Fast Food to Healthy Food

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Fast Food to Healthy FoodSusan Gregory a , Carmela McTyre b & Robin B.Dipietro ca Eastern Michigan University , USAb Hotel & Restaurant Management, Eastern MichiganUniversity , USAc Rosen College of Hospitality Management,University of Central Florida , USAPublished online: 05 Oct 2008.

To cite this article: Susan Gregory , Carmela McTyre & Robin B. Dipietro (2006) FastFood to Healthy Food, International Journal of Hospitality & Tourism Administration,7:4, 43-64, DOI: 10.1300/J149v07n04_03

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Fast Food to Healthy Food:A Paradigm Shift

Susan GregoryCarmela McTyreRobin B. DiPietro

ABSTRACT. A recent headline in the Nation’s Restaurant News (2002)asked the question: “Should Restaurants Bear the Burden of MonitoringAmericans’ Diets?”. Society has grown increasingly conscientious abouthealth care costs and the question is consistent with this trend. In light ofsome highly publicized cases of litigation and debates between con-sumer groups and food service professionals, this question is the corner-stone of a debate centered upon weighing the nutritional value of fastfood, and the responsibility of these organizations to provide healthy al-ternatives for consumers.

The purpose of this study is to discern the role that quick service res-taurants are expected to play in health and nutrition; it will also focusupon what they are actually doing to promote healthier menu items. Thecurrent study examined the fast food industry’s efforts to address itshighly controversial role as a possible contributor to the nation’s healthcare crisis. The setting for this study was the Detroit metropolitan area,which serves as a microcosm of greater metropolitan areas throughout

Susan Gregory, EdD, is Hotel & Restaurant Management Program Director, East-ern Michigan University.

Carmela McTyre, MS, is Lecturer, Hotel & Restaurant Management, Eastern Mich-igan University.

Robin B. DiPietro, PhD, is Associate Professor, Rosen College of Hospitality Man-agement, University of Central Florida.

Address correspondence to: Susan Gregory, Hotel & Restaurant Management, EasternMichigan University, Ypsilanti, MI 48197 USA (E-mail: [email protected]).

International Journal of Hospitality & Tourism Administration, Vol. 7(4) 2006Available online at http://ijhta.haworthpress.com

© 2006 by The Haworth Press, Inc. All rights reserved.doi:10.1300/J149v07n04_03 43

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the United States because of the region’s rich racial, ethnic and culturaldiversity (Upton, 2004). Moreover, the state of Michigan has beenidentified as one of the leading locales for residents who are obese(Burros, 2003; Niesse, 2004; Price, 2003; Hirsch, 2004; Upton, 2004).Because of the recent prevalence of overweight and obesity throughoutmuch of the world, the findings from this study can guide future re-search on an international basis. Implications for management are dis-cussed. doi:10.1300/J149v07n04_03 [Article copies available for a fee from TheHaworth Document Delivery Service: 1-800- HAWORTH. E-mail address:<[email protected]> Website: <http:// www.HaworthPress.com>© 2006 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Fast food restaurant, quick service restaurant, healthy/nutritious menu items

INTRODUCTION

In 2001, the U.S. Surgeon General announced that obesity was aleading cause of preventable death and was only surpassed by smokingas the number one cause of avoidable death in the United States (U.S.Department of Health and Human Services, 2001). This condition hascome about, in large part, as a result of diets that are high in fat content.For years, the fast food restaurant industry has faced criticism from con-sumer groups that their products place maximum emphasis on taste andminimal emphasis on healthiness. Given the restaurant industry’s en-trenched popularity with the public, and its impact on more than 12 mil-lion people it employs, the methods by which it is choosing to addressthis major crisis of credibility is worth analysis (National RestaurantAssociation, 2004).

The fast food industry is an indelible fixture in the story of America’srise as an economic power following World War II. With the foundingand subsequent success of McDonald’s in the 1950s, the industry grewin direct proportion to the burgeoning and geographically expandingpost war population. The products it produces are now consumed dailyby millions of Americans. According to the National Restaurant Asso-ciation (2004), sales at fast food restaurants are projected to reach$123.9 billion in 2004. Despite the continuing rise in sales for the indus-try, health problems related to eating food typically associated with fastfood restaurants have skyrocketed and have prompted growing scrutinyof the industry’s products and methods of preparation (Block, Scribner, &DeSalvo, 2004).

44 International Journal of Hospitality & Tourism Administration

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Fast food or quick service restaurants can be defined as chain restau-rants that have two or more of the following characteristics: expeditedfood service, takeout business, limited or no wait staff, payment ten-dered prior to receiving food, reasonably priced and quickly preparedmeals to-go (Block, Scribner, & DeSalvo, 2004; Long-Tolbert & Tay-lor, 2002).The term has evolved since its first appearance in the early1960s to also include some casual style restaurants that are called “fastcasual.” This type of restaurant essentially utilizes the fast food concept,but the site décor is decidedly upscale and the menu choices are consid-ered healthier by consumers (Brumback, 2003).

