A Fresh Look at Fast Food: Just One Pillar of Obesity?

Bobby Miller

Just about everyone knows obesity is a growing problem in the United States, but a shocking number of people aren’t even aware that they’re overweight. According to a survey conducted by Harris Interactive in 2010, about one third of overweight Americans classify themselves as “normal” in size. Plus, 70 percent of clinically obese individuals only consider themselves “overweight.”

A person can classify their weight by using the body mass index, or BMI, which is calculated based on an individual’s height and weight. The taller a person is, the heavier they can be without having an unhealthy BMI.

Someone is considered overweight if their BMI is 25 to 30. If somebody’s BMI goes above 30, then they’re obese. This sums up most of the American population. According to the National Center for Health Statistics, 34 percent of American adults are obese, and another 34 percent are overweight, but not obese. So, about two thirds of Americans weigh too much.

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Use this graph from Wikimedia.org to find your BMI. The higher blue X marks the spot on this graph for males. The lower green X marks the spot on this graph for females. As you can see, each X falls under the “overweight” category, so the average American is overweight.
Credit: Wikimedia

According to the U.S. Department of Health and Human Services, the average American male is 5 feet, 9 inches tall, or 175 cm, and weighs 191 pounds, 86.6 kg. The average American female is 5 feet, 4 inches tall, or 162.6 cm, and weighs 164 pounds, or 74.4 kg. It should be noted that BMI does not factor in muscle mass, though.

The large number of overweight Americans creates serious problems for the individuals themselves and for the nation as a whole. The Centers for Disease Control and Prevention, or CDC, estimates that the United States loses $147 billion a year in medical costs from obesity. On a personal level, an obese individual tends to have medical costs that are $1,429 higher than those of people with healthy weights. This shouldn’t be surprising since obesity increases one’s risk of “heart disease, stroke, type 2 diabetes, and certain types of cancer,” as the CDC explains.

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The obesity rate for American adults has risen a shocking amount in the past few decades and shows no signs of slowing down.
Credit: CDC.gov

The next generation is heading down the same path. Right now, approximately 17 percent of children and teenagers are obese. The CDC goes on to note that “since 1980, obesity prevalence among children and adolescents has almost tripled.”

Some people blame the obesity epidemic on the likes of Ronald McDonald, Colonel Sanders, and that creepy Burger King guy, but maybe we’re pointing our fingers in the wrong direction. Recent studies suggest that full-service restaurant chains, also known as sit-down restaurants, are often the unhealthiest places a person can eat.

Full-Service Restaurants: The Cunning Calorie Culprits

When we picture calorie-laden food, we usually imagine a giant Big Mac sitting next to a super-sized box of fries and a towering drink. However, thanks to their large portion sizes, full-service restaurant meals can often give us too many calories for the day in just one meal.

Earlier this year, researchers from Drexel University and the University of Pennsylvania, as led by Amy Auchincloss, studied more than 2,600 menu items at full-service restaurants in Philadelphia, Pa. As ScienceDaily explained, they chose this area because “full-service chain restaurants with more than 15 locations nationwide” are legally required to list not just calories but also “sodium, fat, and carbohydrates for each item on all printed menus.”

After studying the menus and customers’ eating habits, the researchers found that the average customer ate and drank about 1,800 calories per meal. To put this number in perspective, remember that most people only need 2,000 to 2,500 calories a day. If customers are receiving that many calories in just one meal, imagine how many they accumulate in three—plus their snacking. Surprisingly, a Big Mac has “only” 550 calories in comparison, as Yahoo Shine reminds us.

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Perhaps we shouldn’t be so quick to blame fast food for health issues related to poor nutrition. Credit: HypnosisHealthInfo.com

Sit-down restaurant meals fared even worse on other scales. Auchincloss and her team found that most patrons ate 3,200 milligrams of sodium and 35 grams of saturated fat in one meal, as compared to the recommended limitations of 2,300 milligrams of sodium and 20 grams of saturated fat per day. And although they’re still far from healthy, Ronald McDonald’s burgers usually give us “only” 970 milligrams of sodium and 10 grams of saturated fat in comparison.

