A bit or a lot on the side? Observational study of the energy content of starters, sides and desserts in major UK restaurant chains

Objectives Our objective was to examine the kilocalorie (kcal) content of starters, sides and desserts served in major UK restaurant chains, comparing the kcal content of these dishes in fast-food and full-service restaurants. Design Observational study. Setting Menu and nutritional information provided online by major UK restaurant chains. Method During October to November 2018, we accessed websites of restaurant chains with 50 or more outlets in the UK. Menu items that constituted starters, sides or desserts were identified and their kcal content was extracted. Accompanying beverages were not included. We used multilevel modelling to examine whether mean kcal content of dishes differed in fast-food versus full-service restaurants. Main outcome measures The mean kcal content of dishes and the proportion of dishes exceeding public health recommendations for energy content in a main meal (>600 kcal). Results A total of 1009 dishes (212 starters, 318 sides and 479 desserts) from 27 restaurant chains (21 full-service, 6 fast-food) were included. The mean kcal content of eligible dishes was 488.0 (SE=15.6) for starters, 397.5 (SE=14.9) for sides and 430.6 (SE=11.5) for desserts. The percentage of dishes exceeding 600 kcal was 26.4% for starters, 21.7% for sides and 20.5% for desserts. Compared with fast-food chains, desserts offered at full-service restaurants were on average more calorific and were significantly more likely to exceed 600 kcal. Conclusions The average energy content of sides, starters and desserts sold in major UK restaurants is high. One in four starters and one in five sides and desserts in UK chain restaurants exceed the recommended energy intake for an entire meal.