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Dining out is almost always ‘a recipe for unhealthy eating,’ researchers find

restaurant food
Photo by Taylor Harding on Unsplash
For the average American, 21 percent of their daily calories now come from restaurant food.

The average American gets about one in five of their calories from restaurant food, but much of that food is of poor nutritional quality, according to a study published Wednesday in the Journal of Nutrition.

The study found that about a third of the meals eaten at full-service restaurants and about 70 percent of those consumed at fast-food establishments have little or no nutritional value.

Furthermore, less than 0.1 percent of restaurant meals purchased by Americans are of “ideal quality,” which the study defines as being sufficiently nutritional to receive a high “healthy diet” score from the American Heart Association (AHA). The AHA recommends that people eat plenty of fruits, vegetables, fish, whole grains, nuts, legumes and seeds, while cutting back on salt, sugar, saturated fat and processed meats.

Needless to say, the findings of this new study are troubling.

“Our findings show dining out is a recipe for unhealthy eating most of the time,” says Dariush Mozzaffarian, the study’s senior author and dean of the Friedman School of Nutrition Science and Policy at Tufts University, in a released statement.

“It should be a priority to improve the nutritional quality of both full-service and fast-food restaurant meals, while reducing disparities so that all Americans can enjoy the pleasure and convenience of a meal out that is also good for them,” he adds.

Study details

For the study, the Tufts researchers analyzed data collected from a nationally representative sample of more than 35,000 American adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2016. As part of the survey, participants provided accounts of all the food they had consumed within a 24-hour period — and where.

Those answers revealed that on any given day, 30 percent of American adults eat at least one meal at a full-service restaurant and 46 percent do so at a fast-food place. Almost 15 percent do so at both.

For the average American, 21 percent of their daily calories now come from restaurant food.

One of the fastest growing trends in Americans’ dining out habits involves breakfast. In 2016,  8 percent of all breakfasts consumed in the United States were purchased at fast-food places, up from 4 percent in 2003.

The study also found that people who eat at full-service restaurants are more likely to be white and to have at least some college education and a higher income. Those who eat at fast-food restaurants are more likely to be black, younger and overweight.

Men are more likely than women to dine at both places.

The study also identified some growing disparities in the nutritional quality of restaurant meals consumed by various demographic groups. For example, white and Mexican-Americans saw the average quality of their fast-food meals increase over the 13 years of the study. That wasn’t true for blacks.  In addition, the proportion of poor-quality fast-food meals purchased by people with a college degree dropped from 74 percent to 60 percent during the study period. For people without a high school diploma, that figure held steady at 76 percent.

New strategies needed

The study comes with several caveats. Most notably, it relies on self-reported dietary information, which may not have been accurate and, thus, could have affected the study’s results. People are particularly likely to over-report their consumption of healthy foods and to underestimate their consumption of unhealthy ones.

If that bias occurred in this study, however, it would mean that the percentages of unhealthy meals purchased by Americans at full-service and fast-food restaurants are even greater than reported.

This study’s findings underscore “the need for strategies to improve the nutritional quality of US restaurant meals,” Mozaffarian and his colleagues conclude.

“Our results highlight specific priorities for improving the healthfulness of restaurant meals consumed by US adults, including greater availability and selection of fruits, vegetables, whole grains, fish/shellfish, and nuts/seeds/legumes,” they write. “Potential strategies could include altering the ‘default’ sides for major menu items, e.g. offering fruits or vegetables in place of French fries. Marketing and pricing are also powerful tools to influence choice, and should be leveraged by restaurants to improve the nutritional quality of meals consumed in their establishment.”

“Our food is the number one cause of poor health in the country, representing a tremendous opportunity to reduce diet-related illness and associated healthcare spending,” says Mozaffarian.  “At restaurants, two forces are at play: what’s available on the menu, and what Americans are actually selecting. Efforts from the restaurant industry, consumers, advocacy groups, and governments should focus on both these areas.”

FMI: You’ll find an abstract of the study on the Journal of Nutrition’s website, but the full study is behind a paywall.