Muller and Woods (1994) defined quick service restaurants as hav-ing attributes of a reliance on a narrow menu and catering to extremelyprice sensitive consumers who develop “habit forming” purchasesthrough top-of-mind advertising. They also characterized this restau-rant segment as having consumer demands for accurate orders, clean lo-cations, and food served at the right temperature in a compressed timeframe. According to the National Restaurant Association, in 2004, thequick service restaurant segment of the U.S. restaurant industry is solarge that it will account for almost half of all commercial restaurant“eating place” sales (Spielberg, 2004).

The concept of obesity has been defined by most health care profes-sionals as a weight condition of being ten pounds or more beyond weightthat is in proportion with one’s height, or having a Body Mass Index(BMI) of 30.0 or higher. BMI is defined as body weight in kilograms di-vided by height in meters squared (Centers for Disease Control and Pre-vention, 2003). For the vast majority of people, overweight and obesityresult from excess calorie intake and/or inadequate physical activity(U.S. Department of Health and Human Services, 2001). Some studieshave found associations between fast food intake and increased BodyMass Index and weight gain (French, Harnack, & Jeffery, 2000;Jeffery & French, 1998).

In order to combat the trend of increasing obesity and the negativepublic perception of how quick service restaurants are contributing tothe obesity issues, another term in the restaurant industry that has beenintroduced recently is “lifestyles of health and sustainability” (LOHAS)or “slow food.” These are terms that describe an emerging movement inthe U.S. (and throughout many parts of Europe) that is emphasizing life-styles that focus more on health and sustainability and merging socialjustice with economic decisions (Nutrition Matters: Not So Fast . . .,2004).

Gregory, McTyre, and DiPietro 45

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The Fast Food Concept: A History of the Issues

Carl Karcher, Richard and Maurice McDonald, and Harland Sandersare names that are imprinted on the history of the fast food restaurant in-dustry. Karcher founded Carl’s Jr. Restaurant (1956), brothers Richardand Maurice were founders of McDonald’s Hamburgers (1948), andHarland Sanders founded Kentucky Fried Chicken, currently operatingas KFC (1952). These restaurateurs were simply trying to make a profitand beat out the competition. The “competition” in the restaurant indus-try in post World War II America consisted of a host of “drive in” con-cepts that sought to capitalize on people’s blooming romance with theautomobile (Armstrong & Loach, 1997; Schlosser, 2002). This conceptincluded providing the customer with a reasonably priced, quicklyprepared meal.

What would evolve to become the fast food restaurant or quick ser-vice restaurant that we recognize today officially began in SouthernCalifornia. Southern California is the birthplace of Jack in the Box,Taco Bell, and McDonald’s (Schlosser, 2002). During the early 1950s,the U.S. entered an era of unprecedented productivity at all levels andthe availability of tasty, quickly prepared meals that could be takenhome and eaten, rather than having to dine in the restaurant, met a grow-ing consumer need to simplify meals (Stokes, 1977). What was occur-ring was a paradigm shift in consumer eating habits; and this shift was aculmination of noted developments that had been quietly revolutioniz-ing the food industry since the end of World War II (Schlosser, 2002).

Between 1945 and 1960, as the parents of baby boomers were popu-lating suburbs and fueling extraordinary growth in the nation’s econ-omy at all levels, the delivery (and sophistication) of food service andproducts was evolving in lockstep. From this evolution came the“super” market, prepackaged frozen foods, and the drive-in and carry-out (“take-out”) restaurant (Meijers, 1995). Additionally, workplacecafeterias had begun experimenting with providing automated lunchcounters, and there was a steep increase in off-site catering that wasneeded as a result of more social and after-hours business activity andthe use of banquet facilities for special events (Stokes, 1977).

The consistent theme which could be found in all of these develop-ments was greatly reducing the time and labor involved in meal prepara-tion for consumers, an activity which was and still is largely a femaleresponsibility in the household (Bianchi & Casper, 2000). But the post-war era’s many technological and manufacturing breakthroughs (i.e.,the transistor, and later the microchip, and automation on the assembly


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line) created options for women in the workplace and in community ac-tivities that had not previously existed. As a result, by the 1960s it wasnot uncommon for one out of twenty American women to work outsidethe home (Bianchi & Casper, 2000). Today, the number of womenworking outside the home continues to grow, causing an even greaterneed for more convenient and quickly prepared food.

Even as the restaurant industry was enjoying record level profits andgrowth throughout the past twenty years, this was juxtaposed by a grad-ually accumulating body of knowledge about the causes of heart diseaseand related health problems by diets high in fatty foods. And ancillary tothis (at least at first) was the growing cost of providing health care in anation which was beginning to visibly age. According to the U.S. Cen-sus Bureau (2001), the median age has been rising steadily from 32.9 in1990 to 35.3 in 2000.

