Even as restaurants make changes to their menus to provide "healthier" options, the number of average calories and sodium in a meal remains the same, according to a new study.


Researchers from the RAND Corp. and the Institute for Population Health Improvement at UC Davis Health System found that in the spring of 2010, an entree from a U.S. chain restaurant had an average of 670 calories. But when they looked at the average calorie counts in a meal a year later in the spring of 2011, there had been no change.


Sodium levels weren't much better -- the average amount of sodium in a U.S. chain restaurant meal was 1,515 milligrams in spring 2010, and only went down to 1,500 milligrams a year later.


"Across the restaurant industry, we see a pattern of one step forward, one step back[1] ," study researcher Helen Wu, a policy and research analyst at the Institute for Population Health Improvement, said in a statement. "Restaurants make changes to their menus regularly, but they may make both healthy and unhealthy changes simultaneously. This study provides objective evidence that overall, we did not see a new wave of healthier entrees come in to replace less healthy ones."


The study, published in the Journal of the Academy of Nutrition and Dietetics[2] , involved analysis of 26,256 menu options from 213 restaurants, 109 of which had data on children's menus (with 1,794 children's menu items). Restaurants ranged from fast-food, to fast-casual, to family, to upscale, and cuisine ranged from American, to pizza, to sandwiches, to Italian, to Asian, to snacks (such as bakery items or ice cream) to seafood and steaks.


Researchers specifically chose the spring 2010 to 2011 time period for their analysis because they wanted to see how menu options changed a year after the federal menu-labeling law was passed, and also wanted to test the "validity of claims that restaurants are increasingly offering overall more healthful menu options." Indeed, 207 of the 213 restaurants in the study were subject to the menu labeling law.


Researchers found that slightly more restaurants made changes in a healthy direction between 2010 and 2011 -- 10 percent -- which is higher than the number of restaurants that made changes in an unhealthy direction -- 7 percent.



For instance, "the 26 restaurants that made healthy changes to sodium in added items did reduce it by 707 mg on average, whereas the 11 that made

unhealthy changes to sodium in added items increased it by less (547 mg)," the researchers wrote in the study.


They found no major differences in the healthfulness of children's entrees, except for a very slight decrease in average calories between 2010 and 2011.


"Across a large and diverse group of U.S. chain restaurant brands, results do not support the hypotheses that voluntary restaurant industry efforts, the impending implementation of a federal menu labeling law, or any changes in consumer preferences led to meaningful changes in the average energy or sodium content of entrees between 2010 and 2011," the researchers wrote in the study. "If healthy changes did occur, then a sufficient number of unhealthy changes to entrées also occurred that offset them, on average."


Earlier, the same researchers found in a Public Health Nutrition study that 96 percent of entrees from chain restaurants don't abide by USDA saturated fat and sodium recommendations[3] .


Of course, we can't say we're totally surprised that "healthy" menu options may not really be that healthy. Take a look at what we found about egg-white breakfast sandwiches[4] , for instance.



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  • McDonald's Oatmeal


    Oatmeal sure <em>sounds</em> healthy, but as <a href="http://opinionator.blogs.nytimes.com/2011/02/22/how-to-make-oatmeal-wrong/">New York Times' food columnist Mark Bittman points out</a>, the McD version is anything but:

    <blockquote>Incredibly, the McDonald's product contains more sugar than a Snickers bar and only 10 fewer calories than a McDonald's cheeseburger or Egg McMuffin. (Even without the brown sugar it has more calories than a McDonald's hamburger.) </blockquote>




  • Starbucks Spinach & Feta Breakfast Wrap


    This seemingly healthy wrap sandwich advertises "cage free" eggs, but <a href="http://www.starbucks.com/menu/food/hot-breakfast/spinach-feta-and-cage-free-egg-white-breakfast-wrap">a quick glance at the ingredient list reveals</a> that the simple egg white is actually made from 12 ingredients:

    <blockquote>Cage free egg whites, whey powder, unmodified corn starch, nonfat dry milk, salt, butter flavor [sunflower oil, natural flavors, medium chain triglycerides, palm kernel oil], xantham gum, guar gum, liquid pepper extract</blockquote>

    See the <a href="http://www.starbucks.com/menu/food/hot-breakfast/spinach-feta-and-cage-free-egg-white-breakfast-wrap" target="_hplink">full information here</a>.




  • Chick-Fil-A Chicken, Egg & Cheese On Sunflower Multigrain Bagel


    Fried chicken is obviously not a healthy breakfast option. But with its multigrain bagel, many consumers might consider it the better breakfast sandwich option. But the term "multigrain" is actually meaningless. <a href="http://www.mayoclinic.com/health/multigrain/AN02047">Explained the Mayo Clinic's Katherine Zeratsky</a>:

    <blockquote>Multigrain and whole grain are not interchangeable terms. Whole grain means that all parts of the grain kernel -- the bran, germ and endosperm -- are used. In contrast, multigrain means that a food contains more than one type of grain; it doesn't tell you whether they're whole or refined grains, or a mix of both.</blockquote>
    In other words, the bagel could be nutritionally interchangeable with a white bagel. What's more, <a href="http://www.chick-fil-a.com/Food/Menu-Detail/Chicken-Egg-Cheese-on-Sunflower-Multigrain-Bagel" target="_hplink">the sandwich provides 20 grams of fat</a> -- nearly two-thirds of the USDA's daily recommendation for most adults -- and 1,230 milligrams of sodium, more than half the recommended daily intake.




  • Burger King Breakfast Bowl


    You might think you're doing yourself a favor by skipping the refined-wheat bun or butter-drenched biscuit. But <a href="http://www.bk.com/en/us/menu-nutrition/index.html" target="_hplink">with 42 grams of fat</a>, this scramble of eggs, veggies, sausage and cheese provides 120 percent of your daily fat, as recommended by the USDA's Dietary Guidelines for Americans.




  • Dunkin Donuts Honey Bran Raisin Muffin


    A bran muffin might sound like the healthiest option among the muffins on offer at Dunkin Donuts. But let's hope America doesn't run on these: while the honey bran raisin muffin <em>does</em> have five grams of fiber, it also contains 44 grams of sugar. That bears repeating: <a href="http://www.dunkindonuts.com/content/dunkindonuts/en/menu/muffins.html?DRP_FLAVOR=Honey+Bran+Raisin" target="_hplink">44 grams of sugar!</a> That's even more than the McDonald's Oatmeal. In fact, you might be better off ordering a doughnut, <a href="http://www.dunkindonuts.com/content/dunkindonuts/en/menu/donuts.html?DRP_FLAVOR=Glazed+Donut" target="_hplink">many of which have a fraction of the sugar content</a>.




  • Healthier Breakfast Options


    Nutritionist Karen Graham gives you great ideas for a healthier breakfast.