Nutritional composition of takeaway food in the UK

Utilization of Away-From-Home Food Establishments, Dietary Approaches to Stop Hypertension Dietary Pattern, and Obesity

INTRODUCTION

Eating meals away from home has been associated with the consumption of unhealthy foods and increased body weight. However, more rigorous assessment of the contribution of different types of away-from-home food establishments to overall diet quality and obesity is minimal. This study examined usage of these food establishments, accordance to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and obesity status in a nationally representative sample of adults in the United Kingdom.

METHODS

A cross-sectional analysis of data from a national survey (N=2,083 aged ≥19 years, from 2008 to 2012) with dietary intake measured using a 4-day food diary, and height and weight measured objectively. Exposures included usage of (i.e., by proportion of energy) all away-from-home food establishments combined, and fast-food outlets, restaurants, and cafés separately. Outcomes included accordance with the DASH diet, and obesity status. Multivariable logistic regressions were conducted in 2016 to estimate associations between food establishments, diet quality, and obesity.

RESULTS

People consuming a higher proportion of energy from any away-from-home food establishment had lower odds of DASH accordance (OR=0.45, 95% CI=0.31, 0.67) and increased odds of obesity (OR=1.48, 95% CI=1.10, 1.99). After adjustment, only use of fast-food outlets was significantly associated with lower odds of DASH accordance (OR=0.48, 95% CI=0.33, 0.69) and higher odds of obesity (OR=1.30, 95% CI=1.01, 1.69).

CONCLUSIONS

Although a greater reliance on eating away-from-home is associated with less-healthy diets and obesity, dietary public health interventions that target these food establishments may be most effective if they focus on modifying the use of fast-food outlets.

Determinants of takeaway and fast food consumption: a narrative review

Out-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.

Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey

BACKGROUND

Out-of-home meals have been characterised as delivering excessively large portions that can lead to high energy intake. Regular consumption is linked to weight gain and diet related diseases. Consumption of out-of-home meals is associated with socio-demographic and anthropometric factors, but the relationship between habitual consumption of such meals and mean daily energy intake has not been studied in both adults and children in the UK.

METHODS

We analysed adult and child data from waves 1-4 of the UK National Diet and Nutrition Survey using generalized linear modelling. We investigated whether individuals who report a higher habitual consumption of meals out in a restaurant or café, or takeaway meals at home had a higher mean daily energy intake, as estimated by a four-day food diary, whilst adjusting for key socio-demographic and anthropometric variables.

RESULTS

Adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal. There was no association between energy intake and frequency of consumption of meals out in children. Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households.

CONCLUSIONS

Higher habitual consumption of out-of-home meals is associated with greater mean daily energy intake in the UK. More frequent takeaway meal consumption in adults and children is associated with greater daily energy intake and this effect is greater in children from less affluent households. Interventions seeking to reduce energy content through reformulation or reduction of portion sizes in restaurants, cafés and takeaways could potentially lead to reductions in mean daily energy intake, and may reduce inequalities in health in children.

Reducing the Salt Added to Takeaway Food: Within-Subjects Comparison of Salt Delivered by Five and 17 Holed Salt Shakers in Controlled Conditions

OBJECTIVES

To determine if the amount of salt delivered by standard salt shakers commonly used in English independent takeaways varies between those with five and 17 holes; and to determine if any differences are robust to variations in: the amount of salt in the shaker, the length of time spent shaking, and the person serving.

DESIGN

Four laboratory experiments comparing the amount of salt delivered by shakers. Independent variables considered were: type of shaker used (five or 17 holes), amount of salt in the shaker before shaking commences (shaker full, half full or nearly empty), time spent shaking (3s, 5s or 10s), and individual serving.

SETTING

Controlled, laboratory, conditions.

PARTICIPANTS

A quota-based convenience sample of 10 participants (five women) aged 18-59 years.

MAIN OUTCOME MEASURES

Amount of salt delivered by salt shakers.

RESULTS

Across all trials, the 17 holed shaker delivered a mean (SD) of 7.86g (4.54) per trial, whilst the five holed shaker delivered 2.65g (1.22). The five holed shaker delivered a mean of 33.7% of the salt of the 17 holed shaker. There was a significant difference in salt delivered between the five and 17 holed salt shakers when time spent shaking, amount of salt in the shaker and participant were all kept constant (p<0.001). This difference was robust to variations in the starting weight of shakers, time spent shaking and participant shaking (ps

CONCLUSIONS

Five holed salt shakers have the potential to reduce the salt content of takeaway food, and particularly food from Fish & Chip shops, where these shakers are particularly used. Further research will be required to determine the effects of this intervention on customers' salt intake with takeaway food and on total dietary salt intake.

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Grants

• Wellcome Trust
• MR/K023187/1 Medical Research Council
• MR/K02325X/1 Medical Research Council
• NIHR-RP-02-12-001 Department of Health
• National Institute for Health Research

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Affiliation(s)

Louis Goffe Institute of Health & Society, Newcastle University, William Leech Building, Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
Wendy Wrieden Institute of Health & Society, Newcastle University, William Leech Building, Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
Linda Penn Institute of Health & Society, Newcastle University, William Leech Building, Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
Frances Hillier-Brown Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom Obesity Research Group, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Queen’s Campus, Stockton on Tees, TS17 6BH, United Kingdom
Amelia A. Lake Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom Centre for Public Policy & Health, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Queen’s Campus, Stockton on Tees, TS17 6BH, United Kingdom
Vera Araujo-Soares Institute of Health & Society, Newcastle University, William Leech Building, Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
Carolyn Summerbell Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom Obesity Research Group, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Queen’s Campus, Stockton on Tees, TS17 6BH, United Kingdom
Martin White Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
Ashley J. Adamson Institute of Health & Society, Newcastle University, William Leech Building, Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom Fuse–the Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
Jean Adams Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom

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Saturated and trans-fatty acids in UK takeaway food

The aim of the study was to analyze the saturated fatty acid (SFA) and trans-fatty acid (TFA) contents of popular takeaway foods in the UK (including English, pizza, Chinese, Indian and kebab cuisine). Samples of meals were analyzed by an accredited public analyst laboratory for SFA and TFA. The meals were highly variable for SFA and TFA. English and Pizza meals had the highest median amount of SFA with 35.7 g/meal; Kebab meals were high in TFA with up to 5.2 g/meal. When compared to UK dietary reference values, some meals exceeded SFA and TFA recommendations from just one meal. Takeaway food would be an obvious target to reduce SFA and TFA contents and increase the potential of meeting UK recommendations. Strategies such as reformulation and smaller takeaway portion sizes warrant investigation.