Nutrient Intake and Dietary Quality Among Children and Adolescents by Fast Food Consumption Status: What We Eat in America, NHANES 2013–2016

To categorize children and adolescents by frequency of fast food (FF) consumption and compare intakes of energy, nutrients, and dietary quality among those with and without intake of fast food. One day of dietary intake data from What We Eat in America, NHANES 2013–2016 were analyzed. The sample included children and adolescents age 2–5 y (N = 1152), 6–11 y (N = 1804), and 12–19 y (N = 2072). FF consumption on intake day included at least one reported food or beverage with the source indicated as “restaurant fast food/pizza”. Based on self-reported frequency of FF consumption in the previous seven days, participants were categorized as: Infrequent (0 times) (IFF), frequent (1 + times) without report of FF source (FF-NC) or frequent (1 + times) with report of FF source (FF-C) on the intake day. Differences between groups in energy, nutrient intake, and diet quality using the Healthy Eating Index (HEI) 2015, were assessed using T-tests in a multiple regression adjusting for confounders. Differences were considered significant at P < 0.001. There were no significant differences in energy or nutrient intakes by FF status among children 2–5 y. However, their total HEI scores (of possible 100) were higher in IFF (57) and FF-NC (54) vs FF-C (50); subcomponent scores of IFF were higher than FF-C and FF-NC for Refined Grains, and higher for Whole Fruit and Total Protein Foods than FF-C. Among children 6–11 y, IFF had lower intake of polyunsaturated fat and higher intake of vitamin D than FF-C, but no differences in HEI scores. Among adolescents, IFF and FF-NC had lower intakes of energy, carbohydrate, total fat, polyunsaturated fat, monounsaturated fat, and sodium than FF-C and total HEI scores were higher in IFF (51) and FF-NC (49) vs FF-C (45). Subcomponent scores of IFF were higher for Total and Whole Fruit, Whole Grains, and Added Sugars than FF-C and higher for Total Fruit in FF-NC vs FF-C. There were no differences in nutrient intake or diet quality between IFF and FF-NC in any age group. Differences in nutrient intakes and diet quality by FF consumption status varied among children and adolescents. These differences highlight the need to tailor nutrition education and messaging by age. U.S. Department of Agriculture.