Fast Food Exposing the Truth

Fast food Exposing the truth

The takeaway on fast food meals

A summary of three fast food studies in Australia and recommendations for change The takeaway on fast food meals A summary of three fast food studies in Australia

Fast food in Australia – We know that overweight and what’s the issue? obesity are risk factors for cancers of the bowel, kidney, pancreas, % More than half of Australian adults oesophagus, endometrium and and nearly a quarter of Australian breast (in post-menopausal women),7 children are either overweight cardiovascular disease and type 2 or obese.1,2 Research shows diabetes, among other diseases;8 that eating fast foods regularly therefore, reducing the negative 28 The average amount a can lead to weight gain,3,4 due impact of fast food on people’s household spends of its to their high energy, total fat health is important for preventing chronic diseases, such as cancer. and saturated fat content.5 food budget on fast food 9 The average fast food meal Fast food consumption in Australia and eating out. provides about half (47%) of an has increased dramatically in recent adult’s daily energy requirement.6 years, with the average household spending 28% of its food budget on fast food and eating out.9 There are many reasons why people have increased their fast food consumption: ranging from the convenience and location of fast food outlets to the low cost and frequent marketing of fast food.

The link between fast food and cancer

Excess fast food intake

is linked to

Weight gain

which leads to

Overweight and obesity

which increases

Risk of cancer and other chronic diseases

1 47% The average fast food meal in Australia provides about half of an adult’s daily kilojoule needs.6 Government action on fast food

Fast food menu labelling The Federal Government has placed In commonly eaten foods, small this recommendation on hold while it reductions of these key nutrients Since 2008, there have been works with industry and public health across the food supply have the some policy developments stakeholders to develop a front-of-pack potential to reduce their intake across in Australia relating to fast labelling system for grocery products.13 the entire population and provide food. In 2009, the National significant health benefits.18 Another recommendation from Preventative Health Taskforce, the review of food labelling law The focus of the Food and Health a panel of independent health, and policy in Australia was that Dialogue has been on setting targets government and food industry the energy (kilojoule) content of for reducing the salt content of experts appointed by the standard fast food items should be grocery items, including breads, Federal Minister for Health and listed on fast food menu boards.12 breakfast cereals and simmer Ageing, recommended that the Although this has not been adopted sauces, and reducing the saturated Federal Government introduce on a national level, several states fat and sodium content of processed comprehensive nutrition labelling have either implemented or are meats. As this is a voluntary on restaurant and takeaway considering their own menu labelling process,19 there is no obligation for 14,15 menus.10 However, the Federal legislation. In February 2012, the food industry to comply, Government did not act on this the NSW Government introduced and progress has been slow. Australia’s first mandatory energy recommendation.11 Unfortunately, fast foods have not labelling on fast food menu boards.16 yet been identified as an action area In 2009, the Federal Government Under the Food Act 2003 (NSW) for the Food and Health Dialogue.19 also commissioned an independent No 43 – Division 4 Requirements However, the Dialogue is investigating review of food labelling law and relating to display of nutritional how it can work with the fast food policy in Australia.12 The independent information for food – fast food industry. An engagement strategy for panel that conducted this review chains with more than 20 outlets the fast food industry was finalised went a step further than the National in NSW or more than 50 outlets in late in 2012.20 Preventative Health Taskforce, Australia must display the number of recommending that interpretive, kilojoules in each menu item or meal traffic light–style labelling should be Marketing to children on their menu boards.17 introduced in both the grocery and The National Preventative Health fast food sectors.12 Nutrient composition Taskforce recommended the introduction of regulations to prevent of fast food unhealthy food television advertising Labelling Logic The National Preventative Health aimed at children between 6am Recommendation 54 Taskforce recommended the and 9pm.10 However, rather than That chain food service regulation of the amount of trans introducing further regulation, the outlets across Australia fats, saturated fats, salt and sugar Federal Government has committed and New Zealand be allowed in foods.10 The Federal to monitoring the food industry encouraged to display the Government formed the Food and self-regulatory codes that have multiple traffic lights system Health Dialogue, a committee of been implemented, including one 11 on menus/menu boards.12 food industry, government and developed by the fast food industry. public health representatives to lead work on the reformulation of food products.11 Reformulation is when food manufacturers change the composition of a food to reduce the amount of energy, total and saturated fat, sodium or sugar in the food.18

