HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bowman, S. A. Articles by Vinyard, B. T. Search for Related Content PubMed PubMed Citation Articles by Bowman, S. A. Articles by Vinyard, B. T.

Fast Food Consumption of U.S. Adults: Impact on Energy and Nutrient Intakes and Overweight Status

Beltsville Human Nutrition Research Center (S.A.B.), Biometrical Consulting Service (B.T.V.), U.S. Department of Agriculture—Agricultural Research Service, Beltsville, Maryland

Address reprint requests to: Shanthy A. Bowman, PhD, U.S. Department of Agriculture—Agricultural Research Service Beltsville Human Nutrition Research Center 10300, Baltimore Avenue, Building 005, Room 125, BARC-West, Beltsville, MD 20705-2350. E-mail: sbowman{at}rbhnrc.usda.gov

	ABSTRACT

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 
Objective: To compare the diet quality and overweight status of free-living adults, ages 20 years and older, grouped based on their fast food intake status.

Methods: USDA’s 1994 to 1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994–1996) data was used. Three separate analyses were conducted: (1) effect of fast food on diet quality of males and females based on day-one data, (2) comparison of dietary and overweight status of adults who ate fast food on one- two- or none of survey days and (3) within-person analysis comparing energy and macronutrient intakes of adults who ate fast food on one of the two survey days. SUDAAN software package was used in pair-wise mean comparisons and regression analyses ( = 0.05).

Results: At least one in four adults reported eating fast food. The diet of males and females who consumed fast food was high in energy and energy density. Fast food provided more than one-third of the day’s energy, total fat and saturated fat; and was high in energy density. Negligible amounts of milk and fruits, but substantially large amounts of non-diet carbonated soft drinks were reported consumed at fast food places. After controlling for age, gender, socio-economic and demographic factors, energy and energy density increased and micronutrient density decreased with frequency of fast food consumption. Adults who reported eating fast food on at least one survey day had higher mean body mass index values than those who did not eat fast food on both survey days. A small, but significant, positive association was seen between fast food consumption and overweight status. Within-person comparisons showed that energy intakes were higher on a fast food day than on a non-fast food day.

Conclusion: Fast food consumption was associated with a diet high in energy and energy density and low in essential micronutrient density. Frequent fast food consumption may contribute to weight gain.

Key words: fast food, energy intake, energy density, nutritional quality, overweight, obesity

	INTRODUCTION

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 
Americans work more hours today than a few decades ago, and some work more than one job. Among married couples, the average combined weekly work hours increased by almost 20 percent over the past three decades [1]. More women are in the work force today than in the past. About seventy five percent of all mothers are in the labor force and unmarried mothers are more likely than married mothers to work [2]. This situation leaves adults with less time for food preparation which is reflected in the increase in away-from-home food consumption. In 1993, about 38 percent of total food expenditure dollars were spent on food away from home. This amount increased to 42 percent in 2001 [3].

The number of fast food places increased by several fold and more people eat in fast food places today than three decades ago [3–7]. Fast food places are one of the popular sources of away-from-home foods. Fast food is quick, convenient, relatively inexpensive for the amount of food obtained, and appeals to all age groups [3,5,6,8].

The U.S. Department of Agriculture (USDA) periodically conducts dietary surveys to monitor food and nutrient intakes of the U.S. population. Our preliminary analysis of USDA’s 1989–1991 Continuing Survey of Food Intakes by Individuals (CSFII 1989–1991) showed that 16 percent of adults, ages 20 years and older, reported consuming fast food on day-1 of the survey. We were interested in looking at fast food consumption of adults in the latest USDA surveys conducted between 1994 and 1996 (CSFII 1994–1996).

The objectives of the study were to compare the diet quality of adults who ate fast food with that of adults who did not eat fast food, to assess fast food’s contribution to the day’s dietary intakes, and to examine potential association between fast food consumption and overweight status.

	METHODS

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 
The CSFII 1994–1996 data was used for the study [9]. The CSFII is nationally-representative and includes people of all ages from birth. Dietary intake data in the surveys was collected through an interviewer-administered 24-hour dietary recall using a multiple-pass technique to reduce under-reporting by the respondents. Data was collected on two non-consecutive days which were 3 to 10 days apart. Overall day-1 response rate for the survey was 80.0 percent [10].

