A new cross-sectional study of the UK’s highest-grossing restaurant chains found that fewer than half of menu items met all applicable voluntary government targets for sugar, salt and calories, suggesting that healthier restaurant menus may be possible but are far from standard.
Published in PLOS Medicine, the study analyzed menu data from 21 major restaurant chains in 2024 and found that just 43% of menu items met all the nutrition targets they were eligible for under UK government reformulation goals. The research does not prove that eating at these restaurants causes poor health outcomes, nor does it measure what people actually ordered. Instead, it offers a snapshot of the nutritional quality of menu offerings and how unevenly restaurants appear to be responding to voluntary public health benchmarks.
Researchers collected publicly available nutrition information from restaurant websites and PDF menus, then compared menu items against the UK’s voluntary sugar, salt and calorie reduction targets. These targets were designed to encourage companies to gradually improve menu offerings without mandatory regulation.
Performance varied sharply.
Nine of the 21 chains had more than half of their menu items meeting all relevant targets, while others fell far behind. Salads and breakfast items were more likely to meet targets, while desserts and pizzas were among the least likely.
“Only 43% of menu items met all of the targets they were eligible for, and adherence to the targets varied widely between restaurants and food categories, showing that healthier menus are achievable but are not yet the norm,” said lead author Alice O’Hagan.
One of the study’s more important findings was that similar types of restaurants often performed very differently from one another, suggesting cuisine category alone does not determine whether healthier reformulation is possible.
“Interestingly, restaurants with similar menu styles performed quite differently in meeting the targets,” O’Hagan said. “This shows the nutritional quality of menus is not fixed by cuisine type, making the shift towards healthier menus a more attainable goal for food companies.”
For American readers, the specific targets in this study are UK-based and reflect British government policy, not U.S. nutrition regulations. But the broader takeaway may feel familiar: Voluntary industry pledges do not always translate into consistent nutritional improvements.
That matters because more meals are eaten outside the home than in previous generations, and restaurant food can meaningfully shape overall dietary patterns.
Importantly, this study does not mean all restaurant food is inherently unhealthy or that calorie, sugar and salt targets alone define whether a meal supports health. Nutrition is more complex than any single metric. But the findings do suggest that when companies are left largely to self-regulate, progress may be inconsistent.
The authors argue that stronger accountability or mandatory standards may produce more reliable improvements.
“Voluntary targets alone are not delivering consistent improvements in the salt, sugar or calorie content of food items on offer in UK restaurants,” co-author Lauren Bandy said.
The bigger lesson may be less about any single chain and more about food systems: If some companies can improve menu nutrition within the same market, healthier defaults may be more achievable than consumers are often led to believe.
This study was supported by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre, the Royal Society, the Wellcome Trust, the SHIFT project and the NIHR Public Health Research programme.