3 kJ

Fast food chains with more than 20 outlets in NSW or more than 50 outlets in Australia must display the number of kilojoules in each menu item or meal on their menu boards.17 Fast food industry initiatives

In recent years, in response Voluntary ‘responsible’ to pressure from the Federal “Being a member of the marketing to children Hungry Jack’s® Birthday Government, public health initiatives Club is great fun. On your groups and consumers, fast food birthday you’ll be sent a chains have introduced healthier The voluntary Australian Quick Service Restaurant Industry (QSRI) birthday card and a voucher options, and some chains Initiative for Responsible Advertising for a free Kids Value Meal have pledged to reduce their and Marketing to Children developed as a little present from us. advertising aimed at children by the fast food industry has been Plus, you’ll receive special under 12 years of age. adopted by some fast food chains, in free food offers to use every an attempt to reduce the advertising month of the year.” Healthier fast of unhealthy fast foods during Hungry Jack’s Kids Club – an example food options children’s programs and allow only of marketing to children not covered by healthier options to be advertised the QSRI Initiative. Some fast food chains have to children.‌21 However, since its introduced healthier options for introduction, independent monitoring The Initiative was revised in 2012, health-conscious customers, and of the QSRI Initiative has found that and now covers children’s sporting one Australian study found that it has not reduced the frequency of events.21‌ Unfortunately, the revised these healthier options contained fast food advertisements.22‌ Further, QSRI Initiative is much less restrictive between 39% and 80% less fat industry monitoring of the QSRI on the types of programs that are 6 compared to regular menu items. Initiative found several breaches of directed to children, and when the However, another study showed compliance.23‌ The limited impact of Initiative applies, stating: that healthier fast food options can the QSRI Initiative is due to the fact “Advertising or Marketing be just as high in saturated fat, that it only covers advertisements that Communications that are placed in sodium and sugar as regular menu are “primarily directed to children”, Medium that is directed primarily to items.5 The fast food industry has and only applies to children’s meals Children (in relation to television this not publicly released sales data for specifically, and not individual includes all C and P rated programs its healthier options, nor has it products or meals not deemed to and G rated programs that are disclosed whether the introduction 22 be children’s meals.‌ However, directed primarily to Children); and/ of healthier options has impacted there are no agreed definitions on or where the Medium attracts an on the sales of regular menu items. what “primarily directed to children” audience share of greater than 50% means, which further limits the of Children.”‌‌21 (Clause 6). QSRI Initiative’s effectiveness. Yet the child audience share of even Monitoring of television food the most popular shows for children advertisements found that children never reaches 50%, and C and P are exposed to many fast food rated programs are not aired in the advertisements that are not primarily peak viewing times for children.24 directed to them (for example, Therefore fast food chains are able advertisements for family meals), to take advantage of this loophole and to many advertisements that are in the regulation and advertise at for products other than designated times when children do not form children’s meals that may still be the largest proportion of the viewing eaten by children (for example, audience, but when large numbers advertisements for single items of children may still be watching their 22 such as fries or desserts).‌ Other favourite programs. examples of marketing not covered by the QSRI Initiative include fast food kids’ clubs, sponsorship of elite sport and mobile device apps.

5 Providing nutrition Nutrient criteria Reformulation information The QSRI Initiative has a set The fast food industry has taken Another clause in the QSRI Initiative of nutrient criteria that defines steps to reformulate some menu is that nutrition information must maximum levels of energy, items to reduce the amount of be provided on company websites saturated fat, sugar and sodium saturated fat, sugar and salt in and/or be available in-store by that are allowed in a meal before it their products.25-27 Despite this, request.21 As there is an array of can be advertised to children (see reformulation by Australian fast children’s meal options available, it is Table 1 on page 12). These nutrition food chains has not been difficult to identify healthier fast food criteria have not been compared to widespread, and the nutrition options without detailed nutrition children’s daily nutritional needs. composition of many fast foods remains high in energy, saturated information available at the point of The criteria are presented in a fat, sodium and sugar.5 sale. Prior to the studies described format that makes them difficult in this report, there had been no for the general public to use as a research conducted into how much basis for making complaints about nutrition information is available fast food advertisements. Some in-store in Australian fast food chains, nutrient criteria are based on the or how easy it is to acquire. amount of nutrients per serve and others are per 100 kJ. Additionally, there are different nutrient cut-offs for children of different ages, meaning a product that cannot be advertised to children younger than 8 years may be allowed to be advertised to 13-year-old children. Finally, the nutrient criteria only apply to meals, and yet nutrition information available on websites and in-store is often only presented for individual items, making comparison between the nutrition composition of a meal and the criteria even more complicated.

