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Food and Health

Trends in the healthiness of U.S. fast food meals, 2008–2017



This study aimed to examine trends in the healthiness of U.S. fast food restaurant meals from 2008 to 2017, using the American Heart Association’s Heart-Check meal certification criteria.


Data were obtained from MenuStat, an online database of the leading 100 U.S. restaurant chains menu items, for the years 2008 and 2012 through 2017. All possible meal combinations (entrées + sides) were created at the 20 fast food restaurants that reported entrée and side calories, total fat, saturated fat, trans fat, cholesterol, sodium, protein, and fiber. Chi-square tests compared the percent of meals meeting each American Heart Association (AHA) nutrient criterion; and the number of AHA criteria met for each year, by menu focus type.


Compared with 2008, significantly fewer fast food meals met the AHA calorie criterion in 2015, 2016, and 2017, and significantly fewer met the AHA total fat criterion in 2015 and 2016. Significantly more meals met the AHA trans fat criterion from 2012 to 2017, compared to 2008. There were no significant changes over time in the percent of meals meeting AHA criteria for saturated fat, cholesterol, or sodium.


Efforts to improve the healthiness of fast food meals should focus on reducing calories, total fat, saturated fat, and sodium.

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We thank the New York City Department of Health and Mental Hygiene for the MenuStat data.

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All authors contributed to the design of the study. EA led secondary data analysis and manuscript writing. EEM, LR, KG, and JEC contributed revisions to the manuscript and approved the final manuscript for submission.

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Correspondence to Eleanore Alexander.

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The authors declare that they have no conflict of interest.


This study was deemed Exempt by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.

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Alexander, E., Rutkow, L., Gudzune, K.A. et al. Trends in the healthiness of U.S. fast food meals, 2008–2017. Eur J Clin Nutr 75, 775–781 (2021).

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