Article

Fast food consumption, obesity and nutrient intake among adults in Indonesia

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Asian countries, including Indonesia, have experienced a significant shift in their diet with increased fast food consumption spurred by rapid economic expansion, urbanisation and social changes. Increasing mortality and morbidity following obesity and noncommunicable diseases have been linked to an imbalanced nutrient intake. This study assessed the pattern of fast food consumption with overweight, obesity and nutrient intake of Indonesian adults. Three hundred eighty-five participants were conveniently recruited; completed a questionnaire encompassing socio-demographics, the pattern of fast food consumption and nutritional status. Also, participants’ anthropometric measurements were obtained. Some participants were overweight (27.5%) and obese (8.6%). Fast food was widely consumed by both genders; males (95%) and females (98%). Fast food consumption rate was significantly associated (p<0.01) with marital status, education level and monthly income. Married individuals (54%), those with post-graduate education (68%), and higher-income earners (62%) consumed more fast food when eating out. There was no significant association between fast food consumption rate and anthropometric parameters, including obesity. However, fast food consumption rate, number of daily meals replaced with fast food was significantly associated (p<0.05) with increased calorie intake and fat intake. This growing tendency of energy-dense food consumption may increase the risk of obesity in the long run, putting people at risk for various noncommunicable diseases. The prevalence of overweight and obesity may be reduced by promoting an active lifestyle, creating a supportive environment for voluntary physical activity and restricting high-energy food consumption.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Rapid lifestyle changes and time demands in the modern era have encouraged people, especially in urban areas, to consume fast food as a practical alternative to meet daily nutritional needs (Thiagarajah, Ng, & Ahmad Bustami, 2024). Fast food, which was originally popular in Western countries, is now part of the global eating culture, including in Southeast Asian countries such as Indonesia (Siswati et al., 2024). ...
... Research shows that regular fast food consumption is associated with increased body mass index (BMI) and the risk of non-communicable diseases such as type 2 diabetes and heart disease Yun et al., 2025). In Indonesia, changes in food preferences, especially among the younger generation, are increasingly moving towards fast food consumption patterns, replacing healthier traditional diets (Thiagarajah et al., 2024;. ...
... The urgency of this study lies in the high obesity rate in Indonesia which is directly proportional to the increase in fast food consumption. Without data-based interventions and appropriate policies, the long-term risks to public health will increase Thiagarajah et al., 2024). A deeper understanding of consumption patterns and the factors that influence them can be the basis for more effective and contextual obesity control strategies. ...
Article
Full-text available
Socio-economic changes and urban lifestyles have driven shifts in food consumption patterns, with an increasing preference for fast food. In Indonesia, this phenomenon is one of the main contributors to the increasing prevalence of obesity, especially in the productive age group. This study aims to analyze changes in people's consumption patterns for fast food and their implications for the prevalence of obesity. The approach used is a qualitative literature study by reviewing academic sources and empirical data from the last five years (2019–2024) obtained from various databases such as PubMed, Scopus, and Google Scholar. The analysis method used is thematic content analysis to identify key themes such as fast food consumption trends, driving factors, and health impacts. The results of the study show that fast food consumption has increased significantly among urban communities, driven by practical factors, media influence, and aggressive marketing. This consumption is positively correlated with an increase in body mass index (BMI) and obesity prevalence, as reflected in Riskesdas data showing an increase in obesity prevalence from 14.8% in 2013 to 21.8% in 2018. In addition, high fast food consumption is generally accompanied by a sedentary lifestyle and low nutritional awareness. These findings indicate the importance of policy interventions based on nutritional education, advertising restrictions, and healthy lifestyle promotion to suppress the increasing obesity trend in Indonesia.
... In Indonesia, the significant growth in consumption of such foods in urban or semi-urban areas, with a 10-15% increase in the number of outlets per year, suggests that traditional markets are not the main factor in increasing BMI (Arif et al., 2020). Although no significant association was found between fast food consumption and obesity, the increasing trend of fast food consumption in Indonesia contributes to excess energy intake with unbalanced nutritional quality (Andriyani et al., 2024). Unbalanced nutritional quality, including low intake of various micronutrients and fiber, as well as high glycemic load, can increase the risk of obesity in the long run. ...
Article
Full-text available
Purpose: Obesity is a growing public health problem in Indonesia, with prevalence influenced by several factors such as unhealthy diet, physical inactivity, and sociodemographic factors such as urbanization and socioeconomic status. It is associated with an increased risk of non-communicable diseases, including diabetes and asthma, and is more common in urban and affluent areas compared to rural areas. Although traditional markets may increase access to healthier food options, their direct impact on reducing obesity remains unclear. This study aims to conduct a multifactorial and bivariate analysis of obesity risk factors by involving analysis of the influence of gender, age, and traditional markets. Methodology: This cross-sectional study analyzed data on Gatak Sub-district Health Center visits (May-July 2024) and the presence of traditional markets from Statistics Indonesia reports, using Pearson Chi-Square and logistic regression to test the impact of age, gender, and market availability on BMI. Results: This study analyzed 9,639 patients, with fewer than half under 50 years old, two-thirds female, and nearly 80% living in areas without traditional markets. Multivariate and bivariate analyses revealed a higher proportion of obesity among patients aged 50 and older and females (p = 0.000). However, the presence of traditional markets showed no significant impact on obesity rates. The presence of traditional markets does not have a significant influence in causing obesity. Age 50 years and above and female gender have a higher risk of obesity. Applications/Originality/Value: This research contributes to understanding the factors that influence BMI in rural areas in Indonesia.
... Indonesia's food and physical environments are becoming more obesogenic, making it difficult to adopt healthy diets and active lifestyles [5]. Asian countries, including Indonesia, have experienced a significant shift in their diet, with increased fast-food consumption driven by rapid economic growth, urbanization, and social change [8]. A previous study showed that fast-food consumption could increase the risk of central obesity [9]. ...
Article
Full-text available
Central obesity poses a greater risk than general obesity. The global prevalence of obesity is increasing, including in Indonesia. The incidence of central obesity is associated with several factors, including sociodemographic status and physical activity levels. This study aims to investigate the association between sociodemographic status and physical activity level with central obesity. This study employed a cross-sectional study involving 111 adults aged 18-59 in South Tangerang City, Indonesia. Sociodemographic factors included age, sex, educational level, family size, and marital status. Physical activity levels were assessed using International Physical Activity Questionnaire (IPAQ). Both sociodemographic status and physical activity data were collected through interviews. The waist circumference was measured using inelastic tape. More than half of the respondents (57.63%) were centrally obese. Sex, marital status, educational level, and physical activity were significantly associated with central obesity (p-value < 0.05). Female (OR 3.639), married (OR 3.381), and less active (OR 2.746) respondents were more likely to have central obesity. A low educational level was found to be protective against central obesity (OR 0.285). Females, individuals with high education level, and married individuals are advised to be physically active to prevent the central obesity.