Fast food: Exposing the truth. 6 Fast food research

Cancer Council NSW has been advocating for several years for stronger regulation in both fast food marketing and menu labelling. Investigating different aspects of fast food allows us to recommend ways that the fast food environment can be improved to promote health. Cancer Council NSW conducted three research studies on fast food to further investigate the fast food environment. This report provides an overview of these studies. The aims of the research were:

Study 1 Study 2 Study 3 To investigate whether a. To analyse the nutrition To observe the sales of nutrition information is composition of children’s healthy and unhealthy fast available online and in-store fast food meals and food meals in fast food stores, at fast food chains. compare these to to see how many healthy children’s daily nutritional meals are being purchased. recommendations. b. To compare the fast food industry-defined nutrient criteria for advertising to children against children’s daily nutritional recommendations.

7 Study 1

Availability and accessibility of nutrition information in-store and online

We surveyed fast food outlets We assessed nutrition information across New South Wales, provided in-store based on: Queensland, Victoria, South • Availability – whether there was Australia and Western Australia any information offered in-store. to determine the availability • Accessibility – whether it was visible and accessibility of nutrition from the counter in-store or available information in-store. A range of without asking a staff member. chains was surveyed, including the four largest chains that are We also surveyed the Australian signatories to the QSRI Initiative websites for each fast food (McDonald’s, KFC, Hungry chain to determine the availability and accessibility of nutrition Jack’s and Red Rooster) as information online. well as a non-signatory chain as a comparison (Subway). The survey included stores in various socio-economic areas, and both metropolitan and regional areas.

Number of stores surveyed from each state

20 stores 20 20 stores stores 132 stores 30 stores

Fast food: Exposing the truth. 8 What we found

Nutrition information was Nutrition information was rarely At times, different nutrient not always available provided for all the products values were provided in different available. Only one store in our McDonald’s stores in the same Of the 222 stores surveyed, study had nutrition information for state. Some of the nutrition 34% (75 stores) had no its entire menu, and information information found in Subway stores nutrition information available was often missing for meal deals, was up to five years old, and some in-store to assist customers including children’s meals. In many of the older information from in choosing healthier options. cases, the information provided was Subway was based on American The proportion of stores only for a limited range of nutrients, dietary recommendations. with nutrition information such as fat or energy content.

available varied from chain Figure 1: The proportion of stores from each chain with nutrition information available to chain, ranging from 33% of Hungry Jack’s stores to 95% 100 of Subway stores providing nutrition information in-store. 90 n 80

Interestingly, significantly more e information was available in 70 low- and medium-income areas 60 than in high-income areas. 50 When nutrition information was 40 available in-store, it was usually 30

‘accessible’ because it was available information availabl 20 without asking a staff member, % of outlets with nutritio readable from the queue for the cash 10 33% 62% 69% 41% 95% 66% registers, or available without making a 0 purchase. However, staff didn’t always ’s s s KFC know that there was information Subway available, or that they were allowed All outlet McDonald’ Red Rooster to give it to customers. This highlights Hungry Jack the need for staff training in this aspect of customer service. Figure 2: The proportion of stores with nutrition information available for each menu item

80 70 60 50 40 30 % of outlets 20 10 4% 2% 31% 1% 72% 62% 50% 29% 14% 16% 22% 0

Mains Sides Snacks Drinks Desserts Breakfast Ingredients Family meals Regular mealsHealthy meals e.g. condiments Children's meals Menu items and meals

9 When asked if there was any nutrition information that could be taken away, some of the staff responses included:

“We had some, but we ran out.” (McDonald’s, QLD)

“It’s available online.” (Red Rooster, WA)

