Differences in How Teenagers Eat Fast Food

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Ebberling CB, Sinclair KB, Pereira MA, et al.: Compensation for energy intake from fast food among overweight and lean adolescents. JAMA 291:2828-2833.

What is the problem and what is known about it so far?

Teenagers have been eating more fast food since the 1970s. Since then, obesity has also been on the rise. Several things about fast food may lead to overeating and obesity. These include huge portion sizes, high calorie content, tastiness, high amounts of refined starch and added sugar, high fat content, and low levels of dietary fiber.

In this study, researchers asked why some teenagers who frequently eat fast food do not become overweight, while others do.

Who was studied?

Teenagers aged 13 to 17 years. Of the 54 total participants, 26 were overweight and 28 were lean.

How was the study done?

Researchers found participants through newspaper advertisements and flyers. They offered two $30 gift certificates to encourage people to respond.

Researchers measured participants' height and weight. They calculated body mass index (BMI) for each adolescent. BMI is a measure of obesity. Adolescents with a high BMI for their age group were considered overweight. The others were considered lean.

In the first phase of the study, researchers fed participants an extra-large fast food meal in a food-court setting. Participants were told to eat as much or as little as they liked.

In the second phase, participants were reached by telephone. They were asked to write down what they ate for 2 days when they didn't eat fast food, and for 2 days when they did eat fast food.

What did the researchers find?

Phase 1: On average, both overweight and lean teenagers ate a very high number of calories during the fast-food meal. They ate an average of 1,652 calories. The overweight adolescents ate more than lean participants.

Phase 2: Overweight teenagers ate more calories on fast-food days than on days without fast food. Lean teenagers did not eat more calories on fast-food days.

Lean teenagers appeared to compensate for high-calorie, fast-food meals by eating less during the rest of the day. Overweight adolescents did not compensate in this way.

What were the limitations of the study?

During phase 2, teenagers self-reported what and how much they ate. Self-reporting can be inaccurate since people may not recall what or how much they ate.

What are the implications of the study?

Public health measures should be aimed at limiting the amount of fast food that children and teenagers eat. This could include nutrition education campaigns, regulation of fast-food advertising, and getting rid of fast food restaurants in schools.