User Post: Reply to a young reader -- Is fast food evil?

I read every email and every comment I get from you, dear readers, but I can only wish I could reply to each and every one of them. Many times I have nothing clever to add to the conversation beyond what's already in the post and in the comments, and quite frankly, I just have a hard time keeping up.

But I do hope I never miss a chance to reply to young readers who want to know more about nutrition.

A middle-school student from California recently asked me for an email interview about fast-food (I'm not sharing her name to protect her privacy). I thought her questions (and my replies) are worth sharing.

Q. In your opinion, what fast-food restaurant would you say is the least healthy? Please Explain.

A. All fast food restaurants serve highly processed foods, and serve food that is high in calories, high in fat (especially worrisome are the trans-fats) high in sugar and salt, and low in fruits and vegetables (French fries are not a vegetable). It would be unwise for me to pick one chain over another. I suggest we eat fast-food only rarely. By rarely I mean once a month or less.

Q. What would you think is the least healthy food out of all the fast-foods? Please Explain.

A. Soda and other sugary drinks.
Soda has nothing in it that we need (we definitely don't need more sugar and corn syrup), and there are many studies that show that our body doesn't count the calories in these sugary drinks . These drinks are just extra calories. It very well may me that soda makes us eat even more.

Fast-food restaurants have the biggest profit margin on soda-that's why they make them so attractive in pricing, super-sizes and refills. But if you ask for the free water instead you'd be shaving 210 calories (the calorie content of a medium soda) from the fast food meal.

The average American kid drinks 300 empty calories in soda and sugary drinks-this is the first thing I'd suggest to change in our diet.

Q. Where do you think the fast-food industry will be in 30 or 50 years?

A. I hope we'll wizen up, and consumer's rejection will lead to shrinkage in the fast-food industry.

I hope fast-food will go back to what it was 30 years ago, and people will go back to cooking most of their meals and eating real food.

That's my hope. For now, fast-food is still growing, and its expansion is unfortunately especially robust in lower income neighborhoods and in places like China, India and South America.

Q. Do you think there are any healthy choices in any fast-food restaurants? If So, Please explain.

A. I think fast-food is trying to offer a few better options. Laws forcing fast-food chains to post calories on menu boards in some cities have also led to the introduction of lower calorie options and smaller portions. Many fast-food restaurants now offer salad, and if you don't add fried meats and lots of dressing to them that is a healthier option.

Q. Are you worried about the consumer's weight and what will happen to them if they have fast-food a lot? Please Explain.

A. Absolutely. A third of American kids are overweight or obese, as are two-thirds of adults.
Studies have shown that eating fast-food frequently is associated with obesity and diabetes .

Q. Instead of people eating fast-food, what do you think they should be eating?

A. We should be eating mostly simple meals prepared at home. The emphasis should be on eating more plants: more fruits, vegetables, and whole grains. We should try to eat less processed food.

Q. What do you think is the worst part of fast-food? [i.e. calorie and fat intake, how clean their restaurant is, etc.]

A. I think you'll be surprised by my answer; there are so many things I don't like about fast-food, but the worst thing for me is that it's so cheap.

For as long as fast-food is cheaper than making a simple, healthy meal at home, it will be very hard to get even motivated people to find the ingredients and the time to do so regularly.

Fast-food is cheap in the short term but very expensive in the long run-obesity and diabetes cost a fortune.

Q. How many calories should people be having each day? Does fast-food take over that number?

A. The number of calories we need changes by body size and build, gender and by levels of physical activity. In the case of kids, growth also needs to be accounted for and requires extra calories.

An adult woman is estimated to need 1800-2200 calories a day.
An adult male is estimated to need 2200-2800 calories a day.

Young kids need fewer calories, as their bodies are smaller. Rapidly growing adolescents need more.

If we take a moderately active average height and weight 12 year-old, a rough estimate of her daily calorie requirement is 1600-1800 calories.

A kids' hamburger-and-fries happy meal at McDonald averages more than 600 calories. Do 12 year-olds go for the happy meal? I think they don't.
The Big Mac Combo with medium fries and medium soda has a total 1250 calories.

You can see that even with the kid size happy meal eating too many calories is really easy: there are 3 meals a day, and a few small meals in between.

The calorie information of fast-food menu items is available online. Take a look at the meals and I think you'll see why pediatricians and nutritionists see these meals as having too many calories.

Q. Would you really believe that McDonalds is the worst fast-food restaurant according to what others are saying?

A. I'd hate to single out one fast-food chain over another. Perhaps because McDonald's is so successful and they market and advertize so heavily they get more criticism. McDonald's by far in the lead in advertizing and marketing to kids. It is said that most kids can recognize McDonald's before they know how to speak.

I think that the practical approach is to see all fast-food as something we should be eating less of.

Q. If you were stranded on an island with only fast-food restaurants and you needed something to eat or you would pass out, what fast food restaurant would you choose?

A. I'd go to the nearest one and revive myself.
I'd then set out to change the food landscape of that island and make it so that there's real food for its inhabitants.

Dr. Ayala

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