“It’s against McDonald’s policy to give out the information.” Online nutrition (McDonald’s, NSW) Some of the nutrition information was not information found always easy to access “You receive it in Subway stores was up to five years All of the websites of the surveyed when you purchase chains contained downloadable old, or based on a product.” nutrition information, and some also American dietary made the information available on (on the packaging) recommendations. their web pages. Although all the (KFC, NSW) websites had the nutrition information available, it was not always obvious “It’s only available at where the information could be found. For example, the KFC website head office.” had a nutrition link visible on the (Hungry Jack’s, VIC) homepage, while on the Red Rooster website visitors had to click through “Nutrition information to individual menu items to get their nutrition information. is available for staff only.” (McDonald’s, SA)

Fast food: Exposing the truth. 10 Recommendations for change

Improved nutrition information in fast food chains

The availability of nutrition information in-store can lead Recommendation 1 to customers purchasing lower The Federal Government should introduce mandatory menu energy meals than when there labelling in-store in fast food chains, nationwide. is no nutrition information available.28, 29 Our study showed Ideally, mandatory menu labelling should cover a range of nutrients and that nutrition information was be made available for all products and meals on the menu. Introducing rarely available for the entire mandatory menu labelling would place the onus on fast food chains to ensure that customers have enough information to make informed menu.30 This makes it difficult for choices. Fast food chains should also continue to provide nutrition customers to compare products information online. and make healthier fast food choices. Although information for most menu items is available Recommendation 2 online, this is not useful when people are deciding what to In the absence of nationwide mandatory menu labelling, the fast buy in-store. food industry should ensure that complete nutrition information This study was conducted before is always available in-store. NSW implemented mandatory Without comprehensive and current nutrition information at the point energy (kilojoule) menu labelling. of sale, customers cannot compare products and meals and use this to The introduction of menu labelling decide what they will buy. Nutrition information should be provided in NSW is an improvement on the in-store for all the individual menu items and meal deals available. amount of nutrition information in-store during this survey. As people are unable to estimate the fat, saturated fat and sodium contents Recommendation 3 of foods,28,31,32 menu labelling should Fast food chains should ensure that staff receive training on the be expanded to include these nutrients to assist customers in making provision of nutrition information to customers. comparisons between foods. If staff don’t know where nutrition information is located or that they are Unfortunately, menu labelling allowed to distribute it, customers cannot use it to compare menu items initiatives have not been introduced and meals. Fast food chains should make certain that this aspect of at a national level. As the large customer service is included in their orientation training, and ensure staff fast food chains have the same or are updated during the course of their employment. very similar menus nationwide, and they have already implemented changes in NSW, this should not place undue burden on the industry. Mandatory menu labelling should be implemented across Australia.

11 Study 2

How healthy are fast food children’s meals?

We assessed the nutrition Table 1: Nutrient criteria from the QSRI Initiative for healthy children’s meals21 composition of children’s fast food meals at Chicken Treat, 4-8-year-old child 13-year-old child Hungry Jack’s, KFC, McDonald’s, Nutrient QSRI criteria Maximum QSRI criteria Maximum Oporto and Red Rooster.33 amount amount All possible combinations of per meal per meal meals (199 different combinations) Energy ≤2,080kJ/serve ≤2,080kJ ≤2,770kJ/serve ≤2,770kJ were included. Saturated fat ≤0.4g/100kJ ≤8.3g ≤0.4g/100kJ ≤11.1g We also compared the QSRI Initiative’s industry-defined nutrient Sugar ≤1.8g/100kJ ≤37.4g ≤1.8g/100kJ ≤49.9g criteria for energy, saturated fat, Sodium ≤650/serve ≤650mg ≤650/serve ≤650mg sugar and sodium (see Table 1) to Australian children’s daily dietary recommendations for a child Table 2: Children’s daily and meal recommendations aged 4, 8 and 12 years.34,35 As a child’s meal should contribute about 30% of their daily nutrient 4-year-old 8-year-old 13-year-old a a a recommendations,36 the meals Daily Meal Daily Meal Daily Meal were also compared to 30% of Energyb 6,025kJ 1,808kJ 7,525kJ 2,258kJ 10,025kJ 3,008kJ daily recommendations (referred Saturated fatc 16g 4.8g 20g 6g 27g 8.1g to as ‘meal recommendations’) for all age groups (see Table 2). Sugard 75g 22.5g 94g 28g 125g 38g

