The Study
Adherence to voluntary UK sugar, salt, and calorie reduction targets in the highest-grossing restaurant chains: A cross-sectional study
This study looked at what’s on the menus of big restaurant chains and checked if their food met government sugar, salt, and calorie goals. It didn’t test if eating this food makes people sick — it just showed what’s on the menu right now.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
The UK government asked restaurants to make food healthier by cutting sugar, salt, and calories—but most didn't.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 535 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Even though restaurants could make healthier choices (some did), most didn't—meaning people eating out are still getting too much sugar, salt, and calories.
- 2Only 36% of menu items met sugar targets, 58% met salt targets, and 61% met calorie targets.
- 3Salads were 96% compliant; chicken dishes were 0% compliant on sugar.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
PLOS Medicine
Year
2026
Authors
A. O’Hagan, Rachel Pechey, Hannah Forde, L. Bandy
Related Content
Claims (6)
In early 2024, only 43% of menu items from the 21 highest-grossing UK restaurant chains met all government nutritional targets for sugar, salt, and calories, with sugar targets met by just 36% of items, showing that most chains did not meet voluntary guidelines even though reformulating food to meet them is technically possible.
Pizza restaurant menu items met only 32% of sugar, salt, and calorie reduction targets, while salad menu items met 96%, showing that nutritional quality differs substantially based on food type, not restaurant brand.
In restaurant menus, fewer items met targets for reducing sugar than for reducing calories or salt, showing that lowering sugar content is harder to achieve than lowering calories or salt.
Restaurants serving similar types of food, such as pizza, show large differences in how closely they follow nutritional targets for sugar, salt, and calories, and these differences depend on the company's own practices, not the type of food they serve.
Chicken restaurant menu items like sauces and desserts contained no reduction in sugar compared to targets, while salad items met 96% of sugar reduction targets.
Nutritional guidelines that focus only on calories, fat, protein, and sugar are linked to higher consumption of ultra-processed foods and do not lead to better public health.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.