Nutritional value of meals at full-service restaurant chains.

OBJECTIVE: To assess the nutritional value of meals at full-service national restaurant chains with outlets in the Philadelphia region in 2011. METHODS: Chains were eligible if nutritional information for all menu items was on company Web pages or printed menus at Philadelphia outlets. Nutrient profiles were analyzed for 2,615 items from 21 eligible chains (out of 29) and compared with United States Department of Agriculture guidelines. RESULTS: Adult meals (entree, side dish, and one-half appetizer) approximated 1,495 kcal, 28 g saturated fat, 3,512 mg sodium, and 11 g fiber; and rose to 2,020 kcal after including a beverage and one-half dessert. Better calorie and fat profiles were observed for entrees tagged "healthy choice" or aimed at seniors or children; however, sodium far exceeded recommended limits. CONCLUSIONS AND IMPLICATIONS: Foods served at full-service restaurant chains are high in calories, saturated fat, and sodium. Standard definitions are needed for "healthy choice" tags and for entrees targeted to vulnerable age groups.

Customer responses to mandatory menu labeling at full-service restaurants.

BACKGROUND: In 2010, Philadelphia enacted a menu-labeling law requiring full-service restaurant chains to list values for calories, sodium, fat, and carbohydrates for each item on all printed menus. PURPOSE: The goal of the study was to determine whether purchase decisions at full-service restaurants varied depending on the presence of labeling. METHODS: In August 2011, this cross-sectional study collected 648 customer surveys and transaction receipts at seven restaurant outlets of one large full-service restaurant chain. Two outlets had menu labeling (case sites); five outlets did not (control sites). Outcomes included differences in calories and nutrients purchased and customers' reported use of nutrition information when ordering. Data were analyzed in 2012. RESULTS: Mean age was 37 years; 60% were female; 50% were black/African-American and reported incomes ≥$60,000. Customers purchased food with approximately 1600 kcal (food plus beverage, 1800 kcal); 3200 mg sodium; and 35 g saturated fat. After adjustment for confounders, customers at labeled restaurants purchased food with 151 fewer kilocalories (95% CI=-270, -33); 224 mg less sodium (95% CI=-457, +8); and 3.7 g less saturated fat (95% CI=-7.4, -0.1) compared to customers at unlabeled restaurants (or 155 less kilocalories from food plus beverage, 95% CI=-284, -27). Those reporting that nutrition information affected their order purchased 400 fewer food calories, 370 mg less sodium, and 10 g less saturated fat. CONCLUSIONS: Mandatory menu labeling was associated with better food choices among a segment of the public dining at full-service restaurants. Consumer education on the availability and use of nutrition information may extend the impact of menu labeling.