Submitted to: Journal of Pediatrics
Publication Type: Peer reviewed journal
Publication Acceptance Date: 8/1/2003
Publication Date: 1/5/2004
Citation: Bowman, S.A., Gortmaker, S.L., Ebbeling, C.B., Pereira, M.A., Ludwig, D.S. 2004. Effects of fast food consumption on energy intake and diet quality among children in a National Household Survey. Journal of Pediatrics. 113(1): 112-118. Interpretive Summary: Few studies have examined fast food consumption in children and diet quality. Children ages 4 to 19 years who had complete food intake records on the first day of the USDA¿s CSFII 1994 1996, 1998 were included in the study. In this cross sectional survey, the primary hypothesis was that subjects who consumed food obtained at fast food places, compared to those who did not, would exhibit higher total energy intake and poorer diet quality over the day studied. The study found that fast food consumption was prevalent among all ages, genders, and socioeconomic groups. Children who ate fast food, compared to those who did not, consumed more total energy, total fat, carbohydrate, and added sugars. Fast food may also compromise diet quality in ways by displacing more healthful food options. Food group choices differed among children who had fast food and children who did not eat fast food on the survey day. Children who ate fast food, consumed more non diet soft drinks, drank less milk, and ate less fruits and non starchy vegetables than children who did not eat fast food. Consumption of fast food appeared to have an adverse effect on dietary quality in children, especially in adolescent children. The findings from this paper will be of use to the public, researchers, and policy makers.
Technical Abstract: Consumption of fast food by children increased by a remarkable five-fold, from 2% of total energy in the late 1970¿s to 10% of total energy in the mid 1990¿s. Data from the USDA¿s Continuing Survey of Food Intakes by Individuals 1994 1996 (CSFII 1994 96) and the Supplemental Children¿s Survey to the 1994 1996 conducted in 1998 were used for the study. Children ages 4 to 19 years who had complete food intake records on the first day of the survey were included in the study. The aim of this study was: first, to examine national patterns of fast food consumption among children; and second, to determine whether children who eat fast food on any given day, compared to those who do not, have poorer diet quality. Multiple regressions were used to control potentially confounding demographic, socio economic, and anthropometric covariates. On any given day, 1720 children (30.3% of the total sample) ate fast food. Fast food consumption was highly prevalent in both genders, all racial ethnic groups and all regions of the country, and increased with age and socioeconomic status. Children who ate fast food, compared to those who did not, had higher intakes of day¿s total energy, total fat, carbohydrate, added sugars, non diet soft drinks, and lower intakes of fluid milk and fruits and non starchy vegetables. Fast food may also compromise diet quality in ways by displacing more healthful food options, especially in adolescent children.