Beyond the Menu: Assessing the Nutritional Quality of 
                 Canadian Restaurant Foods 
                         by      
                    Sarah Alexina Barbara Murphy  
              A thesis submitted in conformity with the requirements 
                 for the degree of Master of Science (M.Sc.) 
                   Department of Nutritional Sciences 
                      University of Toronto 
               © Copyright by Sarah Alexina Barbara Murphy 2019 
                                       
                                                                         
           Beyond the Menu: Assessing the Nutritional Quality of Canadian 
                                 Restaurant Foods 
                               Sarah Alexina Barbara Murphy 
                                 Master of Science (M.Sc.) 
                                   Nutritional Sciences 
                                  University of Toronto 
                                       2019 
         Abstract 
         One of the primary preventative measures of non-communicable diseases is a healthy diet. There is 
         currently no oversight of the nutritional quality of foods served in the restaurant industry, meanwhile 
         increasing numbers of Canadians eat outside the home on a regular basis. This thesis aimed to assess 
         mean saturated fat, sodium, and sugar levels in restaurant foods in Canada, and to determine the 
         proportion of menu items that would require one of Health Canada’s ‘high-in’ labels if applied to the 
         restaurant sector. Analyzing data from 10,950 menu items from 96 chain establishments, this thesis 
         represents the largest study of its kind in Canada. Our results showed the majority of menu items 
         evaluated were high in nutrients of public health concern, and would require at least one ‘high-in’ 
         label. This highlights the urgent need for more legislation and strategies to improve the nutritional 
         quality of restaurant foods in Canada.     
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                                                     Acknowledgments 
              I’d like to take this opportunity to thank the many people who have been instrumental to the 
              completion of this thesis and who have supported me throughout my journey as a graduate student. 
              First and foremost, a huge thank you to my supervisor Dr. Mary L’Abbé for giving me this incredible 
              opportunity and supporting me throughout this adventure. It’s been an incredible privilege to work 
              with someone so brilliant and I’ve learned so much from her along the way. 
              I am also immensely grateful to Mary Scourboutakos, who took me under her wing and introduced me 
              to this great project, and Kacie Dickinson, who mentored me throughout my Masters. Both have been 
              instrumental to the development of this thesis and I will always be indebted to them for all the kindness 
              they have shown me. 
              A very special thank you to my committee members, Dr. Erin Hobin and Dr. Anthony Hanley, for 
              taking the time to learn about my work and give me invaluable feedback on how to best develop it.  
              I would further like to thank my family, friends, and the rest of the L’Abbé lab for their continuous 
              support throughout this process. I could never express enough how much of a difference they make to 
              my life every day. A special thank you to Xulin Liu and Madyson Weippert, who volunteered to 
              conduct the validation checks of my data and its categorizations.  
              This research was supported by a CIHR Project Operating Grant (201610PJI-152979). Their support 
              makes research like mine possible and I am very grateful for their dedication to enabling upcoming 
              researchers to make a difference in the world of health science research.                                
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                                                                                       Table of Contents 
                        
                       Abstract ........................................................................................................................................... ii	
                       Acknowledgments .......................................................................................................................... iii	
                       Table of Contents ........................................................................................................................... iv	
                       List of Tables ................................................................................................................................ vii	
                       List of Figures .............................................................................................................................. viii	
                       List of Appendices ......................................................................................................................... ix	
                       List of Abbreviations .......................................................................................................................x	
                       Chapter 1 ..........................................................................................................................................1	
                          	  Introduction .................................................................................................................................1	
                             1.1	 Overall Rational ...................................................................................................................1	
                       Chapter 2 ..........................................................................................................................................3	
                          	  Background and Literature Review ............................................................................................3	
                             2.1	 Restaurants and Public Health .............................................................................................3	
                                     2.1.1	       Food expenditure outside of the home .....................................................................3	
                                     2.1.2	       Types of restaurant establishments ..........................................................................3	
                                     2.1.3	       Frequency of eating out, obesity, and diet quality ...................................................3	
                                     2.1.4	       Mechanistic links between restaurant food consumption and poor dietary intake ..5	
                                     2.1.5	       Differences between sit-down and fast-food restaurants: frequency of consumption 
                                                  and nutrient intakes ..................................................................................................6	
                             2.2	 Levels of saturated fat, sodium, and sugar in restaurant foods ............................................6	
                                     2.2.1	       Saturated fat in restaurant foods ..............................................................................7	
                                     2.2.2	       Sodium in restaurant foods. .....................................................................................8	
                                     2.2.3	       Sugar in restaurant foods .........................................................................................9	
                             2.3	 Research and policies on menu labelling ...........................................................................10	
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