How young is too young when it comes to developing a fast food habit? Even in California, a state with one of the lowest rates of obesity for young children, the habit starts in toddlerhood.
A whopping 60 percent of 2-to-5-year-olds in California eat fast food at least once a week, and one in 10 eats fast food at least three times a week, according to a policy brief recently published by the UCLA Center for Health Policy Research. The majority of children also fall short of the recommended daily serving of five fresh fruits or vegetables. The numbers for both fast food and produce consumption hold steady from 2007 to 2009, the last two times the information was collected via a telephone survey with the child's main caregiver (most often a parent).
For lead researcher Sue Holtby, M.P.H., of the Public Health Institute, the fast food consumption numbers are troubling because of what it indicates for the rest of the family.
"For this age group, it's probably the whole family that's eating it," Holtby said in a phone interview. "It's fast, cheap and kids like the taste of it. Unfortunately, it sets you to want more of that kind of taste, which can lead to overweight."
But food patterns varied across ethnic groups. Seventy percent of Latino kids in the survey had eaten one fast food meal last week. But when factoring in all ethnicities, that number dropped to 60 percent -- showing that Latino kids are outpacing kids of other ethnicities in fast food consumption. Meanwhile, 40 percent of Asian children ate at least five fruits or vegetables the previous day, in contrast to 56 percent among all ethnic groups.
Because children ages 2 to 5 don't have their own transportation or money, the parents or the caregivers are the ones obtaining the fast food meals for them and deciding how much produce they're eating. Indeed, parents admitted as much during the phone surveys. But, like fast food or vegetable consumption, levels of perceived influence varied across ethnicities as well.
While 90.7 percent of white parents and 93.3 percent of African American parents said they had "a lot" of influence over their children's diets, only 78.1 percent of Latino parents and 70.9 percent of Asian parents reported the same. And in Spanish-speaking homes, parents said they felt they had even less influence, which is in line with a separate finding that more than 84 percent of all food and beverages commercials on Spanish-language television shows for children were for unhealthy foods like candy, soda and fries, compared to 72.5 percent of ads on English-language shows.
While the numbers are concerning, the policy brief also points out that only 10 percent of California's 2-to-5-year-old population is either overweight or obese, as opposed to 25 percent nationwide. And the state's arguably successful attempts to limit the soda industry do point to a possible plan of action against fast food restaurants. For example, soda consumption among young children has steadily decreased in California across all income levels, according to the policy brief; in 2009, only 16 percent of young children had consumed soda the previous day. In 2003, that number was 40.4 percent.
As the brief points out, California takes one of the most aggressive stances against the soda industry. California mandates that daycares serve only low-fat or nonfat milk to toddlers, limit juice and make clean water available. In 2003, the state also became the first in the nation to ban soda sales in elementary schools, and it spread to high schools between 2005 and 2009.
"The reason school foods are so important is because kids spend so much time there," said Juliet Sims, M.P.H., a Program Manager with the Prevention Institute, a non-profit public health organization. "Children on average get 30 to 50 percent of their calories at school."
Sims was not involved in the survey, but reviewed the policy brief and praised the study for pointing out that different groups of children are being disproportionately impacted by unhealthy foods. She also said that more research needs to be done, especially when it comes to parents' perception over their impact on children's diets.
Holtby agrees. She's looking into convening focus groups to explore the reasons parents feel more or less influence over their family's diets, and whether or not their perception matches up with what's actually happening at the table. But for now, Holtby says that the survey serves as a wake-up call for parents to examine what they're really putting in front of their toddlers and young children.
"What we're trying to point out is that it's a very young age for kids to be eating fast food regularly," Holtby concluded. "When you're developing a kid's eating habits and you have so much control, it seems like its a good time to start off with healthy eating habits and just have a fast food meal, once in a while, not every week."
The policy brief is a collaboration between UCLA and the Public Health Institute and was funded by First 5 California, a state initiative focused on improving the health and education of California residents aged five and under. The analysis is based on telephone surveys of 2,600 to 3,400 families in 2003, 2005, 2007 and 2009, the largest state health survey in the nation.