... A number of studies carried out abroad show an adverse association between fast food and overweight or obesity. In Indonesia, a study suggested both waist circumference and BMI have a significantly negative association with increased fast food consumption (18). Another study, in the UK, indicated participants who consumed fast food on a weekly basis had ~20% lower odds of being overweight than those who consumed it rarely or never (19). ...
Article
Full-text available
Overweight and obesity are body mass index (BMI) for age Z-score > +1SD and > +2SD, respectively. Despite its largest contribution to overweight/obesity, there is little attention in our country about fast-food consumption. Hence, this study aimed to assess the prevalence of overweight/obesity and its association with fast-food consumption among adolescents in Southern Ethiopia. From 14 June 2022 to 15 July 2022, a cross-sectional study design was conducted using a structured questionnaire and anthropometric measurements, with a sample size of 563. The data were coded, cleaned, and imported into EPI-INF version 7.2 before being exported to SPSS version 25 for analysis. All variables with p-values less than or equal to 0.25 in bivariate logistic regression were candidate variables for multivariable logistic regression. The response rate of this study was 97%. Based on BMI, the combined prevalence of overweight/obesity was 6.0% (95% CI: 4.2–8.4%). Adolescents who are female, come from high-income families, and eat fast-food frequently are more likely to be overweight or obese. Future health initiatives aimed at lowering the prevalence of overweight and obesity in adolescents should pay special attention to female adolescents and those from high-income families.
Chapter
Full-text available
“Dengan Latihan yang tepat, anak-anak dengan Down syndrome dapat mencapai perkembangan motorik yang lebih baik.”
Article
Full-text available
Background: Adolescent have the characteristics of wanting to be accepted by their peers. Peer influence can also affect consumption, one of which is consumption of fast food, either foreign or domestic. High peer influence has the possibility to make fast food consumption high.Objectives: This research was conducted to analyze the correlation between peer influence and consumption of fast food, foreign and domestic.Methods: This study was an observational analytic study with a cross sectional design on 136 adolescents in SMAN 6 Surabaya who were selected by clustered random sampling. Data collected were the respondent's background: gender, age, and daily pocket money. Respondents also filled a peer influence scale questionnaire and a food frequency questionnaire about fast food.Results: Most respondents had low peer influence (52.21%). The chi square correlation test revealed that there was a significant correlation between peer influence and consumption of French fries (p=0.016), beef burger (p=0.029), chicken burger (p=0.025), and waffle (p=0.014). There was no significant correlation between peer influence and any food from domestic fast food group.Conclusions: There was a correlation between several types of foreign fast food consumption and peer influence. Types of fast food that had a correlation with peer influence were French fries, beef burger, chicken burger, and waffle. Whereas no food from domestic fast food groups had a significant correlation with peer influence. This revealed that peer influence only affects certain fast food that has prestige value.ABSTRAKLatar Belakang: Remaja memiliki ciri-ciri ingin diterima oleh kelompok sosialnya (peer). Peer influence juga bisa memengaruhi konsumsi, salah satunya konsumsi makanan cepat saji, modern maupun tradisional. Peer influence yang tinggi memiliki kemungkinan untuk membuat konsumsi makanan cepat saji remaja menjadi tinggi.Tujuan: Penelitian ini dilakukan untuk menganalisis hubungan antara peer influence dan konsumsi makanan cepat saji, modern maupun tradisionalMetode: Penelitian ini merupakan penelitian observasional analitik dengan studi cross sectional pada 136 remaja di SMAN 6 Surabaya yang dipilih secara clustered random sampling. Data yang dikumpulkan adalah latar belakang responden berupa tinggi badan, berat badan, jenis kelamin, usia, serta uang saku harian. Selain itu, responden diminta mengisi peer influence scale questionnaire dan food frequency questionnaire.Hasil: Sebagain besar responden berstatus gizi gemuk (14%) dan memiliki peer influence sedang (50%). Uji korelasi chi square mengungkapkan adanya hubungan yang signifikan antara peer influence dan konsumsi spaghetti (p=0,007), fried chicken (p=0,009), french fries (p=0,008), beef burger (p=0,018), chicken burger (p=0,009), dan dimsum (p=0,046). Tidak ada makanan dari kelompok makanan cepat saji tradisional yang memiliki hubungan yang signifikan dengan peer influence.Kesimpulan: Terdapat hubungan antara konsumsi beberapa jenis makanan cepat saji modern dan peer influence. Jenis makanan cepat saji yang memiliki korelasi dengan peer influence yaitu spaghetti, fried chicken, french fries, beef burger, chicken burger, dan dimsum. Sedangkan tidak ada makanan dari kelompok makanan cepat saji tradisional yang memiliki hubungan yang signifikan dengan peer influence. Hal ini mengungkapkan bahwa peer influence hanya memengaruhi makanan cepat saji tertentu yang memiliki nilai prestige.
Article
Full-text available
Obesity is a new problem experienced by the world population, especially developing countries. Obese sufferers increase the risk of degenerative diseases, mental health and death. The aim is to analyze the cultural relationship between eating and the incidence of obesity in adolescents. This study was cross sectional survey by using purposive sampling to select samples. A total 79 adolescents were selected and investigated during this study. The result of this study shows a relationship between fast food consumption and the incidence of obesity (p<0.001). There is a significant relationship between food frequency and obesity (p<0.001). There is no correlation between food preference and obesity (p=0.833). Eat culture has a correlation with the incidence of obesity in terms of food consumption, meal frequency but not food preference. Food culture is closely related to local customs. Especially in fast food consumption and daily food preferences. It is suggested to adolescents to concern on their food consumption by knowing the principle of balanced consumption, and more intelligent in choosing the food that will be consumed. © 2018, Indian Journal of Public Health Research and Development. All rights reserved.
Article
Full-text available
Background: Household income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double burden of these factors is a matter of public health importance. The purpose of this study was to test associations of neighbourhood fast-food outlet exposure and household income, in relation to frequency of consumption of processed meat and multiple measures of adiposity, and to examine possible interactions. Methods: We employed an observational, cross-sectional study design. In a cohort of 51,361 adults aged 38-72 years in Greater London, UK, we jointly classified participants based on household income (£/year, four groups) and GIS-derived neighbourhood fast-food outlet proportion (counts of fast-food outlets as a percentage of all food outlets, quartiles). Multivariable regression models estimated main effects and interactions (additive and multiplicative) of household income and fast-food outlet proportion on odds of self-reported frequent processed meat consumption (> 1/week), measured BMI (kg/m2), body fat (%), and odds of obesity (BMI ≥ 30). Results: Income and fast-food proportion were independently, systematically associated with BMI, body fat, obesity and frequent processed meat consumption. Odds of obesity were greater for lowest income participants compared to highest (OR = 1.54, 95% CI: 1.41, 1.69) and for those most-exposed to fast-food outlets compared to least-exposed (OR = 1.51, 95% CI: 1.40, 1.64). In jointly classified models, lowest income and highest fast-food outlet proportion in combination were associated with greater odds of obesity (OR = 2.43, 95% CI: 2.09, 2.84), with relative excess risk due to interaction (RERI = 0.03). Results were similar for frequent processed meat consumption models. There was no evidence of interaction on a multiplicative scale between fast-food outlet proportion and household income on each of BMI (P = 0.230), obesity (P = 0.054) and frequent processed meat consumption (P = 0.725). Conclusions: Our study demonstrated independent associations of neighbourhood fast-food outlet exposure and household income, in relation to diet and multiple objective measures of adiposity, in a large sample of UK adults. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, furthering our understanding of how these factors contribute jointly to social inequalities in health.
