effects of fast food on health research paper

• Research article
• Open access
• Published: 15 February 2022

Determining intention, fast food consumption and their related factors among university students by using a behavior change theory

• Alireza Didarloo 1 ,
• Surur Khalili 2 ,
• Ahmad Ali Aghapour 2 ,
• Fatemeh Moghaddam-Tabrizi 3 &
• Seyed Mortaza Mousavi 4 , 5  

BMC Public Health volume  22 , Article number:  314 ( 2022 ) Cite this article

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Today, with the advancement of science, technology and industry, people’s lifestyles such as the pattern of people’s food, have changed from traditional foods to fast foods. The aim of this survey was to examine and identify factors influencing intent to use fast foods and behavior of fast food intake among students based on the theory of planned behavior (TPB).

A cross-sectional study was conducted among 229 university students. The study sample was selected and entered to the study using stratified random sampling method. Data were collected using a four-part questionnaire including Participants’ characteristics, knowledge, the TPB variables, and fast food consumption behavior. The study data were analyzed in SPSS software (version 16.0) using descriptive statistics (frequencies, Means, and Standard Deviation) and inferential statistics (t-test, Chi-square, correlation coefficient and multiple regressions).

The monthly frequency of fast food consumption among students was reported 2.7 times. The TPB explained 35, 23% variance of intent to use fast food and behavior of fast food intake, respectively. Among the TPB variables, knowledge ( r  = .340, p  < 0.001) and subjective norm ( r  = .318, p  < 0.001) were known as important predictors of intention to consume fast foods - In addition, based on regression analyses, intention ( r  = .215, p  < 0.05), perceived behavioral control ( r  = .205, p  < 0.05), and knowledge ( r  = .127, p  < 0.05) were related to fast food consumption, and these relationships were statistically significant.

Conclusions

The current study showed that the TPB is a good theory in predicting intent to use fast food and the actual behavior. It is supposed that health educators use from the present study results in designing appropriate interventions to improve nutritional status of students.

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Over the past few decades, non-communicable diseases such as eczema, asthma, cancer, type 2 diabetes, obesity, etc. have increased in developed countries [ 1 , 2 ]. Also, these diseases are more prevalent with increasing urbanization in developing countries [ 3 , 4 , 5 ]. The occurrence of many non-communicable diseases is related to diet [ 6 ]. Food habits are rooted from cultural, environmental, economic, social and religious factors. An effective factor in the development of chronic diseases is lifestyle, dietary patterns and habits. Inappropriate food habits and unhealthy environments have increased the incidence of non-communicable diseases in the world [ 7 , 8 ].

Many developing countries with a tendency towards Western dietary culture go away from traditional and local diets [ 6 ]. Healthy foods with nutrients have been replaced by new foods called fast foods [ 9 ]. Fast food is the food prepared and consumed outside and often in fast food restaurants [ 10 ]. Fast food is often highly processed and prepared in an industrial fashion, i.e., with standard ingredients and methodical and standardized cooking and production methods [ 10 ]. In fast food, vitamins, minerals, fiber and amino acids are low or absent but energy is high [ 9 ]. Fast food consumption has increased dramatically in the last 30 years in European and American countries [ 11 ].

Previous studies reported patterns of inappropriate and harmful food consumption in Iranian children and adolescents [ 12 , 13 ]. Most fast food customers are adolescents and youth, as these products are quickly and easily produced and relatively inexpensive [ 14 ]. One Iranian study shows that 51% of children eat inappropriate snacks and drinks over a week [ 15 ]. It is also reported that adults today consume fast food more than previous generations [ 16 ]. Faqih and Anousheh reported that 20% of adolescents and 10% of adults consumed sandwiches 3 or more times a week [ 17 ].

According to two studies, children and adolescents who consume fast food have received more energy, saturated fat, sodium, carbohydrates and more sugar than their peers, but they have less fiber, vitamin A and C, and less fruit and vegetables [ 18 , 19 ]. Also, because of the use of oils to fry these foods at high temperatures, these types of foods may contain toxic and inappropriate substances that threaten the health of consumers [ 20 ].

In a study in the United States on young people between 13 and 17 years old, it was found that there is a significant relationship between weight gain and obesity with pre-prepared foods [ 21 ]. According to the Center for Disease Control and Prevention (2007–2008), 17% of children aged 2 to 19 years and 34% of those aged 20 years and older were obese [ 22 ]. Many Health problems were caused by human health behavior(e.g. exercising regularly, eating a balanced diet, and obtaining necessary inoculations, etc.) and studying behavior change theories/models provides a good insight into the causes and ways of preventing these problems [ 23 ]. One of these theories is the Theory of Planned Behavior (TPB), which is a developed form of the Theory of reasoned action (TRA), and describes a healthy behavior that is not fully under the control of a person [ 24 ]. This theory can successfully predict eating habits and behaviors, and recently this theory has received considerable attention from researchers in identifying norms and beliefs related to the use of fast food [ 25 ].

Based on the TPB, intention to conduct a behavior with following three concepts is controlled: 1. Attitudes (positive and negative evaluation of a behavior), 2. Subjective norms (social pressure received from peers, family, health care providers for doing or not doing a given health behavior), 3. Perceived behavior control (This refers to a person’s perception of the ease or difficulty of performing the behavior of interest.) [ 26 , 27 , 28 ].

The TPB has been tested on different behaviors such as healthy food choice [ 24 ], physical activity [ 29 ], and fast food consumption [ 30 ]. For instance, the study conducted by Seo et al. showed that fast food consumption behavior was significantly associated with behavioral intention and perceived behavioral control. In addition, their findings highlighted that behavioral intention was significantly related to subjective norm and perceived behavioral control [ 28 ].

Given that our study population has cultural diversity and nutritional behaviors different from the societies of other countries and According to the mentioned materials, the researchers decided to test the study with the aim of investigating and explaining the intention and behavior of fast food consumption and their related factors based on the TPB among Urmia University of Medical Sciences students. The results of this study will increase the awareness and knowledge about fast food and, in addition, its results can be used in research, hospitals and healthcare settings.

