Digestive and cardiovascular systemsMost fast food, including drinks and sides, are loaded with

carbohydrates with little to no fiber. When your digestive system breaks down these foods, the
carbs are released as glucose (sugar) into your bloodstream. As a result, your blood sugar increases.
Your pancreas responds to the surge in glucose by releasing insulin. Insulin transports sugar
throughout your body to cells that need it for energy. As your body uses or stores the sugar, your
blood sugarreturns to normal. How many carbs should you eat in a day? This blood sugar process is
highly regulated by your body, and as long as youre healthy, your organs can properly handle these
sugar spikes. But frequently eating high amounts of carbs can lead to repeated spikes in your blood
sugar. Overtime, these insulin spikes may cause your bodys normal insulin response to falter. This
increases your risk for weight gain, insulin resistance, and type 2 diabetes.

Sugar and fatMany fast-food meals have added sugar. Not only does that mean extra calories, but
also little nutrition.The American Heart Association suggestsonly eating 100 to 150 calories of added
sugar per day. Thats about six to nine teaspoons. Many fast-food drinks alone hold well over 12
ounces. A 12-ounce can of soda contains 8 teaspoons of sugar. That equals 130 calories, 39 grams of
sugar, and nothing else.Trans fat is manufactured fat created during food processing. Its commonly
found in:

fried pies

pastries

pizza dough

crackers

cookies

No amount of trans fat is good or healthy. Eating foods that contain it can increase your LDL (bad)
cholesterol, lower HDL (good) cholesterol, and increase your risk for type 2 diabetes and heart
disease.Restaurants may also compound the calorie-counting issue. In one study, people eating at
restaurants they associated as healthy still underestimated the number of calories in their meal by
20 percent.

SodiumThe combination of fat, sugar, and lots of sodium (salt) can make fast food tastier to some
people. But diets high in sodium can lead to water retention, which is why you may feel puffy,
bloated, or swollen after eating fast food. Salt actually makes you hungry, not thirsty A diet high in
sodium is also dangerous for people with blood pressure conditions. Sodium can elevate blood
pressure and put stress on your heart and cardiovascular system.According to one study, about 90
percent of adults underestimate how much sodium is in their fast-food meals. The study surveyed
993 adults and found that their guesses were six times lower than the actual number (1,292
milligrams). This means sodium estimates were off by more than 1,000 mg.Keep in mind that the
American Heart Association recommends adults eat no more than 2,300 milligrams of sodium per
day. One fast-food meal could have half your days worth.

Respiratory systemExcess calories from fast-food meals can cause weight gain. This may lead toward
obesity.Obesity increases your risk for respiratory problems, including asthma and shortness of
breath. The extra pounds can put pressure on your heart and lungs and symptoms may show up
even with little exertion. You may notice difficulty breathing when youre walking, climbing stairs, or
exercising.For children, the risk of respiratory problems is especially clear. One study found that
children who eat fast food at least three times a week are more likely to develop asthma.
Central nervous systemFast food may satisfy hunger in the short term, but long-term results are less
positive. People who eat fast food and processed pastries are 51 percent more likely to develop
depression than people who dont eat those foods or eat very few of them.

Reproductive systemThe ingredients in junk food and fast food may have an impact on your fertility.
One study found that processed food containsphthalates. Phthalates are chemicals that can
interrupt how hormones act in your body. Exposure to high levels of these chemicals could lead to
reproductive issues, including birth defects.

Integumentary system (skin, hair, nails)The foods you eat may impact your skins appearance, but it
might not be the foods you suspect. In the past, chocolate and greasy foods like pizza have taken the
blame for acne breakouts, but according to the Mayo Clinic, its carbohydrates. Carb-rich foods lead
to blood sugar spikes, and these sudden jumps in blood sugar levels may trigger acne. Anti-acne diet
Children and adolescents who eat fast food at least three times a week are also more likely to
develop eczema, according to one study. Eczema is a skin condition that causes irritated patches of
inflamed, itchy skin.

Skeletal system (bones)Carbs and sugar in fast food and processed food can increase acids in your
mouth. These acids can break down tooth enamel. As tooth enamel disappears, bacteria can take
hold, and cavities may develop.Obesity can also lead to complications with bone density and muscle
mass. People who are obese have a greater risk for falling and breaking bones. Its important to keep
exercising to build muscles, which support your bones, and maintain a healthy diet to minimize bone
loss.