Article
Full-text available
Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this burden toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decreases in food prices (eg, beef prices) have increased access to supermarkets, and the urbanization of both urban and rural areas is a key underlying factor. Limited documentation of the extent of the increased effects of the fast food and bottled soft drink industries on this nutrition shift is available, but some examples of the heterogeneity of the underlying changes are presented. The challenge to global health is clear.
Article
Full-text available
Objective: Study the trends in Western fast food consumption (FFC) among Chinese school-age children and the association between FFC and obesity using nationwide survey data. Design: Cross-sectional and longitudinal analyses were conducted to study the trends in FFC and the associations between FFC and weight status (overweight, obesity and body mass index (BMI) z-score). Setting: Longitudinal data from families were collected in the 2004 and 2009 China Health and Nutrition Survey (covering nine provinces throughout China). Subjects: The analysis included 2656 Chinese children aged 6 to 18 years (1542 and 1114 children in the 2004 and 2009 survey, respectively). Results: FFC (reported having consumed Western fast food in the past three months) has increased between 2004 and 2009, from 18.5% to 23.9% in those aged 6-18, and increased more rapidly among those aged 13-17, from 17.9% to 26.3%. The increase was significant in almost all groups by age, sex, family income, and residence. Our cross-sectional and longitudinal analyses did not detect a significant association between FFC and obesity/overweight or BMI z-score (e.g., for BMI z-score, boys: β = 0.02, 95% CI: -0.71, 0.75; girls: β = -0.14, 95% CI: -1.03, 0.75). Conclusions: FFC has increased in Chinese school-age children, especially in older children, boys, and those from low- and medium-income families, rural areas, and East China, but decreased among those from high-income families during 2004-2009. The data did not show a significant association between FFC and obesity.
Article
Full-text available
Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Similarly, higher consumption of fast food at year 7 was associated with a 0.16-unit higher BMI at year 10. After adjustment for baseline away-from-home eating, increased consumption of fast food only (beta: 0.20; 95% CI: 0.01, 0.39) and of both restaurant food and fast food (beta: 0.29; 95% CI: 0.06, 0.51) were positively associated with BMI change, though the estimates were not significantly different (P = 0.47). Increased consumption of restaurant food only was unrelated to BMI change (beta: -0.01; 95% CI: -0.21, 0.19), which differed significantly (P = 0.014) from the estimate for an increase in both restaurant food and fast food intake. We found differential effects of restaurant food and fast food intakes on BMI, although the observed differences were not always statistically significant. More research is needed to determine whether the differential effects are related to consumer characteristics or the food itself.
Conference Paper
Full-text available
This study examined the frequency and characteristics of fast food consumption, and obesity prevalence among community members who attended health centres in the Gombak District. In total, 1173 Malaysian adults were interviewed based on a structured questionnaire. Fast food consumption was higher for mostly young Malays and significantly associated with age, ethnicity, number of children in the household, and perception of their general health in a multivariate model. 21.3% of respondents were obese. However, it was not associated with frequenting fast food restaurants. The high prevalence of fast food consumption points for the need to further educate the community in making healthier life options.
Article
Full-text available
This study aims to understand consumer preference relating to the fast food in Malaysian market. Moreover, this paper seeks to investigate the trend and pattern of fast food consumption and the importance of various factors affecting the choice of fast food among Malaysian consumers. Findings suggest that expenditure for fast food mostly goes to fried chicken, while instant noodles are the least. Moreover, food safety, speed in delivery and food taste suitability has been found as the main influential factors for purchasing the fast food. On the contrary, quality, freshness, easy to cook, and cleanliness are the second priority. Furthermore, 'Halal' status has been indicated as the most important factor for the Muslim consumers. Survey method using convenience sampling has been carried out for conducting this study. Therefore, further research targeting a more diverse group of consumers employing random sampling can provide greater generalization.
Article
Full-text available
The aim of this research was to study the fast food habits of the hostlers in relation to their consumption and awareness and to study the role of their parents and advertisement. Food is considered an important representation of all ethnic groups. Although, the trend change and its impact exits on whole society, whether it belongs to lower middle class and/or elite class. But beside this thing till today there is no proper definition of the fast food. Hostel life is entirely different from the in-home especially in terms of eating habit. So, by keeping this view in mind the study was conducted in Lovely Professional University hostels to know about the consumption and awareness of the hostlers about the fast food eating pattern. The study emphasizes on the ambiguity in the knowledge, awareness and prudent consumption behavior amongst the university hostlers. It provides converging evidence of a direct causal link between food advertising, parent's role and behavioral pattern of the hostlers about the fast food consumption. The study was conducted during the October-November 2011 in the Lovely Professional University hostels. At present 18,000 students residing in the university hostels as information obtained from the university authority from which 10.06% of the total samples i.e., 1811 were targeted and n on-para metric test (chi-square) was applied to check the goodness of fit, at 95% level of significance. The survey provides converging evidence of a direct causal link between food advertising, parent's role and behavioral pattern of the hostlers about the fast food consumption. Understanding hostlers eating attitude and behavior is important in terms of their health which clearly demarks that the adoption of fast food culture among university hostlers in Lovely Professional University is common. The study signifies the direct ambiguity in the knowledge, awareness and prudent consumption behavior amongst the university hostlers.
Article
Full-text available
This paper elucidates the role of processed foods and beverages in the ‘nutrition transition’ underway in Asia. Processed foods tend to be high in nutrients associated with obesity and diet-related non-communicable diseases: refined sugar, salt, saturated and trans-fats. This paper identifies the most significant ‘product vectors’ for these nutrients and describes changes in their consumption in a selection of Asian countries. Sugar, salt and fat consumption from processed foods has plateaued in high-income countries, but has rapidly increased in the lower–middle and upper–middle-income countries. Relative to sugar and salt, fat consumption in the upper–middle- and lower–middle-income countries is converging most rapidly with that of high-income countries. Carbonated soft drinks, baked goods, and oils and fats are the most significant vectors for sugar, salt and fat respectively. At the regional level there appears to be convergence in consumption patterns of processed foods, but country-level divergences including high levels of consumption of oils and fats in Malaysia, and soft drinks in the Philippines and Thailand. This analysis suggests that more action is needed by policy-makers to prevent or mitigate processed food consumption. Comprehensive policy and regulatory approaches are most likely to be effective in achieving these goals.
