By Annie Gasparro And Chelsey Dulaney 

McDonald's Corp. said its sales are continuing to struggle as efforts by its new chief executive to win back customers in the U.S. haven't paid off yet.

The Oak Brook, Ill.-based burger giant is off to a rough start this year, reporting on Wednesday that same-store sales fell 2.6% in the U.S. division in the first quarter, including a 3.9% decline in March--worse than analysts expected. Profit for the period also fell by a steeper-than-expected 32%, in part because of exchange-rate changes.

Customer traffic declined in all of McDonald's major markets, adding to two years of struggles at the world's largest fast-food chain, which is battling changing consumer tastes in America and food-safety issues in Asia. The company said it expects to report a continued decline in same-store sales for April and has decided to close an additional 220 under-performing restaurants, primarily in the U.S. and China.

McDonald's is nearly two months into its turnaround effort under Steve Easterbrook, who became CEO on March 1. While yet to revive sales growth, Mr. Easterbrook's effort to turn McDonald's into a "modern, progressive burger company" seems to have won over the confidence of some investors. Shares have climbed since the announcement in late January that he would step in, including a 3.3% gain Wednesday morning.

"We are evolving to be more responsive to today's customer," Mr. Easterbrook said. "McDonald's management team is keenly focused on acting more quickly to better address today's consumer needs, expectations and the competitive marketplace."

He said he will discuss more details of his plan at an investor presentation May 4.

Janney Capital Markets analyst Mark Kalinowski said some investors are pinning their hopes on Mr. Easterbrook sparking some "pizzazz" at the presentation. But doing so will be a challenge, since McDonald's already has announced meaningful cuts in spending on restaurant openings, and has no brands to sell off, Mr. Kalinowski said in a note to investors.

Barclays analyst Jeff Bernstein noted ahead of Wednesday's earnings release that McDonald's is struggling with intense competition in the fast-food industry, while its own new product releases are limited--recently coming out with a new premium chicken sandwich and sirloin burger.

Mr. Easterbrook made waves in recent weeks with announcements that he will raise wages for workers at corporate-owned McDonald's restaurants, curb antibiotic use in its chicken, and consider selling its breakfast-menu items all day--a measure customers have long wanted. Those plans come as McDonald's is working on revamping and simplifying its menu and putting more marketing muscle behind the brand with a new "I'm Lovin' It" campaign.

Some of the efforts, however, have drawn the ire of some of the franchisees who run the vast majority of McDonald's restaurants and question whether they can afford to implement the plans.

And they seem to have had little impact on sales so far as customer visits continue to drop.

Sales at stores open at least 13 months fell 2.3% globally in the latest quarter, including an 8.3% drop in the Asia-Pacific division, where it is struggling with perception issues after food-safety scares in China and Japan.

Overall, McDonald's reported a profit of $811.5 million, or 84 cents a share, down from $1.2 billion, or $1.21 a share, a year earlier. The results included 17 cents per share related to write-offs and restructuring and 9 cents a share related to foreign currency. Analysts polled by Thomson Reuters had expected earnings of $1.06 a share.

Revenue fell 11% to $5.96 billion, in-line with Wall Street expectations.

Write to Annie Gasparro at annie.gasparro@wsj.com and Chelsey Dulaney at Chelsey.Dulaney@wsj.com

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