Fast Foods and Fast Plaques

• The prevalence of fast-food consumption is high in the US across education, income, and racial groups and is strongly associated with obesity.¹

• Americans spend >100 billion dollars on restaurant fast food each year. As a result of globalization (free movement of people, goods, and money), fast foods restaurants are springing up at a faster rate outside the US.

• With more consumers purchasing meals outside the home, fast food products contribute substantially to daily energy intakes. Although fast food is affordable and convenient, it is also high in calories, saturated fat, sugar, sodium, glycemic load, and low in nutrients. Not only that, the overall quality of the fast food is extremely poor, but those who consume fast food consume fewer servings of heart healthy foods such as fruits and vegetables. Improving the nutrient composition of fast food would have significant health benefits.

• Fast food is the most extreme example of typical western diet and is highly correlated with obesity, dyslipidemia, metabolic syndrome, diabetes, and cardiovascular risk.² Consumption of fast food may be greatly contributing to the escalating rates of obesity in children, adolescents, and adults.^3-6

• Mortality and admissions for acute coronary syndromes were higher in regions with greater numbers of fast-food services in some studies.⁷

• The rising levels of obesity around the world are due, in part, to “obesogenic” environments, and in particular to the clustering of fast food establishments such as McDonalds, Kentucky Fried Chicken, Pizza Hut, Taco Bell, etc. See Table 116 A. 

Table 116 A. Calorie, Sodium and Saturated Fat content of Selected Fast Foods
KFC USA	Serving Size (g)	Total Calories	Sodium Content (mg)	Saturated Fat (g)
Mashed Potato With Gravy	525	680	2130	8
Spicy Crispy Breast	178	420	1250	5
Popcorn Chicken (Large)	174	560	1480	8
Grilled Chicken Breast	152	220	730	2
Potato Wedges	108	290	810	2.5
Biscuit	54	180	530	6
McDonalds USA
Big Mac	214	540	1040	10
Angus Bacon & Cheese	291	790	2070	17
Large French Fries	154	500	350	3.5
Chocolate Triple Thick Shake	713	1160	510	16
Double Cheeseburger	165	440	1150	11

• In addition to obesity fast food is an important source of trans fat. The cooking oil used for French fries in McDonald’s outlets in the US contained 23 % and  Peru 24 % trans fats but <10% in many European countries  and only 1% in Denmark. Trans fat accounted for >30% of fat in some KFC outlets and >20% at McDonald’s. There is marked variation in trans fat content of these foods within the same chain in the same country.⁸

• Many new fast-food menu choices are delivering double the recommended number of calories from fat. Several new burger options offered by fast-food restaurants, when consumed with French fries and a large soda, exceed the 1500 to 2,000-calories per day recommended for total food consumption.

• Fast-food portions in the US are larger than in Europe. The portion size of most fast foods have increased over the years in parallel with the obesity epidemic and health authorities have called on fast-food chains to decrease the sizes of menu items. Although McDonald’s recently phased out its largest offerings, current items are similar to 1998 sizes and greatly exceed those offered when the company opened in 1955.

• Burger King and Wendy’s have increased portion sizes, even while health authorities are calling for portion size reductions.⁹ These observations suggest that voluntary efforts by fast-food companies to reduce portion sizes are unlikely to be effective, and that policy approaches are needed to reduce energy intake from fast food.⁹

• A positive relationship between the density of fast food outlets per area and the obesity status of children have also been reported.¹⁰ Fast food availability is associated with lower fruit and vegetable intake (see Food Desert).¹¹

• Higher fast food prices are associated with better dietary quality whereas higher prices of fruits and vegetables are associated with lower dietary quality, lower fiber intake, and higher rates of obesity particularly in children.¹² This is because the consumption decreases as the price increases.

• The widespread and increasing consumption of fast food worldwide suggests a continuing ignorance of the harm from these foods. Making nutritional information at fast-food restaurants more readily available and easier to use may help consumers to order more healthful or lower-calorie items.¹ 

Sources

1. Anderson B, Rafferty AP, Lyon-Callo S, Fussman C, Imes G. Fast-food consumption and obesity among michigan adults. Prev Chronic Dis. Jul 2011;8(4):A71.

2. Isganaitis E, Lustig RH. Fast food, central nervous system insulin resistance, and obesity. Arterioscler Thromb Vasc Biol. Dec 2005;25(12):2451-2462.

3. Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. Am J Public Health. Mar 2009;99(3):505-510.

4. Schroder H, Fito M, Covas MI. Association of fast food consumption with energy intake, diet quality, body mass index and the risk of obesity in a representative Mediterranean population. Br J Nutr. Dec 2007;98(6):1274-1280.

5. Hickson D, Diez Roux A, Smith A, et al. Associations of Fast Food Restaurant Availability With Dietary Intake and Weight Among African Americans in the Jackson Heart Study, 2000-2004. Am J Public Health. May 9 2011.

6. Isganaitis E, Lustig RH. Fast food, central nervous system insulin resistance, and obesity. Arterioscler Thromb Vasc Biol. Dec 2005;25(12):2451-2462.

7. Alter DA, Eny K. The relationship between the supply of fast-food chains and cardiovascular outcomes. Can J Public Health. May-Jun 2005;96(3):173-177.

8. Stender S, Dyerberg J, Astrup A. High levels of industrially produced trans fat in popular fast foods. N Engl J Med. Apr 13 2006;354(15):1650-1652.

9. Young LR, Nestle M. Portion sizes and obesity: responses of fast-food companies. J Public Health Policy. Jul 2007;28(2):238-248.

10. Fraser LK, Edwards KL. The association between the geography of fast food outlets and childhood obesity rates in Leeds, UK. Health Place. Nov 2010;16(6):1124-1128.

11. Fraser LK, Edwards KL, Cade J, Clarke GP. The geography of Fast Food outlets: a review. Int J Environ Res Public Health. May 2010;7(5):2290-2308.

12. Beydoun MA, Powell LM, Chen X, Wang Y. Food prices are associated with dietary quality, fast food consumption, and body mass index among U.S. children and adolescents. J Nutr. Feb 2011;141(2):304-311.