United States 

Department of 

Agriculture

Economic

Research

Service

Economic

Information

Bulletin

Number 105

December 2012

Nutritional Quality of Food Prepared 

at Home and Away From Home, 

1977-2008

Biing-Hwan Lin

Joanne Guthrie
www.ers.usda.gov

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Lin, Biing-Hwan, and Joanne Guthrie. Nutritional Quality of Food Prepared at 

Home and Away From Home, 1977-2008, EIB-105, U.S. Department of 

Agriculture, Economic Research Service, December 2012.
United States

Department

of Agriculture

www.ers.usda.gov

A Report from the Economic Research Service

Abstract

Food prepared away from home (FAFH)—whether eaten in restaurants, fast-food and 

other locations, or as take-out or delivery to be eaten at home—is now a routine part of the 

diets of most Americans, accounting for 41 percent of food expenditures and 32 percent of 

caloric intake. This report analyzes data on individuals 2 years of age and older from two 

national food consumption surveys (one conducted in 1977-78 and another in 2005-08) to 

assess changes in the consumption and nutritional quality of FAFH versus food prepared 

at home (FAH). In the past three decades, FAH has changed more in response to dietary 

guidance, becoming signifi cantly lower in fat content and richer in calcium, whereas 

FAFH did not. In 2005-08, FAFH was also higher in saturated fat, sodium, and cholesterol and lower in dietary fi ber than FAH. The increased popularity and lower nutritional 

quality of FAFH is prompting new health promotion strategies, such as menu labeling.

Keywords: food away from home, food at home, food consumption, diet quality, 

Nationwide Food Consumption Survey, NFCS, National Health and Nutrition 

Examination Survey, NHANES

Acknowledgments

The authors thank Nicole Larson, University of Minnesota, School of Public Health; 

Margaret A. McDowell, U.S. Department of Health and Human Services, National 

Institutes of Health; and Samantha Snyder, USDA, Economic Research Service (ERS), 

for their comments and suggestions. The authors also thank Ephraim Leibtag for coordination of the report, Angela Anderson for editorial support, and Cynthia A. Ray for 

design support, ERS.

Biing-Hwan Lin

Joanne Guthrie

Nutritional Quality of Food 

Prepared at Home and Away 

From Home, 1977-2008

Economic

Information 

Bulletin 

Number 105

December 2012
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Contents

Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Data and Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

 The Data: 1977-78 and 2005-08 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

 Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Changes in the Nutritional Quality of Food Prepared at Home and 

Away From Home: 1977-2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

 Food Prepared Away From Home Grabs a Larger Share 

 of Caloric Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

 Intake of Total Fat Fell Substantially . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

 Calcium Density Fell for School Foods . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Nutritional Quality of Foods, by Food Source: 2005-08. . . . . . . . . . . . . 10

 Away-From-Home Food Sources Are High in Overconsumed 

 Food Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

 Away-From-Home Foods Are Low in Calcium and 

 Dietary Fiber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
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Summary

What Is the Issue?

Food prepared away from home (FAFH)—whether from table-service 

restaurants, fast-food establishments and other locations, or from a take-out 

or delivery meal eaten at home—is now a routine part of the diets of most 

Americans. Previous Economic Research Service (ERS) research found that 

FAFH tends to be lower in nutritional quality than food prepared at home 

(FAH), increases caloric intake, and reduces diet quality among adults and 

children. This study updates previous research by examining dietary guidance and the nutritional quality of FAH versus FAFH in 2005-08, compared 

with 1977-78. Poor diets contribute to obesity, heart disease, stroke, cancer, 

diabetes, osteoarthritis, and other health conditions that impose a substantial 

economic burden on individuals and society. The increased popularity of 

FAFH is prompting new health promotion strategies, such as menu labeling, 

to address this challenge.

What Did the Study Find?

As the share of food expenditures spent on FAFH has risen over the past 30 

years, so has the share of calories and nutrients consumed from such food. 

Previous ERS research found that FAFH in the 1990s contained less of the 

food components Americans underconsume, such as calcium and dietary 

fi ber, and more of those overconsumed, such as fat, compared with FAH.

Examining the changes in intake from FAFH and FAH, as reported in 

national Federal surveys for 1977-78 and 2005-08, we found that:

• Americans increased their away-from-home share of caloric intake from 

17.7 percent in 1977-78 to 31.6 percent in 2005-08, mainly from tableservice and fast-food restaurants.

• Mean daily consumption of total fat declined signifi cantly over the period 

studied in both absolute terms (grams) and as a share of calories. On 

average, Americans consumed 85.6 grams of total fat per day in 1977-78, 

compared with 75.2 grams in 2005-08. The percent of calories from total 

fat also declined substantially from 39.7 percent to 33.4 percent between 

1977 and 2008. Comparing estimates for total fat content between FAFH 

and FAH shows that the gap has widened over time. Total fat in 1977-78 

accounted for 39.6 and 39.9 percent of calories from FAH and FAFH, 

respectively, compared with 30.5 and 37.2 percent in 2005-08.

