Physicians should encourage parents of young patients to make eating out at restaurants an occasional treat rather than a regular activity, said Lisa M. Powell, PhD, of the University of Illinois at Chicago.
Powell’s latest study concludes that children and teenagers consume significantly more soda and other high-calorie foods, and have poorer nutrient intake when they eat out at fast-food restaurants or full-service establishments compared with when they eat meals at home.
That general message “is not surprising, but [the study] really starts to quantify how serious the problem is,” said Powell, lead author of the study, which was published online Nov. 5 in Archives of Pediatrics and Adolescent Medicine. Adolescents consume an additional 309.5 calories on days they eat at fast-food restaurants, and children take in an extra 126.2 calories when they dine at such establishments, the study said.
“Three hundred additional calories a day is quite serious,” said Powell, professor of health policy and administration in the School of Public Health at the University of Illinois at Chicago.
Dining at a full-service restaurant is not much healthier, data show. When eating at such an establishment, adolescents consume 267.3 extra calories and children take in 160.4 additional calories, according to the study.
“If we don’t start to think about this seriously and try to change some behaviors, these are a lot of additional calories that will compound over time and cause adverse effects,” Powell said. Those adverse effects could include increased body weight and subsequent health conditions such as coronary artery disease, hypertension and type 2 diabetes, health professionals said.
Powell recommends that physicians emphasize to young patients and their parents the health benefits of home-cooked meals over food prepared at restaurants. Doctors also should offer parents tips on how to help their children eat nutritious meals when they dine at a restaurant, said Raquel G. Hernandez, MD, MPH, assistant professor of pediatrics at Johns Hopkins University School of Medicine in Baltimore.
Where health professionals fail in this area is “when they say, ‘Don’t eat out,’?” Dr. Hernandez said. “You can’t give families recommendations that aren’t practical.”
Instead, she encourages physicians to tell parents to look at the menu and portion sizes, skip the appetizer and possibly consider sharing meals.
The National Restaurant Assn. is taking steps to help restaurants offer children healthy meal options. In July 2011, the association launched Kids LiveWell, a nationwide program that promotes restaurants selling children’s meals that contain nutritious items, such as fruits, vegetables and whole grains. The program “underscores that restaurants can be part of the solution to ensuring a healthier generation and providing consumer choice in dining options,” said Dawn Sweeney, president and CEO of the National Restaurant Assn., in a July 2011 statement.
Seventeen percent of children and adolescents are obese, according to the Centers for Disease Control and Prevention. The prevalence of obesity in youths has nearly tripled from 1980, when about 6% were obese, the CDC said.
Researchers for the Archives study examined dietary recall data from 9,416 children and adolescents ages 2-19 who participated in the National Health and Nutrition Examination Survey between 2003 and 2008. They assessed participants’ caloric intake, diet quality and consumption of sugar-sweetened beverages — particularly soda — from two nonconsecutive 24-hour periods.
Researchers asked participants whether they purchased the food and beverages from fast-food restaurants (which includes pizza parlors) or full-service restaurants. The youths also were asked if they consumed the items at home (such as take-out food) or away from home. Youths 12 and older completed their own dietary interviews. For children 2 to 11, a parent or guardian helped document the information.
Researchers found that teenagers from low-income families consumed more calories, total and saturated fat, sugar and sodium when they ate at fast-food establishments compared with wealthier youths of similar ages. Powell said low-income teens probably are on tight budgets and look for the most inexpensive menu items, which often are the least healthy.
American Medical Association policy calls for restaurants to price nutritious items in children’s meals at similar levels to those that are less healthy.
Teenagers of all income levels consumed twice as many additional grams of soda when they ate at fast-food restaurants (200.20g) than when they took the meals home to eat (98.73g). “We attribute that [finding] to the free refills” that are available at many fast-food restaurants, Powell said.
Drinking sugar-sweetened beverages plays a significant role in the nation’s widening waistlines, according to health professionals. Powell said future research should examine how fast-food consumption during different times of day affects caloric and nutrient intake.
The full and original article can be found at: http://www.ama-assn.org/amednews/2012/11/12/hlsb1116.htm