Article
Full-text available
Eating outside of the home environment on a frequent basis has been associated with weight gain. Food choices when eating out are usually high in energy content, which contributes to excessive energy intake; however, the available data on out-of-home eating and obesity are far from conclusive. This systematic review assesses the association between out-of-home eating and body weight in adults over 18 years of age. The literature databases searched included Medline, Embase, Lilacs, The Cochrane Library, and the ISI Web of Knowledge. The review includes a comprehensive quality assessment of all included observational studies, 20 cross-sectional studies, and 8 prospective cohort studies. All but one of the prospective cohort studies and about half of the cross-sectional analyses found a positive association between out-of-home eating and body weight. However, many methodological differences among the studies were found, such as the definition of out-of-home eating and its assessment, which limits comparisons. The results of the present analysis suggest that in future studies fast-food restaurants and other out-of-home dining venues should be analyzed separately, assessments based on a single 24-h recall should be avoided, and controls for at-home choices (which were not included in any of the studies reviewed) are necessary to evaluate this association.
Article
Full-text available
Dietary Guidelines are sets of advisory statements that give dietary advice for population to promote nutritional well-being. They contain information on foods or behaviors that are encouraged and cautionary messages derived from scientific evidence-based reviews and specific local conditions. The Indonesian Dietary Guidelines consisting of 13 messages that were publicized by the Ministry of Health in 1995 and have not been reviewed afterward in relation to nutritional status and health outcome of the population. By reviewing studies on different age groups in the past 10 years and comparing the results with the recommended guidelines, this paper aims to identify if messages have been successfully applied and if there are relevant issues not yet covered in the guidelines. The reviews covered 29 out of 33 provinces, representing studies from sub-district or higher levels (district, provincial, national). Results showed that some messages have been better implemented than others; also that information for some messages was not available for which to conclude of its implementation. In addition, some practices were identified which are prevalent in several age groups and have important public health consequence, but not yet included in the 13-guidelines. These include: smoking, increased intakes of fruit and vegetables, limited intakes of salt and sugar, increased intakes of foods rich in zinc and calcium (besides iron), hand-washing before food preparation and eating, and weight-monitoring. For infants and young children, nutrient density, feeding responsiveness and stimulation should be specifically highlighted. Based on the results, several recommendations in revising the guidelines were given.
Article
Full-text available
To determine which dietary and lifestyle choices and which attitudes toward diet and health most contribute to adiposity and whether those factors differ by gender. Multiple regression was used to estimate the effect of energy intake, energy expenditure, resources, demographics, and attitudes toward diet and health on self-reported body mass index (BMI) in a nationally representative sample of the US population. This study used secondary data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and its telephone follow-up, the Diet and Health Knowledge Survey (DHKS). CSFII is a nationally representative survey of individuals which obtained 24 h recalls of all food intake on two nonconsecutive days. The DHKS data set obtained information on knowledge and attitudes toward dietary guidance and health from individuals 20 y of age and over, who participated in the CSFII. Our sample consisted of responses from 5512 individuals. We found that many of the variables previously found to or hypothesized to influence body weight do so. Our analysis shows that choices and attitudes do matter for adiposity. Moreover, the analysis shows that the choices males and females make often have quite different effects on BMI. For females all the variables we constructed to represent energy intake, energy expenditure, and financial and human resources are significant. Most of the variables that characterize attitudes toward diet and health are significant. For males, far fewer variables are significant. Our tests for gender-related differences show that whether or not males believe their weight is predetermined has no influence on BMI. In contrast, women who do not believe that their weight is predetermined have lower BMI values than those who believe weight is genetically determined. While our qualitative conclusion--choices and attitudes affect BMI--is unsurprising, the quantitative aspects are important. The analysis shows that factors affecting BMI differ systematically by gender. Understanding these systematic differences is critical to the design of information campaigns. Our analysis suggests that entirely different campaigns are necessary to communicate the importance of diet and lifestyle choices to men and to women.
Article
Full-text available
To compare the diet quality and overweight status of free-living adults, ages 20 years and older, grouped based on their fast food intake status. USDA's 1994 to 1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996) data was used. Three separate analyses were conducted: (1) effect of fast food on diet quality of males and females based on day-one data, (2) comparison of dietary and overweight status of adults who ate fast food on one- two- or none of survey days and (3) within-person analysis comparing energy and macronutrient intakes of adults who ate fast food on one of the two survey days. SUDAAN software package was used in pair-wise mean comparisons and regression analyses (alpha = 0.05). At least one in four adults reported eating fast food. The diet of males and females who consumed fast food was high in energy and energy density. Fast food provided more than one-third of the day's energy, total fat and saturated fat; and was high in energy density. Negligible amounts of milk and fruits, but substantially large amounts of non-diet carbonated soft drinks were reported consumed at fast food places. After controlling for age, gender, socio-economic and demographic factors, energy and energy density increased and micronutrient density decreased with frequency of fast food consumption. Adults who reported eating fast food on at least one survey day had higher mean body mass index values than those who did not eat fast food on both survey days. A small, but significant, positive association was seen between fast food consumption and overweight status. Within-person comparisons showed that energy intakes were higher on a fast food day than on a non-fast food day. Fast food consumption was associated with a diet high in energy and energy density and low in essential micronutrient density. Frequent fast food consumption may contribute to weight gain.
Article
Full-text available
Fast food consumption has increased greatly among children in recent years, in tandem with the obesity epidemic. Fast food tends to promote a positive energy balance and, for this reason, may result in weight gain. However, if fast food and obesity are causally related, the question arises of why some children who frequently eat fast food do not become overweight. To test the hypothesis that overweight adolescents are more susceptible to the adverse effects of fast food than lean adolescents. In study 1, we fed participants an "extra large" fast food meal in a naturalistic setting (a food court). The participants were instructed to eat as much or little as desired during this 1-hour meal. In study 2, we assessed energy intake under free-living conditions for 2 days when fast food was consumed and 2 days when it was not consumed. Data were collected in Boston, Mass, between July 2002 and March 2003. Overweight (n = 26) and lean (n = 28) adolescents aged 13 to 17 years. Overweight was defined as a body mass index exceeding sex- and age-specific 85th percentiles based on the 2000 Centers for Disease Control and Prevention growth charts. Energy intake determined by direct observation in study 1 and by unannounced 24-hour dietary recalls, administered by telephone, in study 2. In study 1, mean (SEM) energy intake from the fast food meal among all participants was extremely large (1652 [87] kcal), accounting for 61.6% (2.2%) of estimated daily energy requirements. Overweight participants ate more than lean participants whether energy was expressed in absolute terms (1860 [129] vs 1458 [107] kcal, P =.02) or relative to estimated daily energy requirements (66.5% [3.1%] vs 57.0% [2.9%], P =.03). In study 2, overweight participants consumed significantly more total energy on fast food days than non-fast food days (2703 [226] vs 2295 [162] kcal/d; +409 [142] kcal/d; P =.02), an effect that was not observed among lean participants (2575 [157] vs 2622 [191] kcal/d; -47 [173] kcal/d; P =.76). In this study, adolescents overconsumed fast food regardless of body weight, although this phenomenon was especially pronounced in overweight participants. Moreover, overweight adolescents were less likely to compensate for the energy in fast food, by adjusting energy intake throughout the day, than their lean counterparts.