• Mean daily calcium intake rose from 743 milligrams (mg) in 1977-78 

to 919 mg in 2005-08. For every 1,000 calories from FAH, Americans 

increased their calcium intake from 425 mg to 559 mg in that time 

period, whereas the calcium density in FAFH remained relatively 

constant at 452-460 mg per 1,000 calories. 

• Foods obtained at schools had the highest calcium content among all 

food sources in both periods, but the amount of calcium per 1,000 calories from school foods declined from 742 mg in 1977-78 to 646 mg 

in 2005-08. The amount of calcium per 1,000 calories in fast-foods 

increased from 344 mg in 1977-78 to 372 mg in 2005-08.
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Data from 2005-08 also included information on saturated fat, cholesterol, 

sodium, and dietary fi ber intake that was unavailable in 1977-78, allowing 

further analysis of the nutritional differences between FAH and FAFH in the 

more recent period. We found that in 2005-08:

• FAFH was higher in saturated fat than FAH. The higher percent of calories from saturated fat in fast-foods was especially noteworthy at 13.5 

percent, compared with 11.9 percent in restaurant foods, 12.3 percent in 

school foods, and 10.7 percent in FAH.

• FAFH contained 1,820 mg of sodium per 1,000 calories, considerably 

higher than FAH at 1,369 mg of sodium. Foods from restaurants and 

fast-food establishments were particularly sodium-dense at 2,151 mg and 

1,864 mg of sodium per 1,000 calories, respectively.

• Similarly, FAFH was more cholesterol-dense than FAH at 144 mg and 

126 mg of cholesterol per 1,000 calories, respectively. Within FAFH 

sources, restaurant foods were most cholesterol-dense at 206 mg per 

1,000 calories.

• Even though school foods had the highest calcium content among all 

food sources, low calcium content in foods consumed at restaurants and 

fast-food places resulted in lower calcium content overall for FAFH at 

460 mg per 1,000 calories, compared with 559 mg for FAH.

• FAFH, especially fast-foods, were lower in dietary fi ber (an underconsumed food component) than FAH, 6.8 grams versus 7.7 grams per 

1,000 calories. 

How Was the Study Conducted?

Our analysis used national food consumption survey data from the 1977-78 

Nationwide Food Consumption Survey (NFCS), conducted by the U.S. 

Department of Agriculture (USDA), as well as data from the 2005-06 and 

2007-08 National Health and Nutrition Examination Survey (NHANES), 

conducted jointly by USDA and the U.S. Department of Health and Human 

Services, to examine how the nutritional quality of FAH and FAFH has 

changed. NHANES has been conducted continuously since 1999, however, 

2009-10 NHANES data were not released until after this research was 

completed. Away-from-home sources include restaurants with wait staff, 

fast-food establishments, schools and day care (for children), and other awayfrom-home places (other). Analyses focused on the nutrient intake emphasized in Federal dietary guidelines for Americans 2 years of age and older. 

Changes in the consumption of calories, total fat, and calcium from FAH and 

FAFH sources over the past 30 years were examined statistically. In addition, 

intake of saturated fat, cholesterol, sodium, and dietary fi ber during 2005-08 

were analyzed to examine the differences in the nutritional quality of FAH 

and FAFH. Our analyses incorporated complex survey design effects and 

sample weights to estimate population means and test differences in means 

over time and by food source.
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Introduction

Poor diets contribute to obesity, heart disease, stroke, cancer, diabetes, osteoarthritis, and other health conditions that impose substantial economic burden 

on Americans (USDA/USDHHS, 2011; USDHHS, 2010). The medical costs 

associated with overweight and obesity have been estimated as high as $147 

billion, or 10 percent of all medical costs in 2008 (Finkelstein et al., 2009; 

O’Grady and Capretta, 2012; Tsai et al., 2011). These enormous costs are 

one reason that USDA and other public and private entities place a high 

priority on improving Americans’ diets. 

Food prepared away from home (FAFH)—whether eaten in restaurants, fastfood and other locations, or a take-out or delivery meal eaten at home—is 

now an important part of Americans’ diets. The share of total food expenditures spent on FAFH rose steadily from 25.9 percent in 1970 to a peak of 

41.9 percent in 2006-07 and then declined to 41.3 percent in 2010 (USDA/

ERS, 2012). Previous ERS research found that, in the 1990s, the nutritional 

quality of FAFH was inferior to food prepared at home (FAH) (Guthrie et 

al., 2002). More recent ERS studies found that FAFH increased daily caloric 

intake and reduced diet quality in both adults and children after controlling 

for observed and unobserved personal characteristics that could be associated 

with differences (Todd et al., 2010; Mancino et al., 2010), contributing to 

poor diet and obesity risk.

