• Julia A Wolfson, Cindy W Leung, and Ashley N Gearhardt.
• Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan; Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan. Electronic address: jwolfson@umich.edu.
• Am J Prev Med. 2020 Jun 1; 58 (6): e171-e179.

IntroductionFast food restaurants, including top burger chains, have reduced calorie content of some menu items in recent years. However, the extent to which the nutrition profile of restaurant menus is changing over time is unknown.MethodsData from 2,472 food items on the menus of 14 top-earning burger fast food chain restaurants in the U.S., available from 2012 to 2016, were obtained from the MenuStat project and analyzed in 2019. Nutrition Profile Index scores were estimated and used to categorize foods as healthy (≥64 of 100). Generalized linear models examined mean scores and the proportion of healthy menu items among items offered in all years (2012-2016) and items offered in 2012 only compared with items newly introduced in subsequent years.ResultsOverall, <20% of menu items were classified as healthy with no change from 2012 to 2016 (p=0.91). Mean Nutrition Profile Index score was relatively constant across the study period among all food items (≈50 points, p=0.58) and children's menu items (≈56 points, p=0.73). The only notable change in Nutrition Profile Index score or in proportion of healthy items was in the direction of menu items becoming less healthy.ConclusionsAt large chain burger restaurants, most items were unhealthy, and the overall nutrition profile of menus remained unchanged from 2012 to 2016. Future research should examine the nutrition profile of restaurant menus in a larger, more diverse sample of restaurants over a longer timeframe and examine whether results are robust when other measures of nutritional quality are used.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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