Differences in the sugar content of fast-food products across three countries. Issue 16 (24th November 2020) - Lewis, Nicole
Abstract: Objective: To compare the sugar content of items at four multinational fast-food chains, across three countries. Design: Total sugar (g)/per serving was extracted from online nutrition information, and sugar/100 g serving was calculated. Foods were categorised as: breakfast sandwiches, burgers, sandwiches, desserts and condiments. Beverages were categorised as fountain, frozen or pre-packaged. Sugar (g) was compared across countries using linear mixed-effects models. Pairwise comparisons were performed with Tukey–Kramer adjustments. Setting: USA, Germany and Australia. Participants: Burger King™ (Hungry Jack's™), Kentucky Fried Chicken™, McDonald's™ and Subway™. Results: Differences in total sugar/100 g or ml were observed across countries for burgers ( n 104), desserts ( n 110), sandwiches ( n 178), pre-packaged beverages ( n 36) and frozen beverages ( n 72). Comparing identical items across countries (e.g. BigMac TM from McDonalds in USA, Germany and Australia), burgers ( n 10 available in all three countries) had lower sugar content in Australia (3·4 g/100 g) compared with the USA (4·7 g/100 g, P = 0·02) or Germany (4·6 g/100 g, P = 0·04), yet no differences were observed in other food categories. Comparing the same beverages across countries (e.g. chocolate shake from Burger King), frozen beverages ( n 4 available in all three countries) had lower sugar content in Australia (14·2 g/100 ml), compared with the USA (20·3 g/100 ml, P = 0·0005) or Germany (17·8 g/100 ml, P = 0·0148), yet no differences were observed in other beverage categories. Conclusions: Heterogeneity in fast-food sugar content across countries suggests that reductions are possible and should be implemented to reduce health risks associated with excess added sugar intake.