ORIGINAL RESEARCH

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

Chain/Year	French Fries, kcal			Cheeseburger, kcal		Grilled Chicken Sandwich, kcal	Cola, kcal
	S	M	L	2 oz	4 oz		S	M	L
Chain A
1996	210	450	540	320	530		150	—	—
1997	210	450	540	320	530	440	150	—	—
1998	210	450	540	320	530	440	150	—	—
1999	210	450	540	320	530	440	150	210	310
2000	210	450	540	320	530	450	150	210	310
2001	210	450	540	330	530	450	150	210	310
2002	210	450	540	330	530	450	150	210	310
2003	210	450	540	330	530	400	150	210	310
2004	220	350	520	330	540	400	150	210	310
2005	230	350	520	310	510	420	150	210	310
2006	250	380	570	310	510	420	150	210	310
2007	250	380	570	300	510	420	150	210	310
2008	230	380	500	300	510	420	150	210	310
2009	230	380	500	300	510	420	150	210	310
2010	230	380	500	300	510	420	150	210	310
2011	230	380	500	300	510	350	150	210	310
2012	230	380	500	300	520	350	150	210	310
2013	230	380	500	300	520	350	140	200	280
β	1.8	−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	—	—		—	—	—	—	—	—
1997	—	370		380	730	550	204	280	—
1998	—	—		—	—	—	—	—	—
1999	250	400	590	360	760	530	204	280	407
2000	250	400	590	360	760	530	204	280	407
2001	230	360	500	370	780	550	—	—	—
2002	230	360	500	360	850	580	160	230	330
2003	230	360	500	360	800	580	160	230	330
2004	230	360	500	350	800	570	160	200	330
2005	230	360	500	350	800	570	140	200	290
2006	230	360	500	330	760	510	140	200	290
2007	230	360	500	330	760	510	140	200	290
2008	230	360	500	340	770	490	140	210	290
2009	340	480	580	340	770	490	210	290	390
2010	340	440	540	310	770	490	210	290	390
2011	340	440	540	300	760	470	190	290	380
2012	340	410	500	280	760	470	190	290	380
2013	340	410	500	288	710	510	190	290	380
β	8.9	3.9	−2.0	−5.8	−1.7	−5.5	−0.1	1.5	0.6
P value	.001	.05	.36	<.001	.39	.002	.97	.52	.85
Chain C
1996	260	380	460	320	490	310	90	108	180
1997	270	390	470	320	490	310	90	108	180
1998	270	470	570	320	490	310	90	108	180
1999	270	470	570	320	490	310	90	108	180
2000	270	470	570	320	490	310	90	108	180
2001	270	420	470	310	480	300	104	130	208
2002	250	390	440	310	480	300	112	140	224
2003	250	390	440	310	480	300	112	140	224
2004	250	390	440	310	480	360	112	140	224
2005	280	440	490	320	490	360	112	140	224
2006	370	420	540	320	490	370	140	224	294
2007	330	420	520	320	500	320	140	224	294
2008	340	430	550	260	500	320	140	210	280
2009	330	420	540	270	540	350	160	240	320
2010	330	410	540	270	540	340	160	240	320
2011	320	420	530	270	550	360	160	240	320
2012	320	420	530	290	620	390	160	—	—
2013	310	410	500	290	600	390	160	240	320
β	4.9	−0.5	1.8	−3.0	6.1	4.5	5.2	10.3	10.6
