The ubiquity of fast food restaurants which promote and provide energy-dense foods and sugary beverages has been identified as one significant part of the obesogenic food environment.1 Fast food restaurants typically offer and promote meal deals that include a major food item (e.g. burger), fried potato and a soft drink2 in combination, which is promoted as value for money. One way of reducing energy intake is to consume water as an alternative beverage in meal deals. However, recent research indicates that young adults perceive it to be difficult and more expensive to replace sugary drinks with water in this setting.3
We investigated the types of beverages available at major fast food restaurants, and particularly those included in meal deals, through site visits and purchases in a convenience sample of 16 fast food restaurants in a specific Sydney area. The sample comprised two outlets from each of eight major chains. The availability of tap water was tested by observation or request.
Sugary drinks (including soft drinks, juice-based beverages, flavoured milk, iced teas, and sports drinks)4 and bottled water were available in all restaurants; however sugary drinks comprised the majority of beverage types available (71%). Tap water was available on request in 81% of restaurants.
Sugary drinks were the most frequently promoted beverages (through menus and displays) and comprised 61% of all within store promotions. Sugary drinks were also the default beverage in 80% of meal deals (the remaining 20% explicitly identified a choice). Half of all meal deals that promoted diet sugary drinks (16% of all meal deals), also offered bottled water as an alternative. Bottled water was identified in 16% of within store promotions and was available on request as an alternative in meal deals, at an equivalent price in all cases. The meal deal cost was reduced by 10% when tap water was substituted.
This study confirms that meal deals at fast food restaurants promote the consumption of sugary drinks, however the availability of bottled water is promising. Nevertheless, there is room for improvement, through the promotion of water and the provision of free tap water in fast food restaurants. Currently, the lack of external cues for water contributes to the obesogenic nature of these restaurants.
Given that reductions in the consumption of sugary drinks and energy-dense foods could make a significant contribution to curbing rising obesity rates, efforts to increase public awareness and promote healthier meal deal variations are warranted.