This cross-sectional study was performed on students of Urmia University of Medical Sciences located in northwest Iran in academic year of 2018–2019. The inclusion criteria for the study are females and males who studied at Urmia University of Medical Sciences, and students’ voluntary participation in the study and obtaining written consent from the students and University principals for the students’ participation in the study. The lack of willingness to continue participating in the study and not signing the informed consent form were considered as exclusion criteria.

According to the results of the study of Yar Mohammadi and et al. [ 31 ], with a 95% confidence interval and an error of 0.05, using the formula for estimating the proportion in society, taking into account the 10% drop rate, sample size was estimated 330students. A randomized stratified sampling method was used to select the study samples. The study sample was randomly selected from each of the strata based on the share of the total sample.

Questionnaire

The data gathering tool in this study was a self-reported questionnaire (Additional file  1 ), which was designed according to the existing measures in scientific literature [ 32 , 33 , 34 ]. The study instrument was translated from English to Persian using a standard forward-backward translation technique [ 35 ]. The original instrument was translated by a bilingual specialist. The Persian version was then retranslated into English by two independent bilingual professionals to assess retention of the original meaning in the source language. Subsequently, translators worked separately in the translation process and then prepared the final version of the Persian translation. Content validity of The Persian version of questionnaire was evaluated by a panel of experts such as 3 nutrition specialists, 3 health education specialists, and 2 instrument designers. After receiving their comments, crucial revisions were conducted in the study tool. Finally, validity of the study instrument was confirmed. The present questionnaire including four following sections:

General characteristics

The first part contains personal information such as age, gender, weight, height, field of study, student education, father’s education, mother’s education, father job, mother’s job, ethnicity, marital status, participating in nutrition educational classes, students’ monthly income, family’s monthly income, housing status, information resource for healthy nutrition.

Constructs of the TPB

The second part contains questions about the constructs of the theory of planned behavior (attitude, subjective norms, perceived behavioral control and behavioral intention). In general, attitudes, subjective norm and perceived behavioral control of students were measured using indirect items. The internal reliability of all subscales of the TPB variables was good, with a Cronbach’s alpha of 0.852.

Attitude toward fast food use

The attitude of the people was evaluated using 28 indirect items (14 items of behavioral beliefs, 14 items of expectations evaluation) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from very important to not at all important), and the score of each item varied from 1 to 5. The minimum and maximum score for the attitude subscale was 14 and 350, respectively. The internal reliability of attitude subscale was good, with a Cronbach’s alpha of 0.778.

Subjective norm

Subjective norms of students were measured by 10 indirect items (5 items of normative beliefs, 5 items of motivation to comply) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from very important to not at all important), and the score of each item varied from 1 to 5. The minimum and maximum score for the subjective norm subscale was 5 and 125, respectively. The internal reliability of subjective norm subscale was good, with a Cronbach’s alpha of 0.726.

Perceived behavioral control

Perceived behavioral control were measured by 18 indirect items (9 items of control beliefs, 9 items of perceive power) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from extremely difficult to extremely easy), and the score of each item varied from 1 to 5. The minimum and maximum score for the perceived behavioral control subscale was 9 and 225, respectively. The internal reliability of subscale of perceived behavioral control was good, with a Cronbach’s alpha of 0.815.

Behavioral intention

Behavioral intention was evaluated by 8 items based on five-point the Likert scale (from strongly agree to strongly disagree), and the score of each item varied from 1 to 5. The minimum and maximum score for the Behavioral intention subscale was 8 and 40, respectively. The internal reliability of behavioral intention subscale was good, with a Cronbach’s alpha of 0.821.

Knowledge of participants

And the third and fourth parts are items related to food knowledge and fast food behavior. Students’ knowledge of fast food was evaluated by 14 items, and the score of each item varied from 0 to 2. The minimum and maximum score for the knowledge subscale was 0 and 28, respectively. The internal reliability of students’ knowledge was good, with a Cronbach’s alpha of 0.783.

Fast food use

Students’ fast food consumption was assessed by frequency of use in a past month. The term “Fast food” was defined as hamburgers, doughnuts, hot dog, snack, pizza, fried chicken and fried potatoes. The frequency of fast food use was analyzed for each food category.

Statistical analyses

All statistical analyzes were performed using SPSS 16.0 software. Descriptive statistics methods such as frequencies, means and standard deviations were used along with independent t and χ2 tests. Pearson correlation test was used to investigate the relationship between TPB variables with intent to use fast food and the real use of fast food. Multiple regressions were used for further analysis.

Descriptives

A total of 330 students were selected and recruited to the study, but some subjects (31 samples) were excluded from the study due to incomplete questionnaires (21cases), and no return of questionnaires (10 cases). Statistical analyses were performed on 229 students. Of these, 28.4% of the students were males and 71.6% were females. The results of the study showed that the average age for all the students was 22.10 ± 3.30 (the average age for male and female sexes were 22.66 ± 4.47 and 21.84 ± 2.50, respectively). The two sexes differed in terms of BMI, so that the mean of BMI was higher in boy students than in girls, and this difference was statistically significant. Almost more than 72% of the students had normal weight, and 28% of subjects were in other weights. Approximately 20.51, 54.50, 79.77% of the students reported the professional doctoral degree, Azeri ethnicity and single.

In addition, findings revealed that 64.90% of the participants lived in the dormitory, and 35.10% of them lived in personal or rental housing. The most common level of education for father (37.10%) and mother (44.10%) of students was diploma. Nearly, 46.50% of students gained food information (especially fast food) from health care providers, while 53.50% of them received their food information from other sources. Most students had zero monthly income, but 61.61% of the students reported their family’s monthly income more than 50 million Rials and 38.39% of their family had income lower than the mentioned amount. Table  1 provides detailed information on students’ characteristics.

