Measured energy content of frequently purchased restaurant meals: multi-country cross sectional study

Abstract

ObjectiveTo measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data.DesignCross sectional survey.Setting223 meals from 111 randomly selected full service and fast food restaurants serving popular cuisines in Brazil, China, Finland, Ghana, and India were the primary sampling unit; 10 meals from five worksite canteens were also studied in Finland. The observational unit was frequently ordered meals in selected restaurants.Main outcome measureMeal energy content, measured by bomb calorimetry.ResultsCompared with the US, weighted mean energy of restaurant meals was lower only in China (719 (95% confidence interval 646 to 799) kcal versus 1088 (1002 to 1181) kcal; P<0.001). In analysis of variance models, fast food contained 33% less energy than full service meals (P<0.001). In Finland, worksite canteens provided 25% less energy than full service and fast food restaurants (mean 880 (SD 156) versus 1166 (298); P=0.009). Country, restaurant type, number of meal components, and meal weight predicted meal energy in a factorial analysis of variance (R2=0.62, P<0.001). Ninety four per cent of full service meals and 72% of fast food meals contained at least 600 kcal. Modeling indicated that, except in China, consuming current servings of a full service and a fast food meal daily would supply between 70% and 120% of the daily energy requirements for a sedentary woman, without additional meals, drinks, snacks, appetizers, or desserts.ConclusionVery high dietary energy content of both full service and fast food restaurant meals is a widespread phenomenon that is probably supporting global obesity and provides a valid intervention target.

Barriers and facilitators to implementation of menu labelling interventions from a food service industry perspective: a mixed methods systematic review

“…The average energy content of main meals served in both fast food and full service restaurants exceed public health recommendations (i.e. 600 kcal or less for main lunch/dinner meals) [12,13]. In addition, consumers tend to underestimate the energy, fat and sodium content of meals when eating outside the home [14,15].…”

Bringing harmony to public health debates about food

“…Robinson and colleagues (doi:10.1136/bmj.k4982) and Roberts and colleagues (doi:10.1136/bmj.k4864) both conducted surveys of the energy content of main meal dishes served by full service and fast food restaurants 89. In the United Kingdom, Robinson and colleagues report a mean energy content of 751 kcal in main meal dishes served by fast food chains, and 1033 kcal in dishes served by full service restaurant chains.…”

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

“…Fast-food consumption is positively correlated with obesity rates across countries (19,20) , yet few studies have compared the energy (21) and nutrient (22) content of fast-food offerings across countries. Roberts et al (21) selected 223 meals from 111 randomly selected restaurants in Brazil, China, Finland, Ghana and India and reported that high energy content in fast-food and full-service restaurant meals was widespread globally, with only meals in China having significantly lower energy content compared with those in the USA. Dunford et al (22) examined salt levels in menu items in several multinational fast-food chains across countries and observed differences in salt content across similar products in different countries.…”