Fast food’s impact on public health


Dear Readers: One day last week, I found myself busy during the lunch hour and didn’t stop to eat until around 2 p.m. I went to a fast-food restaurant and ordered a small sandwich, medium fries, and a diet soda. Later I realized the moderate-size meal I had consumed contained nearly 800 calories! The fries were delicious, but were they worth it?

It is estimated that Americans eat 1/3 of their meals away from home. While fast food is a convenient and relatively inexpensive option, the calories add up. Instead of getting more for our dollar, we get more around the waistline. Increased calories lead to weight gain, and obesity is one of the leading contributors to diabetes, heart disease, high blood pressure, stroke, and possibly some types of cancer.

In last week’s column, we mentioned that restaurants with twenty or more stores are required to list calorie counts on their menus. In a study published in the British Medical Journal, more than 242 million food transactions were evaluated over three years. The data was collected in fast-food restaurants in the southern United States. After calorie labeling, a decrease of 60 calories per transaction was observed. However, this was followed by an increase of 0.71 calories per transaction over the next year (1).

Particular subpopulations seem to use the calorie counts more effectively. Women, dieters, and people of higher income levels made healthier choices. The calorie labeling was more effective when a 2000 calorie-a-day recommendation was posted.

At first glance, it seems the effect of calorie labeling would be easy to measure. People either ordered items with more calories or less, right? However, measuring the impact on society’s health is much more complex. For example, after realizing how many calories they were consuming in fast food, some customers may quit going to those restaurants altogether. While this may be a healthy adjustment, measuring its impact on public health is complex.

If you have to eat on the run and fast food is a convenient option, consider these guidelines:

1. “Small-size it” instead of super-sizing it. Americans love to get more for their money, but in the case of high calories, maximizing the value of your dollar just doesn’t pay off.

2. Skip the fries. If you must have them, order a small size.

3. Consider ordering the kid’s meal for about 500 calories. Enjoy the toy.

4. Drink water, unsweetened tea or coffee, or a diet drink. A 20-ounce sugar-sweetened soft drink costs about 250 calories; a 32-ounce provides 385 calories, and a 40-ounce soda pop brings in a whopping 500 calories!

The implementation of calorie counts on menus may not solve the obesity problem in America, but it’s a step in the right direction. Increased awareness and education are vital keys to making healthier choices.

Until next time, be healthy!

Dear Dietitian


1. Petimar, J., Zhang, F., Cleveland, L., Simon, D., Gortmaker, S., Polacsek, M., Bleich, S., Rimm, E., Roberto, C., & Block, J. Estimating the effect of calorie menu labeling on calories purchased in a large restaurant franchise in the southern United States: quasi-experimental study. BMJ 2019;367:I5837

By Leanne McCrate

Leanne McCrate is an award-winning dietitian based in Missouri. Her mission is to educate the public on sound, evidence-based nutrition. Do you have a nutrition question? Email her at [email protected].

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