Business Impact Assessment on Obesity & McDonalds PopulationLevel Nutrition (BIAObesity) Belgium 2020

Background

Obesity remains a major publichealth challenge in Belgium, with prevalence hovering around 15% in adults and rising among children. The government, civilsociety groups and industry stakeholders have recognised that commercial food environments influence dietary choices at a population level. In response, a collaborative effort titled the **Business Impact Assessment on Obesity and McDonalds Population Level Nutrition (BIAObesity)** was launched in 2020 to evaluate the role of McDonalds Belgium in the national obesity landscape.

Objectives of the BIAObesity

• Map the nutritional profile of McDonalds menu items sold in Belgium.
• Quantify the contribution of McDonalds sales to overall dietary intake of key nutrients linked to obesity (energy, saturated fat, sugars, sodium).
• Assess the business policies and practices that affect product formulation, marketing, portion size, and pricing.
• Identify opportunities for improvement that align commercial interests with publichealth goals.

Methodology

The assessment combined quantitative sales data with qualitative policy analysis:

1. Data collection: McDonalds provided anonymised pointofsale data for 20192020, including unit sales, average portion size, and promotional activity.
2. Nutrient profiling: Each menu item was matched to the Belgian Food Composition Database to derive energy, macronutrient and sodium values per standard serving.
3. Population modelling: Using the Belgian National Food Consumption Survey (BNFCS) as a reference, the contribution of McDonalds meals to daily intakes was estimated for different age groups.
4. Policy review: Corporate documents (e.g., sustainability reports, marketing guidelines) were examined for commitments related to nutrition, responsible marketing, and product reformulation.
5. Stakeholder interviews: Semistructured interviews with McDonalds Belgium executives, publichealth experts, and consumer representatives added context to the quantitative findings.

Key Findings

1. Nutrient Contribution

Across all age groups, meals purchased at McDonalds accounted for:

• 7% of total daily energy intake for adults.
• 10% of saturated fat intake for teenagers (1318years).
• 8% of added sugars for children aged 612years.
• 5% of sodium intake for the general population.

When analyzed by meal type, the Value Menu contributed disproportionately to added sugars, while Premium Burgers were the main drivers of saturated fat and sodium.

2. Sales Patterns

Hightraffic locations (citycentre outlets and highway service stations) generated 45% of total sales, with a notable spike in sales during school holidays and winter holidays. Promotional bundles (e.g., Meal Deals) increased average portion size by 15% compared with standard menu items.

3. Corporate Policies

McDonalds Belgium has adopted the following nutritionrelated commitments (as of 2020):

• Reduction of sodium in core menu items by 10% by 2025.
• Introduction of lighter options (e.g., grilled chicken, salads) representing 12% of the menu.
• Voluntary removal of transfat from cooking oils, completed in 2018.
• Compliance with the EU Childrens Food Advertising Directive, limiting TV ads targeting children under 12.

However, the assessment noted gaps: no mandatory frontofpack trafficlight labeling in Belgian restaurants, limited transparency on portionsize options, and continued marketing of highenergy products through digital platforms.

4. Consumer Perceptions

Interviews revealed that many Belgian consumers associate McDonalds with convenience rather than health. Yet, a sizable proportion (28%) reported choosing menu items based on perceived healthier cues such as grilled or salad without fully understanding the overall nutrient profile.

Implications for Public Health

The BIAObesity highlights that while McDonalds represents a modest share of total dietary intake, its products are disproportionately energydense and high in nutrients of concern. The clustering of highsales outlets in urban and periurban areas amplifies exposure, particularly for adolescents and lowerincome groups who rely on affordable fastfood options.

Recommendations

1. Enhanced Nutrient Transparency Implement mandatory frontofpack style labeling (trafficlight or NutriScore) on menus and digital ordering platforms.
2. PortionSize Reforms Offer reducedportion alternatives for highcalorie items and promote combo meals that default to healthier sides (e.g., fruit, water).
3. Product Reformulation Accelerate sodium and saturatedfat reductions, aiming for at least a 20% cut by 2025 across the core menu.
4. Marketing Restrictions Extend the childrens advertising code to cover inapp promotions and limit the use of cartoon characters on highcalorie items.
5. Collaboration with Schools Develop a Healthy Lunchbox program where McDonalds supplies lowenergy snack packs for school events, paired with nutrition education.
6. Monitoring & Reporting Adopt an independent thirdparty audit of salesrelated nutrient data, published annually to track progress.

Next Steps

The assessment proposes a 3year action plan (20212023) with quarterly milestones. A joint steering committee comprising representatives from the Belgian Ministry of Health, the Food Alliance, consumer NGOs, and McDonalds Belgium will oversee implementation.

Conclusion

The 2020 BIAObesity provides a datadriven foundation for aligning commercial operations with publichealth objectives in Belgium. By embracing transparent nutrition information, responsible marketing, and targeted reformulation, McDonalds can play a constructive role in curbing obesity while maintaining its market position.

For further details, the full BIAObesity report is available from the Belgian Federal Public Service Health, Food Chain Safety and Environment.