Kids' Bring Out Fat-Filled Diets for Elders

IOWA CITY, Iowa, Dec. 29 -- Children may be a bad influence on adults' diets, researchers here found.

Adults living with children ate an entire pepperoni pizza-worth of extra fat and saturated fat each week compared with adults in a child-free home, according to Helena Laroche, M.D., of the University of Iowa, and colleagues.

Those living with children also more frequently ate high fat food such as cheese, ice cream, beef, pizza and salty snacks but not chocolate, they reported online for the Jan. 4 issue of the Journal of the American Board of Family Medicine.

The researchers analyzed questionnaire and detailed food survey responses from 6,600 adults ages 17 to 65 in the National Health and Nutrition Examination Survey III (NHANES).

They found that adults in a household with children under age 17 ate an additional 4.9 grams (95% confidence interval 0.8 to 9.1) of fat daily, including an extra 1.7 grams of saturated fat (95% CI 0.3 to 3.3), compared with those lacking children in the home.

Parents or caregivers may buy more restaurant, ready-to-eat, or snack foods, all of which are typically higher in fat content, because of time constraints and picky eaters, the authors said.

In addition, the authors pointed out that consumer studies have shown that parents are "two to three times more likely to name their child, not themselves as the family expert for selection of fast food, snack foods, restaurants and new breakfast cereals."

Also almost "50% of parents believe that meal and grocery choices and restaurant selection are influenced by their children." Parents with children are likely to be susceptible in their food choices to both the marketing of convenience in food choices as well as indirectly to the marketing directed at their children."

Physicians, they added, should aim dietary advice at both adults and children, while emphasizing that children should also be eating healthy foods.

Previous studies have also shown that fat intake is correlated within families, which has been interpreted as parent's influence on children's diet.

To see if the reverse may be true as well, the investigators used data from the second, 1991 to 1994 phase of NHANES III in which questions were asked to identify adults with children, though not the age, sex or number of children. The study included a nationally representative population with a diverse ethnic, racial and economic sample.

About half of the adults (48%) reported one or more children living in the household. This proportion was higher among African-American and Mexican American households (P<0.001). While there was no significant effect on the findings by race, foreign-born status or gender of the adult, the researchers adjusted intake data for race, ethnicity, sex, age, education, foreign birth, and poverty income ratio.

After excluding outliers whose 24-hour dietary recall was in the top or bottom 1% for total kilocalories (135 cases less than 524 kcal or above 5,889 kcal), the researchers reported:

• Total calorie intake for adults with children in the household was 2,332 kcal/day (95% CI 2,275 to 2,389),
• Total calorie intake for adults not living with children in the household was 2,282 kcal/day (95% CI 2,229 to 2,337), and
• Adjusting for this nonsignificant 50 kcal/day difference eliminated the significance of the association between children and adult fat (P=0.07) and saturated fat intake (P=0.12).

This attenuation suggests that part of the association between children and fat consumption is that adults with children eat more calories overall.

Food choices with higher fat content appeared to be a factor as well. Adults with children were significantly more likely than adults without children to consume:

• Cheese more than once a day (adjusted odds ratio 1.39, 95% CI 1.09 to 1.79),
• Pizza, calzones, or lasagna more than once a week (adjusted OR 1.37, 95% CI 1.10 to 1.71),
• Cheese dishes more than once a week (adjusted OR 1.50, 95% CI 1.10 to 2.04),
• Beef more than once a week (adjusted OR 1.65, 95% CI 1.27 to 2.13),
• Ice cream or milkshakes more than once a week (adjusted OR 1.37, 95% CI 1.11 to 1.69),
• Cookies, cakes, brownies, pies doughnuts and other pastries more than once a week (adjusted OR 1.27, 95% CI 1.09 to 1.49),
• Bacon, sausage or other processed meats more than once a week (adjusted OR 1.36, 95% CI 1.14 to 1.62),
• Salty snacks more than once a day (adjusted OR 1.69, 95% CI 1.27 to 2.26), and
• Peanuts more than once a week (adjusted OR 1.24, 95% CI 1.03 to 1.49).

Because adults ages 17 to 21 in the study were more likely to be siblings of other children in the household rather than parent or guardian to children, the researchers did an analysis excluding this group.

They found that the associations between fat consumption and children in the household were even stronger among this older cohort. Total fat intake was 5.5 g higher among adults ages 22 and older living with children (P<0.05) and saturated fat intake 2.0 g higher compared with adults without children in the household (P=0.01).

The study was limited by lack of details on the adult's relationship to children in the household and ages of the children as well as the basis of the analysis on only a single 24-hour dietary recall for each individual.

Even if the findings were due to factors not included in the study, physicians still need to approach dietary counseling differently for adults with children in the household than they would for adults not living with children, Dr. Laroche and colleagues wrote.

In addition, they wrote, "these findings suggest that food advertising aimed at children may influence not only the child's diet but also indirectly affect parents' diets."

The U.S. Department of Agriculture's dietary guidelines recommend that adults keep their total fat intake between 20% and 35% of their caloric intake and consume no more than 10% of their calories from saturated fat (less than 20g for a typical 2,000 kcal diet).