Introduction
Item descriptions on restaurant menus often include claims about health and other
attributes, and these are much less regulated than the language on packaged food labels.
This study tests whether menu items with claims have different nutritional content
from items without claims.
Methods
Investigators compiled a data set of menu items, their claims, and their nutrition
content using MenuStat. Data included 84,788 item-year observations at up to 96 of
the top-selling restaurant chains from 2012 to 2018. Items were identified with general
health, health-related ingredients, nutrient content, product sourcing, and vegan
or vegetarian claims through a matching algorithm. Mixed-effects models were used
to examine the effect of claims on calories, nutrients to limit (e.g., saturated fat
and sodium), and other nutrients by dish types (sides, main dishes, desserts).
Results
Most dishes with claims were lower in calories; however, items with claims were not
consistently lower in other nutrients to limit (sodium, saturated fat, sugar, or trans
fat). Vegan or vegetarian desserts had 128 mg (95% CI=20.9, 235.1) more sodium than
desserts without this claim. Main and side dishes with claims had equivalent or higher
sugar content than items without claims. Many items with claims were lower in saturated
fat, especially main dishes with a nutrient content claim (−2.8 percentage points,
95% CI= −3.4, −2.2).
Conclusions
Items with claims were high in nutrients to limit. Additional efforts to increase
transparency around excessive ingredients, such as the sodium warning labels, could
be implemented by the restaurant industry.
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