Effects on societyToday, more than 2 in 3 adults are considered overweight or obese. More than
one-third of children ages 6 to 19 are also considered overweight or obese. The growth of fast food
in America seems to coincide with the growth of obesity in the United States. The Obesity Action
Coalition (OAC) reports that the number of fast food restaurants in America has doubled since 1970.
The number of obese Americans has also doubled.Despite efforts to raise awareness and make
Americans smarter consumers, one study found that the amount of calories, fat, and sodium in fast-
food meals remains largely unchanged. As Americans get busier and eat out more frequently, it
could have adverse effects for the individual and Americas healthcare system.

http://www.healthline.com/health/fast-food-effects-on-body

Fast food tips

Many fast foods are high in calories, fat, salt, and sugar. Use these tips to guide you in making
healthier choices when eating in a fast food restaurant.

Can You Eat Fast Food?

Fast foods are quick and easy substitutes for home cooking. But fast foods are almost always high in
calories, fat, sugar, and salt.
Some restaurants still use hydrogenated vegetable oils for frying. These oils contain trans fats. These
fats increase your risk for heart disease. Some cities have banned or are trying to ban the use of
these fats.

Now, many restaurants are preparing foods using other types of fat. Some offer low-calorie choices
instead.

Even with these changes, it is hard to eat healthy when you eat out often. Many foods are still cooked
with a lot of fat. Many restaurants do not offer any lower-fat foods. Large portions also make it easy
to overeat. And few restaurants offer many fresh fruits and vegetables.

In general, people with high blood pressure, diabetes, and heart disease must be very careful about
eating fast food.
When You Go to a Fast Food Restaurant
Knowing the amount of calories, fat, and salt in fast foods can help you eat healthier. Many
restaurants now offer information about their food. This information is much like the nutrition
labels on the food that you buy. If it is not posted in the restaurant, ask an employee for a copy.

In general, eat at places that offer salads, soups, and vegetables. In your salads, avoid high-fat items.
Dressing, bacon bits, and shredded cheese all add fat and calories. Choose lettuce and assorted
vegetables. Select low-fat or fat-free salad dressings, vinegar, or lemon juice. Ask for salad dressing
on the side.

Healthier sandwiches include regular or junior size lean meats. Adding bacon, cheese, or mayo will
increase the fat and calories. Ask for vegetables instead. Select whole-grain breads or bagels.
Croissants and biscuits have a lot of fat.

If you want a hamburger, get a single meat patty without cheese and sauce. Ask for extra lettuce,
tomatoes, and onions. Limit how many French fries you eat. Ketchup has a lot of calories from sugar.
Ask if you can get a side salad instead of fries.

Look for meats, chicken, and fish that are roasted, grilled, baked, or broiled. Avoid meats that are
breaded or fried. If the dish you order comes with a heavy sauce, ask for it on the side and use just a
small amount.

With pizza, get less cheese. Also pick low-fat toppings, such as vegetables. You can dab the pizza with
a paper napkin to get rid of a lot of the fat from the cheese.

Eat low-fat desserts. A rich dessert can add fun to a well-balanced diet. But eat them only on special
occasions.

Order smaller servings when you can. Split some fast-food items to reduce calories and fat. Ask for a
"doggy bag." You can also leave the extra food on your plate.

Your food choices can teach your children how to eat healthy, too. Choosing a variety of healthy
foods and limiting portion size are key to a healthy diet for anyone.

Alternative Names
Obesity - fast food; Weight loss - fast food; High blood pressure - fast food; Hypertension - fast food;
Cholesterol - fast food; Hyperlipidemia - fast food
https://medlineplus.gov/ency/patientinstructions/000105.htm

Fast Food: Fast Track to Obesity and Disease?

Dietitians and nutritionists have singled out eating fast food as a fast track to diabetes and
diseases. The Department of Endocrinology at Singapore General Hospital explains why and shares
4 good eating habits.

Fast Food: Fast Track to Obesity and Disease?

MOST FAST FOOD is highly processed with high amounts of sodium, saturated fats and trans fat.

The next time you crave for a double cheese hamburger, think of the whopping calories, saturated
fats, and high amount of sodium that go into this fast food meal. Dietitians and nutritionists have
long singled out eating fast food as a fast track to obesity and disease.

According to the Ministry of Healths National Health Survey, Singaporeans have grown fatter over
the past seven years, with the obesity rate rising from 6.9 per cent in 2004 to 10.8 per cent in
2010.

