When Kids Eat Out

Adolescents are increasingly dining out on fried foods, a new study finds, and the older they are the more frequently they do so. Those trends may portend hefty risks down the line, the authors argue, because the youngsters who ate out most often were generally the heaviest kids and they gained the most weight over the course of a year.

These are worrisome prospects in this nation, where obesity is reaching epidemic proportions even in children, notes study leader Elsie M. Taveras, a Harvard Medical School pediatrician. Then again, she adds, the findings aren’t all that surprising, since studies in adults have shown that restaurants tend to serve larger portions than home cooks do, and that people respond by consuming more calories on days they eat out.

The new findings are especially troubling since the study’s participants—representing all 50 states—had at least one parent schooled in diet and health. Their moms were all nurses being periodically surveyed as part of a long-running diet-and-health study administered by the Harvard School of Public Health.

Fried foods may not be the problem

Taveras’ team administered a dietary questionnaire annually for 4 years to more than 14,000 boys and girls ages 9 to 14. The recruits included only children with what appeared to be normal eating behaviors, Taveras says, which means they weren’t obviously dieting or suffering from eating disorders. In addition to supplying information on their height, weight, physical activity, and their body’s maturation, the volunteers also estimated how often they ate fried foods—such as french fries or chicken nuggets—away from home each week.

That last number turned out to be about the same as the frequency a child typically ate at a fast-food restaurant. As such, Taveras says, the fried-food question appears to capture most visits to fast-food restaurants. And that’s important, because as fried foods are high in calories, so are soft drinks, pastries, sausages, and burgers—fast-food fare that is typically consumed along with fries or fried chicken.

In the October Pediatrics, the Harvard team reports that at the beginning of the study, 3.5 percent of the girls and 6 percent of boys said they went out for fried foods four to seven times a week. But that was the overall figure for the highest-consumption category. Fewer preteens ate out so frequently, and more of the 13-to-14-year-olds did. In the older group, 4.4 percent of girls and 7.7 percent of boys said that they ate restaurant-fried foods four to seven times a week.

Three years later, the overall rates at which these adolescents ate out had more than doubled.

Annually, the researchers also computed each child’s body-mass index (BMI) based on age-specific formulas that account for a child’s physical maturity. Those calculations showed that a child’s BMI tended to be somewhat higher (fatter) the more often he or she ate fast foods away from home.

Moreover, those children who said that they had been eating these foods four to seven times per week gained more weight from year to year than did those in the lower-consumption groups. The extra gain was small but significant, Taveras notes, and could, if unchecked, put even an initially average-weight child at risk of becoming overweight.

To Taveras, the biggest surprise from the research is that the more often children reported eating out, the unhealthier their overall diet appeared to be. They were increasingly likely to drink whole milk, not skim, and sugar-sweetened beverages. They reported eating more red meats and processed meats (such as cold cuts and sausages) and were less likely to take daily multivitamins. Overall, the glycemic load of their diets—a measurement of how quickly the consumed foods would break down into blood sugar—was also higher than the diets of children who ate out less frequently. Consuming high-glycemic-load meals is a risk factor for several chronic diseases, including diabetes and atherosclerosis (SN: 4/8/00, p. 236).

Finally, not only did the kids who ate fried foods frequently also consume high quantities of fat, but they were also eating a lot of the unhealthiest types of fat—saturated and trans fats. This wasn’t surprising since low-cost restaurants favor the use of fats and sugars to make bland foods palatable. Saturated and trans fats are far cheaper for restaurants to use than are healthier monounsaturated fats such as those in olive and canola oils (see Money Matters in Obesity).

Home cookin’

Overall, Taveras and her colleagues conclude, these data and those from related studies suggest that frequent consumption of fried and other fast foods away from home has “pernicious effects on body weight and diet quality.” Added to this is the ready availability of fatty or sweet snacks, soft drinks, and other non-nutritious, high-calorie foods at many middle and high schools. In many cafeterias, these less-than-ideal foods compete directly and aggressively for the attention, dollars, and appetites of school children, a federally funded study has shown (see School Lunches Are Struggling to Earn High Marks).

Don’t look for doctors to intervene on this issue—at least not soon. A major new study has found that doctors don’t routinely discuss a child’s weight problems with the family (SN: 9/24/05, p. 206). Indeed, it found, the younger the child the less likely the topic will come up. Even among overweight teens over age 15—the age group that doctors were most likely to warn about weight issues—only 52 percent reported a health professional bringing up anything about their size, much less ways to trim down.

The responsibility for those issues falls to families. One strategy for parents, Taveras says, may be to encourage adolescents to eat more meals at home as part of family gatherings. Not only might this strategy contribute to slimmer, healthier teens, she says, but it also might offer parents one more chance to connect with busy adolescents—youngsters who face temptations to experiment with other risky behaviors besides eating fried food.