Nutritional and economic outcomes of fast food meal plans designed for weight loss and health
Background: Between 2013-2016, approximately 1/3 of Americans reported consuming fast food each day.¹ Despite the goals of many fast food establishments to increase the perceived healthiness of restaurant items, the potential nutritional and economic effects of eating fast food as part of a weight-loss are unknown. Objective: The purpose of this study was to characterize and compare the nutrient composition, caloric content, HEI (Healthy Eating Index), and cost for three fast food meal plans. Methods: Fast food data collection was limited to items available from June 6, 2020 to April 5, 2021. Items were classified by seven types: breakfast, breakfast sides, entrees, sides, sauces, drinks, and treats. Three 28-day meal plans (randomly-selected control, reduced calorie, and healthy meal plan) were randomly generated using set parameters. Average daily calories, nutrient composition, HEI scores, and cost were calculated using STATA/SE 17.0. Results: The healthy meal plan had significantly lower average daily kcals and trans-fat compared to the randomly-selected control and reduced calorie meal plan (p < 0.05). There was significantly less sugar in the reduced calorie and healthy meal plan compared to the randomly-selected control meal plan (p<0.001). None of the meal plans met the recommendations for fiber, saturated fat, sodium, or the AMDR for all macronutrients. There were no significant differences in HEI score between the healthy and randomly- selected control meal plans. However, when reducing calories, the HEI score significantly decreases (p<0.001) The randomly-selected control and healthy meal plans were approximately 2.5 times the average monthly grocery expense for a single individual living in Texas. When adjusting for cost for total kcals, the healthy meal plan was the most expensive. Conclusion: Despite being more expensive, the healthy meal plan had the lowest average daily kcals and trans fats, met the AMDR for fat and protein, and was 2% below the AMDR for carbohydrates. However, recommendations for other nutrients were not met. Even when focusing on the healthiest foods, if eaten long-term, fast food meal plans may not provide the adequate amount of nutrients and can potentially increase risk for chronic diseases related to ultra-processed foods.