P value	.001	.73	.40	<.001	<.001	<.001	<.001	<.001	<.001
Chain comparison P value	≤.002	.04a	NS	≤.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/Year	French Fries			Cheeseburger		Grilled Chicken Sandwich
	Small	Medium	Large	2 oz	4 oz
	Sodium, mg
Chain A
1996	135	290	350	770	1,200
1997	135	290	350	820	1,290	1,040
1998	135	290	350	820	1,290	1,040
1999	135	290	350	820	1,290	1,040
2000	135	290	350	830	1,310	970
2001	135	290	350	830	1,310	970
2002	135	290	350	830	1,310	970
2003	135	290	350	800	1,250	890
2004	150	220	340	790	1,240	1,020
2005	140	220	330	740	1,150	1,240
2006	140	220	330	740	1,150	1,240
2007	140	220	330	750	1,190	1,190
2008	160	270	350	750	1,190	1,190
2009	160	270	350	750	1,190	1,190
2010	160	270	350	750	1,190	1,190
2011	160	270	350	750	1,190	820
2012	160	270	350	680	1,100	820
2013	160	270	350	680	1,100	820
β	1.9	−2.1	−0.2	−7.5	−10.2	−2.8
P value	<.001	.10	.63	<.001	<.001	.71
Chain B
1996	—	—		—	—	—
1997	—	240		770	1,350	480
1998	—	—		—	—	—
1999	550	820	1,180	760	1,380	1,060
2000	550	820	1,180	760	1,380	1,060
2001	630	690	940	750	1,390	1,110
2002	410	640	880	790	1,430	1,370
2003	410	640	880	790	1,420	1,370
2004	410	640	880	770	1,450	1,410
2005	410	640	880	770	1,450	1,410
2006	380	590	820	780	1,450	1,180
2007	380	590	820	780	1,450	1,180
2008	380	590	820	780	1,450	1,250
2009	590	820	990	770	1,450	1,220
2010	530	670	830	740	1,450	1,220
2011	530	670	830	710	1,410	1,100
2012	480	570	710	690	1,410	1,330
2013	480	570	710	690	1,240	1,350
β	−1.7	2.1	−24.0	−4.1	<0.1	23.7
P value	.75	.79	<.001	.01	.99	.04
Chain C
1996	85	120	150	770	1,130	780
1997	85	120	150	830	1,240	790
1998	85	150	180	830	1,240	790
1999	85	150	180	830	1,240	790
2000	85	150	180	830	1,240	790
2001	85	130	150	800	1,180	740
2002	220	340	380	820	1,210	740
2003	220	340	380	820	1,230	730
2004	220	340	380	820	1,230	1,100
2005	270	430	480	820	1,220	1,100
2006	380	430	550	810	1,200	1,070
2007	340	430	550	800	1,220	950
2008	290	370	480	690	1,190	950
2009	300	380	500	700	1,260	1,000
2010	280	350	460	730	1,290	1,030
2011	350	460	570	670	1,270	1,110
2012	350	460	570	820	1,440	880
2013	330	440	540	800	1,220	1,000
β	18.8	22.0	29.6	−4.7	5.9	17.9
P value	<.001	<.001	<.001	.05	.03	.002
Chain comparison P value	≤.01	<.001a	<.001a	NS	<.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/Year	French Fries			Cheeseburger		Grilled Chicken Sandwich
	Small	Medium	Large	2 oz	4 oz
	Saturated Fat, g
Chain A
1996	1.5	4.0	4.5	6.0	13.0
1997	1.5	4.0	4.5	6.0	13.0	3.0
1998	1.5	4.0	4.5	6.0	13.0	3.0
1999	1.5	4.0	4.5	6.0	13.0	3.0
