Health E-Stat 106: Fast-food Intake Among Children and Adolescents in the United States, August 2021–August 2023

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by Nimit N. Shah, Ph.D., M.P.H., Cheryl D. Fryar, M.S.P.H., Namanjeet Ahluwalia, Ph.D., D.Sc., and Lara J. Akinbami, M.D.

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Fast-food consumption is associated with higher caloric intake and poorer diet quality in children and adolescents (1). During 2015–2018, 36.3% of youth ages 2–19 years consumed fast food on a given day. On average, youth consumed 13.8% of their calories from fast food on a given day (2). This report presents updated estimates of the percentage of calories consumed from fast food on a given day among U.S. children ages 2–11 years and adolescents ages 12–19 years during August 2021–August 2023, based on data from the National Health and Nutrition Examination Survey (NHANES). Trends since 2013–2014 are also presented.

During August 2021–August 2023, 30.1% of youth ages 2–19 years consumed fast food on a given day (Figure 1, Table 1). On average, youth consumed 11.4% of their daily calories from fast food (Figure 2, Table 2). The mean percentage of calories consumed from fast food was 8.5% for children ages 2–11 years and 14.6% for adolescents ages 12–19 years. The difference between boys and girls in the percentage of calories from fast food was not significant overall or by age group. Adolescents ages 12–19 consumed a significantly higher percentage of calories from fast food than children ages 2–11 years overall and by sex.

Among youth ages 2–19 years, the mean percentage of calories consumed from fast food was higher in 2017–March 2020 than August 2021–August 2023 (Figure 3, Table 3). Among children ages 2–11 years, a significant decrease was seen from 2013–2014 to August 2021–August 2023. Among adolescents ages 12–19 years, an increase in mean calories from fast food was seen from 2013–2014 to 2017–March 2020, followed by a decrease.

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Data sources and methods

Data from NHANES August 2021–August 2023 were used to estimate the percentage of calories consumed from fast food on a given day. Trends were assessed using NHANES 2013–2014, 2015–2016, 2017–March 2020, and August 2021–August 2023.

NHANES is conducted by the National Center for Health Statistics and uses a complex, multistage probability design to collect a nationally representative sample of the U.S. civilian noninstitutionalized population (3–5). During August 2021–August 2023, Day 1 dietary recall data were collected by phone after health examinations in mobile examination centers (6). Day 1 dietary weights were used to account for selection probabilities, nonresponse, and day of the week.

Foods and beverages reported on the Day 1 dietary recall from “restaurant fast food/pizza” were classified as fast food. Calories from fast food were divided by total daily calories and multiplied by 100. Statistical testing incorporated Taylor series linearization and orthogonal contrasts. Linear and quadratic trends were assessed using regression models adjusting for varying time between survey cycles. Analyses were conducted using SAS 9.4 (SAS Institute Inc., Cary, N.C.) and SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.).

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References

  1. Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: Effect on energy, beverage, and nutrient intake. JAMA Pediatr. 2013 Jan;167(1):14–20. PMID: 23128151; PMCID: PMC3695401. DOI: https://www.dx.doi.org/10.1001/jamapediatrics.2013.417.
  2. Fryar CD, Carroll MD, Ahluwalia N, Ogden CL. Fast food intake among children and adolescents in the United States, 2015–2018. NCHS Data Brief. 2020 Aug;(375):1–8. PMID: 33054908.
  3. Johnson CL, Dohrmann SM, Burt VL, Mohadjer LK. National Health and Nutrition Examination Survey: Sample design, 2011–2014. Vital Health Stat 2. 2014 Mar;(162):1–33. PMID: 25569458.
  4. Chen TC, Clark J, Riddles MK, Mohadjer LK, Fakhouri THI. National Health and Nutrition Examination Survey, 2015–2018: Sample design and estimation procedures. Vital Health Stat 2. 2020 Apr;(184):1–35. PMID: 33663649.
  5. Akinbami LJ, Chen TC, Davy O, Ogden CL, Fink S, Clark J, et al. National Health and Nutrition Examination Survey, 2017–March 2020 prepandemic file: Sample design, estimation, and analytic guidelines. Vital Health Stat 2. 2022 May;(190):1–36. PMID: 35593699. DOI: https://dx.doi.org/10.15620/cdc:115434.
  6. National Center for Health Statistics. What we eat in America dietary data, NHANES: August 2021–August 2023 24-hour dietary recall interview mode change. 2025 Mar. Available from: https://wwwn.cdc.gov/nchs/data/Nhanes/Public/2021/Whitepapers/Aug2023-What-We-Eat-In-America-Dietary-Data-Whitepaper.pdf.
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Suggested citation

Shah NN, Fryar CD, Ahluwalia N, Akinbami LJ. Fast-food intake among children and adolescents in the United States, August 2021–August 2023. NCHS Health E-Stat. 2025 Jun;(106):1–7. DOI: https://dx.doi.org/10.15620/cdc/174604.

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Figures

Figure 1 is a bar graph on the percentage of children and adolescents ages 2–19 who reported eating fast food on a given day by calories consumed from August 2021 through August 2023.
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Figure 2 is a bar graph on the mean percentage of calories from fast food for children and adolescents ages 2–19 by age group and sex from August 2021 through August 2023.
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Figure 3 is a line graph showing trends in mean percentage of calories from fast food for children and adolescents ages 2–19 from 2013 through 2014 to August 2021 through August 2023.
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