Beth Leonberg, an assistant clinical professor who co-authored the study, noted that most adults should try to “consume fewer than 750 calories, 750 milligrams of sodium, and 8 grams of saturated fat in a single meal.” Restaurants could help this along by offering smaller portion sizes by default. Also, there needs to be standard definitions for “healthy choice” tags, which are now left up to the restaurant’s discretion. Many restaurants only take calories into account when applying this label, so even the supposedly healthy meals often exceed the total daily recommended value for fat and sodium.

Based on other research conducted by the team, nutritional labeling on the menus isn’t enough to promote healthy habits in restaurant patrons. The average person consumes only 155 fewer calories per meal if menus are labeled. This corresponds well to other research showing that labeling calories on fast food restaurant boards has little effect on people’s buying habits.

What, then, can you do the next time you’re at a full-service restaurant? Susan Matthews of EverydayHealth.com recommends skipping appetizers because, on average, they contain 804 calories—roughly as many as most entrées. In that study, “side dishes added an average 289 calories apiece,” she noted, “while the typical alcoholic drink had 244 calories, higher than the average non-alcoholic drink, at 161 calories. Desserts weighed in at 700-plus calories.”

So if a person skips appetizers, has water instead of alcohol or a sugar-laced beverage, and skips dessert, they’ll spare themselves of about 1,700 empty calories. A person can also split an entrée with someone else or pack some of it to go, as Matthews pointed out.

Parents and Childhood Obesity

If sit-down restaurants tend to be that brutal on our bellies, then how much blame can we place on fast food restaurants for the rise in obesity, particularly in young people? Well, Jennifer Poti, Kiyah Duffey, and Barry Popkin of the University of North Carolina spoke on the matter in a study published in late 2013. They concluded that while fast food consumption is hardly a good thing for children, it’s “simply a byproduct of a much bigger problem: poor all-day-long dietary habits that originate in children’s homes,” according to ScienceDaily.

After sifting through years’ worth of data from the National Health and Nutrition Examination Survey, they found that a child’s diet at home and at school was more closely related to poor nutrition and obesity than fast food consumption was. In particular, children who ate lots of processed food and sugary beverages were most at risk for obesity, especially since they usually ate fewer fruits and vegetables.

Popkin, one of the co-authors behind the study, explained that parents ultimately have far more influence over a child’s diet than anything or anyone else. “Children who rely on fast foods may tend to have parents who do not have the means, desire, or time to purchase or prepare healthy foods at home. This is really what is driving children’s obesity and what needs to be addressed in any solution,” Popkin wrote.

Yes, before we wag our fingers at Ronald McDonald, we should remember that parents are the ones taking their children to fast food restaurants, and they tend to chow down on the less-than-nutritious offerings as well.

Even at home, parents can inadvertently promote unhealthy eating habits in their children. In 2012, Dr. W. Stewart Agras of Stanford University examined how parents handled their toddlers—aged 2 to 4 years—at every meal. He became an advocate for the “division of responsibility,” or DOR, approach to how toddlers eat. In the DOR approach, parents are responsible for providing and serving food in reasonable portions while children are responsible for deciding how much to eat—if at all.

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While parents should promote healthy foods, they shouldn’t force kids to eat when they’re full, according to Agras.
Credit: SodaHead.com

This means parents have to back away from the tradition of encouraging or pressuring their children to eat everything on their plate. Many people are raised this way, and this is why restaurants often serve unreasonably large portion sizes—we’ll eat it all even if we’re getting many meals’ worth of calories. Argas believes that this shift in our thinking is essential because forcing a child to eat can ruin their perception of what feeling hungry or feeling full means. This can lead to poor eating habits for life.

He also reminds parents that children themselves usually know best whether they’re full or not. After all, he found that parents often encourage their offspring to eat too much when they themselves are hungry.

How Fast Food and Obesity Relate

Yet, fast food restaurants can’t wash their oily hands of any blame behind the obesity epidemic. Although other factors certainly come into play, numerous studies—old and new—have linked fast food restaurants to obesity in children and adults.

For instance, a household’s proximity to fast food restaurants can put one at a greater risk of obesity. In May 2013, Lorraine Reitzel, of the University of Texas, found that African-American adults living near fast food restaurants have higher BMIs than those living far away from any. Specifically, her analysis shows that people’s BMIs drop 2.4 percent for every mile between them and the nearest fast food restaurant.