This study included adults ages 20 years and older. There were 9,872 adults who had complete food intake records for day-one of the survey, and 9,323 of these adults also had complete food intake records for day-two of the survey. The survey respondents were asked where they obtained each of the foods, including beverages, they reported consumed. Food obtained at fast food places and pizza places were collectively categorized, in the CSFII 1994–1996, as "fast food" [11].

Nutrients and food group definitions in the analysis were the same as those in the CSFII 1994–1996. "Micronutrient density" is defined in this paper as the amount of micronutrient per 1,000 kilocalories, and "energy density" is defined as the number of kilocalories of energy obtained per 100 grams of total food amount consumed. The total food amount consumed included all foods and all alcoholic and non-alcoholic beverages in the form reported consumed (i.e., includes water present in beverages, such as tea, coffee, fruit drinks made from dry mixes, cocoa, and milk drinks), and excluded water such as tap water or bottled water drunk separately (Tables 1, 2 and 3).

Fast food’s contribution to day’s total energy, macronutrient, and selected food groups intakes of males and females was estimated from day-one dietary intake data because of the higher sample size (Table 1). The 9,872 adults were grouped into two categories based on whether they ate fast food or not on day-one. Mean comparisons were made within genders; two means were to be considered statistically different at a level of significance, = 0.05.

The effect of fast food consumption frequency (zero, one, and two days in the survey) on energy, macronutrient, micronutrient density, fluid milk, non-starchy vegetable, fruits and fruit juices, and non-diet carbonated beverages intakes was examined by analyzing two-day average dietary intakes of 9,323 adults who had complete food intake records for both survey days. These adults were grouped into three groups: who did not eat fast food on either survey day (N = 5861), who ate fast food on one of the two survey days (N = 2,623), and who ate fast food on both survey days (N = 839). A multiple regression model was used to control for age, gender, race-ethnicity, household annual income, geographic region, and urbanization (Table 2).

The odds of adults who ate fast food being overweight, or not meeting each one of the recommendations for total fat, saturated fat, or added sugars [12], were estimated by logistic regression analyses after controlling for age, gender, and other socio-economic and demographic variables. "No fast food on both survey days" status was the reference category (Table 3). Body Mass Index (BMI) values were not available for 225 adults (190 adults who did not eat fast food and 35 adults who ate fast food). Adults who had no BMI values were excluded from mean BMI estimations (Table 2) and the logistic regression analysis to determine the odds of being overweight (Table 3), but were included in all the other analyses.

We were interested to know whether adults who ate fast food on only one of the two survey days had the similar energy intakes on the two days. Energy, macronutrients, and food intakes for 2,623 adults, who reported eating fast food on one of the two survey days, were compared, to determine whether these adults consumed more energy and macronutrients on the fast-food day than on the non-fast-food day (Table 4). Both unadjusted means, and means adjusted for age, gender, socio-economic and demographic variables, and day effect (whether the respondent consumed fast food on the first or the second day of the survey) were estimated.

	RESULTS

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 
There were 26.5 percent (95% CI: 24.9–28.1) adults who reported eating fast food. Fast food was consumed by both genders (30% males, 23.5% females). Higher household income and living in suburban areas were associated with more adults eating fast food. More African Americans (31%) than other race-ethnic groups reported eating fast food. Adults living in the Midwest (29%) or in the South (29%) were more likely to be fast food eaters than adults living in the Northeast (20%) or the West (22%).

Noteworthy differences were seen among age groups. The odds of eating fast food decreased with increasing age. Young adults ages 20 to 29 years were about 4 times (odds ratio 4.3; CI 3.7–5.1; p < 0.0001) more likely to eat fast food than adults 55 years of age and older. These odds were 3.1 (CI 2.6–3.7; p < 0.0001) for ages 30 to 39 years and 2.4 (CI 2.0–2.8; p < 0.0001), respectively.

