high palatability 37 of all discussed products, whereas salt extends their shelf-life. 38 Ultra-processed goods, however, are more durable than the other discussed options, as they undergo more processing stages.…”