Sodiume 1,400mg 420mg 1,400mg 420mg 2,000mg 600mg

a. Meal requirement is 30% of daily requirement36 b. Nutrient Reference Values for Australia and New Zealand34: physical activity level of 1.7 (light–moderate activity), average for males and females c. Dietary Guidelines for Children and Adolescents in Australia: saturated fat should comprise no more than 10% total energy intake35 d. Dietary Guidelines for Children and Adolescents in Australia: sugar should comprise no more than 20% total energy intake35 e. Nutrient Reference Values for Australia and New Zealand: upper limit of sodium34

Fast food: Exposing the truth. 12 What we found

Children’s fast food meals The meals that met the QSRI Initiative’s were generally unhealthy Alarmingly, some nutrient criteria generally included meals exceeded the lower-energy drinks, such as water The nutrition composition of sodium and saturated or artificially sweetened soft drinks. children’s meals varied greatly They often had sides that were not both within individual fast food fat recommendations fries, such as fruit, and mains that chains, as well as between the for children aged 4–8 were chicken products in small serve chains. This makes it difficult years for an entire day. sizes, such as a snack-sized wrap or for parents to choose healthier three nuggets. meals for their children, When compared against the QSRI especially in the absence of Initiative’s nutrient criteria, most nutrition information. (between 78 and 84%) of the meals Despite being the did not meet the criteria to allow The average children’s meal default in many fast them to be advertised to children. contained 2,229 kJ, 6.4 g saturated Only 32 meal combinations (16%) food children’s meals, fat, 27.7 g sugar and 702 mg sodium met the industry-defined nutrient no meals containing per meal. This provides 30% of criteria for 4–8-year-old children, a cheeseburger met an 8-year-old child’s daily energy and 44 (22%) met the criteria for recommendation, 32% of their daily the QSRI Initiative’s 9–13-year-old children. This suggests saturated fat recommendation, 29% nutrient criteria. that the majority of children’s meals of their daily sugar recommendation at fast food chains are not healthy and 50% of their daily sodium choices for children, even by the recommendation, and exceeds meal fast food industry’s standards. recommendations for saturated fat and sodium. For younger children, the daily recommendations are Table 3: Proportion of children’s meals exceeding meal and daily recommendations lower, so the average fast food children’s meal would contribute 4-year-old 8-year-old 13-year-old an even greater proportion of their Proportion of children’s meals exceeding requirements for a meal daily recommendations. (30% of daily recommendations) For a 4-year-old child, the average fast Energy 72% 55% 13% food children’s meal contained 37% of daily energy recommendations, Saturated fat 55% 46% 26% 40% of daily saturated fat Sugar 70% 49% 32% recommendations, 37% of daily sugar recommendations and 50% Sodium 90% 90% 63% of daily sodium recommendations. Proportion of children’s meals exceeding requirements for a day A large proportion of meals exceeded Energy 0% 0% 0% the daily recommended levels of Saturated fat 3% 1% 0% energy, saturated fat, sugar and sodium for both 4- and 8-year-old Sugar 0% 0% 0% children. This was as high as 90% Sodium 1% 1% 0% of meals for sodium for 4- and 8-year-olds, and 72% for energy for 4-year-olds.

13 for children. be advertisedthatare unhealthy set toohigh,andallowmealsto industry-defined criteriahavebeen children. Thisshowsthatthe for allages,andenergyin4-year-old for saturatedfat,sugarandsodium The criteriaexceedrecommendations estimated mealrecommendations. nutrients atlevelsthatexceedthe Initiative’s nutrientcriteriaallow recommendations, theQSRI Compared tochildren’s daily sugar andsodium high forsaturated fat, nutrient criteriaistoo The QSRIInitiative’s * Fast food: Exposingthe truth. Sodium Sugar fat Saturated Energy McDonald’s 3packofnuggets,appleslicesandwater Lowest energymeal: Nutrition Information The highestenergymealhadnearlysixtimesmore energythanthelowestmeal. How dothelowest andthehighestenergymealsstackup? Based onan8-year-old child.Amealshouldprovide 30%ofdailyrecommendations

222mg 735kJ serve 7.1g 1.4g Per

recommendations* 1,400mg/day 7,525kJ/day Child’s daily 94g/day 20g/day

recommendations*

% of Estimated Recommendations % Child’s daily 10 20 30 40 50 60 0 16% 10% 8% 7% Energy 4 Year Old Sodium Sugar fat Saturated Energy Chicken Treat cheeseburger, chipsandaPopTop fruitdrink Highest energymeal: Saturated fat 36

