But pediatrics and psychiatry associate professor Kerri Boutelle did not anticipate parents choosing junk food over healthier options on the menu, like low-fat milk, yogurt parfaits and apple dippers.

“We were interested in how parents shopped for fast food for their children,” Boutelle said. “The most interesting thing is that there were healthier items on the menu that they could’ve picked but they didn’t.”

Boutelle surveyed 544 families with children entering a fast-food chain restaurant inside Rady Children’s Hospital during lunchtime.

“We stood outside of the McDonald’s for six weeks and we asked people for receipts when they came home,” Boutelle said.

Preschoolers, children age 2 to 5, frequently purchased french fries, cheeseburgers, hamburgers, soda and chicken nuggets. Older children ate similar meals as preschoolers. Children ages 6 to 11 also ate apple pies and children age 12 to 18 also ate chocolate chip cookies. Also, 53 percent of all children surveyed ate a Happy Meal.

Less than 1 percent of all children and adults purchased fruit and yogurt parfaits. Apple dippers were purchased more frequently for those in the 6 to 12 age range. In addition, families purchased chocolate milk more frequently than white milk while apple juice was purchased more frequently for the younger children.

Families kept their receipts and answered questions, such as what food items were purchased, the size of food items, who ate which items and reasons for purchasing certain items.

Families cited multiple reasons for visiting the fast food restaurant. Eighty-six percent said it was because “the children like the food,” 84 percent said it was “convenient,” 73 percent said they “like the food. In addition, 54 percent said “being hungry with no other options” impacted their decision to buy fast food, 48 percent said it was “a reward for visiting the hospital” and 54 percent said they were
“hungry with no other options.”

The study also found that fast food lunch meals made up between 36 and 51 percent of a child’s daily caloric needs. Furthermore, between 35 to 39 percent of calories came from fat and the meals supplied more than 50 percent of the recommended total daily sodium intake.

For pre-schoolers, it provided almost 100 percent of recommended daily sodium levels. For school-aged children, fast food lunch meals provided 50 percent of the recommended daily sodium intake.

“The take-home message is that parents buy more calories for the kids than they think they do or maybe that shopping at fast food restaurants is not going to help kids eat what they need,” Boutelle said.
“In particular, the preschool-age kids were getting more than three-quarters of their daily needed sodium and a few other caloric nutrients.”

In the study, Boutelle suggests that future studies should assess nutritional content of food items by age.

Boutelle conducted the study because there is currently little data available on fast-food purchasing patterns of families. The study did not have any funding sources or corporate affiliations.

Data was collected in 2008 and results were published August 2011.

Readers can contact Regina Ip at [email protected].