Fast food restaurant menu offerings score poorly in relation to dietary guidance

Introduction: Fast food restaurants are a major source of food away from home and are generally not considered to be supportive of healthy eating. This study was undertaken to assess the congruence between menu offerings at five popular fast food restaurants and multiple dimensions of dietary guidance as well as overall diet quality.

Methods: Menu offerings, as posted on restaurant websites in 2010, were evaluated with the Healthy Eating Index-2005 (HEI-2005), reflecting the dietary guidelines then in effect. Menu items were coded using the Food and Nutrient Database for Dietary Studies and the MyPyramid Equivalents Database, and HEI-2005 scores were calculated.

Results: Each restaurant's full menu scored 50 points or less out of a possible 100 points on the HEI-2005: Wendy's (50), Subway (49), McDonalds (46), Burger King (45), and Taco Bell (41). The HEI-2005 components generally receiving the lowest scores were whole fruit, dark-green and orange vegetables and legumes, whole grains, and sodium. The incongruence between dietary recommendations and foods and beverages marketed on budget/value and kids' menus was also striking. Three restaurant chains marketed subsets of their menu items as ‘healthy'; these offerings received scores that were on average 16 points higher than the scores for the full menus.

Discussion: The incompatibility of fast food restaurant offerings with dietary guidance is worrisome in light of increasing away-from-home eating, aggressive marketing practices aimed at children and youth, and the disproportionate concentration of fast food restaurants in relation to other food sources in low-income and minority neighborhoods.