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Eating out often may add to kids' cardiovascular risk
13/11/05 - 16/11/05, Dallas, Texas
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Scientific Sessions, the largest cardiovascular meeting
in the world, is being held in Dallas, Texas Nov. 13–16.
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DALLAS, Nov. 14 – Children who frequently eat out
score worse on measures of cardiovascular disease (CVD) risk
than those who eat more meals at home, researchers reported at
the American Heart Association’s Scientific Sessions 2005.
“As a culture, we say we value physical activity
and healthy eating, but in reality we’re all about convenience
and convenience foods because we have such busy schedules,” said
study author Karen Olson, R.N., executive director of the
Cardiovascular Research and Education Foundation in Wausau, Wis.
“We are seeing younger and younger patients with
more aggressive cardiovascular disease, and we realized we
needed to take a closer look at our young people to see when
risk factors emerge and why,” she said. “We’re concerned because
we know that children who have cardiovascular risks grow up to
be adults who have these risks.”
The project initially included 759 participants,
but only 621 completed the diet and exercise surveys.
Researchers examined these remaining participants to find out
the relationship between the development of CVD risk factors and
eating outside the home.
Researchers randomly selected students in the 2nd,
5th, 8th and 11th grades who participated in the Wausau SCHOOL
(School Children Have early Onset Of Leading risk factors for
CVD and diabetes) Project, an examination of the development of
risk factors for CVD and diabetes. The SCHOOL project earlier
found that 40 percent of the children followed had at least one
lipid abnormality.
Twenty-percent of the students (126) indicated that
they had eaten out four or more times weekly, not including
lunches in the school cafeteria.
Compared with the 495 students who ate out less
than four times a week, those who dined out often had
significantly:
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Higher systolic and diastolic blood pressure.
Systolic blood pressure (the top, higher number) measures
the force on the arteries when the heart is contracting.
Diastolic blood pressure is the pressure when the heart is
at rest between beats.
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Lower levels of high-density lipoprotein (HDL)
— the “good” cholesterol that protects against heart
disease.
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Smaller LDL particle size. Small, dense LDL
particles are associated with atherosclerosis (a build-up of
artery-clogging plaque).
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Lower scores on the quantitative
insulin-sensitivity check index (QUICKI). Lower insulin
sensitivity is an early sign of progression towards type-2
diabetes.
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Significantly overall higher dietary intake of
starch, sugar, sodium, fat and cholesterol.
“Children who ate out more frequently were not
significantly more overweight than their peers who ate out less
frequently,” Olson said. “But this might just reflect that the
dietary patterns have not yet had their full impact on body
weight. However, their diets and exercise patterns differed
significantly from the children eating at home more often.”

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Researchers questioned children about their activities and,
using pictures illustrating portion sizes, asked about their
typical diet and what they ate during the last week. Compared
with the average consumption in the total group of children,
those eating at home ate slightly less sugar, sodium, fat and
cholesterol, while those eating out ate substantially more foods
containing those ingredients.
“In a 21-meal week, eating out four times shouldn’t
create the high-sugar, high-sodium, high-fat intake that we
saw,” Olson said. “We think it’s not just the eating out but the
way these children are eating all the time, with lots of frozen
pizzas and packaged macaroni and cheese on the days they eat at
home.”
The study didn’t include information about take-out
foods consumed at home, so it may underestimate the number of
fast-food meals consumed by the children, researchers noted.
Children who ate out more often also drank almost
twice as many sodas and other soft drinks, about six cups a week
compared with 3.65 cups a week for the children who ate out less
often. Punch, sugary juice drinks and diet soda were counted as
sodas.
“For these children, soda is no longer a treat —
it’s something you have every day or several times a day,” Olson
said. Sodas are now banned from Wausau School District public
schools but were available at middle and high schools in Wausau
during the study (2002-03 school year).
According to researchers, children who ate out more
often were also significantly less active than their peers. Not
counting school or time spent reading or doing homework at the
computer, children who ate out more often spent an average of
3.59 hours a day in sedentary activities such as playing
computer games and watching television. Children who ate out
less often spent 2.78 hours a day in sedentary activities.
“I think what we’ve tapped into here is a whole
different lifestyle,” said study statistician Bryan Hendricks,
Ph.D., of the University of Wisconsin in Madison.
The researchers are working on interventions to
encourage more physical activity and healthier eating for
children.
“Ideally, we can teach people the skills to
consciously include active living and healthy eating in their
busy lives,” Olson said.
Researchers said that there may be other factors
besides eating out that may have resulted in higher risk factor
scores, noting that the study is retrospective and self-reported
information.
Other co-authors are Dana Macalalad, R.D.; Judy
Omernik, R.D.; Patrick Hughes, M.D.; and David Murdock, M.D.
Funding was provided in part by the Centers for
Disease Control and Prevention, CaRE Foundation and Wausau Heart
Institute and Wausau Health Foundation, Aspirus partners.
Statements and conclusions of study authors that
are published in the American Heart Association scientific
journals are solely those of the study authors and do not
necessarily reflect association policy or position. The American
Heart Association makes no representation or warranty as to
their accuracy or reliability.
Editors note: The American Heart Association has
joined forces with the Clinton Foundation in an alliance to help
prevent childhood obesity. The alliance is addressing the issue
by targeting four key areas that influence children’s lifestyles
and behaviors: industry, schools, health care professionals and
kids themselves. The alliance plans to announce a program where
restaurants can be recognized for meeting healthy criteria for
kids’ meals.
Sources
American Heart Association - Scientific Sessions - 2005
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