Disparities in Adult Fast-Food Consumption in the U.S. by Race and Ethnicity, National Health and Nutrition Examination Survey 2017–2018


      This study provides the most recent estimates for fast-food consumption in the U.S., overall and by race/ethnicity and age.


      Data from adults (aged ≥20 years, N=3,560) in the National Health and Nutrition Examination Survey, 2017–2018, were used to identify the (1) percentage of adults consuming fast food, (2) estimated mean percentage of calories consumed from fast food, and (3) estimated mean total calories consumed from fast food on a typical day. Intake was measured by in-person, 24-hour dietary recall. Analysis was conducted in 2020.


      During 2017–2018, fast food was consumed by 36.5% of adults on a typical day, accounting for 13.8% of daily calories, an average of 309 kcal/day. More non-Hispanic Black adults consumed fast food (42.6%), consumed the largest percentage of daily calories from fast food (17.4%), and consumed the greatest number of daily calories from fast food (381 kcal/day) than adults of other racial/ethnic groups. Young non-Hispanic Black adults had the highest level of fast-food consumption, and this was significantly higher than that among Mexican Americans: percentage consuming fast food (53.5% vs 42.5%, p=0.02) and percentage of calories from fast food (24.1% vs 16.8%, p=0.03). Young non-Hispanic Black adults consumed the highest total fast-food calories, which were significantly higher than that among non-Hispanic Asian young adults (526 kcal vs 371 kcal, p=0.04). No significant differences in the study outcomes were observed by race/ethnicity and age compared with non-Hispanic White adults of the same group.


      Fast-food consumption among adults in the U.S. is high, particularly among young non-Hispanic Black adults.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Saksena MJ
        • Okrent A
        • Anekwe TD
        • et al.
        America's eating habits: food away from home.
        U.S. Department of Agriculture, Washington, DC2018
      1. National statistics: restaurant industry facts at a glance. National Restaurant Association. Updated March 9, 2021. Accessed January 29, 2019.

        • French SA
        • Harnack L
        • Jeffery RW
        Fast food restaurant use among women in the pound of prevention study: dietary, behavioral and demographic correlates.
        Int J Obes Relat Metab Disord. 2000; 24: 1353-1359
        • Jeffery RW
        • French SA
        Epidemic obesity in the United States: are fast foods and television viewing contributing?.
        Am J Public Health. 1998; 88: 277-280
        • Rosenheck R
        Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk.
        Obes Rev. 2008; 9: 535-547
        • Cobb LK
        • Appel LJ
        • Franco M
        • Jones-Smith JC
        • Nur A
        • Anderson CA
        The relationship of the local food environment with obesity: a systematic review of methods, study quality, and results [published correction appears in Obesity (Silver Spring). 2015;23(12):2517–2519].
        Obesity (Silver Spring). 2015; 23: 1331-1344
        • Young LR
        • Nestle M
        The contribution of expanding portion sizes to the U.S. obesity epidemic.
        Am J Public Health. 2002; 92: 246-249
        • Bleich SN
        • Soto MJ
        • Dunn CG
        • Moran AJ
        • Block JP
        Calorie and nutrient trends in large U.S. chain restaurants, 2012-2018.
        PLoS One. 2020; 15e0228891.
        • Block JP
        • Scribner RA
        • DeSalvo KB
        Fast food, race/ethnicity, and income: a geographic analysis.
        Am J Prev Med. 2004; 27: 211-217
        • Bleich SN
        • Jones-Smith JC
        • Jarlenski MP
        • et al.
        Impact of changes in chain restaurant calories over time on obesity risk.
        J Gen Intern Med. 2020; 35: 1743-1750
        • Hales CM
        • Carroll MD
        • Fryar CD
        • Ogden CL
        Prevalence of obesity among adults and youth: United States, 2015‒2016.
        NCHS Data Brief. 2017; : 1-8
        • Hales CM
        • Carroll MD
        • Fryar CD
        • Ogden CL
        Prevalence of obesity and severe obesity among adults: United States, 2017-2018.
        NCHS Data Brief. 2020; : 1-8
        • Ogden CL
        • Fakhouri TH
        • Carroll MD
        • et al.
        Prevalence of obesity among adults, by household income and education—United States, 2011-2014.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 1369-1373
        • NHANES questionnaires, datasets, and related documentation
        Centers for Disease Control and Prevention.
        Date accessed: September 2, 2020
      2. National Health and Examination Survey 2017‒2018. Published November 2020. Accessed August 6, 2021.

        • Fryar CD
        • Ervin RB
        Caloric intake from fast food among adults: United States, 2007-2010.
        NCHS Data Brief. 2013; : 1-8
        • Fryar CD
        • Hughes J
        • Herrick K
        • Ahluwalia N
        Fast food consumption among adults in the United States, 2013-2016.
        NCHS Data Brief. 2018; : 1-8
        • Vikraman S
        • Fryar CD
        • Ogden CL
        Caloric intake from fast food among children and adolescents in the United States, 2011-2012.
        NCHS Data Brief. 2015; (Accessed March 9, 2021): 1-8
        • Fryar CD
        • Carroll MD
        • Ahluwalia N
        • Ogden CL
        Fast food intake among children and adolescents in the United States, 2015-2018.
        NCHS Data Brief. 2020; : 1-8
        • Centers for Disease Control and Prevention
        National Health and Nutrition Examination Survey: analytic guidelines, 2011‒2014 and 2015‒2016.
        Centers for Disease Control and Prevention, Atlanta, GA2018 (Accessed March 9, 2021)
        • StataCorp
        Stata base reference manual release 15.
        StataCorp LLC, College Station, TX2017 (Accessed March 9, 2021)
        • Cohen J
        Statistical Power Analysis for the Behavioral Sciences.
        2nd ed. Academic Press, New York, NY2013
        • Bahadoran Z
        • Mirmiran P
        • Azizi F
        Fast food pattern and cardiometabolic disorders: a review of current studies.
        Health Promot Perspect. 2015; 5: 231-240
        • Fryar CD
        • Carroll MD
        • Ogden CL
        Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2015–2016.
        National Center for Health Statistics, Hyattsville, MD2018 (Accessed March 9, 2021)
        • Zhang Q
        • Wang Y
        • Huang ES
        Changes in racial/ethnic disparities in the prevalence of type 2 diabetes by obesity level among U.S. adults.
        Ethn Health. 2009; 14: 439-457
        • Schoeller DA
        Limitations in the assessment of dietary energy intake by self-report.
        Metabolism. 1995; 44: 18-22
        • Scully M
        • Dixon H
        • Wakefield M
        Association between commercial television exposure and fast-food consumption among adults.
        Public Health Nutr. 2009; 12: 105-110
        • Henderson VR
        • Kelly B
        Food advertising in the age of obesity: content analysis of food advertising on general market and African American television.
        J Nutr Educ Behav. 2005; 37: 191-196