Trends in energy and nutrient content of menu items served by large UK chain restaurants from 2018 to 2020: an observational study


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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 (e.g., 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”). Results: Our study included 7,770, 9,213, and 6,928 menu items from 29 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: -0.43g/year, 95%CI= -0.66, -0.21). This reduction in sugar was evident in beverages, sandwiches and desserts. Among core menu items (N=1,855), sugar content reduced significantly from 2018 to 2020 (per-item: -0.31g/year, 95%CI= -0.45, -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 sugar, salt, and saturated fat content among core menu items, compared to 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.

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epidemiology, health policy, public health, nutrition & dietetics
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BMJ Open
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BMJ Publishing Group
Medical Research Council (MR/K023187/1)
MRC (MC_UU_00006/7)
Department of Health (via National Institute for Health Research (NIHR)) (200689)
This work was supported by the Medical Research Council (grant number MC_UU_00006/7) and the Centre for Diet and Activity Research (CEDAR), a UKCRC funded Centre of Public Health Research Excellence. Funding for CEDAR from Cancer Research UK, British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, and Wellcome Trust is gratefully acknowledged. YH is supported through a Gates Cambridge Scholarship. DT is supported by a PhD studentship awarded by the National Institute for Health Research (NIHR), School for Public Health Research. TB and JA are supported by the CEDAR. No funders had any role in the study design; collection, analysis and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.