2000	1.5	4.0	4.5	6.0	13.0	3.0
2001	1.5	4.0	4.5	6.0	13.0	3.0
2002	1.5	4.0	4.5	6.0	13.0	3.0
2003	1.5	4.0	4.5	6.0	13.0	3.0
2004	2.0	3.0	4.5	6.0	13.0	3.0
2005	2.0	3.0	5.0	6.0	12.0	2.0
2006	2.5	4.0	6.0	6.0	12.0	2.0
2007	2.5	4.0	6.0	6.0	12.0	2.0
2008	1.5	2.5	3.5	6.0	12.0	2.0
2009	1.5	2.5	3.5	6.0	12.0	2.0
2010	1.5	2.5	3.5	6.0	12.0	2.0
2011	1.5	2.5	3.5	6.0	12.0	2.0
2012	1.5	2.5	3.5	6.0	12.0	2.0
2013	1.5	2.5	3.5	6.0	12.0	2.0
β	<0.1	−0.1	−0.1	NC	−0.1	−0.1
P value	.61	<.001	.08	NS	<.001	<.001
Chain B
1996	—	—		—	—	—
1997	—	5.0		9.0	16.0	6.0
1998	—	—		—	—	—
1999	5.0	8.0	12.0	9.0	17.0	5.0
2000	5.0	8.0	12.0	9.0	17.0	5.0
2001	3.0	5.0	7.0	9.0	17.0	5.0
2002	3.0	5.0	7.0	8.0	30.0	5.0
2003	3.0	5.0	7.0	8.0	18.0	5.0
2004	3.0	5.0	7.0	8.0	18.0	4.5
2005	3.0	5.0	7.0	8.0	18.0	4.5
2006	3.0	4.5	6.0	7.0	16.0	3.5
2007	3.0	4.5	6.0	7.0	16.0	3.5
2008	3.0	4.5	6.0	7.0	16.0	4.0
2009	3.5	5.0	6.0	7.0	16.0	4.0
2010	3.5	4.5	6.0	7.0	16.0	4.0
2011	3.5	4.5	6.0	6.0	16.0	3.5
2012	2.5	3.0	3.5	6.0	16.0	3.5
2013	2.5	3.0	3.5	6.0	15.0	4.0
β	−0.1	−0.2	−0.4	−0.2	−0.2	−0.1
P value	.03	.001	<.001	<.001	.28	<.001
Chain C
1996	2.5	4.0	5.0	6.0	10.0	1.5
1997	2.0	3.0	3.5	6.0	10.5	1.5
1998	2.0	3.5	4.0	6.0	10.5	1.5
1999	2.0	3.5	4.0	6.0	10.5	1.5
2000	2.0	3.5	4.0	6.0	10.5	1.5
2001	2.0	3.0	3.5	6.0	10.5	1.5
2002	2.0	3.0	3.5	5.0	10.5	1.5
2003	2.0	3.0	3.5	6.0	10.5	1.5
2004	2.0	3.0	3.5	6.0	10.5	1.5
2005	2.5	3.5	4.0	6.0	10.5	1.5
2006	2.5	3.0	4.0	6.0	10.5	1.5
2007	2.5	3.0	3.5	5.0	10.5	1.5
2008	2.5	3.0	4.0	5.0	10.5	1.5
2009	3.0	4.0	5.0	5.0	11.5	1.5
2010	3.0	3.5	4.5	5.0	11.5	1.5
2011	3.0	4.0	5.0	5.0	12.0	1.5
2012	3.0	4.0	5.0	6.0	16.0	3.5
2013	3.0	3.5	4.5	6.5	13.0	1.5
β	0.1	<0.1	0.1	<−0.1	0.2	<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/Year	French Fries			Cheeseburger		Grilled Chicken Sandwich
	Small	Medium	Large	2 oz	4 oz
	Trans Fat, g
Chain A
2001	—	—	—	—	—	—
2002	—	—	—	—	—	—
2003	—	—	—	—	—	—
2004	—	—	—	—	—	—
2005	2.5	4.0	6.0	1.0	1.5	0
2006	3.5	5.0	8.0	1.0	1.5	0
2007	3.5	5.0	8.0	0.5	1.5	0
2008	0	0	0	0.5	1.5	0
2009	0	0	0	0.5	1.5	0
2010	0	0	0	0.5	1.5	0
2011	0	0	0	0.5	1.5	0
2012	0	0	0	0.5	1.5	0
2013	0	0	0	0.5	1.5	0
β	−0.5	−0.1	−1.1	−0.1	NC	NC
P value	.01	.01	.01	.03	NS	NS
Chain B
2001	3.0	5.0	6.0	1.0	1.5	—
2002	3.0	4.7	6.4	0.7	1.5	0.5
2003	3.0	4.7	6.4	0.7	1.4	0.5
2004	3.0	4.5	6.0	0.5	1.5	0
2005	3.0	4.5	6.0	0.5	2.0	0
2006	3.0	4.5	6.0	0.5	1.5	0.5
2007	3.0	4.5	6.0	0.5	1.5	0.5
2008	3.0	4.5	6.0	0.5	1.5	0
2009	0	0	0	0.5	1.5	0
2010	0	0	0	0.5	1.5	0
2011	0	0	0	0	1.0	0
2012	0	0	0	0	1.0	0
2013	0	0	0	0	1.0	0
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	—	—	—	—	—	—
