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Understanding price incentives to upsize combination meals at large US fast-food restaurants.
Public Health Nutr. 2020 02; 23(2):348-355.PH

Abstract

OBJECTIVE

To understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes).

DESIGN

Combination meals (lunch/dinner: n 258, breakfast: n 68, children's: n 34) and their prices were identified from online menus; corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Linear models were used to examine the difference in total calories per dollar between default and higher-calorie combination meals, overall and by restaurant.

SETTING

Ten large fast-food chain restaurants located in the fifteen most populous US cities in 2017-2018.

PARTICIPANTS

None.

RESULTS

There were significantly more calories per dollar in higher-calorie v. default combination meals for lunch/dinner (default: 577 kJ (138 kcal)/dollar, higher-calorie: 707 kJ (169 kcal)/dollar, difference: 130 kJ (31 kcal)/dollar, P < 0·001) and breakfast (default: 536 kJ (128 kcal)/dollar, higher-calorie: 607 kJ (145 kcal)/dollar, difference: 71 kJ (17 kcal)/dollar, P = 0·009). Results for children's meals were in the same direction but were not statistically significant (default: 536 kJ (128 kcal)/dollar, higher-calorie: 741 kJ (177 kcal)/dollar, difference: 205 kJ (49 kcal)/dollar, P = 0·053). Across restaurants, the percentage change in calories per dollar for higher-calorie v. default combination meals ranged from 0·1 % (Dunkin' Donuts) to 55·0 % (Subway).

CONCLUSIONS

Higher-calorie combination meals in fast-food restaurants offer significantly more calories per dollar compared with default combination meals, suggesting there is a strong financial incentive for consumers to 'upsize' their orders. Future research should test price incentives for lower-calorie options to promote healthier restaurant choices.

Authors+Show Affiliations

Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA.Department of Environmental and Occupational Health, California State University, Northridge, Los Angeles, CA, USA.Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31796142

Citation

Vercammen, Kelsey A., et al. "Understanding Price Incentives to Upsize Combination Meals at Large US Fast-food Restaurants." Public Health Nutrition, vol. 23, no. 2, 2020, pp. 348-355.
Vercammen KA, Frelier JM, Moran AJ, et al. Understanding price incentives to upsize combination meals at large US fast-food restaurants. Public Health Nutr. 2020;23(2):348-355.
Vercammen, K. A., Frelier, J. M., Moran, A. J., Dunn, C. G., Musicus, A. A., Wolfson, J., Ullah, O. S., & Bleich, S. N. (2020). Understanding price incentives to upsize combination meals at large US fast-food restaurants. Public Health Nutrition, 23(2), 348-355. https://doi.org/10.1017/S1368980019003410
Vercammen KA, et al. Understanding Price Incentives to Upsize Combination Meals at Large US Fast-food Restaurants. Public Health Nutr. 2020;23(2):348-355. PubMed PMID: 31796142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding price incentives to upsize combination meals at large US fast-food restaurants. AU - Vercammen,Kelsey A, AU - Frelier,Johannah M, AU - Moran,Alyssa J, AU - Dunn,Caroline G, AU - Musicus,Aviva A, AU - Wolfson,Julia, AU - Ullah,Omar S, AU - Bleich,Sara N, Y1 - 2019/12/04/ PY - 2019/12/5/pubmed PY - 2020/12/18/medline PY - 2019/12/5/entrez KW - Combination meals KW - Fast-food restaurants KW - Price incentives KW - Value pricing SP - 348 EP - 355 JF - Public health nutrition JO - Public Health Nutr VL - 23 IS - 2 N2 - OBJECTIVE: To understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes). DESIGN: Combination meals (lunch/dinner: n 258, breakfast: n 68, children's: n 34) and their prices were identified from online menus; corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Linear models were used to examine the difference in total calories per dollar between default and higher-calorie combination meals, overall and by restaurant. SETTING: Ten large fast-food chain restaurants located in the fifteen most populous US cities in 2017-2018. PARTICIPANTS: None. RESULTS: There were significantly more calories per dollar in higher-calorie v. default combination meals for lunch/dinner (default: 577 kJ (138 kcal)/dollar, higher-calorie: 707 kJ (169 kcal)/dollar, difference: 130 kJ (31 kcal)/dollar, P < 0·001) and breakfast (default: 536 kJ (128 kcal)/dollar, higher-calorie: 607 kJ (145 kcal)/dollar, difference: 71 kJ (17 kcal)/dollar, P = 0·009). Results for children's meals were in the same direction but were not statistically significant (default: 536 kJ (128 kcal)/dollar, higher-calorie: 741 kJ (177 kcal)/dollar, difference: 205 kJ (49 kcal)/dollar, P = 0·053). Across restaurants, the percentage change in calories per dollar for higher-calorie v. default combination meals ranged from 0·1 % (Dunkin' Donuts) to 55·0 % (Subway). CONCLUSIONS: Higher-calorie combination meals in fast-food restaurants offer significantly more calories per dollar compared with default combination meals, suggesting there is a strong financial incentive for consumers to 'upsize' their orders. Future research should test price incentives for lower-calorie options to promote healthier restaurant choices. SN - 1475-2727 UR - https://www.unboundmedicine.com/medline/citation/31796142/Understanding_price_incentives_to_upsize_combination_meals_at_large_US_fast_food_restaurants_ L2 - https://www.cambridge.org/core/product/identifier/S1368980019003410/type/journal_article DB - PRIME DP - Unbound Medicine ER -