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Comparative Study
. 2018 Dec 12:363:k4864.
doi: 10.1136/bmj.k4864.

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

Susan B Roberts  1 , Sai Krupa Das  2 , Vivian Marques Miguel Suen  3 , Jussi Pihlajamäki  4   5 , Rebecca Kuriyan  6 , Matilda Steiner-Asiedu  7 , Amy Taetzsch  2 , Alex K Anderson  8 , Rachel E Silver  2   9 , Kathryn Barger  2 , Amy Krauss  2 , Leila Karhunen  4 , Xueying Zhang  10   11   12 , Catherine Hambly  12 , Ursula Schwab  4   13 , Andresa de Toledo Triffoni-Melo  14   3 , Salima F Taylor  2 , Christina Economos  9 , Anura V Kurpad  6 , John R Speakman  15   12   16
Affiliations
Comparative Study

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

Susan B Roberts et al. BMJ. .

Abstract

Objective: To measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data.

Design: Cross sectional survey.

Setting: 223 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 measure: Meal energy content, measured by bomb calorimetry.

Results: Compared 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.

Conclusion: Very 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.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from SBR) and declare: no support from any organization for the submitted work other than that described above; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
Scatterplot of associations of meal weight with energy content (R2=0.53; P<0.001) and energy density (R2=0.10; P<0.001) for popular meals served in full service and fast food restaurants in six countries
Fig 2
Fig 2
Energy content, weight, and energy density of restaurant meals in six countries. Boxplots show unweighted fifths (five number summary) and weighted means (indicated by filled square)
Fig 3
Fig 3
Individual and mean values for energy content, meal weight, and energy density of meals served in different restaurant types in Finland. Canteen values differed significantly from weighted values for full service and fast food restaurants. **P<0.01. *** P<0.001
See this image and copyright information in PMC

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