Nutritional Composition and Healthiness of Out‐of‐Home Food and Drink: Cross‐Sectional Analyses of Best‐Selling Menu Items in the United Kingdom

The popularity of the out‐of‐home (OOH) food sector has increased substantially in the United Kingdom (UK), while the nutritional quality of best‐selling menu items and the most appropriate methods for assessing their healthiness remain unclear. This study assessed compliance of best‐selling OOH menu items with UK reformulation policies (calorie, salt and sugar reduction targets/guidelines), and compared multiple UK government approaches to healthiness assessments. In 2023/24, a cross‐sectional survey of best‐selling menu items was conducted across the 20 largest UK OOH companies. Nutritional information for 189 best‐selling menu items was collected and analysed. Overall, 41% of items exceeded at least one applicable reformulation guideline, while between 46% and 78% were classified as ‘less healthy’, depending on the assessment approach used. The 2004/5 Nutrient Profiling Model (NPM) yielded the least stringent assessment, reflecting its reliance on nutrient composition per 100 g and lack of consideration for portion size. The Multiple Traffic Light thresholds applied alone or combined with either the NPM or the reformulation policies (75%, 78% and 77% ‘less healthy’ respectively) resulted in more stringent assessments. These findings underscore persistent gaps in nutritional data transparency within this sector. They highlight the generally poor nutritional quality of best‐selling menu items in large UK businesses, the limitations of the 2004/5 NPM for OOH application and the inadequacy of current voluntary reformulation programmes. To improve the nutritional quality of the OOH food, there is an urgent need for healthiness assessment approaches that explicitly account for portion size and total nutrients supplied at the point of purchase.