The number of nearby fast food restaurants puts individuals with low incomes at a particularly high risk for obesity, as Reitzel noted. However, even well-off households tend to have more weight in their bellies if they have more fast food restaurants in their neighborhoods. This study was carefully controlled for other factors such as “gender, age, physical activity, education, employment, TV time, and number of children,” as ScienceDaily.com pointed out.

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Although full-service restaurants are packed with calories, having fast food looming over you doesn’t help your weight either.
Credit: Wikimedia.org

Another study, one led by Dr. Sanae Inagami, of the University of Pittsburgh, found that adults who don’t own cars often resort to fatty fast foods. Individuals without cars who live in areas with numerous fast food restaurants tend to be as much as 12 pounds heavier than those living in areas without such restaurants.

The proximity of fast food restaurants isn’t the only issue—prices come into play as well. Health researchers May Beydoun, Lisa Powell, Xiaoli Chen, and Youfa Wang examined how the prices of different foods in certain areas influence children’s nutrition. Regardless of family income, higher fast food prices are associated with more nutritious diets among children aged 2 to 9 years. Conversely, higher fruit and vegetable prices in an area are often associated with poorer nutrition.

How Governments Can Promote Nutritious Diets

Since it is clear that the convenience and price of food weighs in heavily on people’s diets, some have proposed that governments should regulate the economy in such a way that will encourage citizens to make healthier choices.

A bulletin released by the World Health Organization, or WHO, in February 2014 shares the results of a study that found tighter economic regulation is associated with lower intake of fast food. Specifically, Dr. Roberto De Vogli, of the University of California, found that the average number of annual fast food transactions per capita is rising most quickly in countries where obesity is rising most quickly.

Vogli and his colleagues discovered that fast food businesses and BMIs are shooting up in countries such as Canada, Australia, Ireland, and New Zealand. However, fast food markets and BMIs are not rising quickly in countries such as Belgium, Greece, the Netherlands, and Italy, which have strict market regulation. Of course, unhealthy processed food is also bought at stores and eaten at home, but fast food restaurants are a common source of this food that can easily be studied.

WHO has suggested that countries can curb obesity by creating economic environments that favor fresh, healthy food such as fruits and vegetables over fatty processed food. There should be economic incentives for growing and selling healthy food, such as subsidies, but economic means of discouraging ultra-processed foods and soft drinks, such as higher taxes. This makes sense in light of the discoveries we saw from Beydoun, Powell, Chen, and Wang earlier, who demonstrated that food prices are clearly associated with children’s nutrition.

In addition, the WHO bulletin argues for “zoning policies to control the number and type of food outlets,” which matches up well with the numerous studies showing that people living near fast food restaurants are at greater risk of obesity.

WHO also believes that advertising for unhealthy food and drinks needs to be regulated more strictly, especially when targeted at children. There should also be “trade regulations discouraging the importation and consumption of fast food, ultra-processed foods, and soft drinks,” as its recent bulletin argued.

It’s disturbing to see that the bulletin says little about full-service restaurants and portion sizes, but at least these ideas are steps in the right direction. Classes like home economics desperately need to make a comeback in schools because they teach students how to cook for themselves. These would not only prepare students for life on their own but also give them the opportunity to cook together with their families as a means of bonding.

How You Can Control Your Own Diet

Chances are, if you’re unhappy with your diet, you probably don’t want to sit around and wait for governments to put all these measures into action. What, then, can you do on an individual level to eat healthier? Well, as researcher Reitzel speculated, people are drawn to restaurants because they supposedly save time and, in some cases, money.

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Even busy parents should find time to cook nutritious meals.
Credit: SheKnows.com

However, the best way to monitor your nutritional needs while regulating your portion sizes is to eat at home. Although many people claim they’re too busy to cook, there are plenty of books and websites offering recipes that can be prepared in 30 minutes or less. And remember that eating at home cuts back on time spent traveling to and from the restaurant while also saving gas money. Avoiding full-service restaurants also cuts back on unnecessary time spent waiting around to be served. And even though time is money, can you put a price on good, lifelong health for you and your family?

Aside from trying to eat at home, it’s important to watch your portion sizes, as recent studies have shown. You don’t even need all the scientific data—just listen to your stomach. If your stomach says you’re full, then stop eating. That’s a simple start to solving a complex problem.

In the meantime, many scientists are exploring the issue of obesity to give us even more helpful information on how to curb the epidemic.

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