More people are also developing type 2 diabetes. This type of diabetes occurs when the body
becomes insulin-resistant and is closely linked to obesity.

The sharp rise in obesity and type 2 diabetes among Singaporeans over the past seven years is
alarming, say specialists at the Department of Endocrinology, Singapore General Hospital (SGH), a
member of the SingHealth group. It is a worrying trend that is set to rise unless Singaporeans
adopt a healthier lifestyle.

Poor eating habits linked to obesity

Experts cite poor eating habits such as eating fast food, late night suppers, rushing through meals
and eating while watching television as reasons for poor digestion, overeating and rising obesity.

The convenience of fast food and hawker food also makes it harder to break poor eating habits.
With obesity comes a host of health problems: joint pain, sleep apnea, high cholesterol, high
blood pressure and heart disease.

Why fast food is bad for health

Most fast food rank high on the glycaemic index (GI).

The body digests high-GI foods quickly, converting it into glucose thats released into the
bloodstream. Normally, insulin transforms this glucose into usable energy. However, if you are
insulin-resistant, glucose remains in your bloodstream for too long, damaging your organs.

Most fast food is highly processed with high amounts of sodium, saturated fat and trans fat.

One Big Mac meal with medium fries and medium coke will chalk up 70 per cent of your daily
maximum sodium intake, and up to 60 per cent of your daily maximum saturated fat (20g for
women, 30g for men).

Saturated and trans fats raise so-called bad LDL-cholesterol level. High LDL-cholesterol clogs
heart arteries and raises blood pressure. It can trigger heart disease and strokes.

Because processed foods are stripped of nutrients, they can never satisfy the bodys nutritional
needs. You end up eating more.

4 good eating habits to stave off obesity and disease

Choose healthier options

Avoid fast food and oily hawker food. Choose healthier options such as soup-based dishes, non-
fried items, more fruits and vegetables.

Eat slowly, chew thoroughly

For better digestion, do not eat too fast. Wait a while before going for second helpings as the
brain takes about 20 minutes to register you are full.

Go for healthy snacks

If you must snack, choose healthy substitutes such as almonds and sunflower seeds in
reasonable quantity - instead of fries, biscuits, crackers and sweets.

Reduce sugary drinks

Local kopi and teh si are sugar-loaded. So are soft drinks and canned fruit juices. Quench thirst
with plain water instead.

Poor eating habits and sedentary lifestyles are factors that cause obesity. Get enough physical
activity. Walk more, eat less, and eat healthily. Fast food is convenient, but it is not real food.

https://www.healthxchange.sg/food-nutrition/weight-management/fast-food-fast-track-obesity-
disease

5 Lifestyle Diseases Associated with

Fast Food
Posted by: Medical Observer May 14, 2014 2702 Views
4

While many fast food chains are the best thing that happened to people who see
convenience as the primary consideration when choosing food, these same fast-food
chains and their massive and attractive campaigns have also been blamed for spawning
health problems whose magnitude has never been seen before.
*Obesity*
Since fast food chains produce uniform meals, adult portions wind up being served to children. Even
so-called childrens meals at a fast-food restaurant tend to contain bigger servings.
Also, fast-food meals normally contain little fiberthus, kids feel less full after a meal, and are likely to
eat more.
[pq]The fats, sugar, and salt content of fast food also helps to make kids eat more by appealing to
their primordial tastes.[/pq]

In a US study, over 6,000 children and adolescents were surveyed on their food intake. Results
showed that among kids aged four to eight, those who ate fast food also eat six-percent more for the
rest of that day than kids who didnt eat fast food. This contributed to fast foods eaters consuming
around 15-percent more calories on average than other kids, which amounts to around 57 calories a
day.
Left unchecked, this figure could lead to a weight gain in children of six pounds per day, and could
later lead to childhood obesity. This can also increase risk of heart disease later in life.

*Diabetes*
A 2003 study showed a link between the risk for diabetes and the frequency of eating fast food.
[pq]Abnormal blood-glucose control, a strong risk factor for type 2 diabetes, was found to double
when eating fast food more than twice a week.[/pq]
In another study, monkeys fed on a diet rich in Trans fats (the unhealthy fats that are present in fast
food) were compared with a control group of monkeys fed on a diet with unsaturated fats containing
the same number of calories. The trans-fat-fed monkeys increased their body weight by 7.2 percent
(compare with 1.8 percent for the monkeys on a healthy diet), had 30-percent more abdominal fat (a
risk factor for diabetes and heart disease), and developed signs of insulin resistance, an early
indicator of diabetes.