Over time, however, differences between FAFH and FAH may change 

as consumers buy more pre-prepared items in grocery stores, possibly 

decreasing the differences between the two food sources (Smith, 2010); 

therefore, re-examination of differences between the two food categories is 

merited. In this study, we analyzed food consumption survey data collected 

by the U.S. Department of Agriculture (USDA) during 1977-78 and USDA 

and the U.S. Department of Health and Human Services (USDHHS) in 

2005-08 to examine how the nutritional quality of FAH and FAFH has 

changed over the past 30 years. Data on three dietary components that have 

received considerable attention as a part of public health efforts—food energy 

(calories), total fat, and calcium—are available for both 1977-78 and 2005-

08, allowing trend analysis. Reducing intake of calories and total fat was a 

major focus of dietary advice during much of the time period between the 

two surveys, as was the need to increase calcium intake. Trends in average 

intake, shares of intake by food source, and nutrient density by food source 

were compared statistically. Information on intake of four additional nutrients targeted as public health concerns—cholesterol, saturated fat, sodium, 

and dietary fi ber—are available from the 2005-08 dataset. Differences in the 

FAFH and FAH content of these nutrients in 2005-08 are examined statistically. Comparing dietary quality by food preparation source provides insight 

into how the impact of dietary advice may be moderated by environmental 

factors, such as increased availability and consumption of FAFH.
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Food preparation sources are categorized into two broad categories: FAH 

and FAFH. FAFH is disaggregated further into four sources—restaurant 

with waiter service (restaurant), fast-food establishment (fast-food), school 

cafeteria and school (day care center),1 and other away-from-home places 

(other). We analyzed two sets of nationally representative survey data to 

report mean nutrient intake by food source for adults and children 2 years of 

age and older. Differences in intake over time and by food source were tested 

for statistical signifi cance using SUDAAN software (RTI, 2005) to incorporate survey design and sample weights in the analysis.

1School (day care center) applies to 

children only. 
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Data and Methods

The Data: 1977-78 and 2005-08

Between 1935 and 1998, USDA conducted food consumption surveys 

to assess the nutritional well-being of the U.S. population. Since 2002, 

USDA has worked with USDHHS to collect and release “What We Eat in 

America,” a component of the National Health and Nutrition Examination 

Survey (NHANES), which reports food consumption and nutrient intake data 

from a nationally representative sample of Americans (USDHHS, 2005-06 

and 2007-08). In this study, we analyzed consumption data from USDA’s 

1977-78 Nationwide Food Consumption Survey (NFCS) as well as from the 

two most recent cycles of NHANES—2005-06 and 2007-08—available at 

the time of our analysis. 

The 1977-78 NFCS collected food intake data for 3 consecutive days, and 

the 2005-08 NHANES recorded 2 nonconsecutive days of food intake 

data. In both surveys, respondents were interviewed in person to collect 

intake data for the fi rst day, whereas intake information on subsequent days 

was collected using different methodologies (a self-reported food diary in 

1977-78 versus a telephone interview in 2005-08). We analyzed only fi rstday data to minimize potential bias that may have occurred due to differences in timing (consecutive versus nonconsecutive days) and data collection 

methods (Cavadini et al., 2000). Because the Federal Dietary Guidelines 

for Americans (USDHHS/USDA, 2011) do not apply to individuals under 2 

years of age, infants and toddlers were excluded from the analysis, resulting 

in 18,285 respondents from the 2005-08 NHANES and 29,402 respondents 

from the 1977-78 NFCS.

The surveys collected data on the types and amounts of foods individuals 

ate and where the food was obtained; using this information, calorie and 

nutrient intake data were calculated by USDA. The distinction between food 

at home (FAH) and food away from home (FAFH) in the study was based 

on where the food was obtained, not where it was eaten. FAH is purchased 

at retailers, such as a grocery store, a convenience store, or a supermarket; it 

may be eaten at home or away, as in a brown-bag lunch. FAFH is purchased 

mainly from foodservice establishments and is further disaggregated into 

four sources—restaurant, fast-food, school, and other. It may be eaten at one 

of those establishments or eaten at home, as with a delivery or take-out meal. 

Food consumption survey methodology has improved over the past three 

decades. Some methodological changes may have contributed to the differences reported here:

• A fi ve-step Automated Multiple-Pass Method (AMPM) improves the 

completeness of data collection and has been employed in NHANES but 

not in NFCS (Raper et al., 2004). Adopting AMPM may reduce underreporting, resulting in an increase in reported food intake, but the extent 

of its contribution is unknown. 

• Food sources have been expanded, and Hispanic names of eating occasions have been added in NHANES. Because eating occasions are not 

defi ned for the respondents, interpretations of eating-occasion names may 
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play a role in the observed differences in meal eating patterns. 

Consequently, we chose not to report meal eating patterns and nutritional 

quality by meal occasion in this report.2

Methods

Both NFCS and NHANES employed complex survey designs and provided 

sample weights to generate nationally representative projections. We used 

SUDAAN statistical software (RTI, 2005) to incorporate survey design 

effects and sample weights to generate estimates of means and standard 

errors. NFCS and NHANES were treated as independent samples to test the 

differences in means for the two periods or by food sources. 

There are two approaches to estimating population means and proportions 

(Freedman et al., 2008). We used the mean approach, in which, for a given 

nutrient value (e.g., FAFH’s share of calories), we calculated the share for 

each respondent and then calculated the weighted average using sample 

weights. Alternatively, the weighted sum of a variable (e.g., calories from 

FAFH) can be calculated and then totaled in a fi rst step, and then the analyst 

can take the ratio—the ratio approach. These two approaches often yield 

similar results, although they may produce different but equally valid results 

(Krebs-Smith et al., 1989). 