Resulting Litigation

Initially it would be the tobacco industry which would bear the bruntof a growing concern expressed by some outspoken consumer advocategroups that longtime culturally accepted habits were proving to becounterproductive to health, the targeted habits were smoking, usingfirearms, and eating “junk” foods (Parloff, 2003). The smoking habithad had such critics for many years in select parts of the medical com-munity, but in the late 1970s an anti-tobacco movement began to taketangible and evolving form. What began as an evolving consumermovement ultimately became a legal juggernaut which brought uponthe tobacco industry crippling fines and regulations that have essen-tially rendered impotent its ability to function profitably in the U.S. Theindustry has had to re-shift its entire strategy in order to sell its productsabroad and to diversify (Daynard, 2003).

The firearms industry also became the focus of this grassroots-drivenheightened concern about the public’s health. Throughout the 1990s,the industry was successfully sued by many local and state officials whoclaimed that lax background checks of firearm customers was contrib-uting to an increase in firearm violence and was, therefore, a menace topublic health (Munoz, 2004). Most recently, members of Congress whoare supporters of the industry were able to muster a majority vote toprotect it from frivolous lawsuits.

The ink had hardly dried on litigation against the tobacco industryand firearms industry when it became apparent that the fast food indus-try had already fallen into the crosshairs of a collection of forces which


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viewed the fast food industry as a greater threat to Americans’ healththan tobacco and firearms (Parloff, 2003). And similar to the tobaccoand firearms industries, there were solid medical research findingswhich would serve to lay the foundation for this certain anti-fat move-ment against the fast food industry (Vroom, 2005).

In retrospect, signs and symptoms of the impending challenges thatthe fast food industry face today had begun to show as early as themid-1980s (Schlosser, 2002). In 1983 the California Supreme Courtheard a case (which was eventually settled out of court) brought by anadvocacy group against General Foods. The lawsuit centered upon theway breakfast cereals such as Sugar Crisp and Cocoa Pebbles were mar-keted as “cereals” but contained sugar content more equivalent to can-dies (Parloff, 2003). Three years later, in 1986, at the height of itsexpansion campaign overseas, McDonald’s pursued libel action againsttwo members of the international environmental organization, Greenpeace(Armstrong & Loach, 1997; Schlosser, 2002). The pair, Helen Steel andDavid Morris, had admitted authoring a leaflet titled “What’s WrongWith McDonald’s” which contained scathing criticisms of the fast foodgiant. These criticisms included charges that the company routinely vio-lated civil liberties and labor laws with its teenage workforce. Assertedin the leaflet was the contention that a great deal of McDonald’s adver-tising was targeted toward children while knowing that the high fat andsugar contents of the products sold to these young customers contrib-uted to short term obesity problems and long term health problems, suchas diabetes (Armstrong & Loach, 1997).

Although McDonald’s prevailed in the case, the trial resulted in un-precedented revelations of the inner workings and policies of theworld’s largest fast food provider and proved to be a public relations di-saster for the company (Armstrong & Loach, 1997; Schlosser, 2002).Although many of the more extreme claims in the leaflets were found bythe judge to be untrue, many of the claims were affirmed by crediblemedical witness’ testimony and current research documents (Armstrong &Loach, 1997; Schlosser, 2002). This situation brought the unhealthinessof the product and McDonald’s targeting of children in advertising cam-paigns to the forefront of consumers’ minds.

Since 1980, rates of obesity among small children have doubled.Rates among adolescents during the same time had tripled (Parloff,2003; U.S. Department of Health and Human Services, 2002). Datafrom the National Health and Nutrition Examination Survey indicatesthat 41 percent of adults are overweight and an additional 23 percent areconsidered obese (Centers for Disease Control and Prevention, 2003).


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With the rising obesity rates come increases in health care costs and pre-ventable deaths (U.S. Department of Health and Human Services, 2001;Vroom, 2005). Despite the fact that scientific studies have not found adirect correlation between measures of obesity in children and fast foodusage (French, Story, Neumark-Sztainer, Fulkerson, & Hannan, 2001),the industry is facing non-flattering media coverage regarding the qual-ity and healthfulness of its food (Lawmakers ban obesity lawsuits,2004).

Another concern for foodservice came from an article published inthe parody newspaper “The Onion.” In August 2000, “The Onion” ran asatirical article under the headline “Hershey’s Ordered to Pay ObeseAmericans $135 Billion” (Parloff, 2003). In the article Hershey’s wasaccused of contributing to the unhealthiness of children by selling themtheir products. The following year, the article would appear to be moreprescient than satirical. In December 2001, the U.S. Surgeon Generalobserved that about 300,000 deaths per year are associated with over-weight and obesity, and warned that those conditions might soon causeas much preventable disease and death as smoking (U.S. Department ofHealth and Human Services, 2001). At that time, public health costs at-tributable to overweight and obesity came to about $117 billion. Today,that number continues to increase (Upton, 2004; Ross & Verrengia,2004).