Both males and females who reported eating fast food had substantially higher intakes of energy, total fat, saturated fat, carbohydrate, added sugars, and protein than their counterparts who did not eat fast food (Table 1). Males who ate fast food had especially high energy intake. They consumed about 500 kilocalories more energy than males who did not consume fast food. Fast food eaters, males and females, had lower intakes of nutritious foods such as fruits and fluid milk than the others. They drank about twice the amount of non-diet carbonated soft drinks than those who did not eat fast food.

An examination of fast food’s contribution to day’s total intake showed that fast food provided more than one-third of day’s energy, total fat and saturated fat in the diet of males and females (Table 1). Also, fast food was high in energy density (the number of kilocalories of energy obtained per 100 grams of food amount consumed) and provided 158 to 163 kilocalories per 100 grams of food consumed. Fast food eaters’ diets were lower in vitamin A, carotenes, and vitamin C density. These antioxidants help promote good health and play a role in the prevention of cancer and other health conditions [13–17]. Eating fast food was also associated with consuming a diet low in calcium and magnesium density, nutrients that are associated with bone health [18–22]. Substantially high amounts of non-diet carbonated soft drinks, a beverage high in calories but low in essential micronutrients, and insignificant amounts of nutritious foods such as fluid milk and fruits were consumed at fast food places.

About 10 percent of adults reported eating fast food on both survey days. Frequency of fast food consumption affected nutrient intakes (Table 2). Energy and macronutrient intakes increased, and micronutrient density decreased as frequency of fast food consumption increased from zero days to 2 days. Day’s intakes of nutritious foods such as fluid milk, fruits and fruit juices, and non-starchy vegetables decreased and non-diet carbonated beverages increased as the number of fast food days increased. Small, but significant, differences were seen between the mean body mass index values of adults who reported eating fast food and adults who did not eat fast food on either survey day (Table 2).

Eating fast food was associated with not meeting one or more of the recommendations for total fat, saturated fat, and added sugars (Table 3). Fast food eaters had a slightly higher and statistically significant odds of being overweight (having a BMI value 25 or more) than those who did not report eating fast food (Table 3).

Substantial differences in energy, energy density, and macronutrient intakes were seen between consumption on the fast food and non-fast food days for the 2,623 adults who ate fast food on one of the two survey days (Table 4). The day effect (whether adults ate fast food on day-one or day-two of the survey) in the regression model was not significant. Mean differences in energy and macronutrient intakes were calculated using day-1 and day-2 measurements "within" each respondent. Hence, adjusted means for "among-respondent" characteristics (eg., age, gender, socio-economic and demographic variables) has no effect on the estimation of "within-respondent" mean differences.

	DISCUSSION

 
In the CSFII 1994–1996, at least one in four adults reported eating fast food as compared to one in six adults who reported eating fast food in the CSFII 1989–1991. Fast food was consumed by all socio-economic and demographic groups. Fast food consumption was especially high among young adults. The location of fast food places and higher household income may play a role in more adults living in suburban areas eating fast food.

Both males and females obtained similar percentages of energy and macronutrients from fast food, although males obtained higher amounts energy and macronutrients from fast food than females (Table 1). Fast food provided a little more than one-third the day’s energy for both genders. However, the proportion of food groups obtained from fast food places varied widely; milk and fruits and fruit juices were practically absent.

It is not possible to show cause (fast food consumption) and effect (weight gain) from the CSFII 1994–1996 which is a cross-sectional survey. However, the study findings collectively showed that eating fast food increased day’s energy intakes; increased energy density of the overall day’s diet; and simultaneously decreased micronutrient density. Secondly, adults who ate fast food on one of the two survey days consumed 206 calories (95% CI: 162–250) more on the fast food day than on the non-fast food day. The energy density of the day’s diet was also high (Table 4). Therefore, how often a person eats fast food over an extended time period becomes important in weight management, especially to adults who are trying to either lose weight or maintain weight.

French et al. [6] found that frequency of fast food restaurant use by women was associated with higher energy and fat intakes and greater body weight. Eating out often has been found to result in increased energy intake [23]. The nation’s energy intake has increased over the past 20 years [24]. Food and beverages sold in fast food places often come in large portion sizes [5]. One of the reasons for the observed increase in energy intake could be attributed to consuming large portions sizes of foods and beverages [25,26].

