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Don't Eat Fast Food
A few weeks ago I laid responsibility for obesity in America at the feet of the fast food companies. A bit over the top, maybe, but not too far fetched. My comments did elicit some responses as you might expect.

Fast Food: Not Much Better
(But at Least No Worse)
I know from talking to my patients that people eat a lot of fast food, but I hadn't realized that over 25% of adults in the United States eat fast food at least twice a week. Overall, fast food accounts for 15% of food consumed in the U.S. Even worse, children eat more fast food than they eat at school.

Fast Food and Depression
There's been a fair amount of research into depression and diet, mostly focusing on the Mediterranean Diet in general, one component of it (olive oil) or looking at specific nutrients like omega-3 fatty acids and B vitamins. All of these are associated with a reduced risk of depression.

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Fast Food Kids' Meals

Just as in the United States, kids in Australia eat a lot of fast food
- one recent study estimates that 25% of school children in Australia
eat fast food at least once a week, with that number increasing to
43% in adolescents. That's actually lower than in the United States,
where about 30% of high school age kids eat fast food more than three
times a week.

The fast food industry in Australia self-regulates their advertising
to children through a voluntary code. Those who sign the code pledge
that they may only market to children if those products meet minimum
nutrition standards with regard to the number of calories and the
amounts of sugar, saturated fat and salt in the foods. As you might
expect, these standards are set by the fast food industry itself.
A report in the journal Appetite (2012;58(1):105-110) notes that the
lunch and dinner meals should each provide only about 30% of a child's
daily energy requirements. How do children's fast food meals fare
against that 30% target?

The Australian researchers made use of the nutrition information available
from the website of each fast food chain that sold meals targeted
toward children. They calculated each possible combination of foods
that could be purchased from each chain and analyzed each meal's
calories, saturated fat, salt and sugar contained in each meal. The
six companies that signed the self-regulation pledge - Chicken Treat,
Hungry Jack's, KFC, McDonald's, Oporto and Red Rooster - were included
in the analysis.

Despite having signed the self-regulation pledge, only 16% of the possible
meal combinations actually met the industry-defined criteria set
for children between the ages of 4 and 8. Only 22% of the possible
meals met the criteria for 9-13 year olds. KFC, Chicken Treat and
Red Rooster had no meals
that met the criteria for 4-8 year olds. Furthermore, KFC and Chicken
Treat had no meals that met the criteria for 9-13 year olds. These
companies were not even meeting their own, self-defined standards!

Worse yet, when the nutrition facts for the fast food meals were compared
to children's actual daily requirements, as much as 55% of the meal
combinations exceeded 30% of a child's total daily requirement of
saturated fat and sugar. Six of the meals actually exceeded 100%
of the total daily requirement of saturated fat for 4 year old children
and 2 others exceeded 100% of the total daily limit for sodium for
children up to 8 years old.

Only 3% of the meals contained less than 30% of the estimated recommendations
for 4 year olds, and only 4% of the meals were appropriate for 8
year olds. (All of these - 13 different meal variations - were from
McDonald's.)

The researchers note that although healthier options for children have
been introduced in many fast food restaurants, "there is no evidence
that they are actually being purchased." In fact, one study the researchers
refer to showed that parents who were ordering food for their 6 to
12 year old children were not actually ordering children's meals
at all - they were ordering adult-sized foods for their kids.

What this means for you

In their conclusion, the researchers recommend something that I've been
advocating for years: the fast food chains should simply reformulate
their foods to be healthier, without telling people that it is healthier.
In the mean time, if you must take your kids out for fast food, the
healthier choices for your kids will be the smaller, chicken-based
meals, such as three piece chicken nuggets or snack wraps, and they
will not include soda. Choose milk, juice or water instead.