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        ORIGINAL RESEARCH

        Temporal Trends in Fast-Food Restaurant Energy, Sodium, Saturated Fat, and Trans Fat Content, United States, 1996–2013

        Chain/YearFrench Fries, kcalCheeseburger, kcalGrilled Chicken Sandwich, kcalCola, kcal
        SML2 oz4 ozSML
        Chain A
        1996210450540320530150
        1997210450540320530440150
        1998210450540320530440150
        1999210450540320530440150210310
        2000210450540320530450150210310
        2001210450540330530450150210310
        2002210450540330530450150210310
        2003210450540330530400150210310
        2004220350520330540400150210310
        2005230350520310510420150210310
        2006250380570310510420150210310
        2007250380570300510420150210310
        2008230380500300510420150210310
        2009230380500300510420150210310
        2010230380500300510420150210310
        2011230380500300510350150210310
        2012230380500300520350150210310
        2013230380500300520350140200280
        β1.8−0.6−2.7−1.8−1.4−5.5−0.2−0.3−0.8
        P value<.001<.001.007<.001.002<.001.10.11.11
        Chain B
        1996
        1997370380730550204280
        1998
        1999250400590360760530204280407
        2000250400590360760530204280407
        2001230360500370780550
        2002230360500360850580160230330
        2003230360500360800580160230330
        2004230360500350800570160200330
        2005230360500350800570140200290
        2006230360500330760510140200290
        2007230360500330760510140200290
        2008230360500340770490140210290
        2009340480580340770490210290390
        2010340440540310770490210290390
        2011340440540300760470190290380
        2012340410500280760470190290380
        2013340410500288710510190290380
        β8.93.9−2.0−5.8−1.7−5.5−0.11.50.6
        P value.001.05.36<.001.39.002.97.52.85
        Chain C
        199626038046032049031090108180
        199727039047032049031090108180
        199827047057032049031090108180
        199927047057032049031090108180
        200027047057032049031090108180
        2001270420470310480300104130208
        2002250390440310480300112140224
        2003250390440310480300112140224
        2004250390440310480360112140224
        2005280440490320490360112140224
        2006370420540320490370140224294
        2007330420520320500320140224294
        2008340430550260500320140210280
        2009330420540270540350160240320
        2010330410540270540340160240320
        2011320420530270550360160240320
        2012320420530290620390160
        2013310410500290600390160240320
        β4.9−0.51.8−3.06.14.55.210.310.6
        P value.001.73.40<.001<.001<.001<.001<.001<.001
        Chain comparison P value≤.002.04aNS≤.008b<.001b<.001≤.01≤.02<.001b


        Figure 1.
        Energy content (kcal per portion) for popular menu items at 3 large, national fast-food chains. Energy content for 3 sizes of French fries (small, medium, large); 2 sizes of cheeseburgers (2 oz, 4 oz); 1 size of grilled chicken sandwich; and 3 sizes of cola beverages (small, medium, large) from chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviations: S, small; M, medium; L, large; NS, nonsignificant. a Difference is between Chain B versus Chain C. b Difference is between Chain B versus Chains A and C.

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        Chain/YearFrench FriesCheeseburgerGrilled Chicken Sandwich
        SmallMediumLarge2 oz4 oz
        Sodium, mg
        Chain A
        19961352903507701,200
        19971352903508201,2901,040
        19981352903508201,2901,040
        19991352903508201,2901,040
        20001352903508301,310970
        20011352903508301,310970
        20021352903508301,310970
        20031352903508001,250890
        20041502203407901,2401,020
        20051402203307401,1501,240
        20061402203307401,1501,240
        20071402203307501,1901,190
        20081602703507501,1901,190
        20091602703507501,1901,190
        20101602703507501,1901,190
        20111602703507501,190820
        20121602703506801,100820
        20131602703506801,100820
        β1.9−2.1−0.2−7.5−10.2−2.8
        P value<.001.10.63<.001<.001.71
        Chain B
        1996
        19972407701,350480
        1998
        19995508201,1807601,3801,060
        20005508201,1807601,3801,060
        20016306909407501,3901,110
        20024106408807901,4301,370
        20034106408807901,4201,370
        20044106408807701,4501,410
        20054106408807701,4501,410
        20063805908207801,4501,180
        20073805908207801,4501,180
        20083805908207801,4501,250
        20095908209907701,4501,220
        20105306708307401,4501,220
        20115306708307101,4101,100
        20124805707106901,4101,330
        20134805707106901,2401,350
        β−1.72.1−24.0−4.1<0.123.7
        P value.75.79<.001.01.99.04
        Chain C
        1996851201507701,130780
        1997851201508301,240790
        1998851501808301,240790
        1999851501808301,240790
        2000851501808301,240790
        2001851301508001,180740
        20022203403808201,210740
        20032203403808201,230730
        20042203403808201,2301,100
        20052704304808201,2201,100
        20063804305508101,2001,070
        20073404305508001,220950
        20082903704806901,190950
        20093003805007001,2601,000
        20102803504607301,2901,030
        20113504605706701,2701,110
        20123504605708201,440880
        20133304405408001,2201,000
        β18.822.029.6−4.75.917.9
        P value<.001<.001<.001.05.03.002
        Chain comparison P value≤.01<.001a<.001aNS<.001a≤.001a


