TABLE 4.
Independent associations of fast food consumption and dietary pattern for the remainder of diet with weight status and total dietary intake among US children1
| Low fast food consumption2 | High fast food consumption | Western dietary pattern3 | |
| Overweight/obese (%) | |||
| Model 1 (including fast food only)4 | −2.3 (−6.4, 1.9)5 | 6.7 (0.2, 13.2) | — |
| Model 2 (including fast food and dietary pattern)6 | −2.8 (−6.8, 1.1) | 5.6 (−0.9, 12.1) | 5.9 (1.3, 10.5)* |
| Food groups (kcal/d) | |||
| Milk | |||
| Model 1 (including fast food only) | –21 (−34, −8) | –65 (−85, −45) | — |
| Model 2 (including fast food and dietary pattern) | –13 (−25, 0) | –49 (−68, −30) | –95 (−105, −84)*,** |
| Fruit | |||
| Model 1 (including fast food only) | −5 (−11, 2) | –19 (−26, −12) | — |
| Model 2 (including fast food and dietary pattern) | −1 (−8, 6) | –12 (−20, −5) | –39 (−46, −32)*,** |
| Vegetables7 | |||
| Model 1 (including fast food only) | −2 (−5, 1) | −4 (−9, 0) | — |
| Model 2 (including fast food and dietary pattern) | −1 (−4, 1) | −3 (−8, 1) | –7 (−10, −5)* |
| SSBs8 | |||
| Model 1 (including fast food only) | 21 (10, 33) | 54 (32, 76) | — |
| Model 2 (including fast food and dietary pattern) | 13 (1, 24) | 37 (17, 58) | 98 (86, 110)*,** |
| French fries | |||
| Model 1 (including fast food only) | 38 (31, 46) | 80 (66, 94) | — |
| Model 2 (including fast food and dietary pattern) | 37 (30, 45) | 78 (64, 91) | 13 (4, 22)*,** |
| Nutrients | |||
| Total energy (kcal/d) | |||
| Model 1 (including fast food only) | 199 (135, 264) | 82 (4, 160) | — |
| Model 2 (including fast food and dietary pattern) | 188 (123, 252) | 63 (−15, 140) | 110 (55, 166) |
| Fat (% kcal) | |||
| Model 1 (including fast food only) | 0.5 (−0.2, 1.2) | 2.1 (1.2, 3.0) | — |
| Model 2 (including fast food and dietary pattern) | 0.3 (−0.4, 1.1) | 1.8 (0.8, 2.7) | 1.9 (1.2, 2.6)* |
| Fiber (g/1000 kcal) | |||
| Model 1 (including fast food only) | –0.4 (−0.7, 0.0) | –1.2 (−1.5, −0.8) | — |
| Model 2 (including fast food and dietary pattern) | −0.2 (−0.6, 0.1) | –0.9 (−1.2, −0.5) | –1.7 (−2.0, −1.5)*,** |
| Calcium (mg/1000 kcal) | |||
| Model 1 (including fast food only) | –33 (−55, −11) | –74 (−109, −40) | — |
| Model 2 (including fast food and dietary pattern) | −20 (−41, 1) | –50 (−83, −17) | –144 (−162, −126)*,** |
Data are for 4466 children aged 2–18 y from NHANES 2007–2010. All results account for complex survey design and are weighted to be nationally representative. Each outcome was included as the dependent variable in a separate logistic (overweight/obesity) or linear (dietary outcomes) regression model with fast food consumption (dummy variables for low and high consumption) as the independent variable. *Association with a Western dietary pattern was significantly different from association with low fast food consumption; **association with a Western dietary pattern was significantly different from association with high fast food consumption (P < 0.05, Wald test). All models were adjusted for age (age, age2), sex, race-ethnicity (non-Hispanic white, non-Hispanic black, Mexican American, or other race/ethnicity), income (household income ≤130%, 131–185%, 186–350%, or >350% of the Federal Poverty Level), parental education (<high school, high school, some college, or college degree), 2-d mean total energy intake (age-group specific quintiles), and weight status (nonoverweight/obese, overweight, or obese) where appropriate.
Fast food consumption is defined by the 2-d mean percentage of total energy intake from fast food restaurants: nonconsumers, 0% kcal from fast food; low-consumers, 0.1–30% kcal from fast food; high-consumers, >30% kcal from fast food.
Dietary patterns for the remainder of intake outside the fast food restaurant were determined by cluster analysis by using standardized z scores for the percentage of non–fast food energy intake from each food group.
Model includes fast food consumption as independent variable; associations of outcomes with fast food are unadjusted for dietary pattern.
β 95% CI in parentheses (all such values). Coefficients from logistic models were transformed into differences in prevalence of outcome (overweight/obesity) by exposure.
Model includes fast food consumption and dietary pattern as independent variables; associations of outcomes with fast food are adjusted for dietary pattern for the remainder of diet, and associations of outcomes with dietary pattern for the remainder of diet are adjusted for fast food intake.
Includes fresh, frozen, or canned nonstarchy vegetables.
SSB, sugar-sweetened beverage: includes sodas, fruit drinks, sports drinks, and energy drinks.