Fast Food

Eating out is on the rise. The United States Department of Agriculture's (USDA's) food intake surveys indicate that between 1977 and 1996, daily caloric intake from food eaten outside of the home increased from 18 to 32 percent, with a 40-percent increase between 1987 and 2000 in the proportion of the population that reported eating three or more commercially prepared meals per week. Food-away-from-home expenditures have increased to account for about half of total food expenditures, and fast-food restaurants (defined by the North American Industry Classification System as restaurants offering limited waitperson service) account for nearly 40 percent of the away-from-home market. Furthermore, the rising consumption of restaurant fare has coincided with an increased prevalence of obesity, and several studies have reported a positive association between the frequency of eating at fast-food restaurants and body weight. In addition, a higher per capita number of restaurants has been positively associated with a higher body mass index (BMI), particularly among populations of lower socioeconomic status, who are already at an increased risk for obesity and its related complications. Although these associations do not prove causality, they raise important questions. Customers eating away from home are often confronted with large portions of foods that are higher in calories, saturated fat, and cholesterol compared to foods prepared at home and that may be more likely to contribute to weight gain or exacerbate obesity-related complications. Lack of knowledge about appropriate serving sizes and inadequate nutrition information may further complicate matters and lead to overconsumption of unhealthy foods. Spurred by public interest in health and nutrition, some segments of the fast-food restaurant industry have increased the number of healthy food options on their menus. Moreover, legislation has been proposed to require more extensive nutrition labeling of restaurant foods so that customers will be able to make informed choices about the nutrient content of the foods they select and learn how to incorporate away-from-home eating into a healthy diet that does not contribute to weight gain.

The rise in foods consumed away from home has been attributed to the increase in dual-income households in which both spouses work long hours and do not have time to prepare home-cooked meals. Fast-food restaurants provide a quick and inexpensive alternative. Indeed, by the late 1990s, dollar sales per fast-food outlet were comparable to those per full-service restaurants, and take-out and drive-through traffic now account for more than 60 percent of all fast-food sales, underscoring the importance of convenience. Further, several studies have reported a decline in cooking skills among younger generations, suggesting that even if time were available for food preparation, these individuals might still rely heavily on the restaurant industry. However, foods prepared [Page 259]away from home tend to contain more calories per meal and are higher in saturated fat and cholesterol and lower in dietary fiber, calcium, and iron compared to foods prepared at home. Fast-food consumption has been inversely associated with dietary quality measures such as the USDA's Healthy Eating Index, a scoring system measuring how closely a diet meets USDA Food Guide Pyramid recommendations for grains, vegetables, fruits, milk, and meat/meat alternatives. One study found that individuals who obtained a higher percentage of food from fast-food restaurants had lower Healthy Eating Index scores for fruit, total fat, and saturated fat compared to those who obtained a smaller percentage of their meals from fast-food restaurants.

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