267650 Rating fast food by calories purchased: Is Subway healthier than McDonald's?

Tuesday, October 30, 2012 : 2:45 PM - 3:00 PM

Lenard Lesser, MD MSHS , Robert Wood Johnson Foundation Clinical Scholars Program, University of California, Los Angeles, Los Angeles, CA
Karen Kayekjian, MPH , College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA
Paz Villanueva Velasquez , The Youth, Family, School and Community Partnership in Action, Carson, CA
Virginia Velasquez , The Youth, Family, School and Community Partnership in Action, Carson, CA
Deborah Cohen, MD, MPH , RAND Corporation, Santa Monica, CA
Chi-hong Tseng, PhD , Department of General Internal Medicine, UCLA, Los Angeles, CA
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.

Learning Areas:
Public health or related public policy
Public health or related research

Learning Objectives:
1. Compare what adolescents purchase at a restaurant marketed as “healthy”, with one that does not make such claims; and 2. Evaluate two popular fast food restaurant chains with the Nutrition Environment Measures Survey, an objective checklist scale of “healthiness.”

Keywords: Food and Nutrition, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Robert Wood Johnson Foundation Clinical Scholar and focus my research on food environments and marketing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.