Children who frequently dine out get more starch, sugar, salt, and fat than those who eat at home, says researcher Karen Olson, RN, executive director of the Cardiovascular Research and Education Foundation in Wausau, Wis.
More disturbingly, she tells WebMD, they have higher blood pressure, lower levels of "good" HDL cholesterol, and smaller LDL particle size. Small, dense LDL particles are a known risk factor for atherosclerosis, a build-up of artery-clogging plaque.
They are also more likely to have low insulin sensitivity, an early signal of diabetes, she says. Eating out two or three times a week didn't appear to have heart-harmful effects, Olson says. "But children who eat out four or more times a week seem to be setting [themselves] up for cardiovascular disease down the road."
The message for parents, Olson says, is that "you need to make healthy choices when you eat out." Most restaurants, even those that serve fast food, now have salads and other low-fat, low-sugar choices, she says.
Older Kids Eat Out More
The study, presented here at the annual meeting of the American Heart Association, included 621 children and teens in the second, fifth, eight, and 11th grades. They filled out diet and exercise surveys that asked them where they ate, what they ate, how much they ate, and how often they ate as well as how frequently they engaged in various activities.
About one-fifth of the students indicated that they had eaten out four or more times weekly, not including lunches in the school cafeteria or take-out food brought home to eat.
The older a child, the more frequently he or she dined out, the survey showed. Only 15% of second graders ate out four or more times a week, compared with 37% of 11th graders.
"The children that ate out more frequently were also more sedentary," Olson says. Not counting school or time spent reading or doing homework at the computer, children who dined out more often spent almost four hours a day playing computer games and watching television. Children who ate out less often spent fewer than three hours a day in sedentary activities.
Children who ate out four or more times a week also drank more than 1.5 times as many sodas and other sugary drinks -- about 6 cups a week compared with fewer than 4 cups a week for the children who ate out less often.
Problems With Prepared Foods
Surprisingly, the children who ate out more frequently were not significantly more overweight than their peers. "But this might just reflect that the dietary choices have not yet had their full impact on body weight," Olson says.
She also urges parents to make more balanced meals at home. "Eating out four times [a week] shouldn't create the high-sugar, high-sodium, high-fat intake that we saw. We think these children are also eating a lot of unbalanced meals at home -- frozen pizzas and packaged macaroni and cheese and so on."
Robert Bonow, MD, a past president of the American Heart Association and a heart specialist at Northwestern University in Chicago, agrees that the problem is not just where your child eats, but what he or she eats.
"We've moved to supersized meals in restaurants and to supersized meals at home," he tells WebMD.
An even bigger problem, Bonow says, is that more and more fast-food restaurants are popping up near schools.
"A recent study in Chicago showed that fast-food chains are clustering near schools, while other types of restaurants are located all over the city. We have to teach our kids to make healthy choices early on," he says.