Article
Full-text available
Fast-food consumption has increased greatly in the USA during the past three decades. However, the effect of fast food on risk of obesity and type 2 diabetes has received little attention. We aimed to investigate the association between reported fast-food habits and changes in bodyweight and insulin resistance over a 15-year period in the USA. Participants for the CARDIA study included 3031 young (age 18-30 years in 1985-86) black and white adults who were followed up with repeated dietary assessment. We used multiple linear regression models to investigate the association of frequency of fast-food restaurant visits (fast-food frequency) at baseline and follow-up with 15-year changes in bodyweight and the homoeostasis model (HOMA) for insulin resistance. Fast-food frequency was lowest for white women (about 1.3 times per week) compared with the other ethnic-sex groups (about twice a week). After adjustment for lifestyle factors, baseline fast-food frequency was directly associated with changes in bodyweight in both black (p=0.0050) and white people (p=0.0013). Change in fast-food frequency over 15 years was directly associated with changes in bodyweight in white individuals (p<0.0001), with a weaker association recorded in black people (p=0.1004). Changes were also directly associated with insulin resistance in both ethnic groups (p=0.0015 in black people, p<0.0001 in white people). By comparison with the average 15-year weight gain in participants with infrequent (less than once a week) fast-food restaurant use at baseline and follow-up (n=203), those with frequent (more than twice a week) visits to fast-food restaurants at baseline and follow-up (n=87) gained an extra 4.5 kg of bodyweight (p=0.0054) and had a two-fold greater increase in insulin resistance (p=0.0083). Fast-food consumption has strong positive associations with weight gain and insulin resistance, suggesting that fast food increases the risk of obesity and type 2 diabetes.
Article
Full-text available
Although nutrition experts might be able to navigate the menus of fast-food restaurant chains, and based on the nutritional information, compose apparently 'healthy' meals, there are still many reasons why frequent fast-food consumption at most chains is unhealthy and contributes to weight gain, obesity, type 2 diabetes and coronary artery disease. Fast food generally has a high-energy density, which, together with large portion sizes, induces over consumption of calories. In addition, we have found it to be a myth that the typical fast-food meal is the same worldwide. Chemical analyses of 74 samples of fast-food menus consisting of French fries and fried chicken (nuggets/hot wings) bought in McDonalds and KFC outlets in 35 countries in 2005-2006 showed that the total fat content of the same menu varies from 41 to 65 g at McDonalds and from 42 to 74 g at KFC. In addition, fast food from major chains in most countries still contains unacceptably high levels of industrially produced trans-fatty acids (IP-TFA). IP-TFA have powerful biological effects and may contribute to increased weight gain, abdominal obesity, type 2 diabetes and coronary artery disease. The food quality and portion size need to be improved before it is safe to eat frequently at most fast-food chains.
Article
Full-text available
To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals. Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants. Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35-74 years. The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe. Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets.
Article
Full-text available
Associations between body weight, physical activity and dietary intake among a population of metropolitan transit workers are described. Data were collected during October through December, 2005, as part of the baseline measures for a worksite weight gain prevention intervention in four metro transit bus garages. All garage employees were invited to complete behavioral surveys that assessed food choices and physical activity, and weight and height were directly measured. Seventy-eight percent (N = 1092) of all employees participated. The prevalence of obesity (BMI > or = 30 kg/m2) was 56%. Over half of the transit workers reported consuming fruit (55%) and vegetables (59%) > or = 3/week. Reported fast food restaurant frequency was low (13% visited > or = 3/week). Drivers reported high levels of physical activity (eg. walking 93 minutes/day). However, an objective measure of physical activity measured only 16 minutes moderate/vigorous per day. Compared to other drivers, obese drivers reported significantly less vigorous physical activity, more time sitting, and more time watching television. Healthy eating, physical activity and weight management were perceived to be difficult at the worksite, particularly among obese transit workers, and perceived social support for these behaviors was modest. However, most workers perceived weight management and increased physical activity to be personally important for their health. Although transit workers' self-report of fruit and vegetable intake, and physical activity was high, perceived access to physical activity and healthful eating opportunities at the worksite was low. Obese workers were significantly less physically active and were more likely to report work environmental barriers to physical activity.
Article
Unhealthy dietary practices have increased among college students in South Asia. Higher intakes of energy-dense foods may increase health risks such as weight gain in college students. The purpose of the study was to gather evidence on fast food consumption patterns and factors that influenced fast food consumption among college students in South Asia. Electronic databases (CINAHL, PsycINFO, PubMed, and ScienceDirect) were used to find relevant potential English-written articles. We followed the standard process of identification, screening, eligibility assessment, study quality assessment, and data extraction from the included articles in this review. In total, data were synthesized from 28 articles. Factors such as gender, being younger, higher socio-economic class, higher body mass index (being overweight or obese), study groups such as students from Humanities, low nutrition knowledge, and the internet addiction played the roles as positive determinants (all P values < 0.05) of consuming fast food frequently. Furthermore, taste, brand reputation, accessibility, location, price, ambiance, hygiene practice, variety, promotional offers, and timely service significantly (all P values < 0.05) increased intakes of fast food in college students. Engaged institutional nutrition education intervention and multisectoral approaches are necessary to reduce fast food consumption in college students along with enabling them to make healthy food choices. • Key teaching points • Frequency of fast food consumption (daily to several times a week) has increased among college students in recent years in South Asia. • This systematic review shows that a number of socio-economic, physiological, and behavioral factors influence fast food consumption in college students. • Commonly, male students and persons with higher body mass index consume fast food more often. Taste, price, and convenience, accessibility, availability, ambiance, and location also promote fast food consumption in college students. • Nutrition interventions are needed to promote healthy dietary intake behavior among college students in South Asia.
Article
This study aimed to clarify the association between the frequency of dining out and the risk of obesity, diabetes mellitus, and dyslipidemia among Korean adults. This cross-sectional study surveyed 640 participants aged 20–69 years in Korea. Daily intake of energy, fat, protein, and cholesterol significantly increased as the frequency of dining out increased (P < .001). Energy derived from carbohydrates significantly decreased with the frequency of dining out, while that derived from fat and protein increased (P < .001). Among participants who rarely dined out, the fully adjusted odds ratios (ORs) for hyperglycemia were significantly lower at 0.35 (95% CI, 0.16–0.76). Decreased risk of being hyperglycemia among participants who rarely dined out suggests that the frequency of dining out can be related to diabetes risk.
