Evidence map›Paper›PMID 31796142›Full record

ArticlePublic health nutrition2020

Understanding price incentives to upsize combination meals at large US fast-food restaurants.

Kelsey A Vercammen, Johannah M Frelier, Alyssa J Moran, Caroline G Dunn, Aviva A Musicus, Julia Wolfson, Omar S Ullah, Sara N Bleich

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In one paragraph

Article in Public health nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Combo Deals, Junk Meals: A Systematic Review Examining the Healthiness of Foods Promoted on Meal Delivery Apps.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kelsey A VercammenDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.ORCID 0000-0003-0998-0546
Johannah M FrelierDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Alyssa J MoranDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Caroline G DunnDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Aviva A MusicusDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Julia WolfsonDepartment of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Omar S UllahDepartment of Environmental and Occupational Health, California State University, Northridge, Los Angeles, CA, USA.
Sara N BleichDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Funding

BUILD PODER IITL4GM118977 · NIGMS · CALIFORNIA STATE UNIVERSITY NORTHRIDGE · PI CHAVIRA, GABRIELA, KHACHIKIAN, CRIST SIMON · 2015 to 2023
$18.1M
NIGMS NIH HHS TL4 GM118977
6 · The paper itself

Abstract

objectiveTo understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes).

designCombination meals (lunch/dinner: n 258, breakfast: n 68, children's: n 34) and their prices were identified from online menus; corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Linear models were used to examine the difference in total calories per dollar between default and higher-calorie combination meals, overall and by restaurant.

settingTen large fast-food chain restaurants located in the fifteen most populous US cities in 2017-2018.

participantsNone.

resultsThere were significantly more calories per dollar in higher-calorie v. default combination meals for lunch/dinner (default: 577 kJ (138 kcal)/dollar, higher-calorie: 707 kJ (169 kcal)/dollar, difference: 130 kJ (31 kcal)/dollar, P < 0·001) and breakfast (default: 536 kJ (128 kcal)/dollar, higher-calorie: 607 kJ (145 kcal)/dollar, difference: 71 kJ (17 kcal)/dollar, P = 0·009). Results for children's meals were in the same direction but were not statistically significant (default: 536 kJ (128 kcal)/dollar, higher-calorie: 741 kJ (177 kcal)/dollar, difference: 205 kJ (49 kcal)/dollar, P = 0·053). Across restaurants, the percentage change in calories per dollar for higher-calorie v. default combination meals ranged from 0·1 % (Dunkin' Donuts) to 55·0 % (Subway).

conclusionsHigher-calorie combination meals in fast-food restaurants offer significantly more calories per dollar compared with default combination meals, suggesting there is a strong financial incentive for consumers to 'upsize' their orders. Future research should test price incentives for lower-calorie options to promote healthier restaurant choices.

Indexed as

Energy IntakeMealsBreakfastCommerceDietary FatsDietary SugarsFast FoodsFood LabelingHumansLunchMotivationNutritive ValuePortion SizeRestaurantsSodium, DietaryUnited StatesDietary FatsDietary SugarsSodium, DietaryCombination mealsFast-food restaurantsPrice incentivesValue pricing

Identifiers

PMID31796142
PMCPMC10200672

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.