Energy contribution of sugar-sweetened beverage refills at fast-food restaurants

Abstract

Objective To identify demographic and consumer characteristics associated with refilling a soft drink at fast-food restaurants and the estimated energy content and volume of those refills. Design Logistic and linear regression with cross-sectional survey data. Setting Data include fast-food restaurant receipts and consumer surveys collected from restaurants in New York City (all boroughs except Staten Island), and Newark and Jersey City, New Jersey, during 2013 and 2014. Subjects Fast-food restaurant customers (n 11795) from ninety-eight restaurants. Results Thirty per cent of fast-food customers ordered a refillable soft drink. Nine per cent of fast-food customers with a refillable soft drink reported refilling their beverage (3 % of entire sample). Odds of having a beverage refill were higher among respondents with a refillable soft drink at restaurants with a self-serve refill kiosk (adjusted OR (aOR)=7·37, P<0·001) or who ate in the restaurant (aOR=4·45, P<0·001). KFC (aOR=2·18, P<0·001) and Wendy's (aOR=0·41, P<0·001) customers had higher and lower odds, respectively, of obtaining a refill, compared with Burger King customers. Respondents from New Jersey (aOR=1·47, P<0·001) also had higher odds of refilling their beverage than New York City customers. Customers who got a refill obtained on average 29 more 'beverage ounces' (858 ml) and 250 more 'beverage calories' (1046 kJ) than customers who did not get a refill. Conclusions Refilling a beverage was associated with having obtained more beverage calories and beverage ounces. Environmental cues, such as the placement and availability of self-serve beverage refills, may influence consumer beverage choice.