Researchers say what counts is what people buy, not what's on the menu. (Getty Images )
Adolescents who went to McDonald’s and Subway in Los Angeles bought about the same number of calories at each, despite Subway's reputation as a healthier place to eat, researchers said.
The menus are not the point, lead researcher Dr. Lenard Lesser of the Palo Alto Medical Foundation Research Institute said by phone. “Our study was not based on what people have the ability to pick, our study was based on what adolescents actually selected in a real-world setting.”
The adolescents bought an average of 1,038 calories at McDonald’s and 955 calories at Subway. The calorie difference was not statistically significant, the researchers said. Their work was published Monday in the Journal of Adolescent Health.
Eighty-seven people, ages 12 to 21, were sent to McDonald’s and Subway in the Carson area of Los Angeles in May 2011. UCLA and the Youth, Family, School and Community – Partnership in Action, a group of mostly Filipino families who participate in health-related activities, worked together to choose the restaurants and the participants.
They were told to buy a “meal” at each place, on different days in the afternoon. Their receipts were used to determine the amount they bought.
The fewer calories from Subway, Lesser said, still topped the recommendation of the Institute of Medicine for a teen’s lunch of 850 calories. The study notes that it did not tally what the participants ate the rest of the day.
“Most studies, but not all, have shown a positive relation between eating fast food and weight gain or obesity,” the researchers wrote. And when people go to those restaurants, their choices are influenced by “marketing strategies, such as pricing, signage, promotions and menu design.”
“The Subway chain claims it offers healthy fast food and helps its customers lose weight,” the researchers wrote. But they said the proof should be based on what people buy, not by what’s offered.
The researchers noted that the National Restaurant Assn., a trade group, reported chefs citing healthful children’s meals as the No. 3 trend for 2012. But Lesser said customers are often faced with marketing that doesn’t prompt healthful choices.
Lesser said restaurants can take simple steps to promote healthful options, such as not putting cookies next to the register.
“The message I’m giving is overridden by the sort of marketing aspect” that is “a lot more powerful than what one physician says in the newspaper,” he said. He cited a McDonald’s promotion for pink lemonade that had the store “decked out in pink” with samples available. And at Subway, a meatball sandwich special that was advertised with big posters and advantageous prices.
“We don’t often see those things for the healthier items,” he said.
McDonald's issued a statement through Lainey Garcia, a spokeswoman: "At McDonald's, we are committed to evolving our menu to meet our customers' changing tastes and to providing reliable nutrition information that empowers all our customers to make informed choices -- whenever and wherever they visit us." The statement also noted that McDonald's USA recently introduced a Happy Meal that automatically includes apple slices and a smaller portion of French fries.
Subway was asked to comment as well; representatives were not immediately available Tuesday.
"The most healthy thing to do is to cook at home," said researcher Lesser. "That’s my advice to patients and to the population."
But the researchers conclude that knowing what’s actually purchased in a restaurant is important. “Until then,” they wrote, “parents should steer their children away from fast-food restaurants. No matter which one they choose, they are likely to purchase too many calories.”
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