Fast-Food Offerings in the United States in 1986, 1991, and 2016 Show Large Increases in Food Variety, Portion Size, Dietary Energy, and Selected Micronutrients.

BACKGROUND: US national survey data shows fast food accounted for 11% of daily caloric intake in 2007-2010.
OBJECTIVE: To provide a detailed assessment of changes over time in fast-food menu offerings over 30 years, including food variety (number of items as a proxy), portion size, energy, energy density, and selected micronutrients (sodium, calcium, and iron as percent daily value [%DV]), and to compare changes over time across menu categories (entrées, sides, and desserts).
DESIGN: Fast-food entrées, sides, and dessert menu item data for 1986, 1991, and 2016 were compiled from primary and secondary sources for 10 popular fast-food restaurants. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Linear mixed-effects analysis of variance was performed to examine changes over time by menu category.
RESULTS: From 1986 to 2016, the number of entrées, sides, and desserts for all restaurants combined increased by 226%. Portion sizes of entrées (13 g/decade) and desserts (24 g/decade), but not sides, increased significantly, and the energy (kilocalories) and sodium of items in all three menu categories increased significantly. Desserts showed the largest increase in energy (62 kcal/decade), and entrées had the largest increase in sodium (4.6% DV/decade). Calcium increased significantly in entrées (1.2%DV/decade) and to a greater extent in desserts (3.9% DV/decade), but not sides, and iron increased significantly only in desserts (1.4% DV/decade).
CONCLUSIONS: These results demonstrate broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing variety, portion size, energy, and sodium content. Research is needed to identify effective strategies that may help consumers reduce energy intake from fast-food restaurants as part of measures to improve dietary-related health issues in the United States.