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Fast Food Consumption and its Impact on Health

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Food is known to play an important role in both the development and prevention of many diseases. The habit of taking food also varies from society to society. Globalization and urbanization have greatly affected ones eating habits and forced many people to consume fancy and high calorie fast foods, popularly known as 'Junk food'. Fast food is an important item of the food as it is readymade in nature and easy to eat. Food eaten outside the home is now becoming a significant and regular component of life. These rapid changes in the levels and composition of dietary and activity/inactivity patterns in transitional societies are related to a number of socioeconomic and demographic changes. Numerous studies have concluded that the poor nutritional value, the excessive salt content and the degree of saturated fats and trans fatty acid associated with fast food products likely perpetuate the prevalence of hypercholesterolemia, hypertension, type II diabetes mellitus, obesity and cardiovascular disease in Westernized societies. The present review describes the association between the consumption of such foods and health outcomes.
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EMCJ. January 2020; 5 (1) 28
Fast Food Consumption and its Impact on Health
Jahan I1, Karmakar P2, Hossain MM3, Jahan N4, Islam MZ5
Abstract:
Food is known to play an important role in both the development and prevention of many diseases. The habit of
taking food also varies from society to society. Globalization and urbanization have greatly affected ones eating
habits and forced many people to consume fancy and high calorie fast foods, popularly known as ‘Junk food’.
Fast food is an important item of the food as it is readymade in nature and easy to eat. Food eaten outside the
home is now becoming a significant and regular component of life. These rapid changes in the levels and
composition of dietary and activity/inactivity patterns in transitional societies are related to a number of
socioeconomic and demographic changes. Numerous studies have concluded that the poor nutritional value, the
excessive salt content and the degree of saturated fats and trans fatty acid associated with fast food products likely
perpetuate the prevalence of hypercholesterolemia, hypertension, type II diabetes mellitus, obesity and
cardiovascular disease in Westernized societies. The present review describes the association between the
consumption of such foods and health outcomes.
Keywords: Fast food, Lifestyle, Health and diseases
Received: October 15, 2019; Accepted: December 20, 2019
Introduction:
Food is important for survival1. It provides
necessary nutrition for the body of the human
being1. Fast food, which is available readymade and
easy to eat is now a days an important item of food1.
It often termed as food away from home (FAFH)1.
The term Fast food was introduced by Merriam-
Webster in 19512. According to Merriam-Webster,
fast food is the term given to food that can be
prepared and served very quickly2. Typically it
means any food that sold in a restaurant with low
preparation time and can be given to the customer
for take away2. So, it mainly designed for its quick
availability2. These are specialized products such as
hamburgers, pizzas, fried chicken or sandwitches1,3.
It can be categorized as Junk Food (JF)4. According
to National Institute of Nutrition (NIN), JF are
classified as food products which are high in salt,
sugar, fats and energy (calories) and contain little or
no proteins, vitamins or minerals4,5. Most JFs are
regarded as fast foods as they are prepared and
served fast but not all6. It can be termed as follows
also: EDLNF or EDNPFC: Energy dense low-
nutrient density foods or energy dense and nutrient
poor foods for children, FMNV: Foods of minimal
nutritional value, HFSS foods: Foods that is high in
fat, salt and sugar5.
Fast Food Consumption in the World:
Fast food was first popularized in 1950s in the
United States7. The first fast food restaurants were
established in the United States with White Castle in
19168. Now a days McDonalds, KFC and Pizza Hut
are multinational corporations with outlets across
the globe9.
At present fast food restaurants are one of the largest
segments of the food industry with over 200,000
restaurants and $120 billion in sales in the U.S.
alone10. International chains including McDonald’s
and Yum! Brands have 65 percent and 50 percent of
their sales overseas respectively which indicates that
fast food has a great demand all over the world11.
Multiple studies have shown that increased
frequency of takeaway and fast food consumption is
worldwide, especially in Europe, the United States,
and Australia12–18. The expenditure on fast foods is
more than their expenditure on higher education,
personal computers, software or new cars among
Americans19.
A governmental report in the United Kingdom
revealed that about 22% of residents were found to
purchase foods from takeaway outlets at least once
a week and 58% a few times a month14.
Approximately 28% of Australians consuming
1 Dr. Iffat Jahan, Assistant Professor, Department of Physiology, Eastern Medical College, Cumilla, Bangladesh.
2 Dr. Pijush Karmakar, Assistant Professor, Department of Biochemistry, Eastern Medical College, Cumilla, Bangladesh.
3 Dr. Mohammad Monir Hossain, Assistant Professor, Department of Anatomy, Eastern Medical College, Cumilla, Bangladesh.
4 Dr. Nusrat Jahan, Senior Consultant, Department of Internal Medicine, United Hospital, Dhaka, Bangladesh.
5 Prof. Dr. Md. Zakirul Islam, Professor & Head, Department of Pharmacology, Eastern Medical College, Cumilla, Bangladesh.
