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Children Eating More Outside The Home A Major Cause of Child Obesity

As childhood obesity rises and the American diet shifts towards increasing consumption of foods eaten or prepared outside of the home, concerns about the nutritional quality and the total consumption of such foods are also increasing. According to a study conducted at the University of North Carolina at Chapel Hill and published in the August 2011 issue of the Journal of the American Dietetic Association, eating location and food source significantly impact daily energy intake for children. Foods prepared away from home, including fast food eaten at home and store-prepared food eaten away from home, are fueling the increase in total calorie intake.

Trends in energy intake by eating location have not been examined previously and therefore this study is unique because of its focus on foods consumed away from home as well as foods prepared away from home. The location/source categories showing the greatest increase in percent of kcal/day from 1994 to 2006 were fast food eaten at home and store-bought food eaten away from home. The increase in store-bought foods eaten away from home likely represents an increase in store-prepared foods, and this is a previously unidentified and un-quantified new source of calories prepared away from home.

Researchers also found that the percentage of calories from fast food has increased to surpass intake from schools and has become the largest contributor to foods prepared away from home for all age groups. For foods eaten away from home, the percentage of kcal/day from stores increased to become the largest source of calories eaten away from home. Fast food eaten at home and store-bought food eaten away from home increased significantly.

"Overall, this study highlights the continuing rapid shifts in the sources of food for children in the US -- both where it's eaten and where it's prepared," commented Barry M. Popkin, PhD, Professor of Nutrition, UNC's Gillings School of Global Public Health, University of North Carolina-Chapel Hill. "These results underscore the need to deepen our understanding of food preparation and consumption patterns, and further pinpoint where research and programmatic activity should focus. The differences in energy intake by eating location revealed in this analysis demonstrate that eating location is an important factor in the diet of American children. Further studies of children's diet focusing on energy intake and nutritional quality by eating location are warranted, particularly for store-purchased food overall, carry-out or drive-thru fast food, and hot-and-ready vs. home-prepared foods….By determining the importance of both where children eat and where their food is prepared, this study helps elucidate where children are obtaining their calories. Because of the increased energy intake and lower nutritional quality associated with away-from-home prepared foods, such insight can be used to focus future efforts to reduce calorie intake and improve dietary quality for American children."

The study determined that increased energy intake (+179 kcal/day) by children from 1977-2006 was associated with a major increase in calories eaten away from home (+255 kcal/day). The percentage of calories eaten away from home increased from 23.4% to 33.9% from 1977-2006.

This study was based on a large sample, using data on 29,217 children aged 2 to 18 years from four nationally representative surveys of food intake for the U.S. population: 11,499 participants from the 1977 to 1978 Nationwide Food Consumption Survey (NFCS77); 3,122 participants from the 1989 to 1991 Continuing Survey of Food Intakes by Individuals (CSFII89); 7,952 participants from the 1994 to 1996 Continuing Survey of Food Intakes by Individuals, combined with children ages 2 to 9 surveyed in 1998 (CSFII94); and 6,644 participants from the 2003-2004 and 2005-2006 joint U.S. Department of Agriculture (USDA) National Health and Nutrition Examination Surveys (NHANES03).


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