        Figure 2.
        Sodium content (mg per portion) for popular menu items at 3 large, national fast-food chains. Sodium content for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models, with energy as the dependent variable and time as the independent variable; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviation: NS, nonsignificant. a Difference is between Chain B versus Chains A and C.

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        Chain/YearFrench FriesCheeseburgerGrilled Chicken Sandwich
        SmallMediumLarge2 oz4 oz
        Saturated Fat, g
        Chain A
        19961.54.04.56.013.0
        19971.54.04.56.013.03.0
        19981.54.04.56.013.03.0
        19991.54.04.56.013.03.0
        20001.54.04.56.013.03.0
        20011.54.04.56.013.03.0
        20021.54.04.56.013.03.0
        20031.54.04.56.013.03.0
        20042.03.04.56.013.03.0
        20052.03.05.06.012.02.0
        20062.54.06.06.012.02.0
        20072.54.06.06.012.02.0
        20081.52.53.56.012.02.0
        20091.52.53.56.012.02.0
        20101.52.53.56.012.02.0
        20111.52.53.56.012.02.0
        20121.52.53.56.012.02.0
        20131.52.53.56.012.02.0
        β<0.1−0.1−0.1NC−0.1−0.1
        P value.61<.001.08NS<.001<.001
        Chain B
        1996
        19975.09.016.06.0
        1998
        19995.08.012.09.017.05.0
        20005.08.012.09.017.05.0
        20013.05.07.09.017.05.0
        20023.05.07.08.030.05.0
        20033.05.07.08.018.05.0
        20043.05.07.08.018.04.5
        20053.05.07.08.018.04.5
        20063.04.56.07.016.03.5
        20073.04.56.07.016.03.5
        20083.04.56.07.016.04.0
        20093.55.06.07.016.04.0
        20103.54.56.07.016.04.0
        20113.54.56.06.016.03.5
        20122.53.03.56.016.03.5
        20132.53.03.56.015.04.0
        β−0.1−0.2−0.4−0.2−0.2−0.1
        P value.03.001<.001<.001.28<.001
        Chain C
        19962.54.05.06.010.01.5
        19972.03.03.56.010.51.5
        19982.03.54.06.010.51.5
        19992.03.54.06.010.51.5
        20002.03.54.06.010.51.5
        20012.03.03.56.010.51.5
        20022.03.03.55.010.51.5
        20032.03.03.56.010.51.5
        20042.03.03.56.010.51.5
        20052.53.54.06.010.51.5
        20062.53.04.06.010.51.5
        20072.53.03.55.010.51.5
        20082.53.04.05.010.51.5
        20093.04.05.05.011.51.5
        20103.03.54.55.011.51.5
        20113.04.05.05.012.01.5
        20123.04.05.06.016.03.5
        20133.03.54.56.513.01.5
        β0.1<0.10.1<−0.10.2<0.1
        P value<.001.33.06.06.002.15
        Chain comparison P value≤.001<.001a<.001a<.001a<.001a<.001


        Figure 3.
        Saturated fat content (g per portion) for popular menu items at 3 large, national fast-food chains. Saturated fat content per serving for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 1996 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). Abbreviations: NS, nonsignificant; NC, no change. a Difference is between Chain B versus Chains A and C.