Meanwhile, the restaurant industry faces a tougher battlefield in theinformation war involving scientific research. There has been a trend inrestaurants to increase portion size to improve the price/value relation-ship for the consumer (Peregrin, 2001; Young & Nestle, 2002; and Nes-tle, 2003). Young and Nestle (2002) found that the rise in portion sizesoccurred in all food categories, except bread, beginning in the 1970s, in-creased sharply in the 1980s, and is continuing to rise. The largest in-crease in portion sizes occurred at fast food restaurants (Nielsen &Popkin, 2003). These large portions differ considerably from the serv-ing sizes listed in the Food Guide Pyramid, which serves as a referenceguide for consumers regarding food intake and nutritional requirements(U.S. Department of Agriculture, 1996).

In 2002, the quick service restaurant industry was hit with the first ofa series of lawsuits regarding their role in the obesity epidemic. This suitwas filed by a New York attorney against McDonald’s on behalf of aclass action group of children claiming to have become obese from con-suming the company’s products. It would trigger a massive lobbying ef-fort on the part of the quick service restaurant industry to dilute thevalidity of such legal action (Parloff, 2003). Although the industry pre-


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vailed in that case, there is currently an appeal in process. There are alsoother lawsuits either being filed or being seriously considered by con-sumer advocate groups. Defendants in these lawsuits include McDon-ald’s, Burger King, KFC, and Wendy’s (Upton, 2004; Vroom, 2005).

The Washington D.C.-based industry lobby group, the Center forConsumer Freedom, quickly took the offensive following the filing ofthe lawsuit which was precipitated from the Surgeon General’s report.The group launched a series of print and television ads all driving homethe message that it was personal responsibility that should be at issue,not the nutritional value of the fast food industry’s product. One print addepicted a man’s bloated bare stomach spilling over a belted waist linewith the tag line “Did you hear the one about the fat guy suing the res-taurants? It’s no joke.” Another, a television ad, showed a sleazy law-yer grilling a Girl Scout in court for selling cookies to which he claimshis overweight client had become addicted (Frumkin, 2003a; Parloff,2003).

The restaurant industry was able to rally significant support frommembers of Congress and from President George W. Bush’s adminis-tration. As a result, a legislative agenda under the heading of reformingthe nation’s civil liability laws at both the federal and state levels hasbeen successful in obtaining support for the banning of “frivolous” law-suits (of which the firearm industry also benefited) (Munoz, 2004).These would include banning lawsuits by customers who say they be-came overweight or obese by eating at fast food restaurants (LawmakersBan Obesity Lawsuits, 2004).

Michigan is one of the states that has seen legislative support for thefrivolous lawsuit issue. A bill designed to protect restaurant companiesfrom such frivolous lawsuits, generated in the House of Representa-tives, and strongly lobbied for by the Michigan Restaurant Association,was voted out of the Commerce Committee and sent to the full Housefor a vote (Michigan Restaurant Association, 2004).

Quick Service Restaurant Industry Segment Response

Despite the short term reprieve from lawsuits, the long term focus onthe quality and fat content of its food has been felt by the quick servicerestaurant industry. The negative press has cost the industry some sig-nificant points in the longer term arena of resonating public perception(Parloff, 2003). While on one hand such a message can help the industryfight off the lawsuits, it also shifts a more probing emphasis on the pub-lic health issue–which is the real essence of the controversy facing the


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industry in the first place (Ashe, Jernigan, Kline, & Galaz, 2003;Frumkin, 2003b; Walkup, 2004). And for this reason the industry, ledby McDonald’s, Burger King and Wendy’s, has recently begun to makesignificant improvements in the quality of its menu selections (Ashe etal., 2003; Frumkin, 2003b; Garber, 2004; Walkup, 2004).

The menu items being offered by increasing numbers of quick ser-vice restaurants are emphasizing healthful choices, while at the sametime blunting critics’ claims that all fast food is high in fat, calories andsodium (Frumkin, 2003b). One restaurant chain that changed its con-cept toward healthier products prior to the Surgeon General’s reportwas Subway Restaurants (Ellison & Leung, 2003). The restaurant chainnow faces numerous competitors that are trying to add healthier prod-ucts to their menu line including Quizno’s, Potbelly Sandwiches andothers (Parloff, 2003). Eating better and healthier is becoming an obses-sion in many parts of the United States and throughout the world(Siemering, 2004).

In order to be competitive with this trend toward eating healthier,many other quick service restaurant chains have been attempting to addnew menu items that will attract the health conscious consumer. In Jan-uary 2004, three major hamburger chains, Burger King, Hardee’s andCarl’s Jr., rolled out new “bunless burgers” to complement the low-car-bohydrate diet trends. Recently, McDonald’s and Wendy’s have ex-tended their entrée salad line (Carpenter, 2004).