Main analysis

Table 2 presents the mean score of knowledge and variables of the study-related theoretical framework. As the mean score of subjective norm, perceived behavioral control and behavioral intention in male students compared to female students was high, but those were not significant statistically( p  > 0.05).

Some variables of the TPB were significantly correlated with each other ( P  < 0.01, Table  3 ). In particular, fast food consumption behavior was highly ( r  = 0.382) correlated with behavioral intention. Multiple regression analyses were conducted to determine the relative importance of the variables of the TPB to behavioral intention and fast food consumption behavior (Tables  4 and 5 ). In these analyzes, when the attitude toward behavior, subjective norms, and perceived control was regressed to behavioral intention, the model was very significant ( P  = 0.000) and explained 0.347 of variance of behavioral intention. While attitude and perceived behavioral control were not significant, the subjective norms and students’ knowledge were significantly related to the intention to eat fast food. It seems that subjective norms and students’ knowledge to be the most important predictors of behavioral intent. Table  4 shows more information about predictors of behavioral intention.

The second model, using fast food consumption as a dependent variable, was also very significant ( P  = 0.000), and explained nearly a quarter of the variance (0.231) of fast food consumption. Both behavioral intention and perceived behavioral control were significantly associated with fast food consumption, of which behavioral intention appeared to be more important. Table  5 presents more information about predictors of fast food consumption.

This investigation was conducted on a sample of university students to assess the status of their fast-food consumption. It also examined the factors affecting behavioral intent and fast food consumption by applying the TPB. The results of the present study showed that students consumed fast food at an average of 2.7 times a month. Fast food in male students was often reported more than female students. A study on fast food consumption among students at Daejeon School reported monthly frequencies of fast food types: 2.7 for burgers, 2.1 for French fries, 1.8 for chicken [ 24 ]. Results of Kim study and other similar researches [ 31 , 36 ] approximately were in line with findings of the present study.

Given that most men do not have the time and skill to make traditional foods, and because of a lot of work, they prefer to turn to fast-foods, and so they are more likely to use fast foods. Meanwhile, the results of some studies indicate that most women are not very happy from high weight and are more likely to reduce their weight [ 37 ]. Therefore women do not have a positive attitude toward obesogenic foods compared to men [ 38 ], which can be a reason for consuming less fast food among women. Instead, the results of a study done by Seo et al. In Korea indicated that fast food consumption among high school students was 4.05 times a month and this consumption was reported among boys more than girls [ 28 ]. The results of the Korean study were contrary to the results of the study, meaning that fast food in Korean samples was more than Iranian. The reason for this difference can be traced to factors such as sample size, cultural, social, and economic characteristics of the samples.

Performing and not performing the behavior by a person is a function of several factors based on the theory of planned behavior. One of these factors is the person’s intention and desire to do the behavior. Behavioral intention itself is also affected by factors such as attitude, students’ knowledge, social pressure, and perceived behavioral control. In the present study, based on linear regression analysis, students’ knowledge and social pressure were both related to their intention and consume fast foods. That is, students who had the necessary information about nutrition, especially fast foods, had a high intent to choose and consume foods.

Several studies have examined the relationship between knowledge of foods and their contents and attitudes toward fast foods and processed foods or relationship between attitudes toward food additives and food choice behavior [ 39 , 40 , 41 , 42 ]. Aoki et al. [ 39 ] found that information about food and its contents positively or negatively affects attitudes and intentions towards food. They pointed out that food information was important for consumers in choosing food. Back and Lee [ 43 ] found that consumers had inadequate and incorrect information about foods, which could affect their attitudes or intent. These studies suggest that providing more information about foods and their compounds can help them to improve their attitude towards foods. Therefore, training on the performance, benefits and safety of foods, including positive and negative sides, should prevent misunderstandings about food supplements and reduce food safety concerns.

The findings of the present investigation showed that subjective norms of students were effective on intent to use fast foods. Friends had the most impact on the plan to eat fast foods, as expected. In addition, the normative beliefs of students were also more positive for friends than family and teachers. This conclusion suggests that most training programs should focus on their friends as a critical group that may affect intent to use fast foods.

Results of some previous studies were similar to findings of the current study. One study conducted by Mirkarimi et al. highlighted that subjective norms had the main role on students’ intent to use fast foods [ 44 ]. In the other words, they found that behavioral intention was affected by subjective norms. In addition, the study of Yarmohammadi and et al. showed that subjective norms predict intention and behavior [ 31 ].

In this study, TPB demonstrated to be a sound conceptual framework for explaining closely35% of the variance in students’ behavioral intention to consume fast-food. Among the TPB variables, subjective norm and knowledge of students were the most important predictors of intention to use fast foods. These findings are consistent with other results that identify that subjective norms have a significant effect on consuming fruits and vegetables [ 45 ]. In study of Lynn Fudge, Path analysis highlighted that TPB explained adolescent fast-food behavioral intention to consume fast food. The model identified subjective norms had the strongest relationship with adolescent behavioral intention to consume fast food [ 46 ].