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        Chain/YearFrench FriesCheeseburgerGrilled Chicken Sandwich
        SmallMediumLarge2 oz4 oz
        Trans Fat, g
        Chain A
        2001
        2002
        2003
        2004
        20052.54.06.01.01.50
        20063.55.08.01.01.50
        20073.55.08.00.51.50
        20080000.51.50
        20090000.51.50
        20100000.51.50
        20110000.51.50
        20120000.51.50
        20130000.51.50
        β−0.5−0.1−1.1−0.1NCNC
        P value.01.01.01.03NSNS
        Chain B
        20013.05.06.01.01.5
        20023.04.76.40.71.50.5
        20033.04.76.40.71.40.5
        20043.04.56.00.51.50
        20053.04.56.00.52.00
        20063.04.56.00.51.50.5
        20073.04.56.00.51.50.5
        20083.04.56.00.51.50
        20090000.51.50
        20100000.51.50
        201100001.00
        201200001.00
        201300001.00
        β−0.3−0.5−0.7−0.1<−0.1<−0.1
        P value<.001<.001<.001<.001.06.03
        Chain C
        2001
        2002
        20033.04.55.00.51.00
        20043.04.55.00.51.00
        20053.55.06.00.51.00
        20061.01.01.00.51.00
        20070.51.01.00.51.00
        20080000.51.00
        20090000.51.00
        20100000.51.00
        20110000.51.50
        20120000.51.50
        20130000.51.50
        β−0.4−0.5−0.6NC0.1NC
        P value.001.001.002NS.005NS
        Chain comparison P valueNSNSNSNS<.01aNS


        Figure 4.
        Trans fat content (g per portion) for popular menu items at 3 large, national fast-food chains. Trans fat content per serving for 3 sizes of French fries (small, medium, large), 2 sizes of cheeseburgers (2 oz, 4 oz), and 1 size of grilled chicken sandwich from Chains A, B, and C from 2001 through 2013. β estimates and P values derived from individual simple linear models; chain comparison P values derived from ANOVA (analysis of variance) models, comparing mean values between restaurants. Dashes indicate that data were not available; blank cells indicate that the item was not offered for the year(s). a Difference is between Chain C versus Chains A and B. Abbreviations: NS, nonsignificant; NC, no change.

