title: Calorie Changes in Large Chain Restaurants: Declines in New Menu Items but Room for Improvement.
abstract: BACKGROUND
  Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist.
  
  
  METHODS
  Data (a census of items for included restaurants) were obtained from the MenuStat project. This analysis included 66 of the 100 largest U.S. restaurants that are available in all three of the data years (2012-2014; N=23,066 items). Generalized linear models were used to examine: (1) per-item calorie changes from 2012 to 2014 among items on the menu in all years; and (2) mean calories in new items in 2013 and 2014 compared with items on the menu in 2012 only. Data were analyzed in 2014.
  
  
  RESULTS
  Overall, calories in newly introduced menu items declined by 71 (or 15%) from 2012 to 2013 (p=0.001) and by 69 (or 14%) from 2012 to 2014 (p=0.03). These declines were concentrated mainly in new main course items (85 fewer calories in 2013 and 55 fewer calories in 2014; p=0.01). Although average calories in newly introduced menu items are declining, they are higher than items common to the menu in all 3 years. No differences in mean calories among items on menus in 2012, 2013, or 2014 were found.
  
  
  CONCLUSIONS
  The previously observed declines in newly introduced menu items among large restaurant chains have been maintained, which suggests the beginning of a trend toward reducing calories.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: sbleich@jhsph.edu.
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Wolfson
authors.affiliation: Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Marian P
authors.initials: MP
authors.lastname: Jarlenski
mesh_terms: D002149:Energy Intake; D005515:Food Labeling / Q000706:statistics & numerical data*; D006801:Humans; D008612:Menu Planning / Q000592:standards / Q000639:trends*; D009765:Obesity / Q000517:prevention & control; D012147:Restaurants; D014481:United States