Rating fast food by calories purchased: Is Subway healthier than McDonald's?

INTRODUCTION: Eating fast food is associated with poor diet quality. Restaurants such as Subway have responded to criticism by marketing their food as “healthy.” The study assessed whether adolescents purchasing food at a restaurant marketed as “healthy” (Subway) purchased fewer calories than at a competing chain (McDonald's). METHODS: In comparison to other studies that have not controlled for inter-subject variation, we recruited 97 adolescents who purchased a meal at both restaurants on different days. The students purchased an after-school meal at the restaurant and provided us with their receipt, from which we calculated calories. RESULTS: Adolescents purchased 1038 Calories at McDonald's and 955 Calories at Subway. This difference of 83 Calories was not statistically significant (p=0.11). Participants purchased significantly more calories from the drinks category at McDonald's (151 vs. 61, p<0.01). They also purchased more calories as side dishes (i.e. French fries or potato chips): 201 at McDonald's vs. 35 at Subway (p<0.01). In contrast, they purchased fewer servings of vegetables at McDonald's (0.15 vs. 0.57, p<0.01). DISCUSSION: We found that, despite being marketed as “healthy”, adolescents purchasing a meal at Subway purchase just as many calories as at McDonald's. Despite some evidence that the Subway meals had better nutrient profiles, meals about both restaurants are likely to contribute to overeating.