*Heart disease*
[pq]The animal fats commonly present in fast-food meat can add to fatty deposits and clog the blood
vessels.[/pq]

Oxidized cholesterol, commonly found in most fried and processed foods, is one of the main killers at
work, clogging vessels and damaging arterial walls. Raising the risk for high blood pressure is also
linked to obesity, because being obese can constrict blood vessels. And if you think that heart disease
is only a problem among adults, think againthe decoration of ones hearts health begins as
early as childhood.

*Cancer*
Because of the way most fast foods are prepared- by deep-frying in repeatedly used cooking oil
[pq]eating too much fast food can expose your children to a higher risk of developing cancer.[/pq]
There have also been studies that found a carcinogenic compound in grilled chicken found on the
menu of many big fast food companies.

*Food poisoning*
[pq]In efforts to cut costs, fast-food chains may lower the standards of their meat-packing process by
hiring unskilled or poorly trained workers for a lesser price.[/pq]

This sometimes leads to incidents where manure gets mixed with meat, contaminating it with harmful
salmonella and Escherichia coli 0157:H7 bacteria.
Once contaminated, the processing of the meat ensures that it is distributed to a large number of
people. A US Department of Agriculture study once found that 78.6 percent of ground beef contained
microbes that were primarily spread via feces. Food poisoning by E. coli 0157:H7 can lead to renal
failure, and about five percent of children die from this complication.
http://medicalobserverph.com/growingkids-5-lifestyle-diseases-associated-with-fast-food/

Fast Food Pattern and Cardiometabolic Disorders: A Review of

Current Studies
Zahra Bahadoran, 1 Parvin Mirmiran, 1 ,* and Fereidoun Azizi 2

Author information Article notes Copyright and License information

This article has been cited by other articles in PMC.

Abstract
Go to:

Introduction
A growing trend of fast food consumption along with alarming trend of cardiometabolic
disorders is considered as a globally health problem. Although there is no agreement on the
definition of fast food, it is mainly defined as "easily prepared processed food served in snack
bars and restaurants as a quick meal or to be taken away" in dictionaries and encyclopedias;
industrial foods such as canned foods or snacks may also considered as fast foods.1 In the
recent years, an increasing globally popularity have been developed regarding the fast foods
and take-away foods marketing. Out-of-home meals and fast foods are rich in highly
processed meat and refined carbohydrate, sodium, total fat, saturated and trans fatty acids,
cholesterol, and poor in essential nutrients and dietary fibers; 2 the fast food pattern also has
undesirable effects on overall diet quality especially in children and adolescents.2-4 Fast food
consumption and out-of-home eating behavior is a main risk factor for higher calorie and fat
intake and lower micronutrients density of diet.3,5 Frequent consumption of fast foods is one
of the main reasons for rising trends of overweight and obesity, cardiovascular disease, type 2
diabetes and other metabolic abnormalities.3,6-8Higher availability of fast food services is
associated with higher mortality and hospital admission rates for acute coronary heart disease
as well as a higher risk of overweight and obesity.9,10
Considering to growing interest to Western dietary patterns and trend of fast food
consumption along with global burden of cardiovascular diseases, diabetes, obesity and
hypertension, and the lack of a comprehensive review study on cardiometabolic outcomes of
these dietary patterns, this study aimed to review the current evidence in relation to adverse
effects of fast food patterns on non-communicable diseases with focusing on cardiometabolic
risk factors.
Go to:

Materials and Methods

This is a narrative review article. The original research articles were reviewed published in
English from 1990 to 2014. To search the articles, a number of databases and search engines,
including PubMed, Medline, Scopus and Google Scholar were used. The references of the
articles were also reviewed to identify papers that are more relevant. Searches were
conducted with the search terms fast foods, processed foods, obesity, overweight,
insulin resistance, diabetes, cardiovascular disease, metabolic syndrome,
dyslipidemia and hypertension. Relevant articles including both epidemiological
including cohort, case-control, cross-sectional and clinical studies were assessed for initial
eligibility. Studies with English language evaluated the association between fast food
consumption with cardiometabolic risk factors, with appropriate design and good quality (e.g.
accurate definition of exposure and outcome, study population, clearly defined statistical
methods) were included.