Address of Correspondence: Dr. Iffat Jahan, Assistant Professor, Department of Physiology, Eastern Medical College, Cumilla,
Bangladesh. Mobile: +8801818694693, Email: iffatcom7@gmail.com
Review Article
© 2020 Jahan I, et al. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-ShareAlike
3.0 Unported License (http://creativecommons.org/licenses/by-nc-sa/3.0/). ISSN 2518-6299 (print), 2520-5048 (online)
EMCJ. January 2020; 5 (1) 29
takeaway meals at least twice a week and 37% of US
residents eating fast food at least once over two
nonconsecutive days15,16. The National Restaurant
Association estimates that the average American
eats out an average of four times a week20.
In Turkey, it was revealed in a study that about one-
third of the research participants chose fast food as
snack for once or more times daily21.
About 33 percent of children and adolescents in the
United States consume fast food a day and intake
increase with age22,23. In the United States, $8 billion
is spent on food and beverages by children between
the ages of 4 and 12 years24.
Fast food is particularly popular among adolescents,
with a report from 2001 indicating that 75% of US
teenagers between the ages of 11 and 18 years eat at
fast-food outlets at least once a week and a 2010
report indicating that 70% of Brazilian students (9-
18 years old) consume fast food four times or more
per week17,18.
Fast Food Consumption in Asia:
According to Naido et al., in 2014, 96.6% of the 1.53
million fast-food (FF) outlets in China, 94.7% of the
87,186 outlets in India and 68.6% of 8152 outlets in
Vietnam was available25. American FF restaurants
expanded rapidly in China over the last decade26.
The modern fast-food industry in China started in
Beijing in 198726. The fast food industry had
estimated revenues of $94.2 billion in 2013 which
was 20.0% of the total revenue in China26.
According to a recent report, over two million fast
food restaurants operated in China in 2013,
including franchise and chain operators of all sizes
and independent Chinese-style fast food facilities27.
In Singaporean it was observed that 70.8% of adults
aged 1821 years consumed Western fast-foods on
a weekly basis compared to 3.0% of adult aged 60
years and over28.
Fast Food Industry in Bangladesh:
Fast food culture was started in the early nineties in
Bangladesh1. The first fast food shop started its
business in the Bailey road of Dhaka1. Swiss,
Helvetia etc. are name of some Bangladeshi fast
food shops formed in franchising system1. In early
2000, Bangladesh experienced the entry of the first
international brand of fast food franchise in the
country1. Pizza Hut and KFC entered into
Bangladeshi market having franchise with
Transcom Foods Limited (TFL)1.
Reason behind Preference for Fast Food:
Fast food companies are targeting young children
with great promotion strategies, delicious recipes
and attractive advertisement29. The important
factors for giving preference of fast food include
good taste, easy accessibility, increased convenience
and its pocket friendly nature29,30.
Students usually prefer this kind of foods to save
both time and money31-34. Socioeconomic trends,
such as prolong work hours, more women employed
outside the home and a high number of single-parent
households have changed the way families obtain
their meals13,35-37.
Reason for the choice to dine out include insufficient
time to cook at home, opportunities to socialize or
conduct business, convenience or the need for a
quick meal, enjoyment and family outings or
celebrations (birthdays, anniversaries and other
special occasions)1.
Changing of lifestyle and loss of the family tradition
of eating together may be the reason of increasing
the popularity of fast foods among young
people31,34,38. Singh et al. revealed in their research
that Indian young consumers visit fast food places
for enjoyment but home food was their first
preference39.
Fast Food Items:
Examples of most prominent fast food items include
burger, pizza, fried chicken, hamburger and
sandwich1. Gupta et al. found that the most popular
junk food item was chips (71%) followed by
chocolate (14%), bakery products (13%), soft drinks
(7%), and sugar-sweetened beverages (5%) in their
study6.
A study conducted in Baroda reported higher
consumption of junk food items (56%) such as
chocolates, pastries and sweets and soft drinks
(39%) by school age children40. Another study
conducted in Lucknow reported daily consumption
of junk food items such as chocolate, bakery items,
and ice cream by 28%, 14%, and 35% among school
age children, respectively41.
Fast Food Consumption & its Relation with Age:
In Singaporean children and teens, it was observed
that 70.8% of adults aged 1821 years consumed
Western fast-foods on a weekly basis compared to
3.0% of adult aged 60 years and over28.