Observed changes in dietary patterns over time may come from a variety of 

sources, including an aging U.S. population, the changing racial and ethnic 

makeup of the U.S. population, and other socioeconomic factors that may 

infl uence food consumption decisions. In this study, we compared mean 

dietary patterns for the two periods without adjusting for changing age, 

racial, and ethnic composition over time. Further research would be needed 

to identify the role of such factors.

2In addition to eating-out frequency, 

caloric intake from FAFH and its share 

of total calories are infl uenced by portion size and the difference in caloric 

content of the same food prepared at 

home and away from home. Changes 

in portion sizes over time have been 

studied by Nielsen and Popkin (2003). 

There are more than 7,000 food items 

reported in NHANES, and there are 

additional data challenges in comparing 

the nutritional quality of the same food 

prepared at home and away from home. 

Further research on the factors affecting 

caloric intake by food source is needed 

to explain differences.
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Changes in the Nutritional Quality of Food 

Prepared at Home and Away From Home: 1977-2008

Seven dietary components were examined in the study, including calories, 

total fat, saturated fat, cholesterol, sodium, dietary fi ber, and calcium. In 

1980, the Federal Government began publishing the Dietary Guidelines 

for Americans, a set of recommendations to the U.S. population for healthy 

eating that is updated every 5 years. Over most of the period studied, these 

guidelines encouraged Americans to control their caloric intake to maintain 

or achieve healthy weight, moderate total fat, reduce saturated fat, cholesterol, and sodium, and increase calcium and fi ber intake (Davis and Saltos, 

1999; USDA/USDHHS, 2005). Of these targeted nutrients, only calories, 

total fat, and calcium were reported in the 1977-78 NFCS. Our discussion 

focuses fi rst on the intake trends for calories, total fat, and calcium between 

1977 and 2008, followed by a discussion of intake during 2005-08 of all the 

food components examined in this study.

Food Prepared Away From Home Grabs 

a Larger Share of Caloric Intake

Estimated caloric intake rose signifi cantly from 1,875 calories a day during 

1977-78 to 2,002 calories in 2005-08 (table 1). It should be noted, however, 

that improved survey methodology could contribute to the increase in 

reported caloric intake. Americans increased their shares of caloric intake 

from FAFH, from 17.7 percent in 1977-78 to 31.6 percent in 2005-08 (table 

2, fi g. 1). During 1977-2008, the share of calories from restaurants doubled 

(from 3.3 to 6.7 percent) and fast-food places registered a four-fold increase 

(from 3.1 to 13.2 percent). School’s share of total caloric intake rose to 3.7 

percent in 2005-08 from 3.0 percent in 1977-78. 

Table 1

U.S. mean daily caloric and nutrient intakes of individuals 2 years 

of age and older, 1977-78 and 2005-08

Nutrient Period Mean SE

Calories (kcal)

1977-78 1,875.12 12.84

2005-08 2,002.46 12.29

Total fat (grams)

1977-78 85.63 0.85

2005-08 75.19 0.66

Calcium (milligrams)

1977-78 743.45 11.58

2005-08 918.61 8.47

Saturated fat (grams) 2005-08 25.45 0.23

Cholesterol (milligrams) 2005-08 259.26 2.37

Sodium (milligrams) 2005-08 3,085.15 21.42

Dietary fi ber (grams) 2005-08 13.91 0.14

SE = Standard error of the mean.

kcal = Kilocalories.

Note: The sample size for 1977-78 was 29,402 and for 2005-08 was 18,285.

Source: First-day intake from the USDA 1977-78 Nationwide Food Consumption Survey and 

the USDA/USDHHS 2005-08 National Health and Nutrition Examination Survey.
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Table 2

Average shares of U.S. caloric and nutrient intakes, by food source, for individuals 2 years of age and 

older, 1977-78 and 2005-08

Calories Total fat Calcium Saturated fat Cholesterol Sodium Fiber

Source

Mean

% SE

Mean

% SE

Mean 

% SE

Mean

% SE

Mean

% SE

Mean

% SE

Mean

% SE

Home

1977-78 82.28 0.40 81.94 0.40 83.14 0.35 na na na na

2005-08 68.45 0.44 65.10 0.49 70.26 0.42 65.68 0.48 63.91 0.54 64.14 0.48 68.61 0.45

Away from home:

1977-78 17.72 0.40 18.06 0.40 16.86 0.35 na na na na

2005-08 31.55 0.44 34.90 0.49 29.74 0.42 34.32 0.48 36.09 0.54 35.86 0.48 31.39 0.45

Restaurant

1977-78 3.27 0.22 3.52 0.23 2.86 0.20 na na na na

2005-08 6.72 0.19 7.47 0.22 5.36 0.16 7.09 0.20 8.76 0.25 8.16 0.25 6.90 0.19

Fast-food

1977-78 3.11 0.11 3.21 0.12 2.74 0.10 na na na na

2005-08 13.17 0.27 15.78 0.32 11.66 0.25 15.50 0.32 16.13 0.35 15.59 0.31 13.20 0.28

