Abstract
Background
Given the popularity of restaurants as a meal source in the United States, it is important
to understand the healthiness of their offerings.
Objective
This study’s purpose was to examine the healthiness of meals at national US chain
restaurants in 2017 using the American Heart Association’s (AHA) Heart-Check meal
certification criteria.
Design
Data for this cross-sectional study were obtained from MenuStat, an online database
that includes nutrition information for menu items from the 100 restaurant chains
with the largest sales in the United States in 2017. All possible meal combinations
(meals defined as including an entrée and side item) were created at the 73 restaurants
that reported nutrition information aligning with the AHA criteria: calories, total
fat, saturated fat, trans fat, cholesterol, sodium, protein, and fiber.
Main outcomes measure
Healthy meal (0=did not meet AHA criteria; 1=did meet AHA criteria).
Statistical analyses performed
We used χ2 tests to compare the percent of restaurant meals and meal components compliant with
each AHA criterion and the percent of restaurant meals and meal components meeting
varying numbers of AHA criteria across restaurant service types (ie, fast food, full
service, fast casual).
Results
Among all restaurants, the median calories, total fat, saturated fat, cholesterol,
and sodium of meals exceeded the AHA criteria. Fewer than 20% of meals met the saturated
fat and sodium criteria; 22% of restaurant meals met zero to one AHA criteria, 50%
met two to four AHA criteria, 20% met five to six AHA criteria, and 8% met all seven
AHA criteria.
Conclusions
Given the popularity of restaurants as a source of meals, efforts are needed to improve
the healthiness of restaurant meals.
Keywords
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Biography
E. Alexander is a PhD candidate, Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Biography
L. Rutkow is a professor, Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Biography
E. E. McGinty is an associate professor, Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Biography
J. E. Cohen is a professor, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Biography
K. A. Gudzune is an associate professor, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Article info
Publication history
Published online: March 10, 2020
Accepted:
January 2,
2020
Received:
April 18,
2019
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2020 by the Academy of Nutrition and Dietetics.
