Public Release: 

Little change seen in fast food portion size, product formulation between 1996 and 2013

Study of three chains finds calorie, salt content remain high compared to dietary recommendations

Tufts University, Health Sciences Campus

BOSTON [December 31, 2014, Noon EST ] - Two new reports from researchers at the USDA Human Nutrition Research Center on Aging at Tufts University show little change in fast food portion sizes and product formulation between 1996 and 2013. Led by Alice H. Lichtenstein, D.Sc., director of the Cardiovascular Nutrition Laboratory at the USDA HNRCA, the researchers analyzed the calorie, sodium, saturated fat and trans fat content of popular menu items served at three national fast-food chains between 1996 and 2013. They found that average calories, sodium, and saturated fat stayed relatively constant, albeit at high levels. The exception was a consistent decline in the trans fat of fries. The studies published today in Preventing Chronic Disease, a journal of the Centers for Disease Control and Prevention.

"There is a perception that restaurants have significantly expanded their portion sizes over the years, but the fast food we assessed does not appear to be part of that trend," said Lichtenstein, who is also the Stanley N. Gershoff Professor at the Friedman School of Nutrition Science and Policy at Tufts University. "Our analysis indicates relative consistency in the quantities of calories, saturated fat, and sodium. However, the variability among chains is considerable and the levels are high for most of the individual menu items assessed, particularly for items frequently sold together as a meal, pushing the limits of what we should be eating to maintain a healthy weight and sodium intake."

"For example, among the three chains, calories in a large cheeseburger meal, with fries and a regular cola beverage, ranged from 1144 to 1757 over the years and among restaurants, representing 57% to 88% out of the approximately 2000 calories most people should eat per day," Lichtenstein continued. "That does not leave much wiggle room for the rest of the day."

According to the authors' 2013 data, calorie content of the cheeseburger meal among the three chains represented 65% to 80% of a 2,000 calorie per day diet and sodium content represented 63% to 91% of the recommendation. The U.S. Dietary Guidelines for Americans recommend adults limit their salt intake to a maximum of 2,300 milligrams per day. Depending on the chain, between 1996 and 2013, eating a single 4 oz. cheeseburger could have accounted for 1100 to 1450 mg of daily sodium representing 48% to 63% of target limits.

Lichtenstein and colleagues focused on the four most popular menu items: fries, cheeseburgers, grilled chicken sandwiches, and regular cola, looking for trends in portion size and nutrient content over an 18 year period. They examined 27 items including small, medium and large fries and cola beverages, a grilled chicken sandwich, and 2 oz. and 4 oz. cheeseburgers. The authors used a public database and the internet to access the archived nutrition data.

They found only small fluctuations in calorie content and the amount of saturated fat and sodium. The notable exception was fries, which decreased first in saturated fat in 2001 and then trans fat, likely due to changes to the frying fat. "The decline in trans fat we saw between 2005 and 2009 appears to be related to legislative efforts," Lichtenstein said. "The success of New York City's trans fat ban and others like it, suggest it is worth pursuing these types of approaches because they make the default option the healthier option. Of course, it is important to note that the healthier option in terms of fat does not translate into lower calories or less salt."

Despite public health campaigns, fast food sales remain strong, contributing to our epidemic of obesity and hypertension. "Restaurants can help consumers by downsizing portion sizes and reformulating their food to contain less of these over-consumed nutrients. This can be done, gradually, by cutting the amount of sodium, and using leaner cuts of meat and reduced-fat cheese," Lichtenstein said. "From what we hear some fast-food chains are heading in that direction and also introducing new healthier options. If taken advantage of, these changes should help consumers adhere to the current dietary recommendations."

The authors also note nutrient content varied among similar items from different chains. For example, an order of small fries could differ by as much as 110 calories and 320 mg of sodium from chain to chain. "For this reason our findings strongly suggest that public health efforts promoting reduction of calories and over-consumed nutrients need to shift from emphasizing small, medium and large portion sizes, to additional factors such as actual number of calories and the nutrient content of the items, as is increasingly becoming available at point of purchase," Lichtenstein said. "A 100 calorie difference per day can mean about a 10 pound weight change per year."

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Additional authors of these papers are: Lorien E. Urban, Ph.D., a former postdoctoral research associate in the Energy Metabolism Laboratory at the USDA HNRCA and a graduate of the Friedman School; Susan B. Roberts, Ph.D., director of the Energy Metabolism Laboratory at the USDA HNRCA, professor at the Friedman School, and adjunct professor of psychiatry at Tufts University School of Medicine; Jamie L. Fierstein, a Ph.D. candidate at the Friedman School and Christine E. Gary, a graduate of the Friedman School.

Urban LE, Roberts SB, Fierstein JL, Gary CE and Lichtenstein AH. "Temporal Trends in Fast-Food Restaurant Energy, Sodium, Saturated Fat and Trans Fat Content in the United States, 1996-2013. Prev. Chronic Dis 2014: 11:140202. DOI: http://dx.doi.org/10.5888/pcd11.140202.

Urban LE, Roberts SB, Fierstein JL, Gary CE, Lichtenstein AH, Sodium, Saturated Fat and Trans Fat Content Per 1,000 Kilocalories: Temporal Trends in Fast-Food Restaurants, United States, 2000-2013. Prev Chronic Dis 2014: 11:140335. DOI: http//dx.doi.org/10.5888/pcd11.140335.

This work was supported by the U.S. Department of Agriculture under agreement numbers 58-1950-0-0014 and 1950-51000-072-02S with Tufts University. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the USDA.

About the Jean Mayer USDA Human Nutrition Research Center on Aging and The Friedman School of Nutrition Science and Policy

For three decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies. The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight degree programs - which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics - are renowned for the application of scientific research to national and international policy.

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