Measured energy content of frequently purchased restaurant meals: multi-country cross sectional study

Susan B Roberts (Corresponding Author), Sai Krupa Das, Vivian Marques Miguel Suen, Jussi Pihlajamäki, Rebecca Kuriyan, Matilda Steiner-Asiedu, Amy Taetzsch, Alex K Anderson, Rachel E Silver, Kathryn Barger, Amy Krauss, Leila Karhunen, Xueying Zhang, Catherine Hambly, Ursula Schwab, Andresa de Toledo Triffoni-Melo, Salima F Taylor, Christina Economos, Anura V Kurpad, John R Speakman (Corresponding Author)

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OBJECTIVE: To measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data.

DESIGN: Cross sectional survey.

SETTING: 223 meals from 111 randomly selected full service and fast food restaurants serving popular cuisines in Brazil, China, Finland, Ghana, and India were the primary sampling unit; 10 meals from five worksite canteens were also studied in Finland. The observational unit was frequently ordered meals in selected restaurants.

MAIN OUTCOME MEASURE: Meal energy content, measured by bomb calorimetry.

RESULTS: Compared with the US, weighted mean energy of restaurant meals was lower only in China (719 (95% confidence interval 646 to 799) kcal versus 1088 (1002 to 1181) kcal; P<0.001). In analysis of variance models, fast food contained 33% less energy than full service meals (P<0.001). In Finland, worksite canteens provided 25% less energy than full service and fast food restaurants (mean 880 (SD 156) versus 1166 (298); P=0.009). Country, restaurant type, number of meal components, and meal weight predicted meal energy in a factorial analysis of variance (R2=0.62, P<0.001). Ninety four per cent of full service meals and 72% of fast food meals contained at least 600 kcal. Modeling indicated that, except in China, consuming current servings of a full service and a fast food meal daily would supply between 70% and 120% of the daily energy requirements for a sedentary woman, without additional meals, drinks, snacks, appetizers, or desserts.

CONCLUSION: Very high dietary energy content of both full service and fast food restaurant meals is a widespread phenomenon that is probably supporting global obesity and provides a valid intervention target.

Original languageEnglish
Article numberk4864
JournalBMJ (Clinical research ed.)
Publication statusPublished - 12 Dec 2018


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