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 ; 11: e054804.
Huang Y, Theis DRZ, Burgoine T, Adams JM
DOI : 10.1136/bmjopen-2021-054804
URL : https://bmjopen.bmj.com/content/11/12/e054804
Objective The 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.
Design Observational study.
Setting Energy 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 measures The 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.
Results Our 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.
Conclusions From 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.
Between 2018 and 2020, the sugar content of food and drinks items served by large UK chains decreased by an average of 0.8g (or 6%) per item. This reduction was particularly marked in drinks and may be attributable to the Soft Drinks Industry Levy. No overall changes in salt, saturated fat or calories were seen.
Food prepared outside of the home, such as in restaurants, cafes and fast-food outlets tends to be less healthy. Over the last few years, the UK government introduced the Sugar and Calorie Reduction Programmes as well as the Soft Drinks Industry Levy. Whilst all three may improve the quality of out-of-home food, only the last is mandatory. New regulations on mandatory calorie labelling will come into effect in April 2022.
We tracked how food and drinks items served by large out-of-home food chains changed between 2018 and 2020. We studied calories as well as salt, saturated fat, and sugar content. We used data published on chains’ own websites in 2018, 2019 and 2020. Twenty-nine large chains were included in the analysis.
When we studied all items on menus, we found that sugar content of menu items decreased by an average of 0.8g per item, or 6%. Calorie, salt, and saturated fat content did not change between 2018 and 2020. The decline in sugar content was seen in drinks, sandwiches, and desserts in particular. This reduction may be due to changes in recipes of existing items (reformulation) or introduction of new items with less sugar than existing items.
When we restricted our analysis to just those items on menus in all three years, we found similar reductions in sugar content and this was seen particularly in drinks. This suggests that at least some drinks have been reformulated to reduce their sugar content. Other studies have also found that the Soft Drinks Industry Levy led to reformulation of drinks.
Our results indicate that future policies addressing the overall nutritional quality of restaurant foods, rather than single nutrients, may help the restaurant sector to offer healthier foods.