NCHS Data Brief ■ No. 375 ■ August 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Fast Food Intake Among Children and

Adolescents in the United States, 2015–2018

Cheryl D. Fryar, M.S.P.H, Margaret D. Carroll, M.S.P.H, Namanjeet Ahluwalia, Ph.D., and

Cynthia L. Ogden, Ph.D.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey

● During 2015–2018, over 

one-third (36.3%) of children 

and adolescents consumed fast 

food on a given day.

● During 2015–2018, children 

and adolescents consumed on 

average 13.8% of their daily 

calories from fast food on a 

given day. Adolescents aged 

12–19 consumed a higher 

percentage of calories from 

fast food than children aged 

2–11 years.

● Non-Hispanic white 

adolescents aged 12–19 

consumed a lower percentage 

of calories from fast food 

on a given day than both 

non-Hispanic black and 

Hispanic adolescents.

● The percentage of calories 

from fast food in children 

and adolescents decreased 

from 14.1% in 2003–2004 

to 10.6% in 2009–2010, and 

then increased to 14.4% in 

2017–2018. 

Fast food has been associated with higher caloric intake and poorer diet quality 

in children and adolescents (1). In 2011–2012, children and adolescents aged 

2–19 years consumed on average 12.4% of their daily calories from fast food 

on a given day (2). This report presents 2015–2018 estimates of the percentage 

of calories consumed from fast food on a given day among U.S. children and 

adolescents by demographic characteristics and trends since 2003.

What percentage of children and adolescents consumed fast 

food on a given day?

During 2015–2018, 36.3% of children and adolescents aged 2–19 years 

consumed fast food on a given day (Figure 1). Among children and 

adolescents, 11.1% obtained less than 25% of their daily calories from fast 

food, 13.8% obtained 25%–45% of their daily calories from fast food, and 

11.4% obtained more than 45% of their daily calories from fast food. 

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.

Figure 1. Percentage of children and adolescents aged 2–19 years who consumed fast food on a 

given day, by percentage of daily calories consumed: United States, 2015–2018 

NOTE: Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db375-tables-508.pdf#1.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018.

63.7

11.1

13.8

11.4

36.3

No fast food consumed

Less than 25% of 

calories from fast food

25%–45% of calories

from fast food 

Over 45% of calories 

from fast food
NCHS Data Brief ■ No. 375 ■ August 2020

■  2  ■

Did the percentage of calories consumed from fast food on a given day 

differ by sex or age?

During 2015–2018, children and adolescents aged 2–19 years consumed on average 13.8% of 

their daily calories from fast food (Figure 2). For boys and girls overall, the observed difference 

in the percentage of calories from fast food was not significant. There was no difference by sex 

for children aged 2–11 years but in adolescents aged 12–19, girls (18.5%) had a higher average 

daily intake than boys (14.9%). 

The percentage of calories consumed from fast food increased with age. In children aged 

2–11 years, the average percentage of calories consumed from fast food was 11.4%, while in 

adolescents aged 12–19, the average percentage of calories consumed was 16.7%. This difference 

by age was seen among both boys and girls.

Figure 2. Mean percentage of calories from fast food on a given day among children and adolescents aged 2–19 years, 

by sex and age: United States, 2015–2018 Percent

1Significantly different from those aged 12–19 years.

2Significantly different from boys of the same age group.

NOTE: Access data table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db375-tables-508.pdf#2.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018.

Total Boys Girls

Age group

20

15

5

0

10

2–19

13.8

12.7

14.9

2–11

111.4 110.9

112.0

12–19

16.7

14.9

218.5
NCHS Data Brief ■ No. 375 ■ August 2020

■  3  ■

Did the percentage of calories consumed from fast food on a given day 

differ by race and Hispanic origin? 

Non-Hispanic white children and adolescents aged 2–19 years consumed a significantly lower 

percentage of daily calories from fast food (12.9%) compared with non-Hispanic black (16.9%) 

and Hispanic (14.8%) children and adolescents (Figure 3). No significant difference was seen 

between Hispanic and non-Hispanic black children and adolescents. 

There was no significant difference by race and Hispanic origin for children aged 2–11 

years. However, among adolescents aged 12–19, non-Hispanic white adolescents consumed 

a significantly lower percentage of daily calories (14.8%) from fast food, compared with 

non-Hispanic black (21.5%) and Hispanic (18.5%) adolescents. The observed difference between 

non-Hispanic black and Hispanic adolescents was not significant. 

