Fast Food Intake Among Children and Adolescents in the United States, 2015–2018

Questions for Cheryl Fryar, Health Statistician and Lead Author of “Fast Food Intake Among Children and Adolescents in the United States, 2015–2018.”

Q: Why does NCHS conduct studies on fast food consumption among children and adolescents?

CF: We focus on fast food for this report because fast food continues to play an important role in the American diet. Fast food has been associated with poor diet and increased risk of obesity. In a previous report, we described the percentage of calories consumed from fast food among children and adolescents during 201-2012. This report provides an update on the daily percentage of calories consumed from fast food by children and adolescents aged 2-19 years during 2015-2018 and trends since 2003.

Q: How did the data vary by age groups, sex and race?

CF: There were some demographic differences in the daily percentage of calories consumed from fast food. Adolescents aged 12–19 consumed a higher percentage of calories (16.7%) from fast food than younger children (11.4%) aged 2-11 years. Girls consumed a higher percentage than boys and non-Hispanic white adolescents consumed a lower percentage than the other race and Hispanic origin groups. This brief report did not examine confounders that may possibly explain demographic differences.

Q: Was there a specific finding in the data that surprised you from this report?

CF: While there really wasn’t anything in this report that I hadn’t expected to see or that was surprising to me, this report’s trends analysis is of interest. The daily percentage of calories from fast food in children and adolescents decreased from 14.1% in 2003–2004 to 10.6% in 2009–2010, and then increased to 14.4% in 2017-2018.

Q: How did you obtain this data for this report?

CF: The National Health and Nutrition Examination Survey (NHANES) is the source of the data.  Since 1999, NHANES has been conducted on a continuous basis, and visits approximately 15 counties each year of various population size.  The survey conducts at home health interviews and health examinations in mobile examination centers (MEC) with nearly 5000 people each year.   Information on nutrient intake was obtained from one 24-hour dietary recall interview administered in-person at the MEC.  Specifically, anyone who reported obtaining any food or beverage from “restaurant fast food/pizza” was someone who consumed fast food on a given day.  Dietary recalls cover intake for any given day, specifically the 24-hour period prior to the dietary recall interview (midnight to midnight).

For survey participants < 6 years of age a proxy was used (who was generally the person most knowledgeable about the child’s food intake). For children ages 6- 8, interviews were conducted with a proxy and with the child present to assist in reporting intake information. Interviews of children ages 9-11, were conducted with the child and the assistance of an adult familiar with the child’s intake. Adolescents 12 years or older answered for themselves.

Q: What is the take home message for this report?

CF: The take-home message for this report is that more than one-third (36.3%) of U.S. children and adolescents consume fast food on a given day. Overall, children and adolescents consume, on average, 13.8% of their daily calories from fast food.  And, on a given day, over 11% of children and adolescents consume more than 45% of their daily calories from fast food.

Diet and exercise play important roles in helping individuals achieve and maintain their health.  The USDA/HHS’ Dietary Guidelines for Americans 2015 provides guidance in healthy food choices.  In addition, HHS’ 2018 Physical Activity Guidelines for Americans provides guidance for all ages in improving health through physical activity.