School

1977-78 2.95 0.14 3.08 0.14 3.68 0.15 na na na na

2005-08 3.65 0.21 3.78 0.23 4.45 0.25 3.95 0.23 3.89 0.23 3.88 0.24 3.89 0.24

Others

1977-78 8.40 0.26 8.24 0.25 7.59 0.24 na na na na

2005-08 8.00 0.22 7.86 0.23 8.28 0.18 7.78 0.23 7.32 0.25 8.24 0.23 7.39 0.21

na = Not available. SE = Standard error of the mean. 

Note: The sample size for 1977-78 was 29,402 and for 2005-08 was 18,285.

Source: First-day intake from the USDA 1977-78 Nationwide Food Consumption Survey and the USDA/USDHHS 2005-08 National Health and 

Nutrition Examination Survey.
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Intake of Total Fat Fell Substantially

U.S. daily intake of total fat for individuals 2 years of age and older declined 

signifi cantly from 85.6 grams in 1977-78 to 75.2 grams in 2005-08 (see 

table 1). FAFH’s share of total fat intake rose proportionally more than the 

increase in its share of caloric intake during 1977-2008. The largest change 

was seen in fast-food, which accounted for 3.2 percent of the total fat intake 

in 1977-78, whereas the share rose to 15.8 percent in 2005-08 (see table 2). 

The gap in total fat content between FAH and FAFH was almost nonexistent 

in 1977-78 but has since widened. In 1977-78, total fat accounted for 39.6 

and 39.9 percent of caloric intake from FAH and FAFH foods, respectively 

(table 3). In 2005-08, total fat accounted for 30.5 and 37.2 percent of total 

Table 3

Average nutrient density, by food source, for U.S. individuals 2 years of age and older, 

1977-78 and 2005-08

Total fat Calcium Saturated fat Cholesterol Sodium Fiber

Source Mean SE Mean SE Mean SE Mean SE Mean SE Mean SE

Percent kcal mg/1,000 kcal Percent kcal mg/1,000 kcal mg/1,000 kcal g/1,000 kcal

Total

1977-78 39.72 0.17 405.80 3.97 na na na na

2005-08 33.39 0.14 488.41 3.38 11.37 0.06 130.30 1.23 1,535.80 5.69 7.24 0.06

Home

1977-78 39.61 0.17 425.38 3.85 na na na na

2005-08 30.45 0.17 558.91 10.38 10.68 0.07 126.21 1.68 1,368.87 6.86 7.71 0.07

Away from home:

1977-78 39.93 0.19 451.71 9.20 na na na na

2005-08 37.23 0.17 459.86 23.29 12.36 0.06 143.97 1.56 1,820.17 12.59 6.78 0.06

Restaurant

1977-78 44.78 0.37 325.06 4.55 na na na na

2005-08 38.34 0.40 332.14 6.69 11.85 0.16 205.89 3.98 2,151.42 24.72 7.47 0.11

Fast-food

1977-78 40.25 0.25 343.60 9.65 na na na na

2005-08 41.05 0.17 372.43 5.76 13.47 0.07 143.11 1.61 1,864.29 16.65 5.94 0.06

School

1977-78 39.90 0.22 741.74 20.76 na na na na

2005-08 33.62 0.35 645.66 16.55 12.28 0.13 111.96 3.42 1,609.49 22.12 7.67 0.20

Others

1977-78 38.13 0.28 438.05 9.44 na na na na

2005-08 31.46 0.32 645.11 65.29 11.33 0.14 127.91 3.64 1,591.37 56.63 7.69 0.13

na = Not available. SE = Standard error of the mean. kcal = Kilocalories. mg = Milligrams. g = Grams.

Note: The sample size for 1977-78 was 29,402 and for 2005-08 was 18,285.

Source: First-day intake from the USDA 1977-78 Nationwide Food Consumption Survey and the USDA/USDHHS 2005-08 National Health and 

Nutrition Examination Survey.
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calories from FAH and FAFH, respectively. Food consumed at restaurants 

had the highest total fat content (44.8 percent of calories from total fat) in 

1977-78, but their fat content declined over time and was surpassed by fastfoods in 2005-08. Fast-food places are the only food source from which 

foods have become more fat dense over time, rising from 40.3 percent of 

calories from fat in 1977-78 to 41.1 percent in 2005-08. In contrast, the fat 

content of foods consumed at schools declined over time, from 39.9 percent 

of calories from total fat in 1977-78 to 33.6 percent in 2005-08. During the 

period studied, school foods may have changed in response to the Healthy 

Meals for Healthy Americans Act of 1994 (Public Law 103-448), which 

required the National School Lunch and School Breakfast Programs to meet 

standards based on the 1990 edition of the Dietary Guidelines for Americans, 

including the requirement that no more than 30 percent of the calories in a 

meal come from total fat (Ralston et al., 2008).

