Lisa Tillinger Johansen's presentation based on her book "Fast Food Vinication." At the College of Charleston Think Differently Forum on March 28, 2013.

2. Introduction
• FAST FOOD VINDICATION is a response to the
obesity epidemic and many people who say that
fast food is the cause not only for that, but for
many of the problems in society.
• With a background as an executive in the fast
food industry and as a health educator for both
the Be Well program and for Kaiser
Permanente, I have a unique expertise on this
subject.
• We need to look at the bigger picture of
everywhere we eat, not just at fast food
restaurants.

3. Introduction
• FAST FOOD VINDICATION is a comprehensive
view of the causes and problems associated
with the obesity epidemic and the
contribution of lack of physical activity to it.
• It takes a look at the fast food industry’s
impact on society from its beginnings to
now, the food it
offers, employment, philanthropic
efforts, legislation for menu labeling and its
impact, the banning of fast food restaurants
in some cities and more.

4. Introduction
• FAST FOOD VINDICATION also looks at the
way that we eat and compares the foods
offered at fast food restaurants, sit-down
restaurants and home prepared meals.
• Focus is placed on personal
responsibility, balance and moderation.

5. Employment
• Fast food restaurants offer jobs to a diverse
group of people from teenagers, to older
workers, to people with disabilities and
more.
• 1 in 8 people in the United States work at
McDonald’s at some time in their life.
• In 2001, McDonald’s was responsible for 90%
of the new jobs in America. They hire about 1
million workers each year.

6. Employment
• 40% of the top 50 McDonald’s executives
started their careers in the restaurants, as did
50% of franchisees.
• 67,000 restaurant managers and assistant
managers started off as crew.
• Most fast food restaurants offer training,
development and upward mobility, like KFC
providing employees in Britain the
opportunity to take a 3 year business studies
course, McDonald’s Hamburger University
and employee scholarships.

7. Philanthropy
• Fast food restaurants are very philanthropic.
• Among many of its charities, McDonald’s top
choice is Ronald McDonald House Charities
which helps more than 3.6 million families
each year.
• Wendy’s is heavily involved in adoption
through its Wendy’s Wonderful Kids program
whose efforts have helped place thousands
of children in pre-adoptive and adoptive
homes.

8. Philanthropy
• Taco Bell teams with Boys & Girls Clubs of
America.
• Mark Wahlberg partners with Taco Bell and its
Graduate to Go program, which works with
teens to stay in and graduate from high school.
• Burger King champions education through its
Scholars Program.
• Yum! Brands (Taco Bell, KFC and Pizza Hut)
coordinated one of the largest volunteer efforts
in history with its first annual World Hunger
Relief Week.

9. Community
• Many fast food restaurants get involved at
the local level through donations to athletic
teams, schools, group meetings and many
volunteer efforts through their employees.

10. The Weight of the World
• Two-thirds of people in the U.S. are
overweight or obese.
• Around the globe in 2008, about one male in
ten was obese, as was one in seven females.
• The World Health Organization predicts that
there will be more than 2 billion overweight
people around the world by 2015.
• Of those, 700 million will be considered to be
obese.

11. Health Issues Associated with Obesity
Diabetes Osteoarthritis
Heart Disease Certain Cancers
Heart Attack/Stroke Sleep Apnea
Gallbladder Disease Depression
Kidney Disease Increased Surgery Risk
Hypertension Menstrual Irregularities
High Cholesterol Pregnancy Complications

12. Fast Food
• Approximately 1 in 4 people in the United
States eat at fast food restaurants.
• McDonald’s serves approximately 64 million
customers in 119 countries every day.
• In 2006, KFC served more than 1 billion
chicken dinners worldwide.
• Subway became the largest fast food
restaurant in 2010, expanding to 33,749
restaurants around the globe.