2003	3.0	4.5	5.0	0.5	1.0	0
2004	3.0	4.5	5.0	0.5	1.0	0
2005	3.5	5.0	6.0	0.5	1.0	0
2006	1.0	1.0	1.0	0.5	1.0	0
2007	0.5	1.0	1.0	0.5	1.0	0
2008	0	0	0	0.5	1.0	0
2009	0	0	0	0.5	1.0	0
2010	0	0	0	0.5	1.0	0
2011	0	0	0	0.5	1.5	0
2012	0	0	0	0.5	1.5	0
2013	0	0	0	0.5	1.5	0
β	−0.4	−0.5	−0.6	NC	0.1	NC
P value	.001	.001	.002	NS	.005	NS
Chain comparison P value	NS	NS	NS	NS	<.01a	NS

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/Item	Chain A	Chain B	Chain C
Energy, kcal (% Total meal kcal)
1999
2-oz Cheeseburger	320 (47)	360 (44)	320 (47)
Small French fries	210 (31)	250 (31)	270 (40)
Small cola	150 (22)	204 (25)	90 (13)
Total small meal	680 (100)	814 (100)	680 (100)
4-oz Cheeseburger	530 (38)	760 (43)	490 (40)
Large French fries	540 (39)	590 (34)	570 (46)
Large cola	310 (22)	407 (23)	180 (15)
Total large meal	1,380 (100)	1,757 (100)	1,240 (100)
2003
2-oz Cheeseburger	330 (48)	360 (48)	310 (46)
Small French fries	210 (30)	230 (31)	250 (37)
Small cola	150 (22)	160 (21)	112 (17)
Total small meal	690 (100)	750 (100)	672 (100)
4-oz Cheeseburger	530 (38)	800 (49)	480 (42)
Large French fries	540 (39)	500 (31)	440 (38)
Large cola	310 (22)	330 (20)	224 (20)
Total large meal	1,380 (100)	1,630 (100)	1,144 (100)
2008
2-oz Cheeseburger	300 (44)	340 (48)	260 (35)
Small French fries	230 (34)	230 (32)	340 (46)
Small cola	150 (22)	140 (20)	140 (19)
Total small meal	680 (100)	710 (100)	740 (100)
4-oz Cheeseburger	510 (39)	770 (49)	500 (38)
Large French fries	500 (38)	500 (32)	550 (41)
Large cola	310 (23)	290 (19)	280 (21)
Total large meal	1,320 (100)	1,560 (100)	1,330 (100)
2013
2-oz Cheeseburger	300 (45)	288 (35)	290 (38)
Small French fries	230 (34)	340 (42)	310 (41)
Small cola	140 (21)	190 (23)	160 (21)
Total small meal	670 (100)	818 (100)	760 (100)
4-oz Cheeseburger	520 (40)	710 (45)	600 (42)
Large French fries	500 (38)	500 (31)	500 (35)
Large cola	280 (22)	380 (24)	320 (23)
Total large meal	1,300 (100)	1,590 (100)	1,420 (100)
Sodium, mg (% of total meal)
1999
2-oz Cheeseburger	820 (86)	760 (58)	830 (91)
Small French fries	135 (14)	550 (42)	85 (9)
Total small meal	955 (100)	1,310 (100)	915 (100)
4-oz Cheeseburger	1,290 (79)	1,380 (54)	1,240 (87)
Large French fries	350 (21)	1,180 (46)	180 (13)
Total large meal	1,640 (100)	2,560 (100)	1,420 (100)
2003
2-oz Cheeseburger	800 (86)	790 (66)	820 (79)
Small French fries	135 (14)	410 (34)	220 (21)
Total small meal	935 (100)	1,200 (100)	1,040 (100)
4-oz Cheeseburger	1,250 (78)	1,420 (62)	1,230 (76)
Large French fries	350 (22)	880 (38)	380 (24)