The results of this study showed that the attitude toward fast food behavior did not predict intent and the behavior. However, some studies have reported contradictory findings with the study. For example, the findings of Stefanie and Chery’s study showed that attitude was a predictor for intent to use healthy nutrition [ 47 ]. Yarmohammadi and colleagues stated in their study that attitude was the most important predictor of behavioral intent [ 31 ]. In the study of determinants of fast food intake, Dunn et al. has identified attitude as a predictor of the intent of fast food consumption [ 32 ]. The results of studies by Seo et al., Ebadi et al., along with the findings of this study, showed that attitude toward fast food consumption is not significantly related to behavioral intention [ 28 , 48 ]. Based on the findings of the current study, fast-food consumption of students was also influenced by some the TPB variables. Multiple linear regression analyses revealed that the constructs of the TPB explained fast food use behaviors with R-squared (R 2 ) of 0.23. In these analyses, intention, perceived behavioral control, and knowledge were known as effective factors on fast-food consumption. Among the TPB constructs, behavioral intention was the most important predictor of fast-food consumption. The intention plays a fundamental role in the theory of planned behavior. The intentions include motivational factors that influence behavior and show how much people want to behave and how hard they try to do the behavior [ 49 ]. In study Ebadi et al., regression analysis showed the intention as a predictor of fast food consumption behavior [ 48 ]. In studies of Stefanie et al. and Seo et al., has reported intention as correlate of the behavior [ 28 , 47 ]. All these studies confirmed and supported this part of our study findings. In addition, the results indicated that perceived behavioral control directly influenced the behavior of fast-food consumption. Some investigations confirmed this portion of our results. For instance, the results of Dunn et al. showed that perceived behavioral control (PBC) and intent predicted the behavior of fast food consumption [ 32 ]. Also, in the study of Seo et al., regression analysis showed that fast food consumption behavior was correlated with perceived behavioral control [ 28 ]. Yarmohammadi et al. found that in predicting behavior, perceived behavioral control along with intention could predict 6% of behavior [ 31 ]. Although this study provides valuable knowledge regarding the relationships between behavioral intent and TPB variables, this study, like other studies, has a number of limitations. First, a cross-sectional study was used to examine the relationship between the variables. Due to the fact that in cross-sectional studies, all data are collected in a period of time, as a result, these studies do not have the necessary ability to examine the cause-and-effect relationships between variables. Second, the results of this type of study can only be generalized to populations with similar characteristics and have no generalizability beyond that. Third, since the data of this study were collected using the self-report questionnaire, the respondents may have errors and bias in completing the questionnaire and this can affect the results of the study.

In sum, this study was conducted to identify factors influencing intention and behavior of fast-food consumption among students by using the theory of planned behavior. The findings revealed that changeability of students’ intention to use fast food and their real behavior is dependent on the TPB variables. As this theoretical framework explained 35, 23% of intent to consume fast-foods and fast-food consumption, respectively. Among the TPB constructs, knowledge and subjective norm were known as the most important predictors of intention to use fast foods. In addition, the results indicated that intention and perceived behavioral control were the most important factors influencing consumption of fast foods among participants. It is imperative that health educators and promoters use these results in designing suitable educational interventions to improve people’s nutritional behavior.

Availability of data and materials

The datasets generated during and/or analyzed during the current study are not publicly available due to confidentiality of data and subsequent research, but are available from the corresponding author on reasonable request.

Abbreviations

Theory of Planned Behavior

Theory of Reasoned Action

Statistical Package for Social Sciences

Body Mass Index

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Acknowledgements

The article authors hereby express their gratitude to Vice Chancellors for Research of Urmia University of Medical Sciences and Education Department for supporting this study.

This study is supported by Urmia University of Medical Science, grant number(No: 2017–2323) .

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Authors and affiliations.

Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, The Province of Western Azarbaijan, Urmia, 5756115198, Iran

Alireza Didarloo

Faculty of Health, Urmia University of Medical Sciences, the Province of Western Azarbaijan, Urmia, 5756115198, Iran

Surur Khalili & Ahmad Ali Aghapour

Reproductive Health Research Center, Urmia University of Medical Sciences, the Province of Western Azarbaijan, Urmia, 5756115198, Iran

Fatemeh Moghaddam-Tabrizi

Faculty of Paramedical Sciences, Urmia University of Medical Sciences, the Province of Western Azarbaijan, Urmia, 5756115198, Iran

Seyed Mortaza Mousavi

Department of Paramedical Science, School of Paramedical Sciences, Urmia University of Medical Sciences, Urmia, Iran

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Contributions

All authors contribute in conceive, design of this study. A.D, S.K, A.A,FTM and S.M contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. All authors revised the manuscript critically for important intellectual content and read and approved the final manuscript.

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The questionnire used in the study to collect the data. The first part of the questionnaire included General characteristics. The second part of the questionnaire consisted of the Constructs of TPB. The third part consisted of knowledge of participants. The fourth part consisted of Fast food use.

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Didarloo, A., Khalili, S., Aghapour, A.A. et al. Determining intention, fast food consumption and their related factors among university students by using a behavior change theory. BMC Public Health 22 , 314 (2022). https://doi.org/10.1186/s12889-022-12696-x

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• Published: 27 October 2020

Food and Health

Trends in the healthiness of U.S. fast food meals, 2008–2017

• Eleanore Alexander   ORCID: orcid.org/0000-0002-8998-4186 1 ,
• Lainie Rutkow 1 ,
• Kimberly A. Gudzune 2 , 3 ,
• Joanna E. Cohen 4 , 5 &
• Emma E. McGinty 1  

European Journal of Clinical Nutrition volume  75 ,  pages 775–781 ( 2021 ) Cite this article

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• Cardiovascular diseases
• Risk factors

This study aimed to examine trends in the healthiness of U.S. fast food restaurant meals from 2008 to 2017, using the American Heart Association’s Heart-Check meal certification criteria.

Data were obtained from MenuStat, an online database of the leading 100 U.S. restaurant chains menu items, for the years 2008 and 2012 through 2017. All possible meal combinations (entrées + sides) were created at the 20 fast food restaurants that reported entrée and side calories, total fat, saturated fat, trans fat, cholesterol, sodium, protein, and fiber. Chi-square tests compared the percent of meals meeting each American Heart Association (AHA) nutrient criterion; and the number of AHA criteria met for each year, by menu focus type.

Compared with 2008, significantly fewer fast food meals met the AHA calorie criterion in 2015, 2016, and 2017, and significantly fewer met the AHA total fat criterion in 2015 and 2016. Significantly more meals met the AHA trans fat criterion from 2012 to 2017, compared to 2008. There were no significant changes over time in the percent of meals meeting AHA criteria for saturated fat, cholesterol, or sodium.

Conclusions

Efforts to improve the healthiness of fast food meals should focus on reducing calories, total fat, saturated fat, and sodium.

