Eating at fast-food, full-service restaurants associated with increased calorie intake

November 05, 2012

CHICAGO - Eating meals and other foods from fast-food and full-service restaurants appears to be associated with increased caloric intake for children and adolescents, as well as a higher intake of sugar, total fat, saturated fat and sodium, according to a report published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.

Children and adolescents increasingly eat food away from home, particularly from fast-food outlets, and the upward trends in fast-food consumption have paralleled increasing obesity rates among children and adolescents, according to the study background.

Lisa M. Powell, Ph.D., and Binh T. Nguyen, M.A., of the University of Illinois at Chicago, examined the effects of eating at fast-food and full-service restaurants on total energy intake (similar to total caloric intake), diet quality and the consumption of sugar-sweetened beverages (SSBs), particularly soda, using data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES). The study included 4,717 children ages 2 to 11 years and 4,699 children ages 12 to 19 years.

The study suggests that eating at a fast-food restaurant was associated with a net increase in total daily energy intake of 126 kcal (kilocalories) for children and about 309 kcal for adolescents. Eating at a full-service restaurant also was associated with an increase of about 160 kcal for children and 267 kcal for adolescents, according to the results.

"Furthermore, restaurant consumption among children and adolescents was significantly related to higher nutrient intake of sugar, total fat, saturated fat and sodium. In particular, for example, fast-food consumption among adolescents increased sugar, total fat, saturated fat and sodium intake by approximately 13 percent, 22 percent, 25 percent and 17 percent of the daily reference levels of these respective nutrients," the authors note.

The results indicate that soda and SSB consumption also appeared to be "significantly higher" on days that children and adolescents ate from restaurants, particularly for adolescents. The authors suggest there were positive associations for protein intake at full-service restaurants among children and at both fast-food and full-service restaurants among adolescents.

"Overall, the findings of higher energy and SSB intake and poorer nutrient intake associated with consuming from restaurants suggest that public policies that aim to reduce restaurant consumption - such as increasing the relative costs of these purchases; limiting access through zoning, particularly around schools; limiting portion sizes; and limiting exposure to marketing - deserve serious consideration," the authors comment.

They conclude: "At the same time, regulatory and voluntary policies that aim to set standards for the nutritional content of meals obtained from restaurants are increasingly being implemented, and continued efforts are needed to improve and promote healthy food options in restaurants."
(Arch Pediatr Adolesc Med. Published online November 5, 2012. doi:10.1001/jamapediatrics.2013.417. Available pre-embargo to the media at

Editor's Note: This study was supported in part by grants from the National Cancer Institute and from the Centers for Disease Control and Prevention. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact Lisa M. Powell, Ph.D., call Sherri McGinnis Gonzalez at 312-996-8277 or email An author podcast will be available on the journal website after the embargo lifts:

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