In parallel with an increase in the prevalence of overweight and obesity among children, the rate of eating out has increased rapidly in recent years. The current study clearly demonstrated the significant association between overweight and obesity with higher frequency of eating outside among boys, similar results were observed in previous researches: as in Brazilian children[28], and had been found among children from Etiology of Childhood Obesity (ECHO) study[29], in children and adolescents aged 11–14 years in London Borough[30],in Portugal children[21] and in US elementary schools students[31]. However, we did not observe a significant association between obesity and eating out in group of girls, which may due to boys’ greater preference for fatty food and girls pay more attention to their weight[32–34]. whereas, the result of the UK National Diet and Nutrition Survey (NDNS) indicated that no association between energy intake and frequency of consumption of meals out in children[35].The differences in research result may be partly due to the fact that lacking of uniform standard for the definition of eating out. The definition for our research was refer to restaurant only, not including take-away food, the scope is relatively limited. Moreover, the catering industry has developed rapidly in recent years. With the intensive distribution of restaurant and the convenience of online catering service, children have easy access to eat out. The frequency of eating out of children probably present a growing trend. Therefore, strategies and interventions are warranted to target children’s overall eating-out behavior, to prevent unhealthy eating behaviors among children, such as nutrition and health education.
Consistent with previous studies [19, 36], 6–12 years children were more likely to be overweight and obesity compared with 13–17 years children, which may be related to the fact that younger children tended to eat out. One possible explanation from previous research[37, 38] suggested that the conception and behavior of healthy eating increases while children growing, older children tend to choose more healthy food. Thus, more researches are needed to provide dietary guidance of eating out on younger. Additionally, the study found that children from high-income household were associated with greater prevalence of overweight and obesity, the finding supported by previous researches [39, 40]. Li Miao found that children from high income family with more pocket money were more likely to be overweight and obesity [41]. Furthermore, The study showed that in comparison with children in rural regions, children from urban regions tended to be overweight and obesity, and this difference was also found in other domestic studies[ 42,43], which was likely due to the convenience of eating out in the urban regions[44]. Similar result was founded in a survey conducted among Mexican children found that urban children[45] consumed more energy daily than those in the rural regions. Therefore, dietary nutrition education and intervention about healthy eating is necessary. As seen in the current study, leisure exercise was positive associated with high rate of overweight and obesity, which may be related to the fact that majority of childhood obesity prevention program conducted within obese rather than non-obese children [46], thus Obese children were more likely to participate in exercises[47]. We also found that children those had more leisure sedentary time tended to eat out. the similar result was found among Pakistan children aged 5 to 12 years showed that eating fast food had a significant association with sedentary behavior[48] and Matheson’s study[49]. Sedentary lifestyle that included television viewing and playing video game, television advertising of restaurant foods were attractive for children, which was the possible explanation of the higher rate of eating out. Preventive strategies and practical approaches may need to reduce children’s sedentary time.
The main advantages of this study were that the sample was nationally representative, which can reflect the nutrition and health status of Chinese children. The data gave a general description of eating out behavior of Chinese children aged 6–17 years, and the result provided a reference for further research with similar situation. Additionally, as eating out has become an integral part of the daily life, there are many studies on relationship between eating out and dietary patterns among children, while, insufficient guidance exists on the maximum recommended frequency of eating out. The result of this study provide reference times for eating out by genders. However, the present study had several limitations. Firstly, as the definition of eating out which including restaurant only. It is possible to underestimate the frequency of eating out; secondly, this study was cross-sectional study, the causal relationship between the eating out and overweight and obesity cannot be determined; finally, The calculated intake of nutrients such as energy is a lack, Only the data in the interview-administered questionnaire table are analyzed. Therefore, the conclusion of the study still has practical significance.