13. Fast Food Wars
• As with all businesses, fast food restaurants
compete with each other for customers.
• This is accomplished through revamped core
products, premium items, value menus and
items, limited time menu items, special
promotions like Monopoly games to win free
food and money, free toys with children’s meals
and renovated restaurants.
• McDonald’s recently rolled out McD TV that
plays family-friendly HD programming.

14. Restaurant Dining
• A survey by Scarborough Research of over
210,000 people found that 96 percent of adults
in the United States eat out at a restaurant at
least one time in a typical month.
• In the average 30 day time frame studied, 91
percent ate at a fast food restaurant and 84
percent dined at a sit-down establishment.

15. At Home Eating
• The majority of our meals are eaten at home,
not at restaurants.
• It’s important that we look at everywhere
that we eat in order to have nutritious meals
and maintain a healthy weight.

16. Portion Sizes
• A University of North Carolina study found
that portion sizes of just about everything
have gotten bigger over the past 30 years.
• One example is that the average size of
bagels increased from three inches in
diameter to six inches, adding about 200
more calories.
• Another example is theater popcorn, which
wen from 5 cups (about 270 calories) to 11
cups (around 630 calories).

17. Increased Consumption
• The USDA reported that the average person
in the U.S. eats 30 pounds more sugar
annually than we did 30 years ago. We also
consume more meat (20 pounds), more
cheese (14 pounds), more white flour (35
pounds), and more fat (12 pounds).

18. Increased Consumption
• In 2012, Consumer Reports surveyed 47,565
people who ate 110,517 meals at 102 sit-
down restaurants chains.
• Of those earning the highest marks was an
Italian restaurant that was admired for its big
portions.

19. Fast Food vs. Sit-Down Restaurants
• Often portion sizes at sit-down restaurants
are bigger and have more calories, fat,
sodium and carbohydrate than like meals at
fast food restaurants.
• As an example, the Ruby Tuesday Bacon
Cheeseburger has 1009 calories compared to
the McDonald’s Cheeseburger that has 300
calories.
• Coco’s Original Burger has 760 calories, while
Burger King’s Hamburger has 290 calories.

20. Fast Food vs. Sit-Down Restaurants
• A salad at a sit-down restaurant can have
hundreds more calories than a salad at a fast
food restaurant.
• Many sit-down restaurants offer unlimited
fries with their sandwiches.
• At a sit-down restaurant, often a chip or
bread basket is put in the center of the table
and refilled by request. We can eat more
calories out of the middle of the table than
we should in an entire day.

21. Fast Food vs. Sit-Down Restaurants
• A RAND Corporation study found that entrées at
sit-down family style restaurants had more
calories, fat and sodium on average than meals
at fast food restaurants.
• David Zinczenko, editor-in-chief of Men’s Health
magazine and co-author of the Eat This Not
That! Series stated that sit-down restaurants are
“considerably worse for you than the often-
maligned fast food fare.”
• His menu analysis found that the average sit-
down restaurant entrée had 345 more calories
than the average fast food entrée.

22. Heart Attack Grill
• Located in Arizona, Las Vegas and Dallas, this sit-
down restaurant serves up very unhealthy
fare, with a focus on hamburgers.
• Menu items include the Quadruple Bypass
burger that has 8,000 calories.
• Customers who weigh 350 pounds or more eat
for free.
• Two spokespeople for the restaurant, one in his
20s, died. He was 575 pounds.
• Several customers have suffered heart attacks at
the restaurant, one while eating the 6,000-
calorie Triple-Bypass burger.

23. Heart Attack Grill
The restaurant’s slogan is “A Burger to Die For.”

24. Portions at Home
• A study of more than 63,000 subjects
reported in the Journal of the American
Medical Association found that portion sizes
of desserts and hamburgers were larger
when prepared at home rather than in a
restaurant.

25. Cooking at Home
• A Cornell University study found that the
serving sizes of many recipes found in the 70-
year-old book the Joy of Cooking have gotten
bigger over the years.
• Calories in this cookbook have increased by
40% for most of the book’s classic recipes.
• That’s about 77 extra calories per serving!