Article
Objective: This study analyses the relationship between the level of knowledge about junk food and the dietary habits among adolescents. Method: As a descriptive correlative study, this research used a cross-sectional design. A total of 190 students in Grades 7 and 8 in a junior high school in Jakarta were recruited using a stratified random sampling technique. The study instrument was a questionnaire that contained 10 questions about the adolescents' knowledge level regarding junk food and 20 statements about their dietary habits. Results: The chi-square analysis shows that there is no correlation between the knowledge level regarding junk food and the dietary habits of adolescents at the school (p 0.543; α 0.05). Conclusion: This research is expected to provide information to community nurses, parents, especially those who have teenagers, and to the community.
Article
The nutrition transition hypothesis poses that as low-and-middle-income countries (LMICs) become wealthier and more urbanised, they experience a shift in dietary consumption towards ‘Western’ diets high in sugars, fats, animal-source foods, processed and packaged products. This paper uses panel data covering a period of 23 years to examine how changes in the urban environment relate to food expenditures, dietary diversity and traditional practices (food self-production and sharing) in Indonesia, a country that has experienced rapid economic growth and urbanisation over the last few decades. We first examine trends separately for urban and rural areas, and then use fixed effect models to examine whether change in urban residence is associated with changes in food expenditures, traditional practices, and overall dietary diversity. Results show that, despite some increases in acquisitions of animal-source foods and of packaged and ready-made foods, budget allocations for other food groups has remained constant, and that changes have largely occurred in parallel across urban and rural areas. In turn, traditional diets high in cereal and plant products, as well as traditional food practices continue to be dominant in both rural and urban areas, despite the context of rapid socio-economic change and urbanisation. Fixed effect regression suggests that transition from rural to urban residence is not significantly associated with changes in food expenditures for any of the outcomes examined. On the other hand, there is some evidence that moving specifically to Jakarta is associated with some change towards ‘Western’ food preferences.
Article
The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies — both at the individual and population level — have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.
Article
Objectives: Overweight/obesity is a problem faced by both high- and low- and middle-income countries. This review aimed to report published data on the prevalence of overweight and obesity in Indonesian children, adolescents, and adults, along with the associated risk factors. Study design: Literature review. Methods: We conducted a literature search for articles published in English (through Medline via OvidSP, Scopus, Global Health via OvidSP and Web of Science electronic databases) and Indonesian languages (several websites, direct contact with Indonesian public health researchers, practitioners and Ministry of Health staff) from earliest to March 2016. We screened the results and ensured the quality of included studies with Loney's tools for critically appraising prevalence or incidence studies. Results: We included 17 papers on the topic which were available in full text and passed the critical appraisal process. The prevalence of overweight/obesity has increased over the past two decades in Indonesian children, adolescents and adults. Prevalence rates are higher in boys than girls among children, but higher in females in the adolescent and adult age groups. The prevalence of overweight/obesity is also higher in those living in urban areas and with higher income or education. Conclusions: Overweight/obesity is a serious public health problem in Indonesia with a continuing increase in its prevalence. Interventions at the household level and beyond are needed to successfully lower the prevalence of overweight/obesity in the country.
Article
The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers’ diet.
Article
Food prepared away from home (FAFH)-whether eaten in restaurants, fast-food and other locations, or as take-out or delivery to be eaten at home-is now a routine part of the diets of most Americans, accounting for 41 percent of food expenditures and 32 percent of caloric intake. This report analyzes data on individuals 2 years of age and older from two national food consumption surveys (one conducted in 1977-78 and another in 2005-08) to assess changes in the consumption and nutritional quality of FAFH versus food prepared at home (FAH). In the past three decades, FAH has changed more in response to dietary guidance, becoming significantly lower in fat content and richer in calcium, whereas FAFH did not. In 2005-08, FAFH was also higher in saturated fat, sodium, and cholesterol and lower in dietary fiber than FAH. The increased popularity and lower nutritional quality of FAFH is prompting new health promotion strategies, such as menu labeling.
Article
Survey questions asking about taboo topics such as sexual activities, illegal behaviour such as social fraud, or unsocial attitudes such as racism, often generate inaccurate survey estimates which are distorted by social desirability bias. Due to self-presentation concerns, survey respondents underreport socially undesirable activities and overreport socially desirable ones. This article reviews theoretical explanations of socially motivated misreporting in sensitive surveys and provides an overview of the empirical evidence on the effectiveness of specific survey methods designed to encourage the respondents to answer more honestly. Besides psychological aspects, like a stable need for social approval and the preference for not getting involved into embarrassing social interactions, aspects of the survey design, the interviewer’s characteristics and the survey situation determine the occurrence and the degree of social desirability bias. The review shows that survey designers could generate more valid data by selecting appropriate data collection strategies that reduce respondents’ discomfort when answering to a sensitive question.
Article
Obesity is becoming a serious issue in many developing countries, with negative implications for economic growth and human wellbeing. While previous micro level studies on obesity have mostly used cross-section data, we analyze trends and determinants with panel data from Indonesia. Over the past 20 years, obesity has increased remarkably in Indonesia across all population groups, including rural and low income strata. The problem is particularly severe among women. Panel regressions confirm that changing food consumption patterns, coupled with decreasing physical activity, directly contribute to this trend. From a policy perspective, nutrition awareness and education campaigns, combined with programs to support leisure time exercise especially for women, seem to be most promising to contain the obesity pandemic.
Article
Young adults report frequent away-from-home eating; however, little is known regarding what types of restaurants are patronized or whether associations with dietary intake and weight status differ according to restaurant type. This cross-sectional study in a diverse sample of young adults examines sociodemographic differences in the frequency of eating at different types of fast-food and full-service (server brings food to table) restaurants. In addition, this study examines whether associations between away-from-home eating, dietary intake, and weight status differ according to restaurant type. There were 1,030 men and 1,257 women (mean age=25.3 years) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults). Participants were members of a longitudinal cohort who completed baseline surveys at schools in Minneapolis/St Paul, MN, and completed the EAT-III surveys online or by mail in 2008-2009. Height, weight, and usual dietary intake were self-reported. Regression models adjusted for sociodemographic characteristics were used to examine associations between frequency of restaurant use, dietary intake, and weight status. More frequent use of fast-food restaurants that primarily served burgers and french fries was associated with higher risk for overweight/obesity; higher intake of total energy, sugar-sweetened beverages, and fat; and with lower intake of healthful foods and key nutrients. For example, those who reported burger-and-fries restaurant use on three or more occasions per week consumed nearly one additional sugar-sweetened beverage per day compared to those who reported burger-and-fries restaurant use on less than one occasion per week. More frequent use of fast-food restaurants that primarily served sandwiches/subs was related to a few markers of poorer diet quality, but unrelated to weight status. More frequent use of full-service restaurants was also unrelated to weight status and related to higher intake of vegetables. There may be a need for interventions to promote healthier food choices among young adults who report frequent burger-and-fries restaurant use.
