Differences in Energy and Nutrient Content of Menu Items Served by Large Chain Restaurants in the US and the UK.
Public Health Nutrition 2022
Huang Y, Burgoine T, Theis D, Adams J
DOI : 10.1017/S1368980022001379
PubMed ID : 35642073
PMCID :
Abstract
To quantify the sector-wide energy and nutritional differences of both adult and children's restaurant menu items in the UK and the US in 2018.
Cross-sectional study.
Energy and nutritional information provided on restaurant websites.
Menu items (N = 40,902) served by 42 large UK chains and 96 large US chains.
Mean absolute energy, fat, and saturated fat values were higher in US menu items. For example, the mean adjusted per-item differences of adult menu items between the US and the UK were 45.6kcal for energy and 3.2g for fat. Comparable figures for children's menu items were 43.7kcal and 4g. Compared to UK menu items, US adult menu items also had higher sugar content (3.2g, 95%CI = 0.5g, 6g) and children's menu items had higher sodium content (181.1mg, 95%CI = 108.4mg, 253,7mg). Overall, 96.8% of UK and 95.8% of US menu items exceeded recommended levels for at least one of sodium, fat, saturated fat, or sugars.
Menu items served by large chain restaurants had higher mean absolute levels of energy and nutrients in the US compared to the UK, except for protein and carbohydrates. These differences were prominent in children's menu items, especially for sodium and saturated fat. As more than 95% of all items were considered to have high levels of at least one nutrient of public health concern in the US and the UK, improvements in restaurant menu items are needed in both countries.
Lay Summary
Eating healthy in restaurants is not always easy. Restaurant foods are high in calories and have low nutritional value. The UK and the US are culturally similar and have many chain restaurants in common. However, past studies suggest that even the same item in the same chain restaurant could have different nutritional values in these two countries. In our study, we provide a comprehensive view on whether and how nutritional composition of restaurant foods differ in these two countries.
Using publicly available data, we quantified nutritional differences of menu items served by large chain restaurants in the UK and the US in 2018. We included 42 large UK chains and 96 large US chains. We examined energy, fat, saturated fat, carbohydrates, sugar, protein, and sodium content. We studied adult menu items and children’s menu items separately.
When we studied adult menu items, we found that US items had higher energy, fat, saturated fat, and sugar levels than those in the UK. Similarly, when we studied children’s menu items, we found that US items had higher energy, fat, saturated fat, and sodium levels than those in the US. Given this, there is potential for the energy and nutrient content of menu items in the US could potentially match the levels in the UK. The fact that carbohydrates and protein content do not differ between these two countries suggests differences in portion size may not fully explain the differences in energy and nutrients.
Using international recognised criteria, we found that over 95% of all menu items were high in at least one of sodium, sugar, fat, and saturated fat. This suggests that improvements are needed in chain restaurants in both the US and the UK to bring them into line with policy recommendations.