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Study:
Full-Service Restaurants Just as Unhealthy as Fast-Food

Food served in full-service restaurants often is just as unhealthy as, or even unhealthier than, food served in fast-food restaurants, despite consumer perceptions that full-service restaurants are healthier, according to a new study in the Journal of Nutrition Education and Behavior.

Food prepared away from home is typically higher in calories and lower in nutrition than food prepared at home, and now makes up more than one-third of all calories purchased in the United States, the study says.

Researchers from Drexel University and the University of Pennsylvania studied more than 2,600 menu items served at full-service restaurant chains operating in Philadelphia and concluded that foods served at full-service restaurant chains are high in calories, saturated fat and sodium, and that standard definitions are needed for ‘‘healthy choice’’ tags and for entrees targeted to vulnerable age groups.

While nutrition information provided at full-service restaurants has lagged behind fast-food restaurants, a 2010 menu-labeling ordinance in Philadelphia provided an opportunity for an in-depth study of the calorie and nutrition content of menu items served at full-service restaurants. The study included 21 full-service restaurant chains that offered single-serving entrees and provided calories and sodium information for all menu items on either their websites or printed menus.

The study focused on entrees, appetizers and side dishes, but also provided information on other less consistently labeled menu categories.

“The need to educate customers about the nutritional content of restaurant foods is acute because consumers increasingly eat away from home, restaurants serve large portions of energy-dense and high-sodium foods, and obesity and the prevalence of other diet-related diseases are high,” said lead researcher Amy Auchincloss, PhD, MPH, of the Drexel University School of Public Health.

Currently, no guidelines exist for appropriate nutrient levels of full-service restaurant menu items, but about half of the entrees did not meet the study’s “healthier” calorie criteria, based on general nutrition advice in the U.S. Dietary Guidelines. Nearly one-third of the entrees exceeded the total daily recommended value (DRV) for sodium, and only one-fifth met recommended fiber minimums. Items targeting seniors and children had fewer calories, but often exceeded the DRV for fat and sodium. More than half of the studied restaurants designate some healthy choices on their menus, but the meaning of that designation varies; in most cases, only calorie content is considered and they may still have high sodium levels.

Nutrition education can help consumers to evaluate menu items on their own to make healthier choices. The same research team previously reported that consumers at full-service restaurants who used nutritional information on the menu ordered significantly fewer calories. However, policy changes for restaurants that parallel those of fast food may be more effective. Having a definition for a healthy choice entrée could help consumers who want to choose food for taste and health promotion.

In related nutrition news, Public Health England last week unveiled its latest Change4Life campaign, which this year focuses on getting people throughout England and Wales to “Smart Swap” fatty or sugary foods for healthier alternatives. The campaign has already sparked criticism from the Children's Food Campaign, which says Change4Life should be pushing for more fundamental changes in our food selection, both at the retail level and at the brand level.

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