Dining out is one of the most challenging things to do. When I was at Pritikin, we would call this lecture, Dying Out.
The following study has inspired me to organize some of the prior discussions and threads on dining out/restaurants into one thread, which I will be adding to overtime, Hopefully, some of you will find it helpful.
70% of Fast-Food (FF) meals were of poor quality
50% of Full-Service (FS) meals were of poor quality.
< 0.1% of meals at FF and FS were of ideal quality.
Data on the percentage meeting an ideal diet (≥40 points or ≥80% adherence) are not presented due to very small numbers (most of them are zeros) and large statistical uncertainty. Data are weighted to be nationally representative. AHA, American Heart Association.
The Study
Quality of Meals Consumed by US Adults at Full-Service and Fast-Food Restaurants, 2003–2016: Persistent Low Quality and Widening Disparities
J Nutr 2020;00:1–11.
doi:
https://doi.org/10.1093/jn/nxz299.
https://www.ncbi.nlm.nih.gov/pubmed/31995199ABSTRACT
Background: Meals from full-service restaurants (FS) and fast-food restaurants (FF) are an integral part of US diets, but current levels and trends in consumption, healthfulness, and related sociodemographic disparities are not well characterized.
Objectives: We aimed to assess patterns and nutritional quality (using validated American Heart Association [AHA] diet scores) of FS and FF meals consumed by US adults.
Methods: Serial cross-sectional investigation utilizing 24-h dietary recalls in survey-weighted, nationally representative samples of 35,015 adults aged ≥20 y from 7 NHANES cycles, 2003–2016.
Results: Between 2003 and 2016, American adults consumed ∼21 percent of energy from restaurants (FS: 8.5% in 2003–2004, 9.5% in 2015–2016, P-trend = 0.38; FF: 10.5%; 13.4%, P-trend = 0.31). Over this period, more FF meals were eaten for breakfast (from 4.4% to 7.6% of all breakfasts, P-trend <0.001), with no changes for lunch (15.2% to 15.3%) or dinner (14.6% to 14.4%). In 2015–2016, diet quality of both FS and FF were low, with mean AHA diet scores of 31.6 and 27.6 (out of 80). Between 2003 and 2016, diet quality of FF meals improved slightly, (the percentage with poor quality went from 74.6% to 69.8%; and with intermediate quality, from 25.4% to 30.2%; P-trend <0.001 each). Proportions of FS meals of poor (∼50%) and intermediate (∼50%) quality were stable over time,
with <0.1% of consumed FS or FF meals meeting ideal quality. Disparities in FS meal quality persisted by race/ethnicity, obesity status, and education and worsened by income; whereas disparities in FF meal quality persisted by age, sex, and obesity status and worsened by race/ethnicity, education, and income.
Conclusions: Between 2003 and 2016, FF and FS meals provided 1 in 5 calories for US adults. Modest improvements occurred in nutritional quality of FF, but not FS, meals consumed, and the average quality for both remained low with persistent or widening disparities. These findings highlight the need for strategies to improve the nutritional quality of US restaurant meals.
Discussion
Based on nationally representative data between 2003 and 2004 to 2015 and 2016, American adults consumed ∼1 in 5 total calories from FS and FF restaurants, with ∼9% energy from FS and 12% energy from FF meals. During this period, the overall nutritional quality of FF, but not FS, meals consumed improved modestly, largely owing to increased nuts/seeds/legumes and decreased saturated fat, and (to a lesser extent) increased whole grains. Conversely,
amounts of fruits and vegetables decreased in both FS and FF meals, whereas sodium increased in FS and remained high in FF meals. Notably, overall diet quality scores remained low for both FS and FF restaurant meals, with 50% of FS meals and 70% of FF meals consumed in 2015–2016 having poor diet quality. In addition, persistent or worsening disparities were evident in key population subgroups.