26. Ban or Band-Aid
• Some cities, like South Los Angeles have
banned new fast food restaurants.
• The goal was to get more healthy food
establishments and grocery stores.
• Since the ban went into effect in 2008, only
one new grocery store has opened in the
affected area.

27. Ban or Band-Aid
• A 2009 RAND Corporation study found that
banning fast food restaurant expansion in South
Los Angeles wouldn’t affect the obesity rate or
associated lifestyle diseases like diabetes.
• It found that the convenience stores and gas
stations in the area should receive more focus.
• A 15-year study of thousands of people found
that improved access to grocery stores didn’t
lead to healthier diets.

28. Physical Activity
• Although the numbers are improving, only
around 22 percent of adults in the U.S.
vigorously exercise at least 20 minutes or
more, three or more times per week.
• This percentage lowers to only about 15
percent of U.S. adults who exercise at least
30 minutes five days or more per week.
• Approximately 40 percent of adult Americans
don’t engage in any vigorous exercise.

29. Physical Activity
• Only about half of those aged 12 to 21
exercise vigorously on a regular basis.
• Only around 25 percent engage in even light
to moderate physical activity (for example
bicycling, walking).

30. Healthy Eating Tips
• Eat 3 meals per day plus appropriate snacks.
• Don’t skip meals.
• Monitor portion sizes.
• Read nutrition facts labels.
• Choose a variety of healthy foods, including
lean meats, fish and poultry, whole
grains, low fat/nonfat dairy, fruit, vegetables
and healthy fats.
• Don’t drink your calories.
• Monitor fat and sodium intake.

31. The Healthy Plate
• Aim to have half your plate non-starchy veggies
prepared in a healthy manner.
• The starchy veggies are potatoes, peas, beans,
corn, winter squash and pumpkin. These and all
other starches should be one-quarter of your
plate.
• The other quarter of your plate should be your
protein (2 to 3 ounces for lunch and dinner,
about 1 ounce for breakfast.)
• One piece of fruit and a low-fat dairy product
can also be included.

32. Healthy Substitutions
• Use nonfat or 1% milk instead of 2% or whole
milk.
• Try nonfat/low-fat cheeses instead of regular
cheese.
• Use egg whites or egg substitutes instead of
whole eggs.
• When using oil use unsaturated oils like olive,
canola and peanut oils instead of saturated oils
like coconut and palm kernel oil.
• A serving size of oil is one teaspoon.

33. Healthy Fast Food Choices
• Grilled chicken sandwiches, no mayo
• Single hamburgers, no mayo
• Turkey Burgers
• Salads with grilled chicken and low
fat/nonfat dressing
• Parfaits
• Apple slices
• Oatmeal – with appropriate toppings
• Baked potatoes

34. • A recent study of close to 5,000 adults 18 and
over found that engaging in certain bad
habits, such as inactivity, poor diet, drinking
too much alcohol and smoking, can age you
by 12 years.

35. Next Steps
• When eating out in restaurants, look for
more nutritious items. Order your food how
you want it prepared, i.e. no cheese, no
sauce, no mayo, no gravy, dressing on the
side, etc. Make these healthy choices when
eating at home as well.
• Use food diaries, like the online
www.myfitnesspal.com to determine what
you’re eating and to help you make healthy
changes. Nutrition facts labels also provide
info.

36. Next Steps
• Exercise a minimum of 30 minutes most days
of the week.
• If you need to lose weight, aim for 60
minutes most days of the week.

37. Social Media
• On Facebook at Lisa Tillinger Johansen
• On Twitter @LisaTJohansen
• Web site – www.fastfoodvindication.com
• Web site – www.consultthedietitian.com
• Respond to questions asked through my Web
sites.
• Weekly blog that is posted on both of my
Web sites and on a variety of other sites.