Calcium Density Fell for School Foods 

Mean calcium intake rose signifi cantly from 743 mg a day in 1977-78 to 919 

mg in 2005-08 (see table 1). Mirroring the increasing popularity of eating 

out, the FAFH share of calcium intake rose signifi cantly from 16.9 percent 

in 1977-78 to 29.7 percent in 2005-08 (see table 2). The calcium density of 

FAH rose signifi cantly from 425 mg per 1,000 calories in 1977-78 to 559 mg 

in 2005-08 (see table 3, fi g. 2). The calcium density of FAFH, however, has 

remained essentially constant over time; the increase from 452 mg to 460 mg 

per 1,000 calories between 1977 and 2008 was not statistically signifi cant. 

Examining different sources of FAFH reveals disparate trends. The calcium 

density of restaurant foods has remained constant; whereas foods consumed 

at fast-food places have become more calcium dense, rising signifi cantly 
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from 344 mg to 372 mg per 1,000 calories between 1977 and 2008 (see table 

3). This increase was offset by a decline in calcium density of foods obtained 

at school.

Because milk is a required food component in the USDA National School 

Lunch Program, previous research has shown that foods consumed at school 

cafeterias have the highest calcium density among all food sources (Lin 

et al., 1999). The calcium density of school foods dropped signifi cantly, 

however, from 742 mg to 646 mg per 1,000 calories between 1977 and 2008 

(see table 3). This is consistent with declining average milk consumption 

among children and the proportion of children consuming milk over time 

(Lin and Ralston, 2003). These changes may be attributable to the increased 

availability of non-USDA foods and beverages for sale in schools (so called 

“competitive foods”) over this period (Poppendieck, 2010). Substitution of 

these competitive foods and beverages (e.g., sugar-sweetened beverages in 

place of milk) may have led to the lower calcium density of foods obtained 

at school. Schools are the only food source for which calcium density has 

declined, and the drop is noteworthy at 13 percent.
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Nutritional Quality of Foods, by Food Source: 

2005-08

In addition to calorie, fat, and calcium data, the 2005-08 NHANES included 

information on intake of saturated fat, cholesterol, sodium, and dietary fi ber 

that was not available in the 1977-78 NFCS. This allowed us to conduct more 

extensive comparisons of food quality by food preparation source in the more 

recent period.

Away-From-Home Food Sources Are High in 

Overconsumed Food Components

During 2005-08, FAFH foods accounted for 31.6 percent of caloric intake and 

34.9 percent of total fat intake (see table 2), indicating that FAFH foods are 

higher in fat than FAH. In fact, the shares of total fat intake from restaurant, 

fast-food, and school sources were all higher than their shares of caloric intake. 

There are 11 pair-wise differences in total fat content by various food sources; 

each pair-wise difference was statistically signifi cant at the 1-percent or better 

probability level (table 4). Fast-food had the highest total fat content at 41.1 

percent, followed by restaurant and school foods at 38.3 and 33.6 percent, 

respectively, as compared with 30.5 percent for home foods. Similarly, FAFH 

foods were higher in saturated fat content than home foods (12.4 versus 10.7 

percent of caloric intake), and fast-food had the highest saturated fat content 

(13.5 percent) among all food sources, followed by schools and restaurants 

(12.3 and 11.9 percent, respectively). As in the case of total fat, each pair-wise 

difference in saturated fat content by food source was statistically signifi cant at 

the 1-percent probability level, except for the differences between restaurants 

and schools and between restaurants and other FAFH sources, which were 

signifi cant at the 5-percent level (table 4).

Americans 2 years of age and older consumed an average of 259 mg of 

cholesterol per day during 2005-08 (see table 1), below the 300-mg-per-day 

limit recommended by Federal dietary guidance (USDA/USDHHS, 2010). 

Each of the 11 pair-wise differences in cholesterol density by food source 

was statistically signifi cant at the 1-percent level, except for home foods 

and other FAFH foods (table 4). For every 1,000 calories of intake, restaurant foods contained 206 mg of cholesterol, fast-foods contained 143 mg, 

and other FAFH contained 128 mg. School foods had the lowest cholesterol 

density (112 mg per 1,000 calories) followed by home foods (126 mg per 

1,000 calories).

Individuals 2 years of age and older consumed an average of 3,085 mg of 

sodium per day during 2005-08 (see table 1), compared with the current 

Federal dietary recommendation of less than 2,300 mg per day (USDA/

USDHHS, 2011). As with total fat, saturated fat, and cholesterol, FAFH 

foods are more sodium dense than FAH. With the exception of the difference between foods consumed at school and other FAFH sources, each pairwise difference by food source was statistically signifi cant at the 1-percent 

level. For each 1,000 calories of intake, foods consumed in restaurants and 

fast-food places contained 2,151 mg and 1,864 mg of sodium, respectively, 

compared with 1,369 mg in home foods (see table 3, fi g. 3). 
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Table 4

Statistical signifi cance of differences in nutrient density, by food source, 2005-08