Applebee’s Restaurants signed an agreement in 2003 with WeightWatchers to develop a menu of low-fat, low-calorie dishes for its casual(i.e., upscale, dining in, but still with an emphasis on fast service) res-taurants. Additionally, there have been discussions in the industry aboutmore effective ways to make the nutritional information about its prod-ucts more readily available to the public (Ashe et al., 2003; Frumkin,2003b; Walkup, 2004). Currently most major fast food outlets make thisinformation available on their Websites and in their restaurant loca-tions. Many chains also allow a customizing of the items on their nu-tritional information Websites. They do this in order to make thenutritional information as accurate as possible, according to what theconsumer actually purchases from the restaurant.

Defining Nutritional Value in the Fast Food World

In 1990 Congress passed the Nutrition Labeling and Education Act,which required that nutritional information be listed on packaged foodproducts. At the time, lawmakers considered forcing restaurants to pro-


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vide the same information, but decided it was not practical. The res-taurant industry lobbyists emphasized that because restaurants oftenchanged menu items and have a variety of cooks, it would be very diffi-cult, if not impossible, to obtain exact nutritional information on thevaried and changing menu items that are prevalent in the restaurant in-dustry (U.S. Department of Agriculture, Center for Nutrition Policy andPromotion, 1996).

In place of legislative solutions, the restaurant industry was encour-aged to customize strategies (e.g., place nutritional information onWebsites) and work toward having healthier choices on their menus. Itis an understatement to say that since the Surgeon General’s (2001)landmark announcement about the rise in obesity, the restaurant indus-try, and particularly those organizations that provide fast food, havebeen motivated to address this issue in an unprecedented fashion, andhave done so with some degree of success (French et al., 2001). What ithas not yet been able to do is remove the negative connotation that thewords “fast food” now hold in the wake of such groundbreaking reportsabout the dark side of the industry such as that in Fast Food Nation bySchlosser (2002), and in numerous reports and articles in the public andtrade press (Frumpkin, 2003a; Parloff, 2003; Santora, 2002). Adding tothis mixture of challenges still to be addressed by the industry is theemergence of an independent social movement that is advocating “life-styles of health and sustainability” (known by the acronym LOHAS)(Nutrition Matters: Not So Fast . . ., 2004). Industry publications havebeen abuzz about the LOHAS movement since it was identified in theNation’s Restaurant News earlier in 2004. This demographic group isan apparent synthesis of previously considered fringe ideas going intothe mainstream of more public thinking: renewable energy, naturalfoods, herbal supplements, socially responsible investment funds,naturally organic foods, and various forms of meditation.

The LOHAS group is expected to spend $227 billion in goods andservices relative to these ideas (Nutrition Matters: Not So Fast . . .,2004). Given this development, it is not surprising that menu items suchas a sliced roasted turkey sandwich on wheat bread with lettuce, tomatoand sprouts, fruit salad, and sparkling water are sharing top billing withcheeseburgers, fries and sodas at many restaurants these days. These de-cidedly healthier menu items have been dubbed “slow food” by advo-cates of the LOHAS movement, and it is a term that the industry mightdo well to adopt as it continues its efforts to distinguish itself from thenegative connotation that the “fast food” moniker continues to embody(Nutrition Matters: Not So Fast . . ., 2004).


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International Impact

These trends of overweight and obesity are not occurring in the U.S.alone. Studies have been done in countries such as Canada, England,Scotland, France, Australia and Taiwan that have shown that over-weight and obesity rates are rising at alarming rates. In conjunction withthat, public health experts view the increase in the availability in fastfood as a primary contributor to rising rates of diabetes and high bloodpressure in these countries (Chinn & Rona, 2001; Chu, 2001; Olds &Harten, 2001; Rolland-Cachera, Cole, & Sempe, 1991; Tremblay &Wilms, 2000).

There have been studies that have shown that Asian countries areopening fast food outlets on an everyday basis. AC Nielsen Corpora-tion, market research firm found that Chinese are more likely thanAmericans to eat takeout meals, 41% of Chinese eat fast food at leastonce a week in comparison to 35% of U.S. residents (Goodman, 2004).The current research, based in the U.S., will help to guide futureresearch internationally.

PURPOSE OF STUDY

The purpose of the current study was to identify whether current menuofferings and perceived nutritional value of a sample of the largest quickservice restaurants have responded to the growing concerns regarding theobesity problem in the United States. To be determined through the studywas also what the fast food industry is doing to promote their “healthy”menu items and how, if at all, they are trying to change the image broughton by lingering thoughts of lawsuits regarding obesity.

Through the background literature, the following hypotheses havebeen designed. The current study will analyze and respond to these hy-potheses regarding the quick service restaurant industry:

H1: In order to improve their image, quick service restaurants havechanged the way that they provide nutritional information to theircustomers and to the general public by using Websites and nutri-tional information in restaurant.

