Published online September 30, 2005
PEDIATRICS Vol. 116 No. 4 October 2005, pp. e518-e524 (doi:10.1542/peds.2004-2732)
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ELECTRONIC ARTICLE

Association of Consumption of Fried Food Away From Home With Body Mass Index and Diet Quality in Older Children and Adolescents

Elsie M. Taveras, MD, MPH*, Catherine S. Berkey, ScD{ddagger}, Sheryl L. Rifas-Shiman, MPH*, David S. Ludwig, MD, PhD§, Helaine R.H. Rockett, MS, RD{ddagger}, Alison E. Field, ScD{ddagger},||, Graham A. Colditz, MD, DrPH{ddagger},¶ and Matthew W. Gillman, MD, SM*,#

* Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care
{ddagger} Channing Laboratory, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School
§ Division of Endocrinology
|| Division Adolescent/Young Adult Medicine and Department of Psychiatry, Children’s Hospital Boston
Departments of Epidemiology and #Nutrition, Harvard School of Public Health, Boston, Massachusetts

Objectives. Rates of overweight have increased dramatically among children in the United States. Although an increase in consumption of food prepared away from home has paralleled overweight trends, few data exist relating food prepared away from home to change in BMI in children. The goals of this study were to (1) examine the cross-sectional and longitudinal associations between consumption of fried foods away from home (FFA) and BMI and (2) examine the cross-sectional associations between intake of FFA and several measures of diet quality.

Methods. We studied a cohort of 7745 girls and 6610 boys, aged 9 to 14 years, at baseline in 1996. We obtained BMI from self-reported height and weight, measures of diet quality from a food frequency questionnaire, and weekly servings of FFA during the previous year. We performed linear regression analyses to assess the longitudinal associations between change in consumption of FFA on change in BMI, using data from three 1-year periods from 1996 through 1999. We also related consumption of FFA with intake of selected foods and nutrients at baseline.

Results. In cross-sectional analyses, adjusting for potential confounders, mean (SE) BMI was 19.1 (0.13) among children who ate FFA "never or <1/week," 19.2 (0.13) among those who responded "1 to 3 times/week," and 19.3 (0.18) among those who responded "4 to 7 times/week." In longitudinal multivariate models, increasing (over 1 year) consumption of FFA "never or <1/week" to "4 to 7/week" was associated with increasing BMI (ß = 0.21 kg/m2; 95% confidence interval: 0.03–0.39) compared with those with low consumption of FFA at baseline and 1 year later. At baseline, frequency of eating FFA was associated with greater intakes of total energy, sugar-sweetened beverages, and trans fat, as well as lower consumption of low-fat dairy foods and fruits and vegetables.

Conclusions. These data suggest that older children who consume greater quantities of FFA are heavier, have greater total energy intakes, and have poorer diet quality. Furthermore, increasing consumption of FFA over time may lead to excess weight gain.

Key Words: fried food • obesity • diet quality

Abbreviations: FFA, fried foods away from home • CI, confidence interval

Accepted May 4, 2005.




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