Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake.

OBJECTIVE To examine the effect of fast-food and full-service restaurant consumption on total energy intake, dietary indicators, and beverage consumption. DESIGN Individual-level fixed-effects estimation based on 2 nonconsecutive 24-hour dietary recalls. SETTING Nationally representative data from the 2003-2004, 2005-2006, and 2007-2008 National Health and Nutrition Examination Survey. PARTICIPANTS Children aged 2 to 11 years (n = 4717) and adolescents aged 12 to 19 years (n = 4699). MAIN OUTCOME MEASURES Daily total energy intake in kilocalories; intake of grams of sugar, total fat, saturated fat, and protein and milligrams of sodium; and total grams of sugar-sweetened beverages, regular soda, and milk consumed. RESULTS Fast-food and full-service restaurant consumption, respectively, was associated with a net increase in daily total energy intake of 126.29 kcal and 160.49 kcal for children and 309.53 kcal and 267.30 kcal for adolescents and with higher intake of regular soda (73.77 g and 88.28 g for children and 163.67 g and 107.25 g for adolescents) and sugar-sweetened beverages generally. Fast-food consumption increased intake of total fat (7.03-14.36 g), saturated fat (1.99-4.64 g), and sugar (5.71-16.24 g) for both age groups and sodium (396.28 mg) and protein (7.94 g) for adolescents. Full-service restaurant consumption was associated with increases in all nutrients examined. Additional key findings were (1) adverse effects on diet were larger for lower-income children and adolescents and (2) among adolescents, increased soda intake was twice as large when fast food was consumed away from home than at home. CONCLUSION Fast-food and full-service restaurant consumption is associated with higher net total energy intake and poorer diet quality.