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More calories, more salt, bigger portions: how fast food has changed

REUTERS/Joshua Roberts
Fast food, defined in the study as “easily prepared processed food served in snack bars and restaurants as a quick meal or to be taken away,” has been linked in previous research to excess calories and weight.

The food offered at popular fast-food restaurants in the United States has changed dramatically over the past three decades — and not for the better, according to a study published in the Journal of the Academy of Nutrition and Dietetics.

Although some fast-food venues have added salads and other more healthful items to their menus, their overall offerings tend to be much higher in calories and sodium (salt) than they were 30 years ago, the study found.

They are also being served in much larger portions, a particularly troubling trend given that fast food has become such an integral part of the average American diet.

“Our study offers some insights on how fast food may be helping to fuel the continuing problem of obesity and related chronic conditions in the United States,” says lead author Megan McCrory, an associate professor of health sciences at Boston University, in a released statement.


“Despite the vast number of choices offered at fast-food restaurants, some of which are healthier than others, the calories, portion sizes, and sodium content overall have worsened (increased) over time and remain high,” she adds.

Why these findings matter

As background information in the study points out, about 40 percent of American adults aged 50 to 74 are obese, up from around 23 percent three decades ago. Obesity is now the second leading risk factor for disability in the United States and the fourth leading risk factor for early death.

Fast food, defined in the study as “easily prepared processed food served in snack bars and restaurants as a quick meal or to be taken away,” has been linked in previous research to excess calories and weight. For each meal that Americans eat outside their home, they are likely to consume 100 to 200 more calories than they would if they had the meal in their own kitchen.

In addition to its links with obesity, fast food is also associated with poorer health. Research has shown that the more frequently people eat their meals away from home, the more likely they are to have chronic health conditions, including high blood pressure and type 2 diabetes.

And Americans eat plenty of fast food. On any given day, 37 percent of American adults over the age of 20 — and 45 percent of young adults aged 20 to 39 — have a fast-food meal, McCrory points out.

The calories in a single meal — one with an entrée and a side dish — average 760, or almost 40 percent of the 2,000 calories a day that the Food and Drug Administration uses as a guide for food labels, she adds. Add a sugary beverage, and the meal’s calorie count can jump to almost 1,000.

Study details

Previous studies have described how the calorie counts and portions sizes of fast food meals have changed over the years. But those studies have tended to focus on a small number of restaurants and menu offerings.


McCrory and her colleagues wanted to take a broader look at the issue. They analyzed 1,786 menus items — entrées, side dishes and desserts — offered from 1986 to 2016 at 10 of the most popular fast-food chains in the country: Arby’s, Burger King, Carl’s Jr., Dairy Queen, Hardee’s, Jack in the Box, KFC, Long John Silver’s, McDonald’s and Wendy’s.

During that 30-year period, the number of items in the three categories rose by 226 percent, or almost 23 items each year.  Some of those additional items were healthier options — salads and fresh fruit, for example. But most were not.

Megan A. McCrory, PhD, Department of Health Sciences, Boston University, February 2019
From 1986 to 2016, fast-food entrees and desserts increased significantly in portion size, calories, and sodium, and sides increased significantly in calories and sodium.
In fact, as the options on the restaurants’ menus increased, so did the average number of calories in most of them. The dessert category saw the sharpest increase — a jump of 62 calories every 10 years. The entrée category followed, rising 30 calories per decade.

Those increases were mainly the result of larger portion sizes. Desserts gained an average of 24 more grams in weight, and entrées gained an average of 13 more grams, during each decade of the study.

Interestingly, side items did not increase significantly in either calories or portion size.

The sodium content in all three categories did, however, rise significantly. Entrées had the biggest increase — an average of 4.6 percent more sodium per decade.

Although controversial, some research has linked excess sodium intake with an increased risk of high blood pressure.

The study did find what might be considered a positive change in fast food over the decades: higher levels of iron in desserts and of calcium, particularly in entrees.

But as McCrory and her co-authors point out in their paper, “although certain populations of Americans struggle to get enough iron and calcium, fast food should not be the primary source of these micronutrients because fast food also tends to be high in calories and added sugar.”

Needed: un-supersized meals

The researchers hope that their study will bring greater awareness about the health risks associated with the frequent consumption of fast foods.

They also hope it will bring some changes at fast-food restaurants.

“We need to find better ways to help people consume fewer calories and sodium at fast-food restaurants,” says McCrory.

“The requirement that chain restaurants display calories on their menus is a start,” she adds. “We would like to see more changes, such as restaurants offering smaller portions at proportional prices.”

FMI: You’ll find an abstract of the study on the Journal of the Academy of Nutrition and Dietetics’ website, but the full study is behind a paywall.

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Comments (5)

  1. Submitted by Ray Schoch on 03/04/2019 - 10:05 am.

    An excellent choice of photos to lead this piece…

    I won’t hold my breath waiting for local fast food outlets to offer a) smaller portions; and b) proportionally lower prices. “A” might happen, but I’ll be very surprised if “B” ever takes place. Restaurants have a very high percentage of fixed costs that they have to cover, and the profit margin for fast food outlets, given the intense competition they usually face, is already fairly small – they depend on volume to make money. Beyond the occasional “Sale” of items – lower costs for items related to the Christian celebration of Lent leading up to Easter, for example – I doubt most fast food outlets could stay in business if they offered menu-wide lowering of portion sizes and proportional pricing. They’d still have to pay the people who work there, the utility bills, etc.

  2. Submitted by Paul Udstrand on 03/04/2019 - 10:16 am.

    You forgot to mention how they’ve been adding flavor to taste and making the food so much more delicious. 🙂

  3. Submitted by Charles Holtman on 03/04/2019 - 12:55 pm.

    Dog bites man.

    If I’m happy to consider a bacon cheeseburger, fries and an ice cream cone to be a “meal,” I’m not sure a 4.6% increase in sodium content per decade is going to grab my attention.

  4. Submitted by David Lundeen on 03/04/2019 - 02:11 pm.

    As much as I support Medicare for all, reports like this leave me very conflicted. In all honesty, people shouldn’t be immune from their eating decisions. I realize it’s a complicated issue, especially with the cost of healthy food, and access to it. Maybe we can all agree that a good start for Medicare for all is substantially raising taxes on every fast food purchase. A Big Mac should cost $20 considering the costs it imparts on the rest of society.

  5. Submitted by Ivy Chang on 03/06/2019 - 03:10 pm.

    Which government agency is in charge of fast-food restaurants? The FDA? That’s rules on portion size must be made. Government is too lax to take on food size regulation. They must work with Medicare and Medicaid to lower all costs.

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