Ethical consideration
Ethical issues which have been considered for this study was included prevention of selective
reporting bias of the papers, and honesty in reporting of the results of the studies. Moreover,
related references have been carefully cited throughout the manuscript.
Go to:

Results

Fast food consumption and the risk of overweight and obesity

The alarming trend in the acceleration of overweight and obesity is mainly attributed to
changes in lifestyle determinants and environmental factors. A rapid on-going nutrition
transition with progressive shift to a westernized diet, in particular higher consumption of
industrial and processed foods, and sweetened beverages are major factors contributing to the
global epidemic of obesity.11 Among various dietary factors, out-of-home eating patterns and
regular consumption of fast food have been proposed as determinant factors in the prevalence
of obesity and severe weight gain over time;12,13 an association which has been confirmed in
both prospective and cross-sectional studies. In Table 1, the associations of fast food
consumption with anthropometric measures and risk of obesity in cohort and cross-sectional
studies were reviewed.

Table 1

The association of fast food consumption with anthropometric measures and the risk of obesity in
cohort and cross-sectional studies

Frequent consumption of fast food, 2 times/week, compared to <1 time/week, has been
accompanied with 4.5 kg weight gain during a fifteen-year follow-up of US adolescents and
young adults.6
Participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study
who were in the highest compared to the lowest quartile of fast food consumption, had higher
weight (adjusted mean=5.6 kg, 95% CI= 2.1-9.2), and waist circumference (adjusted
mean=5.3 cm, 95% CI=2.8-7.9) after a 13-yrfollow-up; in this study, fast food intake was
associated with 13-yrchanges in body weight (=0.15, 95% CI= 0.06-0.24) and waist
circumference (=0.12, CI= 0.04-0.20).7 A3-yrfollow-up of adults also showed that increased
consumption of fast foods was associated with an increase in body mass index(BMI) change
(=0.05, 95% CI=0.01-0.09); each one unit increase in fast food consumption (1 time/wk)
was associated with a 0.13 increase in BMI at baseline (= 0.13, 95% CI: 0.04-0.22) and a
0.24 increase in BMI after 3years (=0.24, 95% CI= 0.13-0.34).14
Participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study
who were in the highest compared to the lowest quartile of fast food consumption, had higher
weight (adjusted mean=5.6 kg, 95% CI= 2.1-9.2), and waist circumference (adjusted
mean=5.3 cm, 95% CI=2.8-7.9) after a 13-yrfollow-up; in this study, fast food intake was
associated with 13-yrchanges in body weight (=0.15, 95% CI= 0.06-0.24) and waist
circumference (=0.12, CI= 0.04-0.20).7 A3-yrfollow-up of adults also showed that increased
consumption of fast foods was associated with an increase in body mass index (BMI) change
(=0.05, 95% CI=0.01-0.09); each one unit increase in fast food consumption (1 time/wk)
was associated with a 0.13 increase in BMI at baseline (= 0.13, 95% CI: 0.04-0.22) and a
0.24 increase in BMI after 3 years (=0.24, 95% CI= 0.13-0.34) .14
In a Mediterranean cohort study, a higher risk of weight gain (3 kg during a 5 past year)
(OR=1.2, 95% CI=1-1.4) was observed in adults who consumed more hamburger, pizza, and
sausages; a significantly greater weight gain during a 2-year follow-up was also observed in
the highest compared to the lowest quintile of fast food consumption (0.77 kg vs. 0.47
kg).15 A three-year follow-up of women also indicated that increased consumption of one fast
food meal per week led to a 0.72 kg more weight gain.21
Cross-sectional studies2,16,20-22 also reported a positive association between consumption of fast
food and the anthropometric measures in different populations and various age-groups; in
school children, consumption of fast food was associated with a higher BMI Z-score (=0.08,
95% CI=0.03-0.14), higher body fat (=2.06, 95% CI=1.33-2.79) and an increased risk of
obesity (OR=1.23, 95% CI=1.02-1.49). In a cross-sectional survey, frequency of fast food
consumption was positively associated with body mass index (=0.31, P=0.02), in
adults.16 The association of fast foods and BMI was =0.39 and 0.85 in high- and low-income
in young and middle-aged women, respectively.22 In Singaporean adults, the risk of
abdominal obesity was 1.24 (95% CI=1.03- 1.51) and 1.52 (95 % CI= 1.32- 1.77) in regular
consumers and occasional consumers of fast food meals.17 In the Michigan Behavioral Risk
Factor Survey, the adjusted-odds of obesity in adults consuming 3 times/week compared to
<1 time/week fast food meals was 1.81 (95% CI=1.35-2.44).18 A significant association
between fast food intake and BMI (=0.104, P<0.01) as well as waist circumference
(=0.083, P<0.01) was observed among Iranian young adults.19 In Mediterranean adults, the
association of fast food consumption with BMI was estimated to be =1.76 (95% CI=0. 22,
3.3), and the risk of obesity increased by 129% in >1 time/week fast food consumers,
compared to non-consumers.2 More interestingly, a health community survey in Michigan
found a significant association between local concentrations of fast food outlets with BMI
(=3.21, P<0.001) and poor diet quality (=2.67, P<0.008).20
Findings of a study on 23182 adolescents in Finland showed an strong association between
fast-food outlet near school with breakfast skipping and undesirable eating habits; in this
study, proximity of a fast-food outlet was associated with increased risk of overweight
(OR=1.25, 95% CI=1.03-1.52).23 One study on the participants of National Health and
Nutrition Examination Survey showed that fast food and full-service restaurant consumption,
respectively, was associated with more energy, total fat and sodium intake as well as a
decrease in daily intake of vitamin A, D, and K.24 Fast-food consumption was also
significantly associated with higher intake of total energy (=72.5, P=0.005), empty calories
(=0.40, P=0.006) and BMI (=0.73, P=0.011), and lower healthy eating index score (= -
123, P=0012), vegetables (=-014, P=0004), whole grains (=-0.39, P=0005), fiber (= -
0.83, P=0002), magnesium (=-699, P=0019) and potassium intakes (=-57.5, P=0016).25