 Home Restaurant Fast-food School

Nutrient All away Restaurant Fast-food School

Other 

FAFH Fast-food School

Other 

FAFH School

Other 

FAFH

Other 

FAFH

Total fat

T-statistic -28.74 -18.11 -44.47 -8.11 -2.80 -6.19 8.82 13.40 18.96 26.50 4.54

Signifi cant level 0.00 0.00 0.00 0.00 0.01 0.00 0.00 0.00 0.00 0.00 0.00

Calcium

T-statistic 3.88 18.37 15.71 -4.44 -1.30 -4.56 -17.57 -4.77 -15.60 -4.16 0.01

Signifi cant level 0.00 0.00 0.00 0.00 0.19 0.00 0.00 0.00 0.00 0.00 0.99

Saturated fat

T-statistic -17.67 -6.67 -27.64 -10.53 -4.18 -9.32 -2.07 2.43 7.89 13.73 4.91

Signifi cant level 0.00 0.00 0.00 0.00 0.00 0.00 0.04 0.02 0.00 0.00 0.00

Cholesterol

T-statistic -7.75 -18.46 -7.27 3.75 -0.42 14.63 17.91 14.46 8.25 3.82 -3.19

Signifi cant level 0.00 0.00 0.00 0.00 0.67 0.00 0.00 0.00 0.00 0.00 0.00

Sodium

T-statistic -31.47 -30.50 -27.50 -10.39 -3.90 9.63 16.34 9.06 9.20 4.62 0.30

Signifi cant level 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.77

Dietary fi ber

T-statistic 10.27 1.84 19.03 0.17 0.12 11.96 -0.92 -1.32 -8.48 -12.32 -0.07

Signifi cant level 0.00 0.07 0.00 0.87 0.90 0.00 0.35 0.19 0.00 0.00 0.94

FAFH = Food prepared away from home.

Note: The tests are based on the means, standard errors of the mean, and the sample size (18,285).

Source: First-day intake from the USDA/USDHHS 2005-08 National Health and Nutrition Examination Survey.
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Away-From-Home Foods Are Low in Calcium 

and Dietary Fiber

For every 1,000 calories consumed during 2005-08, FAH contained 559 mg 

of calcium, which was 22 percent higher than the 460 mg per 1,000 calories in FAFH foods as a whole (see table 3). School foods had the highest 

calcium density (646 mg per 1,000 calories), compared with fast-food establishments and restaurants (372 mg and 332 mg, respectively). FAH was also 

higher in dietary fi ber density than FAFH (7.7 compared with 6.8 grams per 

1,000 calories), mainly because of the low fi ber density of fast-food (5.9 

grams). There was no signifi cant difference in the fi ber density of FAH and 

that of food consumed at schools and other FAFH places. The fi ber density 

of restaurant foods was slightly lower than the fi ber density of foods made at 

home; the difference was signifi cant at the 10-percent level. 
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Discussion

Over the past 30 years, food prepared away from home (FAFH) has become 

a regular part of most Americans’ diets, and those who monitor food trends 

expect this to continue (Balzer, 2012). FAFH accounted for 41 percent of 

food spending in 2008 (USDA/ERS, 2012) and contributed 32 percent of 

caloric intake, based on our analysis. Unfortunately, consumption of FAFH 

has been found to increase caloric intake and reduce diet quality in both 

adults and children (Todd et al., 2010; Mancino et al., 2010).

Poor diets contribute to obesity, heart disease, stroke, cancer, diabetes, 

osteoarthritis, and other health conditions that impose substantial economic 

burdens on individuals and society (USDA/USDHHS, 2011; USDHHS, 

2010). With estimates of the medical costs associated with overweight and 

obesity in 2008 ranging as high as $147 billion, or 10 percent of all medical 

costs (Finkelstein et al., 2009), it is not surprising that USDA, USDHHS, 

and other public and private entities place a high priority on improving 

Americans’ diets. 

National food consumption survey data collected in 1977-78 and 2005-08 

were used to compare the nutritional profi les of FAFH and FAFH over the 

past 30 years. In 2005-08, Americans consumed more calories, less fat, and 

more calcium compared with 1977-78. In general, FAH was more dense in 

two underconsumed dietary components—calcium and dietary fi ber—and less 

dense in total fat, saturated fat, cholesterol, and sodium compared with FAFH. 

Given the current epidemic of obesity among Americans, the higher caloric 

intake associated with FAFH has drawn particular policy attention. Anderson 

and Matsa (2011) have argued that this level of concern is exaggerated, as 

individuals may compensate for higher caloric intake from FAFH meals by 

eating fewer calories at a later meal. Levitsky (2005), however, in a review of 

several experimental tests of energy compensation, concluded that compensation for overconsumption appears to be imprecise and suggested that this 

may explain changes in body mass index (BMI) associated with long-term 

exposure to environmental factors that encourage higher caloric intake. 

Because NHANES collects intake data for 2 nonconsecutive days, the data 

are not suitable for examining the extent of compensation. More research on 

the effects of regular, long-term consumption of FAFH on caloric intake, diet 

quality, and weight status is needed, but our results suggest that its association with higher caloric intake and lower diet quality deserves public health 

attention.