H2: Quick service restaurants have responded to criticism regard-ing the nutritional value of their foods by providing more healthyfood items during the past year.


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H3: Quick service restaurants are aggressively marketing theirhealthy menu items in order to build stronger relationships withtheir consumer base and to promote the new healthy menu items.

Research Design

The methodology for the current study included a content analysisquantitative study (Bernard, 2000; Borg, Gall, & Gall, 2003). A cognitiveclassification approach refers to grouping information into cognitive orsemantic schemata-categories of meaning that are systematically relatedto one another (Strauss & Corbin, 1990; Marshal & Rossman, 1989). Ananalysis of secondary data was conducted through a review of literatureusing industry/trade publications, academic research journals, popularpress publications and promotional materials within restaurants for a oneyear period beginning October 2003 to October 2004 and grouped basedon identified domains of understanding. Additional data was collectedand grouped through a review of quick service restaurant Websites andtelevision commercials to ascertain if they implied any nutritional valuefor the menu items served in the fast food restaurants, or if there was nu-tritional information readily available for consumers.

Sample

Three groupings of quick service restaurants were included in thisstudy: Wendy’s, McDonald’s, Burger King, and Arby’s, the largestquick service restaurants focusing on the burger/roast beef/chickensandwich market; Subway and Quizno’s representing the sandwichmarket; and KFC and Popeye’s representing the fried chicken market.All of these restaurant chains are in the top 35 of the top 100 chain res-taurant companies, based on sales and number of units by Nation’sRestaurant News (2004).

Six television channels were chosen and viewed for any nutritionalinformation that was conveyed during television commercials. The tele-vision stations selected, which were viewed over a one month time pe-riod, were Detroit, Michigan area channels: ABC, Fox, NBC, UPN andWB. The researchers collected the data for television commercials overa period of one month by establishing a schedule which included regularviewing of the television for quick service restaurant commercials.

A comprehensive search of four periodical indexes was performed.The indexes reviewed were Infotrac, ABI/INFORM Global, Factivaand First Search using the following key words: fast food, menu, nutri-


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tion and obesity. Approximately 22,700 publications were electroni-cally searched. In each search the words “fast food” and “menu” wereused in an effort to focus the literature review. A total of 202 articleswere published in trade journals (Nations Restaurant News, RestaurantBusiness, etc.), popular press (newspapers, news letters, etc.), and aca-demic publications (Nutrition & Food Science, Food & Nutrition Bulle-tin, etc.). Duplicate articles were culled from the total.

RESULTS AND ANALYSIS OF FINDINGS

The findings from the observations of television commercials shownin the area were tallied for each day (starting the first of March and con-cluding on the 25th of March, 2004). Fast food restaurant chains’ em-phasis on nutrition and healthy eating were determined by performing acontent analysis on the number and type of nutritional information thatthey included in their television commercials.

In television commercials aired, it was determined that between thehours of 10:00 am and 3:00 pm, 44% of commercials representing theidentified quick service restaurants with a focus on nutritional offeringswere aired. During the time slot of 5:00 pm-10:00 pm, 41.25 % of fastfood commercials were shown with focus on nutritional aspects. Thecommercials highlighted food items that clearly were designed to ap-peal to the viewer’s desire to eat in a healthier way (e.g., Subway withthe Atkins Diet chicken salad; Wendy’s with its spinach chicken salad;and McDonald’s assortment of salad offerings).

In addition to the increase in commercials showing healthier fooditems, the research also revealed that most of the quick service restau-rant organizations in the sample provide links to nutritional informationon their official Websites, with the exception of Popeye’s and only lim-ited menu items from Quizno’s. Also, walk-in customers to the restaurantcan, upon request, receive pamphlets containing nutritional informationabout the restaurant’s food. For complete information about nutritioncontent of Quizno’s menu you can e-mail a request to the corporate of-fice. Despite the fact that the Nutrition Labeling and Education Act of1990 (U.S. Department of Agriculture, Center for Nutrition Policy andPromotion, 1996) did not require labeling of restaurant menu items,many restaurants are proactive in providing information to consumers.This fact supports H1 regarding the accessibility of nutritional informa-tion.


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The issue of nutrition and perception of fast food is widespread; theother components of the media such as industry/trade journals, popularpress magazines, and promotional materials within the restaurants werealso studied. There were 70 articles related to quick service restaurantswhich presented information about healthy menu options between Oc-tober 2003 and October 2004. A review of academic journals revealedthat all five articles published during the time period reviewed were re-lated to healthy menu options in quick service restaurants. One hundredtwenty-five articles covered quick service restaurant, non-nutrition menuissues and 43 on nutrition issues. Popular press publications had 22 nu-trition focused articles that covered quick service restaurant menus andseven articles on non-nutrition menu issues (see Table 1).