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Acknowledgements

We thank the New York City Department of Health and Mental Hygiene for the MenuStat data.

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Department of Health Policy & Management, Department of Health & Public Policy, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, USA

Eleanore Alexander, Lainie Rutkow & Emma E. McGinty

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All authors contributed to the design of the study. EA led secondary data analysis and manuscript writing. EEM, LR, KG, and JEC contributed revisions to the manuscript and approved the final manuscript for submission.

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Alexander, E., Rutkow, L., Gudzune, K.A. et al. Trends in the healthiness of U.S. fast food meals, 2008–2017. Eur J Clin Nutr 75 , 775–781 (2021). https://doi.org/10.1038/s41430-020-00788-z

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The Effect of Fast Food Restaurants on Obesity and Weight Gain

We investigate the health consequences of changes in the supply of fast food using the exact geographical location of fast food restaurants. Specifically, we ask how the supply of fast food affects the obesity rates of 3 million school children and the weight gain of over 3 million pregnant women. We find that among 9th grade children, a fast food restaurant within a tenth of a mile of a school is associated with at least a 5.2 percent increase in obesity rates. There is no discernable effect at .25 miles and at .5 miles. Among pregnant women, models with mother fixed effects indicate that a fast food restaurant within a half mile of her residence results in a 1.6 percent increase in the probability of gaining over 20 kilos, with a larger effect at .1 miles. The effect is significantly larger for African-American and less educated women. For both school children and mothers, the presence of non-fast food restaurants is uncorrelated with weight outcomes. Moreover, proximity to future fast food restaurants is uncorrelated with current obesity and weight gain, conditional on current proximity to fast food. The implied effects of fast-food on caloric intake are at least one order of magnitude larger for students than for mothers, consistent with smaller travel cost for adults.

The authors thank John Cawley, the editor, two anonymous referees and participants in seminars at the NBER Summer Institute, the 2009 AEA Meetings, the ASSA 2009 Meetings, the Federal Reserve Banks of New York and Chicago, the FTC, the New School, the Tinbergen Institute, UC Davis, the Rady School at UCSD, and Williams College for helpful comments. We thank Joshua Goodman, Cecilia Machado, Emilia Simeonova, Johannes Schmeider, and Xiaoyu Xia for excellent research assistance. We thank Glenn Copeland of the Michigan Dept. of Community Health, Katherine Hempstead and Matthew Weinberg of the New Jersey Department of Health and Senior Services, and Rachelle Moore of the Texas Dept. of State Health Services for their help in accessing the data. The authors are solely responsible for the use that has been made of the data and for the contents of this article. The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research.

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• Do Fast Food Restaurants Contribute to Obesity? Author(s): Janet Currie Stefano DellaVigna Enrico Moretti Vikram Pathania Over the past thirty years, the prevalence of obesity and obesity-related diseases in the U.S. has risen sharply. Since the early 1970s,...

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Fast food consumption and overweight/obesity prevalence in students and its association with general and abdominal obesity

A. mohammadbeigi.

1 Research Center of Gastroenterology and Hepatology, Qom University of Medical Sciences, Qom, Iran

A. ASGARIAN

2 Research Center for Air Pollutants, Qom University of Medical Sciences, Qom/Iran

3 Department of Anesthesiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran

S. AFRASHTEH

4 Department of Public Health, Vice chancellor of Health, MSc of Epidemiology, Bushehr University of Medical Sciences, Bushehr, Iran

5 Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

6 Health Promotion Research Center, Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran

Nowadays, the prevalence of both fast food consumption and overweight/obesity has been increased. This study aimed to estimate the prevalence of fast food consumption and to assess its association with abdominal and general obesity. In an analytical cross-sectional study, 300 students were selected randomly from two largest universities in Qom, center of Iran, studying in medical and basic sciences fields in 2015. Data collection was conducted by a modified version of NELSON’s fast food questionnaire and anthropometric measures including Waist-Hip Ratio (WHR) and Body Mass Index (BMI). Chi-square, independent t-test, and multivariate logistic regression were used for statistical analysis. According to our results, 72.4% (67.4% in females vs 80.7% in males) had at least one type of fast food consumption in the recent month including sandwich 44.4%, pizza 39.7%, and fried chicken 13.8%, The obesity prevalence based on BMI and WHR was 21.3% (95% CI: 19.4, 23.2%) and 33.2% (95% CI: 0.7, 35.7), respectively. Fast food consumption was related to abdominal obesity as WHR (OR: 1.46, 95% CI: 1.11, 2.26), but was not related to general obesity as BMI (OR: 0.97, 95% CI: 0.63, 1.52). The prevalence of fast food consumption and obesity/overweight in Iranian student is high. Fast food consumption was associated with abdominal obesity based WHR, but did not related to general obesity based on BMI.

In adolescent students, 72.4% and 34% have used at least one type of fast foods in recent month and in recent week.

The obesity prevalence based on BMI and WHR was 21.3 % (18.2% in females vs 26.3% in males) and 33.2% (40.1% in females vs 21.9% in males), respectively.

Fast food consumption was associated with WHR, while was not related to BMI.

Sandwich consumption was associated with obesity/overweight based on BMI to 35%, fried chicken to 40%, and pizza more than 80%.

Introduction

The percentage of caloric intake from fast foods has increased fivefold over the past three decades among adolescents [ 1 , 2 ]. In addition, obesity prevalence increased dramatically worldwide as one of the most serious public health problem especially in childhood and adolescents in current century [ 3 ]. Fast food consumption has increasing’ trend due to convenience, costs, menu choices, flavor and taste [ 4 ]. About 30% of children to more than 50% in college students use fast food daily[ 2 , 5 ]. Moreover, more than 33% of adults and 17% of children and teenagers are obese in united states [ 6 ]. Increased food consumption and substantial changes in the food habits are the most important factors of obesity epidemic [ 7 ] besides the poor diet among young people at recent years [ 8 ].