Both FAH and FAFH changed in many ways between the two periods. 

Over time, FAH has come to include more pre-prepared items, which might 

make FAH more nutritionally similar to FAFH (Smith, 2010). Despite this 

continuing trend, the nutritional quality of FAH changed much more than 

that of FAFH, perhaps in response to dietary recommendations, such as those 

to reduce fat and saturate fat intake; it also became more calcium dense. 

Given these differences, many experts encourage Americans to eat more 

home-prepared meals as a means of improving diets. Time constraints associated with changes in household structure and women’s workforce involvement, however, may discourage cooking (Mancino and Newman, 2007). 

Innovations that simplify and speed food preparation, such as pre-washed, 
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peeled, and/or chopped vegetables (Lucier et al., 2006) and quick, healthy, 

simple recipes (USDA/NAL, 2012), have become popular and may help 

address such barriers. 

To improve FAFH nutritional quality, not only must healthy food options 

be available but consumers must respond by making those choices. There 

are several reasons why consumers might behave differently when choosing 

and consuming food prepared away from home compared with homeprepared food (Lin et al., 1999). They might have different attitudes about 

FAFH, considering it a special treat, compared with FAH. Even if they are 

concerned about FAFH’s nutrient content, they might lack the information to 

make good choices or have fewer healthy options available. 

School food is a special case in that schools are more regulated environments. Changes in USDA school meal regulations that occurred in the 1990s 

appear to have had an effect on the quality of school food, reducing its total 

fat content. Fat content declined most in elementary schools, where school 

food services faced less competition from non-USDA “competitive” foods 

(Newman et al., 2009). More recent legislation, the Healthy Hunger-Free 

Kids Act of 2010, requires further improvement in USDA school meals 

and limits the availability of less-healthful competitive foods and beverages 

(USDA/FNS, 2010). This has the potential to further improve the nutritional 

profi le of foods obtained at school.

Outside of the school environment, other solutions may be considered. One 

policy change now underway hinges on improving nutrition information. 

Since the 1990s, most packaged food sold in retail outlets has been required 

to carry nutrition labeling. This may have encouraged consumers to make 

healthier purchases. In contrast, consumers may have less knowledge of the 

nutritional content of food prepared in restaurants and other outlets. In 2010, 

the Patient Protection and Affordable Care Act mandated that calorie information be made available on menu boards in chain restaurants with more 

than 20 outlets nationally to provide consumers with nutritional information 

that may help them make better choices.

Will menu labeling improve food choices? A limited amount of research has 

been conducted based on implementation of local menu labeling laws. The 

fi ndings from these studies were not completely consistent, but generally 

suggested that menu labeling had a relatively limited impact on consumer 

behavior (Larson and Story, 2009; Lowenstein, 2011). Information may not 

be the only factor driving differences in consumer choices when purchasing 

FAFH. As mentioned previously, consumers may have different attitudes 

about FAFH; they may still consider it an occasional treat for which less 

nutritional concern is warranted. This attitude may have fi t with the eating 

patterns of 1977-78 but does not match eating patterns today. Nutrition 

education efforts and point-of-purchase messages raising awareness of 

the importance of FAFH as a part of the everyday diet may be helpful and 

increase consumer response to menu labeling information. Menu labeling 

may also prompt restaurants to offer more healthy options and to reformulate 

current offerings. A California study found that restaurants were particularly likely to reformulate items high in calories, fat, or sodium in response 

to the establishment of a State menu labeling law (Robert Wood Johnson 
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Foundation, 2011). Such supply-oriented effects may increase the effectiveness of menu labeling.

Another potential explanation for differences in FAH and FAFH can be 

proposed based on behavioral economic theory. Behavioral economics posits 

that visceral factors, such as hunger and sensory stimuli, may overwhelm 

self-control, resulting in more impulsive decisions that deliver short-term 

rewards (Mancino and Kinsey, 2008). For example, when hungry, the sight 

and smell of a high-calorie treat may be particularly irresistible. FAFH decisions are more likely to be made just prior to eating, and thus fall prey to 

this problem. Current behavioral economic research explores strategies for 

avoiding these problems, such as pre-commitment. For example, ordering a 

healthy meal online and picking it up on the way home may help consumers 

avoid the temptation to choose a less healthy option when standing in line at 

a take-out restaurant. Behavioral economics also has demonstrated the power 

of defaults in guiding choice. In response, public health advocates have urged 

restaurants and fast-food places to make the healthier options for beverages 

and side dishes the default choice in children’s meals, with positive results 

among operators who have made the switch (CSPI, 2011). Several other 

strategies based on behavioral economics may encourage healthful choices 

(Wansink, 2006) and merit further study.

Implementing menu labeling regulations will provide an opportunity to 

test the value of nutrition information in helping consumers make better 

choices when eating out. Consumer education, increased numbers of healthy 

FAFH offerings, and behavioral economic strategies may also help, reinforcing information approaches. Given the importance of FAFH in overall 

diet quality, the success of such efforts will have important implications for 

improving Americans’ diets and health.
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