Fast Food Has Become Larger and Less Healthy Over 3 Decades, Study Finds

Even a 226 percent increase in menu options isn't helping.

The menu at a modern-day McDonald’s differs noticeably from its original 1955 spread. Peppered among burgers and fries are side salads, smoothies, and “artisan grilled chicken,” all meant to reflect a shifting, healthier society. But despite the efforts of fast-food restaurants to provide nutritious options, a new study in the Journal of the Academy of Nutrition and Dietetics shows that fast food is even more unhealthy now than it was 30 years ago.

While menus have made some crucial changes — like swapping margarine for butter and reducing the levels of trans fats in French fries — the calorie and sodium contents of fast food sides, entrees, and desserts have increased significantly in that time, the study claims. Entree and dessert portions have increased in size as well, write the authors, led by Boston University health sciences associate professor Meagan McCrory, Ph.D.: Entrees increased by 13 grams per decade, while desserts increased by 24 grams per decade.

In their analysis, McCrory and her team used nutritional data provided by ten fast food restaurants: McDonald’s, Wendy’s, Long John Silver’s, KFC, Jack in the Box, Hardee’s, Dairy Queen, Carl’s Jr., Burger King, and Arby’s.

In particular, they looked at changes in the menus of these restaurants in 1986, 1991, and 2016 to get a sense of how they shifts over three decades. While more food options are offered now than ever before — the variety of choices rose by 226 percent over 30 years — the nutritional value of fast food, combined with its popularity, continues to contribute to obesity. Between 2013 and 2016, about 37 percent of Americans ate fast food on a given day, the CDC notes.

McDonald's may have some healthier options than it used to, but that doesn't mean it's overall healthy. 

Unsplash / Amandine Lerbscher

“Given the popularity of fast food, our study highlights one of the changes in our food environment that is likely part of the reason for the increase in obesity and related chronic conditions over the past several decades, which are now among the main causes of death in the US,” McCrory explains.

McCrory and her colleagues found that, while calories increased across sides, desserts, and entrees over the last 30 years, the latter two saw the largest jump: Desserts increased by 62 kilocalories per decade while entrees increased by 30 kilocalories in the same period. Meanwhile, the amount of sodium in entrees also increased, with the daily value growing by 4.6 percent per decade. Physicians recommend people limit their sodium intake because it can drive high blood pressure.

The researchers did find one positive development: an increase in iron and calcium levels in desserts. This is a step in the right direction, they write: If you’re going to get a fast food dessert, at least it will contain nutrients that are good for healthy bone mass and preventing anemia, a condition in which blood doesn’t have enough healthy red blood cells.

McCrory emphasizes that she hopes these study’s findings lead to restaurants not simply offering healthier options, but smaller options at proportional prices as well. Nutritionists haven’t figured how to curb our appetites for calories and sodium — and while a salad may be on the menu, that doesn’t mean we’re not going to choose the Big Mac.

Background: US national survey data shows fast food accounted for 11% of daily caloric intake in 2007-2010.
Objective: To provide a detailed assessment of changes over time in fast-food menu offerings over 30 years, including food variety (number of items as a proxy), portion size, energy, energy density, and selected micronutrients (sodium, calcium, and iron as percent daily value [%DV]), and to compare changes over time across menu categories (entrées, sides, and desserts).
Design: Fast-food entrées, sides, and dessert menu item data for 1986, 1991, and 2016 were compiled from primary and secondary sources for 10 popular fast-food restaurants.
Statistical Analysis: Descriptive statistics were calculated. Linear mixed-effects analysis of variance was performed to examine changes over time by menu category.
Results: From 1986 to 2016, the number of entrées, sides, and desserts for all restaurants combined increased by 226%. Portion sizes of entrées (13 g/decade) and desserts (24 g/decade), but not sides, increased significantly, and the energy (kilocalories) and sodium of items in all three menu categories increased significantly. Desserts showed the largest increase in energy (62 kcal/decade), and entrées had the largest increase in sodium (4.6% DV/decade). Calcium increased significantly in entrées (1.2%DV/decade) and to a greater extent in desserts (3.9% DV/decade), but not sides, and iron increased significantly only in desserts (1.4% DV/decade).
Conclusions: These results demonstrate broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing variety, portion size, energy, and sodium content. Research is needed to identify effective strategies that may help consumers reduce energy intake from fast-food restaurants as part of measures to improve dietary-related health issues in the United States.
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