Wide ranges of causes are associated with obesity and overweight that varied from genetic to environmental factors [ 3 , 7 ]. However, our surround environment is one of the key factors that effective in the rapid development of the obesity epidemic in the world [ 7 ]. Fast food consumption is strongly associated with weight gain and obesity. Fast food consumption could increase the risk of obesity and obesity-related diseases as a major public health issue [ 9 , 10 ]. Obesity and overweight are the most important factors of non-communicable diseases related to years of life lost in cardiovascular diseases [ 11 , 12 ].

Fast food is defined by a convenience food purchased in self-service or carry out eating venues without wait service [ 9 ]. Todays, the number of women in the workforce is increased due to changes in the family structure and urbanization in all countries over the past years. Moreover, the working of people for longer hours expands and the food and mealtimes have changed seriously. A rapid growth is observed in fast food industries and restaurants [ 13 ]. Consequently, some worse consequences such as overweight and obesity have increasing trend [ 9 ]. Previous research has identified a strong positive association between the availability of fast food and its consumption as well as fast food consumption and obesity outcomes [ 5 , 8 , 10 , 14 , 15 ]. However, some studies assessed the fast food consumption on the general obesity based on Body Mass Index (BMI) [ 5 , 8 , 10 , 16 ]. Nevertheless, the association between fast food consumption and obesity type (abdominal/general) is unclear [ 3 , 10 ]. We aimed to estimate the prevalence of fast food consumption and obesity/overweight in two different governmental and nongovernmental universities, and to assess the association of fast food consumption with abdominal/general obesity.

This cross-sectional study was conducted on 300 students of two large Universities in Qom, center of Iran, that randomly selected and studying in medical and basic sciences fields at spring 2015. Sample size was calculated based on the fast food prevalence in recent studies with considering the power equal to 90% and first type error equal 5% as well as based on the minimal significant difference expected regarding fast food consumption between the two university and students who used and not used fast food. The study subjects were selected based on the multistage sampling method. In the first phase, according to the stratified random sampling method, 150 students selected from the Qom Medical University, and 150 students selected from a nongovernmental University (Qom branch of Islamic Azad University). Then in each stratum, simple random sampling was used for selecting some classes and recruitment of students. In the third phase, in each selected class, all the eligible students were called to participate in the study. After describing the objectives and the method of data gathering, the informed consent is taken from all the volunteer subjects. Moreover, the ethic committee of Qom University of Medical Sciences approve the study protocol.

Data collection was conducted by a modified version of standard NELSON’ fast food questionnaire [ 17 ]. The reliability and validity of this questionnaire is assessed by them and reported as a reliable measure with fair validity. Moreover, the content validity of modified version of questionnaire changed based on cultural and nutritional differences in Iranian people, was assessed by experts in epidemiology, nutrition and health education majors. Moreover, the reliability of questionnaire was assessed by Cronbakh Alpha and estimated as 0.861.

The main outcomes in our questionnaire were fast food consumption, type of fast food and the frequency of consumption. The variables that evaluated in fast food consumption were selected based on more frequent items that used in Iran based on cultural and religious condition such as different types of sandwich, fried chicken, fried potato, hotdog and pizza.

Obesity indexes data of such as waist and circumference for calculating Waist-Hip Ratio (WHR), height and weight for computing BMI were collected. Waist, hip circumference, and height of subjects were measured by anthropometric tape measure. Moreover, the weight of students was measured by a valid scale (SECA 830). BMI and WHR were calculated by standard formulae [ 18 , 19 ].

The WHR index was used for measuring the abdominal obesity and BMI for general obesity. Frequency, mean, and standard deviation were used for description of data. Chi-square test was used to assess the relationship between fast food consumption and quantitative demographic variables with obesity in studied subjects. Independent t-test were used for comparing the mean of age, BMI and WHR and their components in studied subjects between used and un-used fast food consumption. Finally, multivariate logistic regression was used to control the potential confounders including job, educational level, field of study and type of university. The statistical analysis was conducted using SPSS software (Chicago, IL, USA) and the type one error considered in 0.05 level.

Overall, 72.4% (67.4% in females vs 80.7% in males) have fast food consumption. These students used at least one type of the fast foods in the recent month. However, the most common type of fast food consumption was sandwich 44.4%, pizza 39.7%, fried chicken 13.8%, respectively. Figure 1 showed the distribution of different type of fast foods in recent month after survey.

The prevalence of different the types of fast food consumption in studied students.

Table I shows the comparison of fast food consumption in students by chi square test between who were consumed fast food in recent month and who not consumed. This table showed that there was significant difference between subjects who used and did not use fast food in recent month regarding to the gender, marital status, education level, university, and major of study. The married and male students as well as who studied in basic sciences and nongovernmental university were used more fast food. Nevertheless, there was no significant relationship between job and residency place at night with fast food consumption.

Table II shows that there was a significant difference between studied subjects who used and not used fast food in past month regarding to waist and WHR (p < 0.05). Nevertheless, the difference in age, weight, height, hip, and BMI was not significant between two groups.

Comparing the mean of age, BMI and WHR and their components in studied subjects between used and un-used fast food consumption.

