Energy contents of frequently ordered restaurant meals and comparison with human energy requirements and US Department of Agriculture database information: a multisite randomized study

Authors: URBAN, LORIEN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; WEBER, JUDITH - University Of Arkansas; HEYMAN, MELVIN - University Of California; SCHICHTL, RACHEL - University Of Arkansas; VERSTRAETE, SOFIA - University Of California; LOWERY, NINA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; DAS, SAI KRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SCHLEICHER, MOLLY - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ECONOMOS, CHRISTINA - Friedman School At Tufts; MASTERS, WILLIAM - Friedman School At Tufts; ROBERTS, SUSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/24/2015
Publication Date: 1/19/2016
Citation: Urban, L.E., Weber, J.L., Heyman, M.B., Schichtl, R.L., Verstraete, S., Lowery, N.S., Das, S., Schleicher, M.M., Rogers, G., Economos, C., Masters, W.A., Roberts, S. 2016. Energy contents of frequently ordered restaurant meals and comparison with human energy requirements and US Department of Agriculture database information: a multisite randomized study. Journal of the Academy of Nutrition and Dietetics. 116(4):590-598. https://doi.org/10.1016/j.jand.2015.11.009.

Interpretive Summary: The cause of obesity may be attributed to excess energy intake, which is potentially due to the consumption of more meals at restaurants than at home. In the United States, the actual energy content of meals from individual and small-chain restaurants is mainly unknown because only large-chain restaurants (defined as those with 20 or more locations) are required by the Food and Drug Administration to provide nutrition information. The objective of this study was to assess whether similar, frequently ordered meals from non- and large-chain restaurants differed in energy content. The study was conducted from 2011 to 2014 in three geographically diverse locations: San Francisco, California, Boston, Massachusetts, and Little Rock, Arkansas. Non-chain restaurants, from nine of the nation's most popular cuisines, were randomly selected in these three cities. The most frequently ordered meals from these non-chain restaurants were selected, and meal energy content was measured by bomb calorimetry. An average meal from these non-chain restaurants contained 1,205 +/- 465 kcal. The energy content of meals at non-chain restaurants did not differ from that of similar meals at large-chain restaurants. However, the type of cuisine did affect the energy content, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy per meal (1,495 kcal). Of note, almost all meals measured in this study had a high-energy content, with 92% exceeding the typical energy requirements for a single eating occasion. This study found non-chain restaurants, just like their large-chain counterparts, serve meals with high energy content. It is likely that restaurants in general, rather than specific categories of restaurants, contribute to obesity by exposing patrons to excessive portions that induce overeating through established biological mechanisms.

Technical Abstract: BACKGROUND: Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ~50% of US restaurants are individual or small-chain (non-chain) establishments that do not provide nutrition information. OBJECTIVE: To measure the energy content of frequently ordered meals in non-chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. DESIGN: A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non-chain restaurants, together with equivalent meals from large-chain restaurants. SETTING: Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. MAIN OUTCOME MEASURES: Meal energy content determined by bomb calorimetry. STATISTICAL ANALYSIS PERFORMED: Regional and cuisine differences were assessed using a mixed model with restaurant nested within region cuisine as the random factor. Paired t tests were used to evaluate differences between non-chain and chain meals, human energy requirements, and food database values. RESULTS: Meals from non-chain restaurants contained 1,205 +/- 465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P=0.41). There was a significant effect of cuisine on non-chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. CONCLUSIONS: Non-chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy. Restaurants in general, rather than specific categories of restaurant, expose patrons to excessive portions that induce overeating through established biological mechanisms.