Article
Obesity and type 2 diabetes follow a socioeconomic gradient. Highest rates are observed among groups with the lowest levels of education and income and in the most deprived areas. Inequitable access to healthy foods is one mechanism by which socioeconomic factors influence the diet and health of a population. As incomes drop, energy-dense foods that are nutrient poor become the best way to provide daily calories at an affordable cost. By contrast, nutrient-rich foods and high-quality diets not only cost more but are consumed by more affluent groups. This article discusses obesity as an economic phenomenon. Obesity is the toxic consequence of economic insecurity and a failing economic environment.
Article
This study examined the association between TV viewing, fast food eating, and body mass index. Associations between hours of TV viewing, frequency of eating at fast food restaurants, body mass index, and behaviors were assessed cross sectionally and longitudinally over 1 year in 1059 men and women. Fast food meals and TV viewing hours were positively associated with energy intake and body mass index in women but not in men. TV viewing predicted weight gain in high-income women. Secular increases in fast food availability and access to televised entertainment may contribute to increasing obesity rates in the United States.
Article
Studies have shown that energy intake increases when both the fat content and energy density of the entire diet increases. When the fat content and energy density vary independently of one another, however, energy density, but not fat content, influences intake. The present study examined whether energy intake in lean and obese women is affected when either the energy density or the fat content of a portion of the diet is manipulated and palatability is held constant. In a within-subjects design, 17 lean and 17 obese women consumed meals in the laboratory for four, 4-d test periods. In 3 of these test periods the energy density (4.4 and 6.7 kJ/g) or the fat content (16% and 36% of energy) of compulsory entrees representing 50% of each subject's usual energy intake was manipulated. Additional self-selected foods were consumed ad libitum at meals and as snacks. There were no systematic differences in palatability of the manipulated foods across conditions. Obese and lean participants responded similarly to the dietary manipulations. Intake of self-selected foods at meals was reduced significantly by 16% for both lean and obese subjects in the low- compared with the high-energy-density condition. The fat content of the compulsory foods had no significant effect on energy intake. Ratings of hunger did not differ between diets. These results indicate that when a portion of the diet was manipulated, the energy density, but not the fat content, of the foods affected total energy intake at meals in both lean and obese women.
Article
To determine if the source from which food is obtained has contributed to the increased obesity of the US population, while controlling for demographic, lifestyle and regional factors. Multiple regression was used to estimate the effect of food source on body mass index (BMI) while accounting for other factors which have been shown to affect obesity in a nationally representative sample of the US population. This study used secondary data from the 1994-1996 Continuing Survey of Food Intake by Individuals (CSFII). The CSFII is a nationally representative sample of 16,103 individuals, obtaining for each respondent 24 h recalls of all food intake on two nonconsecutive days as well as demographics and information on lifestyle choices. For a large number of demographic and lifestyle factors, our results support those which have previously been found to contribute to increased overweight. Our contribution is to examine whether the source from which food is obtained also contributes to increased overweight. Our evidence suggests that this is the case. The average height for males in our sample was 1.77 m. For two such males, one who ate food away from home (FAFH) during the previous 24 h period and the other who did not, results suggest that the first will be about 1 kg heavier, all other factors being equal. For two females of average height (1.63 m) the same is true for those who ate fast food, but not at restaurants. In all cases, except females who ate at restaurants, the effects are significant in the regression (P<0.05). The trends in both increased US obesity and in increased consumption of FAFH are unlikely to be coincidental. FAFH, and particularly fast food consumption, are likely to be contributing factors to increased obesity.
Article
To examine demographic, behavioral and dietary correlates of frequency of fast food restaurant use in a community-based sample of 891 adult women. A survey was administered at baseline and 3 y later as part of a randomized, prospective intervention trial on weight gain prevention. Women (n = 891) aged 20-45 y who enrolled in the Pound of Prevention study. Frequency of fast food restaurant use, dietary intake, demographic and behavioral measures were self-reported. Dietary intake was measured using the 60-item Block Food Frequency Questionnaire. Body weight and height were directly measured. Twenty-one percent of the sample reported eating > or = 3 fast food meals per week. Frequency of fast food restaurant use was associated with higher total energy intake, higher percentage fat energy, more frequent consumption of hamburgers, French fries and soft drinks, and less frequent consumption of fiber and fruit. Frequency of fast food restaurant use was higher among younger women, those with lower income, non-White ethnicity, greater body weight, lower dietary restraint, fewer low-fat eating behaviors, and greater television viewing. Over 3 y, increases in frequency of fast food restaurant use were associated with increases in body weight, total energy intake, percentage fat intake, intake of hamburgers, French fries and soft drinks, and with decreases in physical activity, dietary restraint and low-fat eating behaviors. Intake of several other foods, including fruits and vegetables, did not differ by frequency of fast food restaurant use. Frequency of fast food restaurant use is associated with higher energy and fat intake and greater body weight, and could be an important risk factor for excess weight gain in the population.
Article
To examine demographic, behavioral and dietary correlates of frequency of fast food restaurant use in a community-based sample of 4746 adolescent students. A survey was administered to students in classrooms at 31 secondary schools in a large metropolitan area in Minnesota, United States. Height and body weight were measured. Students in grades 7-12 who were enrolled in participating schools, had parental consent and were in attendance on the day of data collection. Frequency of fast food restaurant use (FFFRU), dietary intake, and demographic and behavioral measures were self-reported. Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Height and body weight were directly measured. FFFRU was positively associated with intake of total energy, percent energy from fat, daily servings of soft drinks, cheeseburgers, french fries and pizza, and was inversely associated with daily servings of fruit, vegetables and milk. FFFRU was positively associated with student employment, television viewing, home availability of unhealthy foods, and perceived barriers to healthy eating, and was inversely associated with students' own and perceived maternal and peer concerns about healthy eating. FFFRU was not associated with overweight status. FFFRU is associated with higher energy and fat intake among adolescents. Interventions to reduce reliance on fast food restaurants may need to address perceived importance of healthy eating as well as time and convenience barriers.
Article
Obesity and type 2 diabetes have reached epidemic proportions in the United States. It is well-established that increasing physical activity plays an important role in reducing risk of obesity and diabetes. Few studies, however, have examined the association between sedentary behaviors such as prolonged television (TV) watching and obesity and diabetes. Using data from a large prospective cohort study, the Health Professionals' Follow-up Study, we have demonstrated that increasing TV watching is strongly associated with obesity and weight gain, independent of diet and exercise. Also, prolonged TV watching is associated with a significantly increased risk of type 2 diabetes. Men who watched TV more than 40 h per week had a nearly threefold increase in the risk of type 2 diabetes compared with those who spent less than 1 h per week watching TV. The increased risk was not entirely explained by the decreased physical activity and unhealthy eating patterns associated with TV watching. Thus, public health campaigns to reduce the risk of obesity and type 2 diabetes should promote not only increasing exercise levels but also decreasing sedentary behaviors, especially prolonged TV watching.
