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Preventing Chronic Disease | Sodium, Saturated Fat, and Trans Fat Content Per 1,000 Kilocalories: Temporal Trends in Fast-Food Restaurants, United States, 2000–2013 - CDC

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Preventing Chronic Disease | Sodium, Saturated Fat, and Trans Fat Content Per 1,000 Kilocalories: Temporal Trends in Fast-Food Restaurants, United States, 2000–2013 - CDC



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Sodium, Saturated Fat, and Trans Fat Content Per 1,000 Kilocalories: Temporal Trends in Fast-Food Restaurants, United States, 2000–2013

Lorien E. Urban, PhD; Susan B. Roberts, PhD; Jamie L. Fierstein, MS; Christine E. Gary, MS; Alice H. Lichtenstein, DSc

Suggested citation for this article: Urban LE, Roberts SB, Fierstein JL, Gary CE, Lichtenstein AH. Sodium, Saturated Fat, and Trans Fat Content Per 1,000 Kilocalories: Temporal Trends in Fast-Food Restaurants, United States, 2000–2013. Prev Chronic Dis 2014;11:140335. DOI: http://dx.doi.org/10.5888/pcd11.140335External Web Site Icon.
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Abstract

Introduction
Intakes of sodium, saturated fat, and trans fat remain high despite recommendations to limit these nutrients for cardiometabolic risk reduction. A major contributor to intake of these nutrients is foods prepared outside the home, particularly from fast-food restaurants.
Methods
We analyzed the nutrient content of frequently ordered items from 3 US national fast-food chains: fried potatoes (large French fries), cheeseburgers (2-oz and 4-oz), and a grilled chicken sandwich. We used an archival website to obtain data on sodium, saturated fat, and trans fat content for these items from 2000 through 2013. The amount of each nutrient per 1,000 kcal was calculated to determine whether there were trends in product reformulation.
Results
Sodium content per 1,000 kcal differed widely among the 3 chains by food item, precluding generalizations across chains. During the 14-year period, sodium content per 1,000 kcal for large French fries remained high for all 3 chains, although the range narrowed from 316–2,000 mg per 1,000 kcal in 2000 to 700–1,420 mg per 1,000 kcal in 2013. Among the items assessed, cheeseburgers were the main contributor of saturated fat, and there was little change in content per 1,000 kcal for this item during the 14-year period. In contrast, there was a sharp decline in saturated and trans fat content of large French fries per 1,000 kcal. Post-2009, the major contributor of trans fat per 1,000 kcal was cheeseburgers; trans fat content of this item remained stable during the 14-year period.
Conclusion
With the exception of French fries, little evidence was found during the 14-year period of product reformulation by restaurants to become more consistent with dietary guidance to reduce intakes of sodium and saturated fat.

Introduction

High intakes of sodium and of saturated and trans fats are associated with increased risk of developing hypertension and cardiometabolic syndrome, respectively (1–3). The 2010 Dietary Guidelines for Americans indicated that these nutrients are a public health concern as a result of their overconsumption (1). A major contributor to intake of these nutrients is foods prepared outside the home, particularly from fast-food restaurants (4–6), which is concerning because the contribution of foods prepared outside the home has steadily risen during the last 3 decades (7,8).
In a companion article (9), we examined trends over time in the portion size of frequently consumed foods and beverages (3 sizes of fried potatoes [French fries] and regular cola, 2 sizes of cheeseburgers, and a grilled chicken sandwich) (10) among 3 of the top US-based fast-food chain restaurants (11). On the basis of analysis of these data, no consistent temporal trends in portion sizes were found. However, the data indicated that the items assessed contributed a disproportional amount of energy, sodium, saturated fat, and trans fat to total daily intake, as assessed by comparing the amounts per serving to recommendations (9).
Independent of issues related to portion size, another potential contributor to excess intake of sodium, saturated fat, and trans fat is product formulation, defined here as the amount of these nutrients in a food expressed per unit of energy. Understanding the relationship between portion size and product formulation and the total intake of overconsumed nutrients can aid in development of effective public health strategies designed to encourage people to select among available products for those with the lowest contents of sodium, saturated fat, and trans fat. It may also serve to incentivize purveyors to reduce levels in their product formulations.


To address this issue, we summarized the available data for sodium, saturated fat, and trans fat content per 1,000 kcal offered by 3 national fast-food chain restaurants for their most frequently ordered menu items: French fries, 2 sizes of cheeseburgers, and a grilled chicken sandwich. Our aim was to document trends in product formulation during a 14-year period, from 2000 through 2013, as a complement to the data on temporal trends in portion sizes provided in the companion article (9).

Acknowledgments

This work was supported by the US Department of Agriculture under agreement nos. 58-1950-0-0014 and 1950-51,000-072-02S with Tufts University. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the US Department of Agriculture. The authors thank Ashley Equi for her help with data acquisition.

Author Information

Corresponding Author: Alice H. Lichtenstein, DSc, Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA 02111. Telephone: 617-556-3127. E-mail: alice.lichtenstein@tufts.edu.
Author Affiliations: Lorien E. Urban, Susan B. Roberts, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts; Jamie L. Fierstein, Christine E. Gary, Freidman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.

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