Consuming fast food (FF) has been associated with higher energy intake and poorer diet quality. However, it is unclear whether dietary intake of those who consume FF frequently varies from infrequent consumers (FF-O) on a day when FF is not consumed. This study compared energy and nutrient intake and diet quality between FF-O and frequent consumers with and without FF on the intake day (FF-C and FF-NC, respectively).


One day of dietary intake data from 7,927 adults 20+ years in What We Eat in America NHANES 2013-2016 was analyzed. Participants reported frequency of FF consumption in the previous 7 days and were classified as FF-O (0 times; N=2596), FF-NC (1+ times, no FF on intake day; N=2096), or FF-C (1+ times w/ FF on intake day; N=3235). Adjusted estimates of energy and nutrient intakes by FF status were calculated, and diet quality was measured using the Healthy Eating Index (HEI) 2015. Differences by FF status were assessed using t-tests.


Energy (kcal) intake of FF-C (2289) was higher than FF-O (1972) and FF-NC (2025) (P<0.001).FF-C had higher intakes of all macronutrients and sodium compared to FF-O and FF-NC (P<0.001). Intake of most micronutrients did not differ by FF status. Total HEI scores were higher for FF-O (55) vs FF-NC (53) vs FF-NC (50). HEI subcomponent scores for Total fruit, Intact fruit, Whole grains and Added sugars were similar between FF-O and FF-NC but higher than FF-C.Subcomponent scores for Total vegetables, Dark green vegetables/legumes, and Saturated fat were higher for FF-O vs FF-C only. There were no differences by FF status in subcomponent scores for Total protein, Dairy, Seafood/plant protein, Fatty acids, Sodium or Refined grains.


Consuming FF on the intake day was associated with higher energy intake and lower diet quality as compared to those who did not consume FF, but few differences were noted between FF-O and FF-NC. Efforts to align dietary intake with recommendations are essential.