High consumption of these foods in the younger age
demographic has also been observed in studies from
US, Europe and South Korea 12,42-45.
Seventy Five Percent of US teenagers between the
ages of 11 and 18 years eat at fast-food outlets at
least once a week17. 70% of Brazilian students (9
18 years old) consume fast food four times or more
per week18.
Jahan I, et al. Eastern Medical College Journal
EMCJ. January 2020; 5 (1) 30
Figure-1: Mean percentage of calories from fast
food among children and adolescents aged 2-19
years, by weight status and age: United States, 2011-
2012
Fast Food Consumption & its Relation with
Gender:
A Swedish study reported that female students led a
healthier lifestyle than male students which was
similar to the findings by Bipasha et al46. In their
study Ansari et al found, men had reported frequent
consumption of snacks than women38. Similar
findings were also found among the University
students of France47.
Figure-2: Mean percentage of calories from fast
food among children and adolescents aged 2-19
years, by sex and age: United States, 2011-2012
Harmful Effects of Fast food:
Social Hazards:
The fast food consumption has been increased
dramatically since the early 1970s which has effect
on social health also5. With changes in lifestyle,
there is increase in the consumption of junk food
among school going children48.
Nutritional habits which is the pre-requisites for
learning is decreased as well as the strength-
children need for making friends, interacting with
family, participating in sports and games or simply
feeling good about them due to more consumption
of out of home meals5.
Obesity, Overweight & Fast food:
Dietary habits and lifestyle practices are the
important determinants for overweight31-34. The
dietary factors associated with overweight were due
to increased frequency of eating at fast food and
having sweetened tea or coffee49. The shift from
healthy, homemade food to more convenient, longer
lasting fast foods combined with a sedentary
lifestyle has resulted in obesity and related health
complications34,50.
Figure-3: Percentage of children and adolescents
aged 2-19 years who consumed fast food on a given
day, by calories consumed: United States, 2011-
2012
There are almost 500 million people are obese and
two billion overweight or obese in worldwide51-53.
Kuchler claims that promotion strategies by fast
food companies are also responsible for rising
obesity rates1.
Consumption of fast food among children in the
United States have an adverse effect which
increased risk for obesity10. In China obesity rates
also have increased rapidly in the past few yeras54,55.
Several studies have been performed to observe the
association between fast food and obesity26. The
majority of the study were conducted in Western
countries and showed positive association between
fast food and obesity56-61.
A systemic review based on 16 studies conducted in
Western countries examined the association
between fast food and risks of weight gain and
obesity, and revealed mixed results58. In a previous
study of over 24,000 children aged 2–18 years in
Beijing found that children consuming western fast
food 3 times per week were 1.50 times overweight
or obese compared to children with fast food <1 time
per week62.
A longitudinal study (during 2000-2009) was done
to see the associations between changes in BMI,
WHtR (Waist-Height Ratio) and WHpR (Waist-Hip
Ratio) and changes in Western fast food which
revealed positive association between the number of
Western fast food consumption and subsequent
increase in central adiposity63.
Jahan I, et al. Eastern Medical College Journal
EMCJ. January 2020; 5 (1) 31
A study was done on young adults to see the
association between fast food consumption and
change in BMI over a 3-year period also showed that
increased fast food consumption was associated
with a higher BMI64.
Rouhani et al. found increased incidences of
overweight and obesity among Isfahani (Iranian)
girls aged 11-13 years those who intakes of fast
foods more65.
Figure-4: The effects of Fast Food on the body
High consumption of JF has been identified as a
major cause of overweight in India among school
age children from 9.7% to 13.9% from 2001 to
201066. In some previous studies it was found that
high consumption of fried foods and sugary drinks
has been significantly associated with high body
mass index and weight gain in children67,68.
Some researchers also found that those who ate fast
food at home and also those students who attended
school close to fast food restaurants were more
probable to be overweight69.
Fast food eating on regular basis can increase the
risk of weight gain and obesity because of having a
high energy density with the presence of high levels
of fat and sugar in the meal and a correspondingly
low level of fiber and protein31,34,38.
A study was done in an urban private medical
student in Bangladesh, showed that a quarter of
respondents were overweight which is higher than
the national average49.
The students who used to eat at fast food shops 2-3
times per month were more likely to be overweight
as compared to the other groups who eat at fast food
shops once per month or less49. Eating at fast food
shops was also found to be associated with gaining
weight in other studies64.
Consumption of fast foods two times or more per
week has been associated with 31% higher
prevalence of moderate abdominal obesity in men
and 25% higher prevalence in women70.