Restaurant visits to each of the chains revealed that all of them hadpromotional materials in the restaurant entryway and dining room pro-moting “healthier” menu items, or promoting the availability of nutri-tional information for their current menu items, to their consumers withthe exception of Popeye’s. Popeye’s did not provide any of their menunutritional information at the time of this study. The restaurants that hadpromotional pieces focused on the introduction of healthier menu items,whether those were low-carbohydrate menu items, grilled instead offried items, or entrée salad lines. This study found that although it wasonce the case where fast food could be immediately equated with un-healthy food (i.e., high fat and sugar content), this is no longer true. Re-sponding to H2 regarding whether major fast food organizations have


TABLE 1. Content Review of Publications from October 2003 to October 2004

Academic Journals Trade Journals Popular Press

# of Total ArticlesRegarding Fast

Food (QSR)Restaurants Menu

Offerings

5 29 168

# of ArticlesRegarding

Healthy/NutritiousMenu Items

5 22 125

# of Healthy MenuItem Articles

Compared to FastFood (QSR) Menu

Articles

100% 75.8% 74%

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responded to the criticisms regarding the quality of food items, a majorresponse has occurred. The major fast food providers have respondedquickly and meaningfully to the concerns raised by the Surgeon Generaland further emphasized by litigation and consumer advocates. It wasfound that these providers have greatly modified their menus to be moreinclusive of products that offer consumers wider choices and choicesmore conducive to healthiness (Carpenter, 2004; Frumpkin, 2003a, b;Garber, 2004).

Based on a review of the menus of the restaurants that were part ofthis study, it was found that all offered some degree of healthy choices(though not substantiated at Popeye’s). There was also ample evidencethrough the content analysis that the industry, as a whole, is seeking al-ternatives to previous methods of food preparation and has started mak-ing menu items healthier by frying products in oils other than animal orsaturated fats, and also broiling or baking products.

In response to H3, marketing efforts have been directed at promotingto consumers the new “healthier” menu items. The research shows thatthe quick service restaurant organizations do this through media for-mats such as television, trade/industry publications, internal restaurantmarketing and nutritional information available online or in restaurants.In the past six months, some of the largest restaurant chains are intro-ducing new menu items and/or promoting current menu items by focus-ing on their nutritional value (Carpenter, 2004; Frumpkin, 2003a, b;Garber, 2004).

With regards to the response of fast food restaurants to criticism re-garding the nutritional value concerns of their customers, it is evidentfrom the research that companies are determining that it is important tofocus on the nutritional value of their food. Some chains (McDonald’s,Wendy’s and Subway in particular) are being more aggressive in intro-ducing menu items and reinforcing this with the public through adver-tisements and information. McDonald’s was the first quick servicerestaurant to introduce fruit as a substitute for French fries in its chil-dren’s meal, as well as advertising a meal for adults consisting of asalad, bottled water and a pedometer that was marketed as a “Go Ac-tive” meal. McDonald’s has been issuing press releases all year in orderto keep their brand in the spotlight by focusing on their healthy menuinitiatives. Wendy’s recently introduced combo meal options where aside salad, baked potato or chili can be substituted for French fries. Inaddition Wendy’s has added fresh fruit to their menu offerings.

A review of traditional menu offerings (hamburgers) and new“healthier” offerings were compiled through information on respective


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quick service restaurant Websites. In addition to calories, fat grams andserving size, some of the sites list food exchanges, food allergens andlist of gluten free menu items. All of the Web sites reviewed had the ba-sic menu offering calorie and fat content totals without dressing, orother toppings. Wendy’s Restaurant Web site has a calorie calculatorwhere you can add the provided components to a salad (dressing, nuts,croutons, etc.) and obtain the revised calorie and fat counts. BurgerKing and McDonald’s Websites separate out condiments that can beadded to an item with individual calorie and fat count amounts.

The quick service restaurant industry is promoting “healthy” menuitems by the use of commercials on television, making information avail-able on Websites, promoting items internally, and using the trade journalsto inform the industry how they are being aggressive in this area.

LIMITATIONS OF STUDY

The scope of the current study was limiting in the following ways:

1. Time constraints limited the number of television channels watchedand the dates of coverage of those channels. The television view-ing was also confined to the Detroit metropolitan area.

2. Menu nutritional information was only obtained from companyprint materials and the World Wide Web. If a company did nothave a Website, or provide nutritional materials, they were not in-cluded in the study.

Implications for Practitioners

The current research presents many implications for practitioners.Over the past few years, many changes have taken place in restaurantchains that have impacted a paradigm shift in the quick service restau-rant industry. One of the changes that show the industry’s proactivestance is that most chain restaurants now have nutritional informationon their Websites, or have information accessible in the restaurants.This is not currently mandated by the government, as it is for food man-ufacturers in the Nutrition Labeling and Education Act of 1990 (U.S.Department of Agriculture, Center for Nutrition Policy and Promotion,1996). There are many implications that need to be addressed by man-agement in the U.S. and internationally given the scope of the risingobesity.


