Researchers find that Dining out is almost always a recipe for unhealthy eating

The average American gets about one in five of their calories from restaurant food, but much of that food is of poor nutritional quality, according to a study published Wednesday in the Journal of Nutrition.

The study found that about a third of the meals eaten at full-service restaurants and about 70 percent of those consumed at fast-food establishments have little or no nutritional value.

Furthermore, less than 0.1 percent of restaurant meals purchased by Americans are of “ideal quality,” which the study defines as being sufficiently nutritional to receive a high “healthy diet” score from the American Heart Association (AHA). The AHA recommends that people eat plenty of fruits, vegetables, fish, whole grains, nuts, legumes and seeds, while cutting back on salt, sugar, saturated fat and processed meats.

Needless to say, the findings of this new study are troubling.

The study’s senior author and dean of the Friedman School of Nutrition Science and Policy at Tufts University, in a released statement.

“It should be a priority to improve the nutritional quality of both full-service and fast-food restaurant meals, while reducing disparities so that all Americans can enjoy the pleasure and convenience of a meal out that is also good for them,” he adds.

Study details

For the study, the Tufts researchers analyzed data collected from a nationally representative sample of more than 35,000 American adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2016. As part of the survey, participants provided accounts of all the food they had consumed within a 24-hour period — and where.

Those answers revealed that on any given day, 30 percent of American adults eat at least one meal at a full-service restaurant and 46 percent do so at a fast-food place. Almost 15 percent do so at both.

For the average American, 21 percent of their daily calories now come from restaurant food.

One of the fastest growing trends in Americans’ dining out habits involves breakfast. In 2016,  8 percent of all breakfasts consumed in the United States were purchased at fast-food places, up from 4 percent in 2003.

The study also found that people who eat at full-service restaurants are more likely to be white and to have at least some college education and a higher income. Those who eat at fast-food restaurants are more likely to be black, younger and overweight.

Men are more likely than women to dine at both places.

The study also identified some growing disparities in the nutritional quality of restaurant meals consumed by various demographic groups. For example, white and Mexican-Americans saw the average quality of their fast-food meals increase over the 13 years of the study. That wasn’t true for blacks.  In addition, the proportion of poor-quality fast-food meals purchased by people with a college degree dropped from 74 percent to 60 percent during the study period. For people without a high school diploma, that figure held steady at 76 percent.

New strategies needed

The study comes with several caveats. Most notably, it relies on self-reported dietary information, which may not have been accurate and, thus, could have affected the study’s results. People are particularly likely to over-report their consumption of healthy foods and to underestimate their consumption of unhealthy ones.

If that bias occurred in this study, however, it would mean that the percentages of unhealthy meals purchased by Americans at full-service and fast-food restaurants are even greater than reported.

This study’s findings underscore “the need for strategies to improve the nutritional quality of US restaurant meals,” Mozaffarian and his colleagues conclude.

“Our results highlight specific priorities for improving the healthfulness of restaurant meals consumed by US adults, including greater availability and selection of fruits, vegetables, whole grains, fish/shellfish, and nuts/seeds/legumes,” they write. “Potential strategies could include altering the ‘default’ sides for major menu items, e.g. offering fruits or vegetables in place of French fries. Marketing and pricing are also powerful tools to influence choice, and should be leveraged by restaurants to improve the nutritional quality of meals consumed in their establishment.”

“Our food is the number one cause of poor health in the country, representing a tremendous opportunity to reduce diet-related illness and associated healthcare spending,” says Mozaffarian.  “At restaurants, two forces are at play: what’s available on the menu, and what Americans are actually selecting. Efforts from the restaurant industry, consumers, advocacy groups, and governments should focus on both these areas.”