Fast food consumption and dyslipidemia

Another cardiometabolic risk factor regarding fast food pattern highlighted in the literature is
impaired metabolism of lipids and lipoproteins. In Coronary Artery Risk Development in
Young Adults (CARDIA), participants who consumed 2.5 compared to <0.5 meal/week of
fast food meals, had higher levels of serum triglycerides (1173.6 mg/dl vs. 955.2 mg/dl),
and lower high-density lipoprotein cholesterol (HDL-C) (52.00.7 mg/dl vs. 57.51.1 mg/dl),
over 13 years of follow-up; moreover, longitudinal associations ( coefficient SE) of
weekly fast food consumption with 13-year changes of triglycerides (TG), low-density
lipoprotein cholesterol (LDL-C) and HDL-C were =0.240.40, =0.160.14, and
=0.080.06), respectively.7 A greater increase in 3-year changes of TG levels was found in
Tehran Lipid and Glucose Study (TLGS) participants, who consumed more fast food meals at
baseline (10.6% vs. 4.4% increase, in the fourth compared to first quartile of fast food
intake); serum triglycerides to HDL-C ratio, an independent risk factor of cardiovascular
disease, also increased in adults with higher compared to lower fast food intakes (3.7% vs. -
5.5%, in the fourth compared to the first quartile).8
A cross-sectional analyses in TLGS study also indicated that fast food consumption (g/week)
was significantly associated with serum TG (=0.07, P<0.05), HDL-C (= -0.05, P<0.05)
and atherogenic index of plasma (=0.06, P<0.05) only in middle-age adults; a higher
prevalence of hypertriglyceridemia was also observed in the highest compared to the lowest
tertile of fast foods (42.3 vs. 34.2%).19Postprandial lipemia and lipid peroxidation increased
after consumption of a fast food meal, compared to a healthy meal; triglyceride levels,
malondialdehyde, and thiobarbituric acid reactive substances (TBARS) were significantly
higher and HDL-C levels were significantly lower after fast food meal.26