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1. It is important for managers to be proactive in providing nutritionalinformation for consumers that is easily accessible. As restaurants“roll-out” new menu items, especially those items declared to behealthy, nutritional information needs to be provided.

2. Quick service restaurants need to make the nutritional informationeasy to access and easy to understand. Consumers should not beforced to have nutritional degrees to understand the informationpresented regarding food items. It should be in laymen’s termsand should present the consumers with a choice of nutritionallybased products that are easy to understand.

3. Give consumers a simple to understand choice in their menu op-tions. Recently some of the bigger chains, Burger King, McDon-ald’s and Wendy’s, have added healthy options with their combomeals. The quick service industry has introduced and perfectedthe use of the “combo meals,” where they package the sandwich,fried items and drink together in order to increase penny profit. In2004, all of these top chains introduced healthy options to theircombo meals, or “healthy combo meals.” McDonald’s and Wendy’sintroduced fruit as an option for French fries in their kid’s meals,along with the option of juice or milk for the soft drink replace-ment. McDonald’s and Burger King offered salad combo mealsfor adults packaged with bottled water, with McDonald’s adding apedometer in the meal in order to encourage adults to exercisemore. The challenge for quick service restaurants will be to intro-duce healthy menu combos that are attractive in price, variety andprofitability.

4. Restaurant chains need to continue to keep the healthy items onthe menu; they need to do this despite slow sales or lower profitmargins than the regular menu items. Critical to organizations’long term success is realizing that, despite wanting to producefood and menu items only for the mass markets, diversity in menuofferings is what will keep consumers coming back, and will offerenough variety to appease a larger group of consumers. Droppinga healthy menu item due to low sales or lower profitability is notnecessarily a smart long term business move. Organizations haveto continue to keep focused on the long term goals, and with theclear paradigm shift that is occurring in the quick service restau-rant industry, organizations need to be cognizant of these facts.

5. The practice has been for restaurants in the study to publish favor-able nutritional information about the main ingredients in themenu item. They often leave off the calorie count and other nutri-


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tional information from condiments and side items that are part ofthe “fully dressed” menu item as it appears on marketing promo-tions. For example, in Wendy’s Mandarin Chicken Salad, the cal-orie total does not include the dressing, almonds or crispy noodles.This gives a deflated calorie and fat gram total and could be mis-leading to the consumer. A total calorie and fat gram count for theentire menu item needs to be provided so that consumers have theknowledge to make informed food choices.

6. Quick service restaurants can work on creating partnerships withassociations that focus on health and nutrition related issues in or-der to encourage a “healthier overall consumer.” It is clear fromthe research on obesity that the epidemic is not caused solely bythe foods eaten, but by the level of activity that goes along with theconsumption of those calories. If quick service restaurants canpartner with public organizations that can encourage a healthierlifestyle, or provide a balance between the amount of food eatenand the activity level of the person, it would be beneficial for theconsumers and the quick service restaurant industry.

As an example of partnerships, there is currently a move in the schoollunch programs in many areas of the country to promote a healthiermenu for students by partnering with the federal government. The gov-ernment is subsidizing income in the schools that can convert theirmenus over to more healthy options for students and discourage the lesshealthy items (Bellis, 2003). There is a move to remove non-healthyitems from school cafeterias that will encourage students to eat healthierand to watch what they eat.

CONCLUSIONS AND RECOMMENDATIONSFOR FURTHER RESEARCH

Restaurants have an opportunity to take a proactive and offensiverole in dealing with the obesity crisis in the U.S. and internationally.Quick service restaurant organizations may find it beneficial to workwith the communities in which they operate in order to promote the en-tire industry’s efforts to tout its new actions toward providing healthierproducts. Clearly, continuing to provide menu items that incorporate adiverse array of healthy items is needed. This can include combining atraditional burger meal with a salad, or providing combo meals thatmight include fruit as an alternative to fries. Recently, McDonald’s,


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Wendy’s and Burger King have made such adjustments to their chil-dren’s menus, with Wendy’s taking the lead in promoting the choice ofside items for all of their combo meals.

Finally, this study has reinforced the idea that it must be the responsi-bility of both the customer and the industry to address the nutritionalvalue of the foods. It is not realistic to expect the industry to bear theburden for the food choices that consumers make, but it is also naivetéon the part of the industry to expect consumers (who view and are influ-enced by, very well designed multi-media advertising campaigns) totake full responsibility for their purchasing choices–especially when alarge share of these consumers are children. This study revealed that thecollective efforts underway between the triumvirate of consumers,stakeholders, and policymakers to respond to this need for amendingthe practices of the quick service restaurant industry is one that holds thebest hope of addressing both the short term and long term consequencesof the nutritional value issue.

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RECEIVED: 10/21/04REVISIONS RECEIVED: 02/28/05

ACCEPTED: 03/28/05

doi:10.1300/J149v07n04_03


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Documents

Fast Food to Healthy Food