Abstract
Background
Policies on menu labeling have been proposed as a method to improve the food environment.
However, there is little information on the nutrient content of chain restaurant menu
items and changes over time.
Objective
To evaluate the energy, saturated fat, and sodium content of entrées 6 and 18 months
post-implementation of restaurant menu labeling in King County of Washington State
for items that were on the menu at both time periods, and across all items at 6 and
18 months and to compare energy content to recommendations provided by the 2005 Dietary
Guidelines for Americans.
Setting
Eligible restaurants included sit-down and quick-service chains (eg, burgers, pizza,
sandwiches/subs, and Tex-Mex) subject to King County regulations with four or more
establishments. One establishment per chain was audited at each time period.
Statistical analyses
Hypothesis one examined entrées that were on the menu at both time periods using a
paired t test and hypothesis two compared quartiles at 6 months to the distribution at 18
months using a Mantel-Haentzel odds ratios and 95% CIs, and a Cochrane-Armitage test
for trend. The content of entrées at 18 months was compared with one-third (assuming
three meals per day) of the nutrient intake recommendations for adults provided by
the 2005 Dietary Guidelines for Americans.
Results
The audit included 37 eligible chains of 92 regulated chains. Energy contents were
lower (all chains −41, sit down −73, and quick service −19; paired t tests P<0.0001) for entrées that were on the menu at both time periods. There was a significant
trend across quartiles for a decrease in energy, saturated fat, and sodium for all
entrées at sit-down chains only. At 18 months entrées not designated for children
exceeded 56%, 77%, and 89% of the energy, saturated fat, and sodium guidelines, respectively.
Conclusions
Modest improvements in the nutrient content of sit-down and quick-service restaurant
entrées occurred but overall levels for energy, saturated fat, and sodium are excessive.
Keywords
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Biography
B. Bruemmer is a senior lecturer emeritus, Program in Nutritional Sciences, School of Public Health, University of Washington, Seattle.
Biography
J. Krieger is chief, Epidemiology and Planning Unit, Chronic Disease and Injury Prevention Department, Public Health-Seattle and King County, Seattle, WA.
Biography
N. Chan is assistant chief, Assessment Policy Development, and Evaluation Department, Public Health-Seattle and King County, Seattle, WA.
Biography
B. E. Saelens is an associate professor of child health, behavior, and development, Department of Pediatrics, Seattle Children's Research Institute, Seattle, WA.
Article info
Publication history
Published online: June 15, 2012
Accepted:
April 17,
2012
Available online 14 June 2012Footnotes
FUNDING/SUPPORT This project was supported by grant nos. 67291 and 65233 from Healthy Eating Research program of the Robert Wood Johnson Foundation.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
Identification
Copyright
© 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
