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Abstract
Background: Fast food consumption has been shown to contribute to excess caloric intake and the development of obesity. Interventions that target key contributors to meal decisions have been suggested as a means for improving the foods that children select. Research suggests important points of intervention may be accompanying caregivers or meal decision makers. However, little is known about which caregivers accompany children to fast food restaurants and to what extent they influence meal purchases.
Objective: To determine whether there are differences in the caloric and nutritional content of foods purchased for children at fast food restaurants by categories of caregiver (e.g., mother, father, grandparent) or their characteristics (e.g., gender, BMI) or by meal decision makers (i.e., child, caregiver, or joint).
Design: Natural experiment: At three different time points, survey and receipt data were cross-sectionally collected from caregiver-child dyads at McDonalds and Burger King Restaurants in San Francisco County. Surveys inquired about their food purchases, demographic and anthropometrics, and relationship of the caregiver to the child. Nutritional content of fast food purchases were obtained from the companies' corporate websites, announcements, and press releases. Differences in nutritional content by different caregiver categories and characteristics and by meal decision makers were analyzed by multiple linear regression.
Results: Data from 761 caregiver-child dyads were analyzed. No statistically significant differences were found in the caloric content of fast food purchased for children by different caregiver categories or characteristics or by different meal decision makers.
Conclusion: This analysis has found no evidence that different caregivers or different meal decision makers influence calories purchased at fast food restaurants.