Overweight teens are more vulnerable than lean teens to one of the hazards of fast food — gaining weight. That new finding is prompting some experts to call for parents to talk to their kids about the risks of fast food in the same spirit they would talk to them about the risks of smoking.
A new study reports that not only do overweight teenagers consume more calories in a single fast food meal, but they are less likely to compensate for eating the fast food by making more healthful choices throughout the day.
"Our findings provide a basis for how fast food could promote excessive weight gain," says lead author Cara Ebbeling, a research associate at Children's Hospital, Boston. "In that context, our findings also add to the argument for the decrease in marketing of fast food to children, eliminating fast food in schools and promoting nutritional food campaigns for children."
The study, published this week in the Journal of the American Medical Association, had two parts. First the researchers measured how many calories teens consumed from one extra large meal while eating in a food court. Secondly, the researchers asked, do teens who eat more fast food compensate by eating less in later meals?
According to experts, the results are compelling.
Overweight teens consumed 400 more calories than lean teens in a single fast food meal, although both groups put away more calories than needed. Ebbeling says that the key finding is that overweight adolescents did not compensate for consuming the extra calories in a fast food meal by eating less throughout the day, whereas the lean kids did.
"The study really shows how kids could overeat fast food, that they probably are overeating fast food, and how that could contribute to adolescents being overweight," says Simone French, associate professor of epidemiology at the University of Minnesota. "It's another peg in the literature that supports fast food is a risky food."
Parents' Advice Is Key
Some nutrition experts say that parents need to take an active role in keeping their kids away from fast food.
"What's being offered in the home, the food environment in the school setting, and also the amount of physical activity — these are all part of the equation," says Nancy Krebs, professor of pediatrics at the University of Colorado at Denver and co-chair of the American Academy of Pediatrics Task Force on Obesity.
The American Academy of Pediatrics encourages family meals as a way to combat the rise in pediatric obesity.
"It's [eating out] like letting your child play in the street. Families who are eating out three to four times a week, that's asking for a dietary pattern that encourages overconsumption," says Krebs. "We ask families to come up with strategies for not overeating when they are out."
"I think that parents need to pay attention to this kind of information early," warns Howard Eisenson, director of Duke University Diet and Fitness Center in Durham, N.C. "Just like talking to their children about the hazards of smoking, they need to talk to them about the hazards of harmful eating."
With 75 percent of U.S. teens eating fast food one or more times a week, many experts feel studies such as Ebbeling's are critical to understanding the role of fast food in the pediatric obesity epidemic.
"We chose to study fast foods because consumption increased in the 1990s during the same time period that we've seen the increase in pediatric obesity," says Ebbeling.
Earlier research has shown that eating fast food contributes to weight gain because of enormous portion size, high energy density, excessive amounts of refined starch and added sugars, high fat content and low levels of dietary fiber — it also tastes good.
Eisenson says that the health risks to obese children and teenagers are enormous. "They develop diabetes at a younger age, they develop the complications of diabetes at a younger age, they develop the risk factors for heart disease at a younger age. Basically, they have impaired function and impaired quality of life."
And even though the study showed that lean teens aren't as vulnerable to gaining weight from eating fast food, their health is still at risk.
"Even lean kids are getting fewer vegetables and whole grain foods," says French. When you eat fast food, "you are displacing these more healthful foods."
Fast Food Industry
The fast food industry does need to take responsibility for their part of the picture, at least by limiting the marketing of products to children, some argue.
Michael Jacobson, executive director for the Center for Science in the Public Interest, says that the public health measures may be warranted to limit fast food consumption in children.
"'Limit in two ways," says Jacobson. "Get typical fast food out of schools, limit marketing efforts aimed at youths, and improve the foods [less salt, saturated and trans fat: greater availability of whole grains, fruits, veggies, etc.] as much as possible so that even kids who won't make wise choices will be protected to some extent."
However, Michael Goran, professor and associate director of the Institute for Prevention Research, Department of Preventative Medicine, University of Southern California, is not in favor of limiting fast food.
"I am not a big fan of limiting stuff because we know that can turn negative," says Goran. "Although the fast food companies are doing a better job of making healthier choices available, these tend to be marketed to adults. We need to find better ways to market healthier choices to kids and make them just as appealing."
Laurie Tansman, nutrition coordinator in the Department of Clinical Nutrition at Mount Sinai Hospital in New York City, is optimistic about the role the fast food industry has already taken in America's obesity crisis.
"I think that there is no question that the fast food industry — and the food industry in general — is being more aggressive in their response to the public's concern to overweight and obesity," says Tansman.
For its part, the National Restaurant Association said: "This study unfairly targets the quickservice industry and, as the study's title suggests, is primarily focused on energy intake. There is no reference to today's sedentary society and the lack of physical activity and physical education programs in our children's schools."
Yet many others believe that the fast food industry has a long way to go; fast food restaurants are everywhere and it's heavily marketed to children and teenagers.
"If the fast food industry is serious about helping with the obesity epidemic, there are steps they can do to help people make healthy choices," says French. "People often believe that individual choice matters, but people's choices are shaped by the incentives and information in their environment."
Eating out is becoming a danger zone for people who have a tendency to gain weight.
Eisenson warns, "It's almost like we should put a sign out that says, 'People who struggle with weight issues should eat here at their own risk.' "