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Fast food for children and adolescents

Debby Demory-Luce, PhD, RD, LD
Kathleen J Motil, MD, PhD
Section Editors
Jan E Drutz, MD
Amy B Middleman, MD, MPH, MS Ed
Deputy Editor
Alison G Hoppin, MD


Fast food restaurants or quick-service establishments are often the overall choice for food away from home [1-3]. Socioeconomic trends, such as longer work hours, more women employed outside the home, and a high number of single-parent households have changed the way families obtain their meals [4-7]. As parents experience busier lifestyles, they demand convenience for their family meals. The consumption of fast food is fostered because of the quick service, convenience, good taste, and inexpensive prices relative to more traditional home-style restaurants [8,9].

This topic review will discuss the epidemiology and nutritional consequences of fast food consumption in children and adolescents, as well as influences that affect fast food intake and management strategies. Other dietary habits among adolescents are discussed separately. (See "Adolescent eating habits".)


Epidemiology — The National Restaurant Association estimates that the average American eats out an average of four times a week [10]. About 33 percent of children and adolescents in the United States consume fast food on a typical day, providing on average about 12 percent of daily calories, and intake increases with age [11,12]. In non-metropolitan areas, adolescents and parents who live in towns with five or more fast food outlets were 30 percent more likely to eat fast food compared with those in towns with no fast food outlets [13]. The influence of in-town fast food outlets on fast food intake was strongest among families with low motor vehicle access. In contrast, fast food dining is less common when families have closer proximity and easier access to supermarkets [14].  

In the United States, more than 47 percent of today's food dollar is spent away from home, a value that has almost doubled over the past 50 years [15-17]. Driven by consumers' growing interest in convenience, sales at quick-service restaurants are expected to generate $201 billion in 2016, with a projected annual growth of 2.5 percent for several years [18]. Snack, convenience, fast foods, and sweets continue to dominate food advertisements viewed by children [19,20]. The marketing of these items contributes to the fast food consumption of children in the United States [20-23]. On a typical day, preschool-aged children (2 to 5 years) view 10 television fast food advertisements, elementary-school children (6 to 11 years) view 12 television advertisements, and adolescents (12 to 18 years) view up to 15 television advertisements [24,25]. Hispanic preschoolers, children, and adolescents viewed, on average, 11.6 to 12.4 television food ads per day, an observation of particular concern given the higher rates of obesity among Hispanic youth [26]. One study indicates that 98 percent of television food-product advertisements viewed by adolescents promote foods that are high in fat, sugar, or sodium [27]. In the United States, $8 billion is spent on food and beverages by children between the ages of 4 and 12 years, and these children also exert a strong influence on their parents' choices of quick-service establishments [28].

Increases in fast food consumption have been reported in other countries. Longitudinal studies conducted among Chinese school-aged children show substantial increases in consumption of western-style fast food, particularly among adolescents, based on data obtained from the 2004 and 2009 Chinese Health and Nutrition Survey [29]. The increase in fast food consumption was observed among all age, gender, and family income groups.

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Literature review current through: Nov 2017. | This topic last updated: Apr 19, 2016.
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