Eating fast food was associated with having higher BMI values (Table 2); a weak, but positive association was seen between fast food consumption and overweight status (Table 3). There are limitations to this finding; the body mass index values were computed using self-reported height and weight. The odds of being overweight was numerically higher for two-days than one-day fast food consumption (Table 3), but one-day and two-day odds were not significantly different from each other. More long-term data is needed to study the effect of frequency of fast food consumption on weight status of adults.

In the U.S., 64.5 percent of adults are overweight and 30.5 percent are obese [27]. Obesity increases the risk of many health conditions such as cardiovascular disease, stroke, hypertension, cancer, and diabetes [28–30]. It is important that fast food consumers should be aware of the nutritional consequences of eating fast food.

	CONCLUSION

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 
The percentage of adults eating fast food increased from the early 1990s (CSFII 1989–1991) to the mid-1990s (CSFII 1994–1996). This trend is likely to continue.

Adults who wish to restrict their energy intakes should be cognizant of the high energy content of fast food. Adults who eat frequently at fast food places may reduce the number of visits to fast food places, if they wish to control their energy intakes and improve their overall diet quality.

Fast food places should display or make available information on energy and macronutrient content of foods and beverages they sell. Consumers should strive to utilize the nutritional information on foods and beverages sold. If no nutrition information is provided, consumers should ask for nutritional information.

As more mothers and meal-preparers continue to enter the labor force, they are left with less time for food shopping and food preparation. Making weekly meal plans and organizing grocery shopping according to their meal plans will help adults from not having to make spontaneous meal decisions that may result in frequent fast food consumption.

Received May 13, 2003. Accepted September 23, 2003.

	REFERENCES

TOP ABSTRACT INTRODUCTION METHODS RESULTS CONCLUSION REFERENCES

 