Adolescents aged 12–19 consumed a higher percentage of calories from fast food than did 

children aged 2–11 years for all race and Hispanic origin-groups.

Figure 3. Mean percentage of calories from fast food on a given day among children and adolescents aged 2–19 years, 

by race and Hispanic origin and age: United States, 2015–2018 Percent

1Significantly different from non-Hispanic white children and adolescents of the same age group.

2Significantly different from those aged 12–19 years.

NOTE: Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db375-tables-508.pdf#3.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018.

Non-Hispanic white Non-Hispanic black Hispanic

Age group

25

20

15

5

0

10

2–19

12.9

116.9

114.8

2–11

211.5

212.9 211.8

12–19

14.8

121.5

118.5
NCHS Data Brief ■ No. 375 ■ August 2020

■  4  ■

Has the percentage of calories consumed from fast food on a given day 

among children and adolescents changed between 2003 and 2018? 

Overall, the average percentage of calories consumed from fast food among children and 

adolescents decreased from 14.1% in 2003–2004 to 10.6% in 2009–2010, and then increased to 

14.4% in 2017–2018 (Figure 4).

A similar pattern was observed by age group. In children aged 2–11 years, the average 

percentage of calories consumed from fast food decreased from 12.1% in 2003–2004 to 8.5% in 

2009–2010, and then increased to 11.5% in 2017–2018. For adolescents aged 12–19, the average 

percentage of calories consumed from fast food decreased from 16.4% in 2003–2004 to 13.1% in 

2009–2010, and then increased to 18.0% in 2017–2018.

Figure 4. Trends in mean percentage of calories from fast food on a given day among children and adolescents aged 

2–19 years: United States, 2003–2004 through 2017–2018 Percent

1Significant quadratic trend from 2003–2004 through 2017–2018. 

NOTE: Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db375-tables-508.pdf#4.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2003–2018.

Survey years

2003–

2004

2–111

12–191

2005–

2006

2–191

2007–

2008

2009–

2010

2011–

2012

2013–

2014

2015–

2016

2017–

2018

20

15

5

0

10
NCHS Data Brief ■ No. 375 ■ August 2020

■  5  ■

Summary

Fast food has been associated with increased intake of calories, fat, and sodium (3). During 

2015–2018, over one-third of U.S. children and adolescents aged 2–19 years consumed fast food. 

Children and adolescents consumed an average 13.8% of their calories from fast food on any 

given day. Adolescents aged 12–19 consumed a higher average percentage of daily calories from 

fast food than did younger children, overall and across all demographics. The average percentage 

of calories from fast food was higher among non-Hispanic black and Hispanic adolescents than 

non-Hispanic white adolescents. The average percentage of calories consumed from fast food 

among children and adolescents decreased from 2003–2004 to 2009–2010, and then increased 

after 2009–2010.

Definitions

Fast-food: For each food and beverage item that respondents reported consuming during their 

24-hour dietary recall, the participant is also asked about the source where they obtained those 

items. Food reported as “restaurant fast food/pizza” was considered fast food for these analyses.

Calories, kilocalories: A calorie is a measure of the energy produced as foods or beverages are 

burned for energy in the body. The term calorie is usually used when discussing energy from 

foods and diets, but the calorie being referred to is actually a kilocalorie (4). In this report, the 

term calorie refers to kilocalorie. 

Percentage of daily calories from fast food: Computed as the calories from foods reported as fast 

foods divided by total calories reported for an individual on a given day multiplied by 100.
NCHS Data Brief ■ No. 375 ■ August 2020

■  6  ■

Data source and methods

Data from the National Health and Nutrition Examination Survey (NHANES) 2003–2018 

were used for these analyses (5). Data from 2015–2018 were used to test differences between 

subgroups. Eight, 2-year cycles were used in testing trends over time in mean percentage of 

calories from fast food.

NHANES is a cross-sectional survey conducted by the National Center for Health Statistics 

(NCHS) designed to monitor the health and nutritional status of the civilian noninstitutionalized 

U.S. population. It consists of home interviews followed by standardized physical examinations 

in mobile examination centers (MEC). The NHANES sample is selected through a complex, 

multistage probability design (6). 

Dietary information was obtained via an in-person, 24-hour (midnight to midnight) dietary 

recall interview with trained interviewers in the MEC (7). Dietary interviews for participants 

less than six years of age were conducted with a proxy. Interviews of children aged 6 to 8 years 

were conducted with a proxy, and the child was present to assist in reporting intake information. 

