Comparative evidence of the consumption from fast-food restaurants between normal-weight and obese Saudi schoolchildren.

Objective: To provide an in-depth analysis of the relationship between obesity and fast-food consumption by comparing urban obese and normal-weight Saudi Arabian children.

Design: A multicentre cross-sectional study was conducted from December 2015 to March 2016. Participants were divided into two groups (normal weight and obese) and further stratified by sex. Groups were randomly selected using a multistage stratified cluster-sampling technique. A self-paced questionnaire was used to collect data relating to food consumption. Weight height and waist circumference were measured and bioelectrical impedance analysis was performed in all children.

Setting: Capital of Saudi Arabia, Riyadh.

Subjects: Children aged 9·00-11·99 years (n 1023).

Results: Compared with normal-weight groups, intake frequency of fast food/week was higher among the obese groups (P<0·001), irrespective of fast-food consumption outside (P<0·001) or inside (P<0·001) the home; and larger portion sizes were preferred in obese groups (P<0·001). Families eating fast-food meals together was a protective factor against obesity (OR; 95 % CI: 2·67; 1·44, 4·96, P<0·001), with similar results for families ordering from a 'healthy meals menu' for their children (1·90; 1·24, 2·90, P=0·002). Taste of fast foods (P=0·021), child-friendly menu (P=0·020) and meal cost (P<0·001) were identified as main reasons why parents took their children to fast-food restaurants; these data were replicated for parents with obese boys, but not girls.

Conclusions: Development of effective interventions to reduce fast-food consumption in Saudi Arabian schoolchildren requires greater research-based evidence of fast-food consumption habits and practices associated with increased childhood obesity.