1. U.S. Department of Labor, Bureau of Labor Statistics: "Working in the 21^st Century (Chartbook): Married Couples Are Working Longer." Available at: http://www.bls.gov/opub/working/page17b
2. U.S. Department of Labor, Bureau of Labor Statistics: Working in the 21^st Century (Chartbook): more mothers work. Available at: http://www.bls./opub/working/page16b.htm
3. U.S. Department of Labor, Bureau of Labor Statistics: "Average Annual Expenditures and Characteristics of All Consumer Units, Consumer Expenditure Survey, 1993–2001." Available at: http://www.bls.gov/cex/2001/standard/multiyr.pdf
4. Guthrie JF, Lin B-H, Frazao E: Role of food prepared away from home in the American diet, 1977–78 versus 1994–96: changes and consequences.J Nutr Educ Behav34 :140 –150,2002 .[Medline]
5. DeMaria AN: Of fast food and franchises [Editor’s Page].J Am Coll Cardiol41 :1227 –1228,2003 .[Free Full Text]
6. French SA, Harnack L, Jeffery RW: Fast food restaurant use among women in Pound of Prevention study: dietary, behavioral and demographic correlates.J Obes Relat Metab Disord24 :1353 –1359,2000 .
7. French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P: Fast food restaurant use among adolescents: associations with nutrient intake, food choices, and behavioral and psychosocial variables.In J Obes Relat Metab Disord25 :1823 –1833.
8. French SA: Pricing affects food choices.J Nutr133 :841S –843S,2003 .[Abstract/Free Full Text]
9. U.S. Department of Agriculture, Agricultural Research Service, Food Survey Research Group: "The Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey, 1994–96 ." CD-Rom data.
10. Tippett KS, Cypel YS (eds): "Design and operation: The Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey, 1994–96 ." U.S. Department of Agriculture, Agricultural Research Service, Nationwide Food Survey Report, No. 96-1,264 pp.1998 .
11. U.S. Department of Agriculture, Agricultural Research Service: "Food and Nutrient Intakes by Individuals in the United States, by Sex and Age, 1994–96 ." Nationwide Food Surveys Report No. 96-2,1998 .
12. Institute of Medicine (US), Food and Nutrition Board: "Dietary Reference Intakes ." Washington, DC: National Academy Press,2000 .
13. Brown DJ, Goodman J: A review of vitamins A, C, and E and their relationship to cardiovascular disease.Clin Excell Nurse Pract2 :10 –22,1998 .[Medline]
14. Ford ES, Mokdad AH: Fruit and vegetable consumption and diabetes mellitus incidence among U.S. adults.Prev Med.32 :33 –39,2001 .[Medline]
15. Institute of Medicine (US), Food and Nutrition Board: "Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids ." Washington, DC: National Academy Press,2000 .
16. Joshipura KJ, Hu FB, Manson JE, Stampfer MJ, Rimm EB, Speizer FE, Colditz G, Ascherio A, Rosner B, Spiegelman D, Willett WC: The effect of fruit and vegetable intake on risk for coronary heart disease.Ann Intern Med134 :1106 –1114,2001 .[Abstract/Free Full Text]
17. McDermott JH: Antioxidant nutrients: current dietary recommendations and research update.J Am Pharm Assoc40 :785 –799,2000 .[Medline]
18. Illich JZ, Brownbill RA, Tamborini L: Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density.Eur J Clin Nutr57 :554 –565,2003 .[Medline]
19. Moyad MA: Osteoporosis. Part III—Not just for bone loss: potential benefits of calcium and vitamin D for overall general health.Urol Nurs23 :69 –74,2003 .[Medline]
20. New SA, Millward DJ: Calcium, protein, and fruits and vegetables as dietary determinants of bone health.Am J Clin Nutr77 :1340 –1341,2003 .[Free Full Text]
21. New SA, Robins SP, Campbell MK, Martin JC, Garten MJ, Bolten-Smith C, Grubb DA, Lee SJ, Reid DM: Dietary influences on bone mass and bone metabolism: further evidence os a positive link between fruit and vegetable consumption and bone health?Am J Clin Nutr71 :142 –151,2000 .[Abstract/Free Full Text]
22. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP: Potassium, magnesium, and fruits and vegetable intakes are associated with greater bone mineral density in elderly men and women.Am J Clin Nutr69 :727 –736,1999 .[Abstract/Free Full Text]
23. Eke-Clemens LH, Slawson DL, Klesges RC: The effect of eating out on quality of diet in premenopausal women.J Am Diet Assoc99 :442 –444,1999 .[Medline]
24. Nielsen SJ, Siega-Riz AM, Popkin BM: Trends in energy intake in U.S. between 1977 and 1996: similar shifts seen across age groups.Obes Res10 :370 –378,2002 .[Medline]
25. Matthissen J, Fagt S, Biltoft-Jensen A, Beck AM, Ovesen L: Size makes a difference.Public Health Nutr6 :65 –72,2003 .[Medline]
26. Young RL, Nestle M: Expanding portion sizes in the U.S. marketplace: implications for nutrition counseling.J Am Diet Assoc103 :231 –234,2003 .[Medline]
27. Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000.JAMA288 :1722 –1727,2002 .
28. Brag GA: The underlying basis for obesity: relationship to cancer.J Nutr132(Suppl) :3451S –3455S,2002 .
29. Calle EE, Rodriguez C, Walker-Thurmod K, Thun MJ: Overweight, obesity, and mortality from cancer in a prospective studied cohort of U.S. adults.N Engl J Med348 :1625 –1638,2003 .[Abstract/Free Full Text]
30. Paeratakul S, Lovejoy JC, Ryan DH, Bray GA: The relation of gender, race, and socioeconomic status to obesity and obesity comorbidities in a sample of U.S. adults.Int J Obes Relat metab Disord26 :1205 –1210,2002 .[Medline]

This article has been cited by other articles:

				J. L. J. Greenwood, M. A. Murtaugh, E. M. Omura, S. C. Alder, and J. B. Stanford Creating a Clinical Screening Questionnaire for Eating Behaviors Associated with Overweight and Obesity J Am Board Fam Med, November 1, 2008; 21(6): 539 - 548. [Abstract] [Full Text] [PDF]