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        Year/ItemChain AChain BChain C
        Energy, kcal (% Total meal kcal)
        1999
        2-oz Cheeseburger320 (47)360 (44)320 (47)
        Small French fries210 (31)250 (31)270 (40)
        Small cola150 (22)204 (25)90 (13)
        Total small meal680 (100)814 (100)680 (100)
        4-oz Cheeseburger530 (38)760 (43)490 (40)
        Large French fries540 (39)590 (34)570 (46)
        Large cola310 (22)407 (23)180 (15)
        Total large meal1,380 (100)1,757 (100)1,240 (100)
        2003
        2-oz Cheeseburger330 (48)360 (48)310 (46)
        Small French fries210 (30)230 (31)250 (37)
        Small cola150 (22)160 (21)112 (17)
        Total small meal690 (100)750 (100)672 (100)
        4-oz Cheeseburger530 (38)800 (49)480 (42)
        Large French fries540 (39)500 (31)440 (38)
        Large cola310 (22)330 (20)224 (20)
        Total large meal1,380 (100)1,630 (100)1,144 (100)
        2008
        2-oz Cheeseburger300 (44)340 (48)260 (35)
        Small French fries230 (34)230 (32)340 (46)
        Small cola150 (22)140 (20)140 (19)
        Total small meal680 (100)710 (100)740 (100)
        4-oz Cheeseburger510 (39)770 (49)500 (38)
        Large French fries500 (38)500 (32)550 (41)
        Large cola310 (23)290 (19)280 (21)
        Total large meal1,320 (100)1,560 (100)1,330 (100)
        2013
        2-oz Cheeseburger300 (45)288 (35)290 (38)
        Small French fries230 (34)340 (42)310 (41)
        Small cola140 (21)190 (23)160 (21)
        Total small meal670 (100)818 (100)760 (100)
        4-oz Cheeseburger520 (40)710 (45)600 (42)
        Large French fries500 (38)500 (31)500 (35)
        Large cola280 (22)380 (24)320 (23)
        Total large meal1,300 (100)1,590 (100)1,420 (100)
        Sodium, mg (% of total meal)
        1999
        2-oz Cheeseburger820 (86)760 (58)830 (91)
        Small French fries135 (14)550 (42)85 (9)
        Total small meal955 (100)1,310 (100)915 (100)
        4-oz Cheeseburger1,290 (79)1,380 (54)1,240 (87)
        Large French fries350 (21)1,180 (46)180 (13)
        Total large meal1,640 (100)2,560 (100)1,420 (100)
        2003
        2-oz Cheeseburger800 (86)790 (66)820 (79)
        Small French fries135 (14)410 (34)220 (21)
        Total small meal935 (100)1,200 (100)1,040 (100)
        4-oz Cheeseburger1,250 (78)1,420 (62)1,230 (76)
        Large French fries350 (22)880 (38)380 (24)
        Total large meal1,600 (100)2,300 (100)1,610 (100)
        2008
        2-oz Cheeseburger750 (82)780 (67)690 (70)
        Small French fries160 (18)380 (33)290 (30)
        Total small meal                              910 (100)1,160 (100)980 (100)
        4-oz Cheeseburger1,190 (77)1450 (64)1,190 (71)
        Large French fries350 (23)820 (36)480 (29)
        Total large meal1,540 (100)2,270 (100)1,670 (100)
        2013
        2-oz Cheeseburger680 (81)                    690 (59)600 (65)
        Small French fries160 (19)480 (41)330 (35)
        Total small meal840 (100)1,170 (100)930 (100)
        4-oz Cheeseburger1,100 (76)1,380 (66)1,220 (69)
        Large French fries350 (24)710 (34)540 (31)
        Total large meal1,450 (100)2,090 (100)1,760 (100)
        Saturated fat, g (% total meal)
        1999
        2-oz Cheeseburger6 (80)9 (64)6 (75)
        Small French fries1.5 (20)5 (36)2 (25)
        Total small meal7.5 (100)14 (100)8 (100)
        4-oz Cheeseburger13 (74)17 (59)10.5 (72)
        Large French fries4.5 (26)12 (41)4 (28)
        Total large meal17.5 (100)29 (100)14.5 (100)
        2003
        2-oz Cheeseburger6 (80)8 (73)6 (75)
        Small French fries1.5 (20)3 (27)2 (25)
        Total small meal7.5 (100)11 (100)8 (100)
        4-oz Cheeseburger13 (74)18 (72)10.5 (75)
        Large French fries4.5 (26)7 (28)3.5 (25)
        Total large meal17.5 (100)25 (100)14 (100)
        2008
        2-oz Cheeseburger6 (80)7 (70)5 (67)
        Small French fries1.5 (20)3 (30)2.5 (33)
        Total small meal7.5 (100)10 (100)7.5 (100)
        4-oz Cheeseburger12 (77)16 (73)10.5 (72)
        Large French fries3.5 (23)6 (27)4 (28)
        Total large meal15.5 (100)22 (100)14.5 (100)
        2013
        2-oz Cheeseburger6 (80)                              6 (71)4 (57)
        Small French fries1.5 (20)2.5 (29)3 (43)
        Total small meal7.5 (100)8.5 (100)7 (100)
        4-oz Cheeseburger12 (77)10 (74)13 (74)
        Large French fries3.5 (23)3.5 (26)4.5 (26)
        Total large meal15.5 (100)13.5 (100)17.5 (100)
        Trans fat, g (% total meal)
        2003
        2-oz Cheeseburger0.7 (19)0.5 (14)
        Small French fries3 (81)3 (86)
        Total small meal3.7 (100)3.5 (100)
        4-oz Cheeseburger1.4 (18)1 (17)
        Large French fries6.4 (82)5 (83)
        Total large meal7.8 (100)6 (100)
        2008
        2-oz Cheeseburger0.5 (100)0.5 (14)0.5 (100)
        Small French fries03 (86)0
        Total small meal0.5 (100)3.5 (100)0.5 (100)
        4-oz Cheeseburger1.5 (100)1.5 (20)1 (100)
        Large French fries06 (80)0
        Total large meal1.5 (100)7.5 (100)1 (100)
        2013
        2-oz Cheeseburger0.5 (100)00.5 (100)
        Small French fries000
        Total small meal0.5 (100)00.5 (100)
        4-oz Cheeseburger1.5 (100)1 (100)1.5 (100)
        Large French fries000
        Total large meal1.5 (100)1 (100)1.5 (100)


        Figure 5.
        Comparison of energy, sodium, saturated fat, and trans fat content for popular menu items at 3 large, national fast-food chains. Energy (kcal), sodium (mg), saturated fat (g), and trans fat (g) content for 1999, 2003, 2008, and 2013 in popular small-sized (ie, 2-oz cheeseburger, small French fries, and small cola) and large-sized (ie, 4-oz cheeseburger, large French fries, and large cola) meals from chains A, B, and C. Trans fat data were not available for 1999. Dashes indicate that data were not available. Abbreviation: NA, not applicable.

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