Are Restaurant Health-Related Corporate Social Responsibility Commitments Associated With Nutritional Changes to Menu...

This study aimed to evaluate the associations between health-related corporate social responsibility commitments and the nutrition quality of menu offerings in 66 U.S.-based restaurant chains in 2012-2018.

Data on health-related corporate social responsibility (from n=4,096 web text sections) and menu items (n=124,110) were abstracted from the WayBack Machine and MenuStat databases in 2020 and analyzed 2020-2023. Generalized linear mixed models evaluated differences in menu nutrition quality (adapted Nutrition Environment Measures Study in Restaurants score) and the nutrient content of menu items (kcal, total fat, saturated fat, sugar, sodium, and fiber) between restaurants with and without health-related corporate social responsibility, including yearly trends. Exploratory analyses tested differences among new menu items only (n=28,387).

There were no differences in the adapted Nutrition Environment Measures Study in Restaurants score of menus between restaurants with and without health-related corporate social responsibility. However, restaurants with health-related corporate social responsibility offered menu items with slightly lower calories (352.9 vs 364.1 kcals), total fat (15.3 vs 16.0 g), saturated fat (5.8 vs 6.1 g), sugar (22.5 vs 23.8 g), sodium (571.3 vs 621.6 mg), and fiber (1.8 vs 1.9 g) than restaurants without health-related corporate social responsibility (p<0.05). Among only new menu items, restaurants with health-related corporate social responsibility offered new items that were lower in calories, total fat, saturated fat, sodium, and sugar in 2012. However, the nutrient content for these new menu items also became less healthful over time: +17.8 kcal per year (95% CI=11.1, 24.4), +0.8 g total fat per year (95% CI=0.4, 1.2), +0.4 g saturated fat per year (95% CI=0.1, 0.8), +30.7 mg sodium per year (95% CI=15.0, 46.4), and +1.1g sugar per year (95% CI=0.4, 1.8).

Health-related corporate social responsibility commitments were associated with small differences in the nutrient content of some menu items but did not translate into meaningful improvements in overall nutrition quality of restaurant offerings. Stronger industry initiatives and policy action are needed to improve the nutrition quality of restaurant menu offerings.