NHANES: A Third of American Children Regularly Eat Fast Food

More than 36% of U.S. kids ate fast food on any given day from 2015 to 2018, National Health and Nutrition Examination Survey (NHANES) data showed.

Among U.S. children and adolescents ages 2-19, more than 11% consumed more than 45% of their daily calories from fast food, reported Cheryl Fryar, MSPH, of the National Center for Health Statistics (NCHS) in Hyattsville, Maryland, and colleagues.

The NCHS Data Brief also found that roughly 14% of these youth obtained 25-45% of their daily calories from fast food, while about 11% obtained less than a quarter of their daily calories from it.

However, about 64% of U.S. youth didn’t consume any fast food on a typical day, the data showed.

These numbers are quite alarming, particularly given the fact that fast food tends to be calorie-dense, as well as high in sodium and saturated fats, leading to an increased risk for later-life heart disease, preventive cardiology dietitian S. Skylar Griggs, MS, RD, LDN, of Boston Children’s Hospital, told MedPage Today.

“It is also reflective of our fast-paced culture, grabbing food on the go that is inexpensive and filling,” she added.

Griggs, who wasn’t involved with the survey, pointed out that the COVID-19 pandemic may just magnify fast food consumption.

“The pandemic has brought with it a large spike in unemployment, and families will be looking for items cheap and easy,” she explained. “As providers we should be ready to provide reasonable alternatives to these food choices that are not labor intensive or more expensive.”

For healthcare providers managing pediatric patients, special attention should be given to questions geared towards fast food intake during well visits, including in-office counseling of “healthier” quick food options, Griggs recommended.

For example, providers can advise that kids swap out fried chicken sandwiches for grilled chicken, or choose either fries or a soda — but not both. “I simply don’t think it’s realistic to ask these kids to not eat fast food at all, as much as we would love it to be the case,” Griggs said.

For the cross-sectional survey, the researchers relied on in-person 24-hour dietary recalls, defining fast food as food items that were listed as “restaurant fast food/pizza.” Beverages were not included in the fast food category.

Recalls for younger participants were conducted with a proxy, but those ages 12 and older responded to the survey themselves. The report didn’t indicate how many participants were included in the analysis, although in total, about 19,000 people of all ages provided data in NHANES during the two biennial iterations and the age distribution generally reflects that of the population at large.

Fryar’s group also found that the amount of fast food consumed tended to vary among age and ethnic groups. For example, teens tended to eat more fast food than younger kids did, with the percentages jumping from about 11% of average daily percentage of calories among kids ages 2-11 to up to 17% for those ages 12-19.

Additionally, non-Hispanic white children tended to consume the least amount of fast food on any given day, accounting for about 13% of their daily calories. Fast food accounted for about 15% and 17% of average daily calories for Hispanic and non-Hispanic Black youth, respectively.

On the other hand, no significant differences were noted in fast food consumption between boys and girls in general.

When the researchers compared this recent data to prior survey data, the amount of daily fast food consumed in the recent years was not much different from than what U.S. youth ate more than a decade ago, the team said. In comparison, children and teens consumed about 14.1% of their daily calories from fast food during 2003-2004 compared with about 14.4% in 2017-2018. However, this is an uptick from a low seen in 2009-2010 when fast food accounted for 10.6% of kids’ daily calories, Fryar and co-authors said.

Griggs suggested also taking note of populations with a higher prevalence of fast food consumption, and thus provide “direct education around fast food intake and options in the neighborhood, as well as the risks for high blood pressure, high cholesterol, and obesity.”