Abstract
Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000–2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants’ practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide.
Highlights
Quick-service, fast-casual, and full-service restaurant (QSR, fast-casual restaurants (FCR), and full-service restaurants (FSR)) chains offer a variety of inexpensive and convenient food and beverage products to customers on the premises, as takeaway, or delivered at home, work, or other locations [1]
This step involved the lead investigator contacting international researchers to identify resources that offered recommendations issued by authoritative bodies for transnational quick-service restaurants (QSR) chains to implement nutrient-profiling criteria or specific performance metrics for product reformulation, and portion size targets for meals, side dishes, desserts, and beverages sold to children, teens, or adults that align with a healthy diet
The section below describes the results for step 1 and step 2 based on the findings from published studies presented in a narrative summary
Summary
Quick-service, fast-casual, and full-service restaurant (QSR, FCR, and FSR) chains offer a variety of inexpensive and convenient food and beverage products to customers on the premises, as takeaway, or delivered at home, work, or other locations [1]. Fast-food meals and sugary beverages marketed by transnational QSR chains are perceived to be a symbol of Western culture, capitalism, and the globalization of the food supply [2,3]. Technical innovation and trade liberalization enabled the international expansion of restaurant franchise businesses worldwide since the 1960s that generated some economic benefits and many health consequences [2,3,4]. While QSR chains contributed to economic development by creating. Res. Public Health 2019, 16, 2732; doi:10.3390/ijerph16152732 www.mdpi.com/journal/ijerph
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