Article
Fast foods are frequently linked to the epidemic of obesity, but there has been very little scientific appraisal of a possible causal role. Here we review a series of studies demonstrating that the energy density of foods is a key determinant of energy intake. These studies show that humans have a weak innate ability to recognise foods with a high energy density and to appropriately down-regulate the bulk of food eaten in order to maintain energy balance. This induces so called 'passive over-consumption'. Composition data from leading fast food company websites are then used to illustrate that most fast foods have an extremely high energy density. At some typical outlets the average energy density of the entire menus is approximately 1100 kJ 100 g(-1). This is 65% higher than the average British diet (approximately 670 kJ 100 g(-1)) and more than twice the energy density of recommended healthy diets (approximately 525 kJ 100 g(-1)). It is 145% higher than traditional African diets (approximately 450 kJ 100 g(-1)) that probably represent the levels against which human weight regulatory mechanisms have evolved. We conclude that the high energy densities of many fast foods challenge human appetite control systems with conditions for which they were never designed. Among regular consumers they are likely to result in the accidental consumption of excess energy and hence to promote weight gain and obesity.
Article
Many health disparities in the United States are linked to inequalities in education and income. This review focuses on the relation between obesity and diet quality, dietary energy density, and energy costs. Evidence is provided to support the following points. First, the highest rates of obesity occur among population groups with the highest poverty rates and the least education. Second, there is an inverse relation between energy density (MJ/kg) and energy cost (US dollars/MJ), such that energy-dense foods composed of refined grains, added sugars, or fats may represent the lowest-cost option to the consumer. Third, the high energy density and palatability of sweets and fats are associated with higher energy intakes, at least in clinical and laboratory studies. Fourth, poverty and food insecurity are associated with lower food expenditures, low fruit and vegetable consumption, and lower-quality diets. A reduction in diet costs in linear programming models leads to high-fat, energy-dense diets that are similar in composition to those consumed by low-income groups. Such diets are more affordable than are prudent diets based on lean meats, fish, fresh vegetables, and fruit. The association between poverty and obesity may be mediated, in part, by the low cost of energy-dense foods and may be reinforced by the high palatability of sugar and fat. This economic framework provides an explanation for the observed links between socioeconomic variables and obesity when taste, dietary energy density, and diet costs are used as intervening variables. More and more Americans are becoming overweight and obese while consuming more added sugars and fats and spending a lower percentage of their disposable income on food.
Article
Consumption of fast food, which have high energy densities and glycemic loads, and expose customers to excessive portion sizes, may be greatly contributing to and escalating the rates of overweight and obesity in the USA. Whether an association exists between fast food consumption and weight gain is unclear. Sixteen studies (six cross sectional, seven prospective cohort, three experimental) meeting methodological and relevance criteria were selected for inclusion in this systematic review. While more research needs to be conducted specifically in regard to effects of fast food consumption among subpopulations such as children and adolescents, sufficient evidence exists for public health recommendations to limit fast food consumption and facilitate healthier menu selection. As the fast food industry continues to increase both domestically and abroad, the scientific findings and corresponding public health implications of the association between fast food consumption and weight are critical.
Faktor-faktor Yang Berhubungan Dengan Pola Makan Siap Saji (Fast Food) Pada Mahasiswa Program Studi Ilmu Kesehatan Masyarakat STIKes Hangtuah Pekanbaru
  • L Al-Insyirah
Al-Insyirah, L. (2016). Faktor-faktor Yang Berhubungan Dengan Pola Makan Siap Saji (Fast Food) Pada Mahasiswa Program Studi Ilmu Kesehatan Masyarakat STIKes Hangtuah Pekanbaru. Al-Tamimi Kesmas: Jurnal Ilmu Kesehatan Masyarakat, 5(2), 102-110. [In Bahasa Indonesia].
Laporan Provinsi DKI Jakarta, Riskesdas
  • Balitbangkes Kemenkes
Balitbangkes Kemenkes RI. (2018a). Laporan Provinsi DKI Jakarta, Riskesdas 2018. Retrieved from website: https:// repository.badankebijakan.kemkes.go.id/id/ eprint/3881/1/CETAK%20LAPORAN%
Laporan Nasional Riset Kesehatan Dasar (Riskesdas
  • Balitbangkes Kemenkes
Balitbangkes Kemenkes RI. (2018b). Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2018. Retrieved from website: https://www.litbang.kemkes.go.id/ laporan-riset-kesehatan-dasar-riskesdas/ [In Bahasa Indonesia].
Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: Changes and consequences
  • J F Guthrie
  • B.-H Lin
  • E Frazao
Guthrie, J.F., Lin, B.-H. and Frazao, E. (2002). Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: Changes and consequences. Journal of Nutrition Education and Behavior, 34(3), 140-150. https://doi.org/10.1016/ s1499-4046(06)60083-3
Fast food, central nervous system insulin resistance, and obesity
  • E Isganaitis
  • R H Lustig
Isganaitis, E. and Lustig, R.H. (2005). Fast food, central nervous system insulin resistance, and obesity. Arteriosclerosis, Thrombosis, and Vascular Biology, 25(12), 2451-2462. https:// doi.org/10.1161/01.ATV.0000186208.06964.91
Fast food consumption and overweight/obesity prevalence in students and its association with general and abdominal obesity
  • A Mohammadbeigi
  • A Asgarian
  • E Moshir
  • H Heidari
  • S Afrashteh
  • S Khazaei
  • H Ansari
Mohammadbeigi, A., Asgarian, A., Moshir, E., Heidari, H., Afrashteh, S., Khazaei, S. and Ansari, H. (2018). Fast food consumption and overweight/obesity prevalence in students and its association with general and abdominal obesity. Journal of Preventive Medicine and Hygiene, 59(3), E236-E240. https://doi.org/10.15167/2421-4248/
Dangerous Junk Food: Bahaya Makanan Cepat Saji dan Gaya Hidup Sehat
  • R W Sari
Sari, R.W. (2008). Dangerous Junk Food: Bahaya Makanan Cepat Saji dan Gaya Hidup Sehat. Retrieved from website: https:// opac.perpusnas.go.id/DetailOpac.aspx?id=326929 [In Bahasa Indonesia].
Indonesia's Urban Story
  • World Bank
World Bank. (2016). Indonesia's Urban Story. Retreived from World Bank website: https:// www.worldbank.org/en/news/feature/2016/06/14/ indonesia-urban-story