Fast food has taken a reputational beating in recent years, with public health advocates attacking the cholesterol, salt, and calories it contains.
But it turns out that the food in classier sit-down restaurants is just as bad.
When Americans eat out at any type of eatery, they consume more fat, cholesterol and sodium, and calories than they do at home, according to data the federal government collected in its National Health and Nutrition Examination Survey (NHANES).
The food at sit-down restaurants was in some ways worse than the burgers, fries, and shakes that have become the symbol of fattening American eating habits.
People who ate at sit-down establishments consumed more cholesterol and sodium than those who ate fast food, according to University of Illinois kinesiology and community health professor Ruopeng An, Ph.D., who crunched the NHANES numbers.
Americans got nearly as many calories at eateries with tablecloths as at those with plastic seats. But sit-down restaurant meals did contain slightly more vitamins, minerals, and fiber as well as slightly less fat and sugar.
“These findings reveal that eating at a full-service restaurant is not necessarily healthier than eating at a fast food outlet,” An said. “In fact, you may be at higher risk of overeating in a full-service restaurant than when eating fast food. My advice to those hoping to consume a healthy diet and not overeat is that it is healthier to prepare your own foods, and to avoid eating outside the home whenever possible.”
Marion Nestle, Ph.D., a professor of nutrition and food studies at New York University, said the findings did not surprise her.
“Restaurant meals are loaded with calories and do not come with nutrition facts. And the portions are huge,” Nestle told Healthline. “What surprises me here is how low the calorie differences are.”
Changing the Nutrition Message
The study suggests that public health efforts to improve Americans’ eating habits may need some fine-tuning.
For instance, recent efforts to encourage better eating habits single out fast food restaurants. For example, federal menu labeling regulations only apply to chain restaurants with 20 or more locations.
Despite the public conversation about the nutritional pitfalls of fast food, Americans continue to eat it frequently. From 2003 to 2010, the period An studied, Americans reduced the share of calories they got from fast food by just 1.5 percent, to 11.3 percent.
The results point to demographic differences in eating habits. Men and African Americans had a bigger jump in consumption between home meals and restaurant meals than their peers, for example.
Poorer people ramp up their calorie and fat intake more at fast food restaurants, upper-class people more at sit-down establishments. Middle-class people got the biggest share of their calories from restaurant foods of both types.
Obese people consumed more calories at sit-down restaurants than any other group, suggesting they may be unaware of the nutritional pitfalls that can come with a white tablecloth.