Adolescents are just as likely to consume too many calories at Subway as at McDonald's, shows study

Journal of Adolescent HealthMay 10 2013

Adolescents are just as likely to consume too many calories at Subway as at McDonald's, a new study in Journal of Adolescent Health finds, despite the fact that they think Subway offers healthier food.

Adolescents purchase about 1,000 calories worth of food for an afternoon meal at both fast food restaurants—150 calories more per meal than the Institute of Medicine recommends for this age group.

"We were interested in looking at how the restaurant marketing environment affects what adolescents purchase," said Lenard Lesser, M.D., the study's lead author and a family physician and researcher at the Palo Alto Medical Foundation Research Institute. Lesser and his colleagues asked adolescents where they would go for an unhealthy meal and for a healthy meal. "When we asked them where they would go for a healthy meal, most of them said Subway," Lesser said. "Our study was really designed to look at what adolescents actually ordered at the restaurants, not simply what was offered on the menu."

The study enrolled 97 adolescents ages 12 to 21 to purchase meals at both restaurants on different days in the South Los Angeles area. They purchased an average of 1,038 calories from McDonald's and 955 calories from Subway, which researchers found to not be a significant difference.

Nutritionally, the meals purchased from McDonald's differed somewhat from Subway meals. The adolescents purchased more calories from sugary drinks and French fries and fewer cups of vegetables from McDonald's. The McDonald's meals contained more grams of carbohydrates and sugars than the Subway meals. However, overall sodium amounts were greater in the Subway meals, probably due to more processed meats and breads, Lesser said. There was no significant difference in fat content between meals from the two restaurants. The study authors stated that while Subway "may be 'healthier', it still may not be healthy."

Brian Saelens, Ph.D., of the Seattle Children's Hospital Center for Child Health, Behavior and Development commented, "At Subway, there are a few opportunities to make more healthful choices, but there's lots of opportunities to make unhealthful ones. If the general mantra at these restaurants and other restaurants is to eat a lot and eat unhealthily, just sticking healthful things [on the menu] is not going to change a lot of people's behavior."

"Restaurants will announce initiatives to make kids' menus more healthy, government and legislators will announce policies to make food healthier, but until we have policies from government or initiatives from industry that really improve the outcome of what people are eating and how healthfully they're eating, we're not going to succeed in solving the crisis of poor eating," Lesser said.