Interviews of children aged 9–11 years were conducted with the child and the assistance of 

a proxy familiar with the child’s intake. Participants aged 12 years or older answered for 

themselves. Limitations, such as underreporting, are associated with 24-hour recalls and have 

been well characterized (7,8). However, despite these limitations, dietary data still have utility 

in assessing population outcomes (9). Fast food consumption, expressed as a percentage of total 

energy intake, partially adjusts for misreporting (8). 

Day 1 dietary sample weights, which accounted for the differential probabilities of selection, 

nonresponse, and noncoverage, as well as day of the week of dietary recall and nonresponse to 

the dietary interview, were incorporated into the estimation process. Taylor series linearization 

was used to compute variance estimates. Differences between subgroups, as well as linear trends, 

were evaluated using orthogonal contrasts to calculate a Student’s t statistic. If a quadratic trend 

was found, Joinpoint software and piecewise regression were used to determine if changes in 

trend occurred over time (10). Differences were considered significant at p < 0.05. Statistical 

analyses were conducted using SAS-callable SUDAAN version 11.0 (RTI International, Research 

Triangle Park, N.C.).

About the authors

Cheryl D. Fryar, Margaret D. Carroll, Namanjeet Ahluwalia, and Cynthia L. Ogden are with the 

National Center for Health Statistics, Division of Health and Nutrition Examination Surveys.
NCHS Data Brief ■ No. 375 ■ August 2020

■  7  ■

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 167(1):14–20. 

2013. 

2. Vikraman S, Fryar CD, Ogden CL. Caloric intake from fast food among children and 

adolescents in the United States, 2011–2012. NCHS Data Brief, no 213. Hyattsville, MD: 

National Center for Health Statistics. 2015.

3. Wu HW, Sturm R. What’s on the menu? A review of the energy and nutritional content of 

U.S. chain restaurant menus. Public Health Nutr 16(1):87–96. 2013. 

4. Energy. In: Food, nutrition, and diet therapy. 7th ed. Krause MV, Mahan LK, editors. 

Philadelphia, PA: WB Saunders Company. p 9–23. 1984.

5. National Center for Health Statistics. National Health and Nutrition Examination Survey: 

Questionnaires, datasets, and related documentation. Available from: https://wwwn.cdc.gov/nchs/

nhanes/default.aspx.

6. Chen TC, Clark J, Riddles MK, Mohadjer LK, Fakhouri THI. National Health and Nutrition 

Examination Survey, 2015−2018: Sample design and estimation procedures. National Center for 

Health Statistics. Vital Health Stat 2(184). 2020.

7. Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES dietary data: 

Focus on collection, release, analytical considerations, and uses to inform public policy. Adv Nutr 

7(1):121–34. 2016. 

8. Subar AF, Freedman LS, Tooze JA, Kirkpatrick SI, Boushey C, Neuhouser ML, et al. 

Addressing current criticism regarding the value of self-report dietary data. J Nutr 145(12): 

2639–45. 2015. 

9. Hebert JR, Hurley TG, Steck SE, Miller DR, Tabung FK, Peterson KE, et al. Considering 

the value of dietary assessment data in informing nutrition-related health policy. Adv Nutr 

5(4):447–55. 2014.

10. National Cancer Institute. Joinpoint trend analysis software (Version 4.5.0.1). 2017.
NCHS Data Brief ■ No. 375 ■ August 2020

Keywords: diet • restaurant • pizza • calories • NHANES Suggested citation

Fryar CD, Carroll MD, Ahluwalia N, 

Ogden CL. Fast food intake among children 

and adolescents in the United States, 

2015–2018. NCHS Data Brief, no 375. 

Hyattsville, MD: National Center for Health 

Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Ryne Paulose-Ram, M.A., Ph.D., Acting 

Director

Lara Akinbami, M.D., Acting Associate 

Director for Science

For e-mail updates on NCHS publication 

releases, subscribe online at: 

https://www.cdc.gov/nchs/email-updates.htm.

For questions or general information

about NCHS:

Tel: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

Internet: https://www.cdc.gov/nchs

Online request form: https://www.cdc.gov/info

ISSN 1941–4927 Print ed.

ISSN 1941–4935 Online ed.

CS318264 

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road, Room 4551, MS P08

Hyattsville, MD 20782–2064

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

For more NCHS Data Briefs, visit:

https://www.cdc.gov/nchs/products/databriefs.htm.

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS

PERMIT NO. G-284