Obesity is associated with an increase in respiratory
problems. Even without diagnosed medical
conditions, obesity may cause episodes of shortness
of breath or wheezing with little exertion. Obesity
also can play a role in the development of sleep
apnea, a condition in which sleep is continually
disrupted by shallow breathing and asthma70,71.
A recent study published in the journal Thorax
suggests that children who eat fast food at least three
times a week are at increased risk of asthma and
rhinitis, which involves having a congested, drippy
nose70,71.
Regular consumption of fast food meals was related
to increases in energy intake of 56 kcal/day and 187
kcal/day among adults and children,
respectively70,71. A higher frequency of fast-food
consumption was associated with a weight gain of
0.72 kg over 3 years and of 4.5 kg over a 15-year
period above the average weight gain71,72.
Non-Communicable Disease & Fast Food:
The Global Burden of Disease study found diet as a
major factor for increasing hypertension, diabetes,
obesity and other CVD73. Increased consumption of
junk food is also associate with increased risk of
early development of diet-related noncommunicable
diseases29,48,74,76.
It is no longer confined to the developed countries
but also spread to the developing countries as
well29,30. The young generation taking unhealthy fast
foods causing a long-term negative effect on their
health38.
Frequent consumption of fast food has adverse
effects on human health because of its excessive
content of energy and fat and low nutritional
value75,77-80.
High consumption of junk food is also responsible
for increased risk of early development of diet-
related noncommunicable diseases, including
hypertension, dyslipidemia, impaired glucose
tolerance, metabolic syndrome, musculoskeletal
disorders and cancers29,30,48,74.
Jahan I, et al. Eastern Medical College Journal
EMCJ. January 2020; 5 (1) 32
Non-communicable diseases (NCDs) are increased
day by day in low middle-income countries (LMIC)
because of changing of lifestyle with increasing
urbanization, economic development and
globalization81. Unhealthy dietary patterns also have
negative environmental impacts on climate
change81.
There is a relation between different type of cancer
and Fast Food consumption also. One of the major
causes of Gastro-intestinal Carcinoma is fast food
consumption and it can be 25% due to high fat and
fried food39. Though most of the fast food users are
well informed about the negative effects associated
with fast food consumption, but they were still
reported to have fast food in regular basis without
considering their health complications30. In the long
run which will increase their healthcare costs also30.
Oral Health & Fast Food:
There is also a convincing evidence base linking of
poor oral health, in particularly periodontal disease,
to amplified CVD risk. Periodontal disease occurs as
the result of untreated dental caries, which is in turn
driven by a number of factors including poor oral
hygiene and excess sugar consumption82.
Behavioral Symptoms & Fast food:
In Norwegian adolescents, showed that those having
high junk food were more likely to have
hyperactivity-inattention disorder83.
The latest nationwide cross-sectional sample survey
for assessing psychological symptoms of adolescent
and eating habits found that fast foods pattern, sugar
sweetened beverages pattern and the meats pattern
were significantly associated with higher risk of
psychological symptoms84.
Metabolic Consequences & Fast Food:
Food dense in calories, when oxidized in the body
causes enormous formation of acetyl Co-A. Acetyl
Co A in excess is channelized out of mitochondria
for its participation in other metabolic pathways and
for its effective utilization. These pathways include
denovo fatty acids synthesis and biosynthesis of
cholesterol, which causes excess fatty acid and
cholesterol formation85.
Another pathway which acetyl Co A is involved in
formation of ketone bodies, which is inactive when
energy levels are high, but is active in case when
impaired glucose tolerance sets in. Carbonated soft
drinks, in addition to towering amount of sugar
reportedly contain methylglyoxal (MG), which is
strongly associated with human carbonyl stress86.
Prevention:
The younger people who are getting addicted to fast
food, which may arise a serious public health
concern and urgent action should be taken to tackle
this public health problem31,32,72,87,88.
Balanced diet should be given preference instead of
junk or fast foods not only by young people but also
in all age group5. Specific health education
programme, dietary guidelines and effective public
awareness campaigns should be initiated against the
unhealthy lifestyle of university students and
improve their health29. A combined initiative from
families, universities, public health experts and the
government is needed to tackle this public health
problem30.
Figure-5: Recommendation for decreasing the
consumption of Fast Food
Conclusion:
The rapid growth of the FF industry has become a
public health concerns considering its negative
health consequences including obesity related risks.
Children, parents and general public should be
advocated about the associated ill health effects of
the junk foods in various forms. Ensuring
availability of variety of healthy food menu at
markets or restaurants will give better options for
general public, thereby promoting healthy lifestyle.
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