				C. H Halsted Perspectives on obesity and sweeteners, folic acid fortification and vitamin D requirements Fam. Pract., September 30, 2008; (2008) cmn058v1. [Abstract] [Full Text] [PDF]

				J. L. Pomeranz and K. D. Brownell Legal and Public Health Considerations Affecting the Success, Reach, and Impact of Menu-Labeling Laws Am J Public Health, September 1, 2008; 98(9): 1578 - 1583. [Abstract] [Full Text] [PDF]

				M. T. Bassett, T. Dumanovsky, C. Huang, L. D. Silver, C. Young, C. Nonas, T. D. Matte, S. Chideya, and T. R. Frieden Purchasing Behavior and Calorie Information at Fast-Food Chains in New York City, 2007 Am J Public Health, August 1, 2008; 98(8): 1457 - 1459. [Abstract] [Full Text] [PDF]

				M. Berman and R. Lavizzo-Mourey Obesity Prevention in the Information Age: Caloric Information at the Point of Purchase JAMA, July 23, 2008; 300(4): 433 - 435. [Full Text] [PDF]

				V. L. Forman-Hoffman, K. K. Richardson, J. W. Yankey, S. L. Hillis, R. B. Wallace, and F. D. Wolinsky Retirement and Weight Changes Among Men and Women in the Health and Retirement Study J. Gerontol. B. Psychol. Sci. Soc. Sci., May 1, 2008; 63(3): S146 - S153. [Abstract] [Full Text] [PDF]

				J. L. J. Greenwood and J. B. Stanford Preventing or Improving Obesity by Addressing Specific Eating Patterns J Am Board Fam Med, March 1, 2008; 21(2): 135 - 140. [Abstract] [Full Text] [PDF]

				N. F. Krebs, J. H. Himes, D. Jacobson, T. A. Nicklas, P. Guilday, and D. Styne Assessment of Child and Adolescent Overweight and Obesity Pediatrics, December 1, 2007; 120(Supplement_4): S193 - S228. [Abstract] [Full Text] [PDF]

				K. J Duffey, P. Gordon-Larsen, D. R Jacobs Jr, O D. Williams, and B. M Popkin Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study Am. J. Clinical Nutrition, January 1, 2007; 85(1): 201 - 208. [Abstract] [Full Text] [PDF]

				V. P. Siwik and J. H. Senf Food cravings, ethnicity and other factors related to eating out. J. Am. Coll. Nutr., October 1, 2006; 25(5): 382 - 388. [Abstract] [Full Text] [PDF]

				R. N. Close and D. A. Schoeller The Financial Reality of Overeating J. Am. Coll. Nutr., June 1, 2006; 25(3): 203 - 209. [Abstract] [Full Text] [PDF]

				E. Isganaitis and R. H. Lustig Fast Food, Central Nervous System Insulin Resistance, and Obesity Arterioscler. Thromb. Vasc. Biol., December 1, 2005; 25(12): 2451 - 2462. [Abstract] [Full Text] [PDF]

				E. M. Taveras, C. S. Berkey, S. L. Rifas-Shiman, D. S. Ludwig, H. R.H. Rockett, A. E. Field, G. A. Colditz, and M. W. Gillman Association of Consumption of Fried Food Away From Home With Body Mass Index and Diet Quality in Older Children and Adolescents Pediatrics, October 1, 2005; 116(4): e518 - e524. [Abstract] [Full Text] [PDF]

				D. Demory-Luce Fast Food and Children and Adolescents: Implications for Practitioners Clinical Pediatrics, May 1, 2005; 44(4): 279 - 288. [PDF]

				P. W. Speiser, M. C. J. Rudolf, H. Anhalt, C. Camacho-Hubner, F. Chiarelli, A. Eliakim, M. Freemark, A. Gruters, E. Hershkovitz, L. Iughetti, et al. Childhood Obesity J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1871 - 1887. [Abstract] [Full Text] [PDF]

This Article Abstract Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bowman, S. A. Articles by Vinyard, B. T. Search for Related Content PubMed PubMed Citation Articles by Bowman, S. A. Articles by Vinyard, B. T.