The overweight/obesity prevalence based on BMI classification (higher 25 kg/m 2 ) was 21.3% (95% CI: 19.4, 23.2%) calculated 18.2% (95% CI: 16.1, 20.3) in females vs 26.3% (95% CI: 22.7, 29.8) in males. Moreover, the obesity prevalence based on WHR was 33.2% (95% CI: 30.7, 35.7) calculated 40.1% (95% CI: 36.6, 43.5) in females vs 21.9% (95% CI: 18.8, 25.0) in males, respectively. Therefore, we considered a subject as obese if he/she had BMI more than 25 or WHR more than 0.9 in males and more than 0.8 in females. According to this definition, 37.2% (41.2% in females vs 30.7% in males) were affected to overweight and obesity. Therefore, the consumption of fast food was related to obesity. Moreover, a significant relationship was observed between obesity and consumption of sandwich (OR: 1.35, 95% CI: 1.4, 2.41), fried chicken (OR: 1.4, 95% CI: 1.22,1.73), and pizza (OR: 1.8, 95% CI: 1.1, 2.9). In addition, the fast food consumption was related to WHR as abdominal obesity (OR: 1.46, 95 CI: 1.11, 2.26), but was not related to BMI as general obesity (OR: 0.97, 95% CI: 0.63, 1.52) ( Tab. III ). Based on multivariate regression model ( Tab. IV ) only marital status, type of university and gender were the most related factors of fast food consumption. Therefore, studying in nongovernmental university (OR: 3.16, 95% CI: 1.8, 5.6), single status (OR: 3.08, 95% CI: 1.26, 5.01) and being females (OR: 2.96, 95% CI: 1.61,4.53) are the most important related factors of fast food consumption, respectively in Qom, Iran.

The relationship between fast food consumption and obesity in studied subjects.

Multivariate analysis of predictive factors of fast food consumption in under studied subjects.

The adjusted variables in this model were job, educational level, field of study and type of university.

According to our results, 72.4% and 34% have used at least one type of the fast foods in recent month and recent week, respectively. It seems that the consumption of fast food in Qom students is high due to lack of recreational facilities and entertainment in this religious city. However, the fast food consumption in our study was lower than other studies [ 4 , 20 ]. Results of studies in students of King Faisal University reported that more than 90% of people used fast foods monthly that was higher our estimate. In addition, a same study in female students aged 18 to 25 years showed that 47.1% had fast food consumption for two or more time per week [ 5 ].

The obesity prevalence in our study was estimated 21.3% and 33.2%, based on BMI and WHR, respectively. In a previous study, the obesity/overweight prevalence was 29.7% 5 and nearly half of them used fast foods. Moreover, in Shah et al. study, more than 34% of Chinese medical students were pre-obese and obese [ 4 ].

According to our results WHR was significantly different between subjects who used and not used fast food while, the difference in BMI was not significant. Therefore, fast food consumption was related to WHR, but did not related to BMI. In addition, consumption of sandwich, fried chicken and pizza were associated with obesity/overweight based BMI. Same direct association were demonstrated the association between fast food consumption and overweight/obesity in different studies [ 10 , 14 , 15 , 21 , 22 ]. Fast foods are poor in micronutrients, low in fiber, high energy density, high in glycemic load9 and large portion size with sugar [ 4 ] and could be more energetic than the daily energy requirements [ 6 , 9 ]. In addition, the average energy density of an entire menu in fast food restaurant is approximately more than twice the energy density of a healthy menu [ 22 ]. According to some studies [ 3 , 22 , 23 ] obesity is the core of some important non-communicable diseases such as hypertension, hyperlipidemia, hypercholesterolemia, cardiovascular diseases, metabolic syndrome and type 2 diabetes [ 12 , 22 , 23 ]. Increase in energy density of diet by fat or sugar, together with concomitant eating behaviors like snacking, binge eating and eating out; promote unhealthy weight gain through passive overconsumption of energy [ 4 , 6 ].

Fast food consumption is positively related to overweight and obesity due to extremely high energy density of these foods [ 6 , 22 ]. Moreover, a study a significant association was observed between BMI and fast food consumption [ 4 ]. Two commonly eaten fast foods including fried foods and hotdogs have been associated with risk of obesity and weight gain [ 22 ]. Moreover, fast food consumption was related to general obesity in female adolescents. Moreover, obesity/overweight was significantly associated with frequency of fast food consumption [ 5 ].

This study found the prevalence of obesity was higher in females, while the prevalence of fast food consumption was higher in males. However, male students who are married are more interesting to eating fast food and it might be due to the religious culture of Qom as the most religious city of Iran. In the other hand, the single female students are not free to go in fast food restaurants than married ones. Moreover, three variables including marital status, type of university and gender are the most associated factors of fast food consumption. Based on our results in multivariate model, both studying in nongovernmental University and being single increase the odds of fast food consumption more than three fold. Moreover, female students used fast food 2.9 folds more than male students. The main reasons of students for fast food consumption are taste and comfort to access to these foods and lack of cooking skills [ 5 ]. The higher fast foods consumption in females and single students might related to lower wasting time in android social networks than male students [ 25 , 26 ]. Moreover, since in nongovernmental university the price of kitchen food is high, the students are more interesting to have eating in fast food restaurants. However, the fast food prevalence is high in students and teenagers probably due to low cost [ 4 , 16 ]. Nevertheless, because comfort accesses to fast food the corresponding expenditures are rising among people [ 15 ]. Moreover, the price of health outcomes of consequences of fast food consumption are more expensive and need to more investigations [ 9 , 15 ].

We could not measure the morphometric characters and adipocity measures of students as other body compositions indexes. Moreover, lack of cooperation of students for anthropometric measurements was another limitation of the current study.

Conclusions

The prevalence of fast food consumption and obesity/overweight in Iranian student is high. Studying in nongovernmental University, being single and females were associated with fast food consumption to three fold. Fast food consumption could have associated to abdominal obesity based WHR to 46%, but was not related to general obesity based on BMI. However, this study showed the different effect of fast foods on abdominal and general obesity as a hypothesis. Future studies need to determine the pure effect of fast food consumption on different dimensions of obesity.

The relationship between demographic variables and fast food consumption.

Acknowledgments

The authors would like to thank the research Vice-Chancellor of Qom University of Medical Sciences for financial supporting of this work. They are also grateful students who participated in this study.

Funding source: Qom University of Medical Sciences.

Conflict of interest statement

None declared.