Total large meal	1,600 (100)	2,300 (100)	1,610 (100)
2008
2-oz Cheeseburger	750 (82)	780 (67)	690 (70)
Small French fries	160 (18)	380 (33)	290 (30)
Total small meal	910 (100)	1,160 (100)	980 (100)
4-oz Cheeseburger	1,190 (77)	1450 (64)	1,190 (71)
Large French fries	350 (23)	820 (36)	480 (29)
Total large meal	1,540 (100)	2,270 (100)	1,670 (100)
2013
2-oz Cheeseburger	680 (81)	690 (59)	600 (65)
Small French fries	160 (19)	480 (41)	330 (35)
Total small meal	840 (100)	1,170 (100)	930 (100)
4-oz Cheeseburger	1,100 (76)	1,380 (66)	1,220 (69)
Large French fries	350 (24)	710 (34)	540 (31)
Total large meal	1,450 (100)	2,090 (100)	1,760 (100)
Saturated fat, g (% total meal)
1999
2-oz Cheeseburger	6 (80)	9 (64)	6 (75)
Small French fries	1.5 (20)	5 (36)	2 (25)
Total small meal	7.5 (100)	14 (100)	8 (100)
4-oz Cheeseburger	13 (74)	17 (59)	10.5 (72)
Large French fries	4.5 (26)	12 (41)	4 (28)
Total large meal	17.5 (100)	29 (100)	14.5 (100)
2003
2-oz Cheeseburger	6 (80)	8 (73)	6 (75)
Small French fries	1.5 (20)	3 (27)	2 (25)
Total small meal	7.5 (100)	11 (100)	8 (100)
4-oz Cheeseburger	13 (74)	18 (72)	10.5 (75)
Large French fries	4.5 (26)	7 (28)	3.5 (25)
Total large meal	17.5 (100)	25 (100)	14 (100)
2008
2-oz Cheeseburger	6 (80)	7 (70)	5 (67)
Small French fries	1.5 (20)	3 (30)	2.5 (33)
Total small meal	7.5 (100)	10 (100)	7.5 (100)
4-oz Cheeseburger	12 (77)	16 (73)	10.5 (72)
Large French fries	3.5 (23)	6 (27)	4 (28)
Total large meal	15.5 (100)	22 (100)	14.5 (100)
2013
2-oz Cheeseburger	6 (80)	6 (71)	4 (57)
Small French fries	1.5 (20)	2.5 (29)	3 (43)
Total small meal	7.5 (100)	8.5 (100)	7 (100)
4-oz Cheeseburger	12 (77)	10 (74)	13 (74)
Large French fries	3.5 (23)	3.5 (26)	4.5 (26)
Total large meal	15.5 (100)	13.5 (100)	17.5 (100)
Trans fat, g (% total meal)
2003
2-oz Cheeseburger	—	0.7 (19)	0.5 (14)
Small French fries	—	3 (81)	3 (86)
Total small meal	—	3.7 (100)	3.5 (100)
4-oz Cheeseburger	—	1.4 (18)	1 (17)
Large French fries	—	6.4 (82)	5 (83)
Total large meal	—	7.8 (100)	6 (100)
2008
2-oz Cheeseburger	0.5 (100)	0.5 (14)	0.5 (100)
Small French fries	0	3 (86)	0
Total small meal	0.5 (100)	3.5 (100)	0.5 (100)
4-oz Cheeseburger	1.5 (100)	1.5 (20)	1 (100)
Large French fries	0	6 (80)	0
Total large meal	1.5 (100)	7.5 (100)	1 (100)
2013
2-oz Cheeseburger	0.5 (100)	0	0.5 (100)
Small French fries	0	0	0
Total small meal	0.5 (100)	0	0.5 (100)
4-oz Cheeseburger	1.5 (100)	1 (100)	1.5 (100)
Large French fries	0	0	0
Total large meal	1.5 (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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