Parents Wildly Underestimate Children’s Calorie Intake

As a weight loss surgeon, I see more and more patients come to my office who are adolescents that are morbidly obese. There is a common denominator among them: they don’t eat at home, and they don’t cook.  They come in with their parents, and their parents have no idea what their kids are eating, and if they do- the have no idea how many calories are in the meals they are consuming.  So when a study presented last week at the annual meeting of The Obesity Society confirmed that parents tend to underestimate the calorie content in their kids’ fast food meals, I wasn’t shocked. This is similar to studies that have shown that adults underestimate calories in their own meals at  restaurants. But this is the first study to show how well parents estimate the calorie content of their kids’ fast food meals.

The new study involved 330 children (ages 3-15) and their parents. Of the group, 57 percent of the children were overweight or obese. The children were ethnically diverse – 33 percent black, 30 percent Hispanic, 19 percent white, 3 percent Asian, and 15 percent other or multiracial. The researchers visited 10 restaurants in each of four New England cities: three McDonald’s, three Burger King, two Subway, one KFC, and one Wendy’s. Each restaurant was visited six times at dinnertime.

The researchers found that many of the parents purchased “large” meals for their children; the average meal contained 733 calories, that is way more than they should be having for dinner. The parents thought the meals contained about 562 calories, still too many calories. Seventy two percent  if the parents underestimated the calorie content of their children’s meals, with 24 percent underestimating by more than 500 calories.

“There was an association between larger meals and larger underestimations, which may hold some promise for menu labeling”, said lead researcher, Jason Block, MD, of Harvard Medical School. Still, even with calorie labeling, a larger problem is when kids go to eat without parental supervision. The largest underestimation was at Burger King, followed by Subway, Wendy’s, and McDonald’s.

Many of the calories consumed at fast food restaurants are via sugar-sweetened beverages, in addition to fat laden fries. Kids age 2 – 19 consume about 7.2 trillion calories in sugar sweetened beverages per year. Other new research presented at the Annual Meeting showed that overweight kids who replaced their usual sugary beverages with water or other calorie-free drinks gained less weight than their peers who continued drinking sweetened beverages. In our previous post we show how that schools that have strict regulations about the food they sell children have less obesity and morbid obesity (click here).

While some estimate the cost of childhood obesity at about 3 billion per year, according to William Dietz, MD, PhD who is the Former Director of the Division of Nutrition, Physical Activity, and Obesity at the Centers of Disease Control and Prevention (CDC). Studies such as these highlight the importance of parent education in addressing and reversing this expensive and complex health threat. As a parent, this study is a wake-up call to all of us- we need to get kids out of the restaurants, and get them home where they can learn to cook, and learn an appreciation for food.

The idea that providing the nutritional content for food would help is a partial answer- a bigger answer, getting the kids to take charge, having them cook at home, learn about great food, local food, and getting the families out of the restaurants and into their own kitchens.

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and received his MD. Dr. Simpson, then became a renowned weight loss surgeon, and a leading advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he advocates teaching people to improve their health through their food. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcom Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit


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