title: Macronutrient Composition of Menu Offerings in Fast Food Restaurants in the U.S.
abstract: A high intake of fast food is associated with increased obesity risk. This study assessed recent changes in caloric content and macronutrient composition in large U.S. fast food restaurants.
  
  
  
  Data from the MenuStat project included 11,737 menu items in 37 fast food restaurants from 2012 to 2014. Generalized linear models were used to examine changes in the caloric content and corresponding changes in the macronutrient composition (non-sugar carbohydrates, sugar, unsaturated fat, saturated fat, and protein) of menu items over time. Additionally, macronutrient composition was compared in menu items newly introduced in 2013 and 2014, relative to 2012. Analyses, conducted in January 2016, controlled for restaurant and were stratified by menu categories.
  
  
  
  Overall, there was a 22-calorie reduction in food items from 2012 to 2014. Beverages had a 46-calorie increase, explained by an increase in calories from sugar (12 calories) and saturated fat (16 calories). Newly introduced main courses in 2014 had 59 calories fewer than those on 2012 menus, explained by a 54-calorie reduction in unsaturated fat, while other macronutrient content remained fairly constant. Newly introduced dessert items in 2014 had 90 calories more than those on 2012 menus, explained primarily by an increase of 57 calories of sugar.
  
  
  
  Overall, there were relatively minor changes in menu items' caloric and macronutrient composition. Although declines in caloric content among newly introduced fast food main courses may improve the public's caloric intake, it appears that the macronutrient composition of newly introduced items did not shift to a healthier profile.
authors.affiliation: Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: marian.jarlenski@pitt.edu.
authors.forename: Marian P
authors.initials: MP
authors.lastname: Jarlenski
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, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
mesh_terms: D057140:Fast Foods / Q000032:analysis / Q000706:statistics & numerical data*; D009753:Nutritive Value; D014481:United States