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BMJ. 2018 Dec 12;363:k4864. doi: 10.1136/bmj.k4864.

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

Author information

1
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA susan.roberts@tufts.edu j.speakman@abdn.ac.uk.
2
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
3
Ribeir√£o Preto Medical School of University of Sao Paulo, Ribeirao Preto, SP, 14 049 900, Brazil.
4
Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, 70211, Finland.
5
Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, 70211, Finland.
6
Division of Nutrition, St John's Research Institute, Bengaluru, 560034, India.
7
Department of Nutrition and Food Science, University of Ghana, Legon-Accra, Ghana.
8
Department of Foods and Nutrition, University of Georgia, Athens, GA, USA.
9
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
10
State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, PRC.
11
Chinese Academy of Sciences, Shijingshan District, Beijing 100049, PRC.
12
Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen AB24 2TZ, UK.
13
Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland.
14
University of Ribeirao Preto (UNAERP), Ribeirao Preto, SP, Brazil.
15
State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, PRC susan.roberts@tufts.edu j.speakman@abdn.ac.uk.
16
Center of Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, PRC.

Abstract

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.

PMID:
30541752
PMCID:
PMC6290458
DOI:
10.1136/bmj.k4864
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from SBR) and declare: no support from any organization for the submitted work other than that described above; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

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