Temporal trends in fast-food restaurant energy, sodium, saturated fat, and trans fat content, United States, 1996-2013

Abstract

Introduction: Excess intakes of energy, sodium, saturated fat, and trans fat are associated with increased risk for cardiometabolic syndrome. Trends in fast-food restaurant portion sizes can inform policy decisions. We examined the variability of popular food items in 3 fast-food restaurants in the United States by portion size during the past 18 years.

Methods: Items from 3 national fast-food chains were selected: French fries, cheeseburgers, grilled chicken sandwich, and regular cola. Data on energy, sodium, saturated fat, and trans fat content were collated from 1996 through 2013 using an archival website. Time trends were assessed using simple linear regression models, using energy or a nutrient component as the dependent variable and the year as the independent variable.

Results: For most items, energy content per serving differed among chain restaurants for all menu items (P ≤ .04); energy content of 56% of items decreased (β range, -0.1 to -5.8 kcal) and the content of 44% increased (β range, 0.6-10.6 kcal). For sodium, the content of 18% of the items significantly decreased (β range, -4.1 to -24.0 mg) and the content for 33% increased (β range, 1.9-29.6 mg). Absolute differences were modest. The saturated and trans fat content, post-2009, was modest for French fries. In 2013, the energy content of a large-sized bundled meal (cheeseburger, French fries, and regular cola) represented 65% to 80% of a 2,000-calorie-per-day diet, and sodium content represented 63% to 91% of the 2,300-mg-per-day recommendation and 97% to 139% of the 1,500-mg-per-day recommendation.

Conclusion: Findings suggest that efforts to promote reductions in energy, sodium, saturated fat, and trans fat intakes need to be shifted from emphasizing portion-size labels to additional factors such as total calories, frequency of eating, number of items ordered, menu choices, and energy-containing beverages.

Figure 1

Energy content (kcal per portion) for popular menu items at 3 large, national fast-food chains. Energy content for 3 sizes of French fries (small, medium, large); 2 sizes of cheeseburgers (2 oz, 4 oz); 1 size of grilled chicken sandwich; and 3 sizes of cola beverages (small, medium, large) from chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviations: S, small; M, medium; L, large; NS, nonsignificant. ^a Difference is between Chain B versus Chain C. ^b Difference is between Chain B versus Chains A and C. [Table: see text]

Figure 2

Sodium content (mg per portion) for popular menu items at 3 large, national fast-food chains. Sodium content for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models, with energy as the dependent variable and time as the independent variable; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviation: NS, nonsignificant. ^a Difference is between Chain B versus Chains A and C. [Table: see text]

Figure 3

Saturated fat content (g per portion) for popular menu items at 3 large, national fast-food chains. Saturated fat content per serving for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviations: NS, nonsignificant; NC, no change. ^a Difference is between Chain B versus Chains A and C. [Table: see text]

Figure 4

Trans fat content (g per portion) for popular menu items at 3 large, national fast-food chains. Trans fat content per serving for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 2001 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models, comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). ^a Difference is between Chain C versus Chains A and B. Abbreviations: NS, nonsignificant; NC, no change. [Table: see text]

Figure 5

Comparison of energy, sodium, saturated fat, and trans fat content for popular menu items at 3 large, national fast-food chains. Energy (kcal), sodium (mg), saturated fat (g), and trans fat (g) content for 1999, 2003, 2008, and 2013 in popular small-sized (ie, 2-oz cheeseburger, small French fries, and small cola) and large-sized (ie, 4-oz cheeseburger, large French fries, and large cola) meals from chains A, B, and C. Trans fat data were not available for 1999. Dashes indicate that data were not available. Abbreviation: NA, not applicable. [Table: see text]