1,789mg 4,359kJ 31.7g serve 22g Per Nutrient 8 Year Old

recommendations* 1,400mg/day 7,525kJ/day Child’s daily 94g/day 20g/day nutrient recommendations 30% ofdaily Sugar 13 Year Old recommendations* % Child’s daily Sodium 128% 110% 34% 58% 14 1x

The highest energy children’s meal had nearly six times more energy than the lowest energy children’s meal. Recommendations for change Healthier fast food meals for kids

The abundance of meal combinations and their wide Recommendation 4 variation in nutrition composition The fast food industry should reformulate their menu items to make it difficult for parents to reduce the amount of energy, saturated fat, sugar and sodium. compare meals and choose healthier options for their This will mean that even if people are eating unhealthy fast food meals, children. Several fast food the amounts of these nutrients consumed will be reduced. chains have reformulated their menu items and now offer healthier meal combinations. Recommendation 5 It is important that fast food The QSRI Initiative’s nutrient criteria should be revised to ensure chains continue to do this, that children’s fast food meals do not exceed 30% of children’s especially in the absence of nutrition information in-store. daily needs. The majority of children’s meals This will align the nutrient criteria with meal recommendations, and ensure did not meet the QSRI Initiative’s that only healthier meals are allowed to be advertised to children. Additionally, nutrient criteria to allow the meals setting maximum levels of saturated fat and sugar in meals rather than to be advertised to children. complex criteria that need to be calculated will ensure the nutrient criteria are In addition, most meals were more user-friendly and simple. high in energy, saturated fat, sugar and sodium when compared to children’s dietary recommendations. Fast food chains should be encouraged to provide accompanying nutrition information for all the various combinations of children’s meals, to allow parents the opportunity to choose healthier meals for their children.

Fast food: Exposing the truth. 16 Study 3

How popular are healthy fast food meals?

We observed the sales of Table 4: Menu items in Tick Approved Meals from McDonald’s healthy and unhealthy meals at 20 McDonald’s stores across Choose 1 main + 1 salad + 1 drink Sydney, to see how many people Hamburger were choosing the healthier options.37 Heart Foundation Tick Seared chicken burger approved meals were chosen as McChicken the healthy option. Bottle of water Filet-o-Fish Garden salad At the time of this study, McDonald’s Small orange juice still offered some meals that carried 6 Chicken nuggets the Heart Foundation Tick; however, Tandoori chicken wrap this has since been removed. Heart Foundation Tick approved Sweet chilli chicken wrap meals had to meet specific nutrient criteria, and meal elements could not be swapped for other menu 38 items. We looked for the meals Table 5: Explanation of meal types surveyed shown in Tables 4 and 5.

We surveyed each store twice – once Meal Explanation of meal type at lunchtime and once at dinnertime. Surveys occurred over a two-week Healthier (Heart Each meal must meet criteria for energy, Foundation Tick saturated fat, trans fats and vegetable content period, which included both the approved) meals37 school holidays and school term All meals contain a side salad and healthy drink times, and weekdays and weekends. (water or juice), and menu items in the meals Stores surveyed were in a variety of cannot be swapped socio-economic areas. As it is not Unhealthy meals All purchases of at least one main menu item possible to see what is placed in (e.g. burgers, wraps, chicken products) that drive-through and takeaway bags, are not part of a Tick approved meal only eat-in purchases were classified Purchases of Tick approved meals with an additional as healthy or unhealthy. unhealthy menu item (e.g. fries, soft drink or dessert) Not counted in this study Purchases of only side items (e.g. fries), desserts (e.g. sundae) or drinks (e.g. soft drink) Drive-through purchases

17 What we found

Australians were not choosing healthier fast food options We observed a total of 1,448 meal purchases during the 40 hours of data collection. The majority of meals (66%) were eat-in purchases. Only 11 healthy meal purchases were observed, which was less than 1% of all purchases observed. The stores where healthy meal purchases were observed were generally busier, with higher total sales. There were no differences in the number of healthy meals purchased across different socio-economic status areas or at different times during the day.

