Trends in Consumption of Solid Fats, Added Sugars, Sodium, Sugar-Sweetened Beverages, and Fruit from Fast Food Restaurants and by Fast Food Restaurant Type among US Children, 2003-2010

Energy intakes from fast food restaurants (FFRs) have declined among US children. Less is known about the corresponding trends for FFR-sourced solid fats, added sugars, and sodium, and food groups of interest, such as fruit and sugar-sweetened beverages (SSBs). Using data from a single 24-h dietary recall among 12,378 children aged 4-19 years from four consecutive cycles of the nationally-representative National Health and Nutrition Examination Survey (NHANES), 2003-2010 a custom algorithm segmented FFRs into burger, pizza, sandwich, Mexican cuisine, chicken, Asian cuisine, fish restaurants, and coffee shops. There was a significant population-wide decline in FFR-sourced solid fats (-32 kcal/day, p-trend < 0.001), added sugars (-16 kcal/day; p-trend < 0.001), SSBs (-0.12 servings (12 fluid ounces or 355 mL)/day; p-trend < 0.001), and sodium (-166 mg/day; p-trend < 0.001). Declines were observed when restricted to fast food consumers alone. Sharp declines were observed for pizza restaurants; added sugars, solid fats, and SSBs declined significantly from burger restaurants. Fruit did not change for fast food restaurants overall. Temporal analyses of fast food consumption trends by restaurant type allow for more precise monitoring of the quality of children's diets than can be obtained from analyses of menu offerings. Such analyses can inform public health interventions and policy measures.