Comments (13)

  1. Submitted by Bob Barnes on 01/30/2020 - 08:55 am.

    The AHA recommends not eating natural fats? And yet they claim to want to prevent heart disease…oh the irony. Natural fats are the best thing you can eat to prevent heart disease. Carbs are what causes heart attacks, not fats.

    Grains = bad (all carbs). Legumes = bad (typically high in carbs). Fruits = bad if you eat too many because they are loaded with sugar. Fruit juice is really bad.

    Leave the potatoes out, take the bun off your burger and add some whole green veggies to your meal.

    • Submitted by scott schneider on 01/30/2020 - 11:45 am.

      Grains and legumes are bad? I beg to differ.

      • Submitted by David Markle on 01/30/2020 - 01:15 pm.

        I’m with you, Scott. And I’ll add that fast food is typically high in fat, whether of vegetable or animal origin, and I believe that nothing is higher in calories than fat.

        • Submitted by Bob Barnes on 01/30/2020 - 01:59 pm.

          Calories aren’t the issue. There are 3 types of foods: Fats, Proteins and Carbs. Your body will self regulate needed calories if you eat a high fat diet. If you eat lots of carbs, you will get fat, period. Your body can’t process all that sugar so it turns into body fat. The body fat is never burned off because you keep eating more carbs.

          Your body needs to burn fat for energy (keto) instead of carbs. Carbs cause inflammation due to the body releasing insulin. Over time you need more and more insulin as you build up resistance to it. That leads to diabetes. But it also causes inflammation which causes your blood vessel to shrink and plug.

          • Submitted by Pat Berg on 01/30/2020 - 03:04 pm.

            Care to provide some cites for any of these claims?

          • Submitted by Greg Smith on 01/30/2020 - 03:38 pm.

            Partially true. Glycogen ( carbs) are needed for immediate energy needs. Is run away. Short term storage. Also certain organs are obligate glucose users. The body does have a definite requirement for glucose. Just not a super size fry worth.

            • Submitted by Bob Barnes on 01/30/2020 - 04:11 pm.

              There are enough carbs in food that you don’t need to eat any carb specific foods. If you get 30 mins of exercise a day, you only need about 50 grams of carbs daily. That’s about 3 slices of bread….half a can of pop…. a couple cookies. You’ll get (long aka fiber) carbs in your veggies and other foods.

              From all my research on this subject, a person should be at about 65-70% natural fat, 25% protein and the rest carbs. Proteins will vary depending on if you want to build muscle mass or run marathons et al.

      • Submitted by Bob Barnes on 01/30/2020 - 01:53 pm.

        Grains and legumes are mostly, if not all, carbs. They are bad for you because of that. It doesn’t matter if it’s whole grain or not, it’s still carbs. Peas, beans etc are also high in carbs compared to leafy green veggies like lettuce, spinach, broccoli etc.

        Saturated fats are the best for you. As long as they are natural like animal fat. The processed stuff like vegetable oils are terrible for you.

  2. Submitted by Ray Schoch on 01/30/2020 - 11:01 am.

    Major revision of restaurant menus seems…ahem…unlikely, especially in a fast-food context. Everyone’s diet is essentially a compromise, so I’d argue that the best (not the most convenient or efficient) way to approach this is via better-educated consumers, and in that context, the sources of information going to those consumers are critical. Alas, most people are getting what little nutritional information they’re exposed to via TV, where the profit motive inherent in commercial broadcasts makes accuracy much less likely than it might be from a source that didn’t need to make a profit.

  3. Submitted by Susan Lesch on 01/30/2020 - 02:45 pm.

    If the authors had said that restaurant chefs use inferior ingredients and prepare them in unhealthy ways, then I could learn something from this study. But that’s not what they said.

    • Submitted by Susan Lesch on 01/31/2020 - 06:03 am.

      The authors bring their considerable expertise to the table only to misdirect their frustrations. They seem to say that restaurants are bad. Instead what they really say is that consumers buy unhealthy food.

  4. Submitted by Karen Sandness on 01/31/2020 - 11:00 am.

    The food in chain restaurants, especially “family restaurants,” is pretty unhealthy, and the portions are too large. That is especially apparent if one has traveled overseas and seen what portion sizes are in other countries.

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