Figure 3: Sales of healthy, unhealthy and takeaway meals 34% 66% <1%

Healthy Unhealthy Takeaway meals meals meals

Fast food: Exposing the truth. 18 <1%

Only 11 healthy meals were purchased out of the 1,448 observed. This was less than 1%. Recommendations for change

Improved nutritional value of all fast foods

Although healthier options are available at fast food chains, there Recommendation 6 have been no sales data published The Food and Health Dialogue should set targets for to show if healthier options are voluntary reformulation of fast foods, and move towards being purchased. Studies have mandatory reductions. shown that when healthier options are available in fast food chains, The Federal Government needs to set targets that will prompt the fast sales of unhealthy items can food industry to reformulate their menu items, especially children’s meals, increase.39 Customers who do to reduce the energy, saturated fat, sugar and sodium contents. Should choose healthier options may be the fast food industry fail to meet these voluntary targets, mandatory reformulation should be introduced to ensure they do. more likely to purchase additional unhealthy items, such as drinks or desserts.40 Therefore, the availability of healthier options may Recommendation 7 not mean that customers make The fast food industry should promote their healthier menu healthier choices, as demonstrated items (for example water or side salads) in preference to their by our research. Cancer Council unhealthy menu items (such as soft drinks or fries). NSW is, however, firmly of the view that the choice should still be Greater promotion of healthier options may encourage people to purchase provided for those who prefer a these items over the unhealthier menu items. healthier fast food meal. Since our study was conducted, the Heart Foundation Tick has been removed from all fast food products.41 Although there are still some healthier options offered by fast food chains, the low purchase rates in this study provide even more evidence of the need for widespread reformulation of fast food menu items and promotion of healthier items. This is especially important considering the potential for public health impact by reducing energy, saturated fat, sugar and sodium in the population’s diets.

Fast food: Exposing the truth. 20 A healthier fast food deal

The fast food industry has undertaken some voluntary Recommendations activities to make healthy eating Cancer Council NSW calls on the Federal Government and the easier, such as the introduction fast food industry to step up and implement initiatives that make of healthier options, reformulation it easier for customers to make healthier fast food choices. to reduce the energy, saturated fat, sugar and sodium contents Specifically: of menu items, and the provision 1. The Federal Government should introduce mandatory menu labelling of some nutrition information. in-store in fast food chains, nationwide. However, there is no evidence 2. In the absence of nationwide mandatory menu labelling, the fast food that these voluntary initiatives industry should ensure that complete nutrition information is always have had any impact. These available in-store. initiatives could go further to reduce the contribution of fast 3. Fast food chains should ensure that staff receive training on the food to Australians’ diets. As provision of nutrition information to customers. Australians are consuming fast 4. The fast food industry should reformulate their menu items to reduce food more frequently, these the amount of energy, saturated fat, sugar and sodium. changes would be an important 5. The QSRI Initiative’s nutrient criteria should be revised to ensure that step to address rising levels of children’s fast food meals do not exceed 30% of children’s daily needs. overweight and obesity. 6. The Food and Health Dialogue should set targets for voluntary reformulation of fast foods, and move towards mandatory reductions. 7. The fast food industry should promote their healthier menu items in preference to their unhealthy menu items.

Acknowledgements Published articles Suggested citation Funding support for Study 1 The three research studies have Wellard L, Hughes C, Chapman K, was provided by Cancer Council been peer reviewed and published Glasson C. The takeaway on fast Australia. Studies 2 and 3 were in the following articles: food meals: a summary of three fast funded by Cancer Council NSW. food studies in Australia. Sydney: Wellard L, Glasson C, Chapman Cancer Council NSW; 2012 We would like to thank Sze Sze Chan K, Miller C. Fast facts: the and Jordon Ma, University of Sydney availability and accessibility of Nutrition and Dietetics students, for nutrition information in fast food research assistance; members of chains. Health Promot J Aust. Cancer Council Australia’s Nutrition 2011;22(3):184-8. and Physical Activity Committee for Wellard L, Glasson C, Chapman K. the co-ordination of data collection Fries or a fruit bag? Investigating in their states; and Cancer Council the nutritional composition of fast NSW staff and volunteers for their food children’s meals. Appetite. time and effort in collecting, entering 2012;58(1):105-10. and checking the data, and reviewing the draft report. Wellard L, Glasson C, Chapman K. Sales of healthy choices at fast food restaurants in Australia. Health Promot J Aust. 2012;23(1):37-41.

21 References

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