Authors' contributions

AM: contributions to the conception, design of the work; analysis, and interpretation of data and Final approval of article.AA: contributions the acquisition and analysis of data for the work and Drafting the article. EM: contributions to the conception or design of the work; interpretation of data for the work; and Final approval of the article. SA: contributions to the conception or design of the work; interpretation of data for the work; and Final approval of the article. SK: contributions to the conception or design of the work analysis, or interpretation of data for the work; and Final approval of the article.HA: contributions to the conception, design of the work; analysis, and interpretation of data and Final approval of article.

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Fast Foods and their Impact on Health

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QUEST JOURNALS

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Introduction: - We decided to take this topic because of it important in health. Fast food restraints on widely distributed throughout KSA partially in big cities like (Riyadh). In addition to that most of fast food restraint use unhealthy making food. The problem is in increasing fast food consumption by young people that leads to many healthy problems which include health care cost, and physical inactivity. Background:- Effect of Fast Food on Health is a popular in our population. The present work is aimed at studying of effect the fast food on pre-clinical student in college of medicine Imam University. Material and method: This is Cross sectional study that were conducted in the college of medicine at Imam Muhammad bin Saud University in Riyadh. Our target population isPre-clinical medical male studentbetween 18 and 35 years old. Sample size of 90 students was calculated statistically (30 students from each preclinical year). Results:- Thirty-nine percent of those were between 18 and 21 years old, while the others were older than 21 years old. Majority of our population sample (48.4%) are in 3rd year and 29.7 percent of them are in 2nd year. More than half of participants (56.3%) reported that their GPA was between 3 and 3.5 out of 5, with only 15.6% of them was below 3. More than 90 percent of the participants admitted that fast food is not good for their health. The most important factor for chosen fast food was the cost in nearly the half (48.4%), while advertisement came as second driven factor for choosing fast food in 23.4 percent of the participants. The most important factor for chosen fast food was the cost in (48.4%). (23.4%) of the participants driven factor for chosen fast food was advertisement. burger was the most popular kind of fast food , then sandwich (12.5%). Conclusion:- Fast food become popular in all world country including our community. Because many factor like: enjoy the taste, advertisement, limited time, and cost .Fast food has effect on our health including: increase our weight,cardiovascular disease and (DM).

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Background- Ayurveda has given a unique concept of Viruddha Ahara. Junk food an energy-dense food could be consider as Viruddha Ahara because of its serious physical and mental health consequences. Aim - Find out the frequency of consumption of Junk food preparation and their effects on Physical & Mental health in the youngsters of Bhopal city with special reference to Viruddha Ahara. Study Design- was Observational cross sectional study. Material and Method- Modified Questionnaire based on WHO STEPS1, 2 and 3 guidelines was used to collect the data. 600 youngsters of age group between 12-25 years from various schools and colleges of Bhopal city were selected by stratified random sampling technique and Statistical Analysis was done with epi infoTM version 7 software. Appropriate statistical tests were applied such as frequency distribution, cross tabulation (M x N/ 2 x 2 Table), chi square test, z statistics and logistic regression analysis. Odds ratios (OR) with 95% confidence inte...

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Junk foods are rich in calories, salt and fats. Excess consumption of junk foods leads rise to wide variety of health disorders. Foods rich in high fat and sugar leads to weight gain along with other problems like infections, food poisoning, cancer, ulcer and dental diseases.Nutrition counselling regarding the importance of balanced diet, harmful effects of junk foods will help to curb the junk food addiction and improving their nutritional status. The main objective of the study was to find out the awareness on the ill effects of Junk food among Higher Secondary Students in Tirunelveli district. Survey method was adopted in this study. Sample consists of 300 Higher Secondary Students in Tirunelveli. Junk Food Awareness Scale was developed by Maria Saroja. M and Michael JeyaPriya.E (2018) has been used for collecting data. Mean, SD and't'-test was used for analysis the data.Present study revealed that, there was a significant difference among Higher Secondary Students in their awareness about the ill effects of Junk food.

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Junk food consumption has peaked in high-income countries but is still increasing rapidly throughout much of the developing world. While the adverse health impacts of junk food are undeniable, much less attention has been paid to its environmental impacts. This chapter takes a more nuanced approach to the topic by consolidating the evidence on the health and sustainability implications of junk food production and consumption. It begins with a review of the nomenclature used in the literature to describe junk food, followed by a descriptive analysis of current global consumption patterns and trends. Associated health and environmental impacts are then considered with some options to address these. Based on the available evidence, it is concluded that junk food is incompatible with sustainability objectives and concurrent efforts to curtail its production and consumption should be a key agenda item in promoting healthy and sustainable food systems.

https://www.ijhsr.org/IJHSR_Vol.8_Issue.6_June2018/IJHSR_Abstract.02.html

International Journal of Health Sciences and Research (IJHSR)

Introduction: Increased inclination to replace traditional meals with energy-dense imbalanced junk foods is responsible for the inception of many diseases especially Non Communicable Diseases among school going adolescents. Objective: To study the consumption pattern and knowledge about ill effects of junk food in school children of Jorhat urban. Materials and methods: A cross-sectional descriptive study was undertaken in schools of urban area of Jorhat district of Assam over a period of one year from June 2016 to May 2017. Results: Among the study participants who consumed junk food frequently (≥5 days), consumption ranges between 5.6% to 24.1% while those who had the practice of taking junk food infrequently (1-4 days), we found that their habit ranges from 49.4% to 70.8% in different junk food products. Expenditure pattern of pocket money revealed that 33.3% (majority) of the adolescents spend their pocket money to pay vehicle rent, 16% use it to buy chips, 13.5% spend their pocket money to buy ice cream while 6.9% of the adolescents spend it on chocolate. Knowledge on ill effects of junk food revealed that 51.5% (majority) pointed out stomach problem and 16.8 % mentioned obesity as ill effect of junk food consumption while 22.4% of the participants do not know the ill effect of junk food consumption. Conclusion: Consumption of junk food amongst urban school going adolescents in Jorhat district of Assam is highly prevalent. General awareness about the ill effects of junk food amongst the adolescents was average which warrant appropriate public health interventions.

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