COMMENTARY |
Fast Food and Obesity in Children
Departments of Psychology, Epidemiology, and Public Health
Yale University
New Haven, CT 06520-8205
In July 2003, the US National Chamber of Commerce released a report on fast food and obesity, saying: "This study finds that fast food restaurants are not a chief culprit in the fattening of America."1 Fast-food companies, of course, are involved in chambers of commerce across the country. The National Chamber of Commerce has on its board of directors executives from CocaCola and PepsiCo.2
With billions of dollars at stake, the food industry may find it difficult to take an objective position on their products. Typical is fare issued by the National Soft Drink Association:
"... soft drinks do not cause pediatric obesity, do not reduce nutrient intake, and do not cause dental cavities in children."3and
"The soft drink industry has a long commitment to promoting a healthy lifestyle for individuals—especially children."3
Reminiscent are early statements by the tobacco industry. The "Frank Statement to Cigarette Smokers" issued by the industry in 1954 said:
"We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business... "4and
"We believe the products we make are not injurious to health."
The report by Bowman et al5 offers a good test of whether fast food is associated with increased calorie intake and rising risk of obesity in children. Preceding it is work showing that: 1) the number of meals eaten outside the home has increased dramatically6 (the restaurant industry accounted for 46.1% of every food dollar in 1999, up from 25% in 1955; >40% of American adults eat at a restaurant in a typical day7); 2) people eat more in the presence of large portions8; 3) portion sizes have grown very large both at home and in restaurants, with fast-food establishments having especially large servings of foods such as soft drinks and French fries9; and 4) the frequency of visits to fast-food restaurants by children is associated with increased intake of soft drinks, cheeseburgers, pizza, French fries, total fat, and total calories and decreased intake of vegetables, fruit, and milk.10
Bowman et al, making both between- and within-subjects comparisons in nationally representative data from 6212 children and adolescents, report that 30.3% of children eat fast food on a given day. This itself is startling, but consider that on days children eat fast food they consume an additional 187 kcal (summing theoretically to 6 pounds of calories per year). A study with young adults found that among whites, but not blacks, eating fast food more than twice versus less than once per week was associated with 86% increased risk of becoming obese.11
The food industry claims their products are not the primary cause of obesity. An inference is that the industry is blameless and the foods may not contribute to obesity at all. Companies then cast themselves as victims of food activism and decry attempts to curb business as usual. Mounting science makes this position increasingly difficult to defend.
The nation’s children deserve protection from damaging forces. There are early signs of bold action among policy makers to decrease exposure of children to the toxic food and physical-inactivity environment. On the horizon are actions such as removing fast food, snack food, and soft drinks from schools, curbing food advertising directed at children, and enhancing opportunities for physical activity.12
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FOOTNOTES |
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Received for publication Sep 23, 2003; Accepted Sep 23, 2003.
Address correspondence to Kelly D. Brownell, PhD, Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205. E-mail: kelly.brownell{at}yale.edu
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REFERENCES |
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 TOP REFERENCES |
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1. Buccholz, TG. Burger, fries and lawyers: the beef behind obesity lawsuits. Available at: http://www.legalreformnow.com/resources/burgers.pdf. Accessed September 14, 2003
2. US Chamber of Commerce web site. Available at: http://www.uschamber.com/about/board/all.htm. Accessed September 14, 2003
3. National Soft Drink Association web site. Available at http://www.nsda.org/softdrinks/CSDHealth/Index.html. Accessed June 19, 2002
4. Tobacco.org. Daily doc: The "Frank Statement" of 1954. Available at http://www.tobacco.org/Documents/dd/ddfrankstatement.html. Accessed September 14, 2003
5. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics.2003; 113 :112 –118
6. Neilson SJ, Siega-Riz AM, Popkin BM. Trends in energy intake in U.S. between 1977 and 1996: similar shifts seen across age groups. Obes Res.2002; 10 :370 –378[Web of Science][Medline]
7. National Restaurant Association. Frequently asked questions. Available at http://www.restaurant.org/faq.cfm#population. Accessed September 15, 2003
8. Rolls BJ. The supersizing of America: portion size and the obesity epidemic. Nutr Today.2003; 38 :42 –53[CrossRef][Medline]
9. Neilson SJ, Popkin BM. Patterns and trends in food portion sizes, 1977–1998.
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10. French SA, Story M, Neumark-Sztainer, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord.2001; 25 :1823 –1833[CrossRef][Web of Science][Medline]
11. Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast food consumption, obesity and risk of type 2 diabetes in young adults: the CARDIA Study [abstract]. Circulation.2003 :107
12. Brownell KD, Horgen KB. Food Fight: The Insider Story of the Food Industry, America’s Obesity Crisis, and What We Can Do About It. New York, NY: Contemporary Books/McGraw-Hill; 2004
PEDIATRICS (ISSN 1098-4275). ©2004 by the American Academy of Pediatrics
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