Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
J Nutr. 2020 Apr 1;150(4):873-883. doi: 10.1093/jn/nxz299.
Meals from full-service restaurants (FS) and fast-food restaurants (FF) are an integral part of US diets, but current levels and trends in consumption, healthfulness, and related sociodemographic disparities are not well characterized.
We aimed to assess patterns and nutritional quality (using validated American Heart Association [AHA] diet scores) of FS and FF meals consumed by US adults.
Serial cross-sectional investigation utilizing 24-h dietary recalls in survey-weighted, nationally representative samples of 35,015 adults aged ≥20 y from 7 NHANES cycles, 2003-2016.
Between 2003 and 2016, American adults consumed ∼21 percent of energyfrom restaurants (FS: 8.5% in 2003-2004, 9.5% in 2015-2016, P-trend = 0.38; FF: 10.5%; 13.4%, P-trend = 0.31). Over this period, more FF meals were eaten for breakfast (from 4.4% to 7.6% of all breakfasts, P-trend <0.001), with no changes for lunch (15.2% to 15.3%) or dinner (14.6% to 14.4%). In 2015-2016, diet quality of both FS and FF were low, with mean AHA diet scores of 31.6 and 27.6 (out of 80). Between 2003 and 2016, diet quality of FF meals improved slightly, (the percentage with poor quality went from 74.6% to 69.8%; and with intermediate quality, from 25.4% to 30.2%; P-trend <0.001 each). Proportions of FS meals of poor (∼50%) and intermediate (∼50%) quality were stable over time, with <0.1% of consumed FS or FF meals meeting ideal quality. Disparities in FS meal quality persisted by race/ethnicity, obesity status, and education and worsened by income; whereas disparities in FF meal quality persisted by age, sex, and obesity status and worsened by race/ethnicity, education, and income.
Between 2003 and 2016, FF and FS meals provided 1 in 5 calories for US adults. Modest improvements occurred in nutritional quality of FF, but not FS, meals consumed, and the average quality for both remained low with persistent or widening disparities. These findings highlight the need for strategies to improve the nutritional quality of US restaurant meals.
全服务餐厅（FS）和快餐店（FF）的餐食是美国家庭饮食的重要组成部分，但目前消费的水平和趋势、健康状况以及相关的社会人口差异还没有得到很好的描述。
我们旨在评估美国成年人食用的 FS 和 FF 餐的模式和营养质量（使用经过验证的美国心脏协会[AHA]饮食评分）。
利用 7 个 NHANES 周期（2003-2016 年）中 35015 名年龄≥20 岁的成年人的 24 小时膳食回忆的代表性全国样本进行了一系列的横断面调查。
在 2003 年至 2016 年间，美国成年人从餐厅摄入的能量占总能量的 21%（FS：2003-2004 年为 8.5%，2015-2016 年为 9.5%，P 趋势=0.38；FF：10.5%；13.4%，P 趋势=0.31）。在此期间，早餐时摄入的 FF 餐更多（从所有早餐的 4.4%增加到 7.6%，P 趋势<0.001），午餐（15.2%至 15.3%）和晚餐（14.6%至 14.4%）没有变化。在 2015-2016 年，FS 和 FF 的饮食质量都很低，AHA 饮食评分的平均值分别为 31.6 和 27.6（满分 80 分）。2003 年至 2016 年间，FF 餐的饮食质量略有改善，（质量差的比例从 74.6%降至 69.8%；质量中等的比例从 25.4%升至 30.2%；P 趋势均<0.001）。FS 餐的质量差（约 50%）和质量中等（约 50%）的比例在时间上保持稳定，只有<0.1%的 FS 或 FF 餐达到理想质量。FS 餐质量的差异仍然存在于种族/民族、肥胖状况和教育程度，并且随着收入的增加而恶化；而 FF 餐质量的差异仍然存在于年龄、性别和肥胖状况，并且随着种族/民族、教育程度和收入的增加而恶化。
在 2003 年至 2016 年间，FF 和 FS 餐为美国成年人提供了五分之一的卡路里。FF 餐的营养质量有所改善，但 FS 餐没有改善，两种餐的平均质量仍然较低，且差异持续存在或扩大。这些发现强调了需要制定策略来提高美国餐厅餐的营养质量。
