Fast Food study

Fast Food study - Effects of Fast-Food Consumption on...

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Effects of Fast-Food Consumption on Energy Intake and Diet Quality Among Children in a National Household Survey Shanthy A. Bowman, PhD*; Steven L. Gortmaker, PhD‡; Cara B. Ebbeling, PhD§; Mark A. Pereira, PhD§; and David S. Ludwig, MD, PhD§ ABSTRACT. Background. Fast food has become a prominent feature of the diet of children in the United States and, increasingly, throughout the world. However, few studies have examined the effects of fast-food con- sumption on any nutrition or health-related outcome. The aim of this study was to test the hypothesis that fast-food consumption adversely affects dietary factors linked to obesity risk. Methods. This study included 6212 children and ad- olescents 4 to 19 years old in the United States partici- pating in the nationally representative Continuing Sur- vey of Food Intake by Individuals conducted from 1994 to 1996 and the Supplemental Children’s Survey con- ducted in 1998. We examined the associations between fast-food consumption and measures of dietary quality using between-subject comparisons involving the whole cohort and within-subject comparisons involving 2080 individuals who ate fast food on one but not both survey days. Results. On a typical day, 30.3% of the total sample reported consuming fast food. Fast-food consumption was highly prevalent in both genders, all racial/ethnic groups, and all regions of the country. Controlling for socioeconomic and demographic variables, increased fast-food consumption was independently associated with male gender, older age, higher household incomes, non-Hispanic black race/ethnicity, and residing in the South. Children who ate fast food, compared with those who did not, consumed more total energy (187 kcal; 95% confidence interval [CI]: 109–265), more energy per gram of food (0.29 kcal/g; 95% CI: 0.25–0.33), more total fat (9 g; 95% CI: 5.0–13.0), more total carbohydrate (24 g; 95% CI: 12.6–35.4), more added sugars (26 g; 95% CI: 18.2–34.6), more sugar-sweetened beverages (228 g; 95% CI: 184– 272), less fiber ( 1.1 g; 95% CI: 1.8 to 0.4), less milk ( 65 g; 95% CI: 95 to 30), and fewer fruits and non- starchy vegetables ( 45 g; 95% CI: -58.6 to 31.4). Very similar results were observed by using within-subject analyses in which subjects served as their own controls: that is, children ate more total energy and had poorer diet quality on days with, compared with without, fast food. Conclusion. Consumption of fast food among chil- dren in the United States seems to have an adverse effect on dietary quality in ways that plausibly could increase risk for obesity. Pediatrics 2004;113:112–118; fast food, obesity, dietary composition, diet quality, energy intake. ABBREVIATIONS. CSFII, US Department of Agriculture’s Con- tinuing Survey of Food Intakes by Individuals; BMI, body mass index; MSA, metropolitan statistical area. F rom its origins in the 1950s, fast food has grown into a dominant dietary pattern among children in the United States today.
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