Fast food consumption and the risk of diabetes, metabolic syndrome and
cardiovascular disease
The adverse effects of fast foods consumption on the development of metabolic abnormalities
has been reported in several investigations. The associations of fast food consumption with
the risk of insulin resistance, diabetes, metabolic syndrome and cardiovascular disease in
cohort and cross-sectional studies were summarized in Table2. A 15-yrfollow-up of
American women showed that higher fast food intake 2 times resulted in greater insulin
resistance.6 In the CARDIA Study, participants in the 3rd and 4th, compared to the first quartile
category, of fast food intakes at baseline, had greater odds of metabolic syndrome after 13-
yrof follow-up (OR= 1.9, 95% CI= 1.11-3.26 and OR= 2.14, 95% CI= 1.24-3.70, in 3rdand
4thquartiles, respectively); homeostatic model assessment of insulin resistance (HOMA-IR) at
final examination was also positively associated with fast food consumption at baseline
(3.90.14 vs.0.30.18 in the highest compared to the lowest quartile of fast foods).A one-
follow-up of adults showed that higher consumption of processed meat products was
independently associated with the incidence of metabolic syndrome (OR= 2.5, 95% CI= 1.0-
6.2).30

Table2

The association of fast food consumption with the risk of insulin resistance, diabetes, metabolic
syndrome and cardiovascular disease in cohort and cross-sectional studies

The prospective approach of TLGS also showed that the risk of metabolic syndrome in the
highest, compared with the lowest, quartile of fast foods increased by 85% (OR=1.85, 95%
CI=1.172.95); in this study, the adverse effects of fast food consumption were more
pronounced in younger adults (<30 yr), and participants who had greater waist to hip ratio,
consumed less phytochemical-rich foods or had low-fiber diet (P<0.05).8 Non-alcoholic fatty
liver disease, a hepatic feature of metabolic syndrome, could be a result of fast food
consumption. In an intervention study, 4-wkconsumption of fast food meals (2meals/day) in
healthy subjects increased serum levels of alanin aminotransferase (22.111 U/l to 69.376
U/l), insulin resistance index (0.890.42 to 1.60.83) and hepatic triglyceride content
(1.11.9% to 2.84.8%) as well as body fat percent (20.19.8% to 23.88.6%).31
A prospective cohort of Singaporean women showed that consumption of fast food 2
times/wk increased the occurrence of type 2 diabetes (hazard ratio= 1.27, 95% CI= 1.03-1.54)
and coronary heart disease mortality (hazard ratio = 1.56, 95% CI= 1.18-2.06).27
Increased consumption of burger, fried chicken meals, sausage and other processed meat
products as well as French fries was associated with an increased risk of developing type 2
diabetes mellitus; a prospective study of 84,555 women in the Nurses' Health Study indicated
that higher intake of French fries increased the 20-years risk of diabetes by 21% (OR=1.21,
95% CI=1.09-1.33).28 In Black Women's Health Study, the 10-year incidence rate of type 2
diabetes for higher intake of hamburgers and fried chicken ( 2 meals/week compared to
none) was 1.40 (95% CI= 1.14, 1.73) and 1.68 (95% CI= 1.36, 2.08), respectively.29Meta-
analysis of seven prospective cohorts found that higher consumption of processed meat
increased the risk of type 2 diabetes by 19% (95% CI=1.11-1.27).32
More interestingly, rather than the consumption of fast foods, the rate of accessibility to fast
food services has been reported as a risk factor for cardiovascular disease; risk-adjusted
outcomes in regions with high compared to low accessibility to fast food services were
greater for mortality (OR= 2.52, 95% CI=1.54-4.13) and acute coronary hospitalizations
(OR= 2.62, 95% CI=1.42-3.59).9
Go to:

Discussion
This review provides further evidence warning us against the irreparable effects of fast food
consumption on public health especially the increasing global burden of obesity and
cardiovascular diseases. Frequent consumption of fast foods as well as out-of-home meals is
a serious dietary risk factor for development of increasing trend of obesity and other related
abnormalities. Higher consumption of fast foods has undesirable effects on dietary intake and
overall diet quality, which leads to increased incidence of metabolic disorders including
obesity, insulin resistance, type 2 diabetes as well as cardiovascular disorders.
Briefly, compared to non-consumers or <1 time/week, regular consumption of fast foods and
out-of-home meals 1-3 times/week was associated with an 20-129%elevated risk of general
and abdominal obesity.9,15,17,18 Increased risk of type 2 diabetes and metabolic syndrome in
subjects with higher consumption of fast foods (mean 2 times/week) was reported 27-68%
and 85-150%, respectively.7,8,14,27-29 Higher consumption of fast foods and higher exposure to
multiple sources of accessible, cheap, energy-dense fast foods were also accompanied with a
56-162% increased risk of coronary heart disease mortality.9,27
Several possible mechanisms have been suggested to explain undesirable effects of fast foods
on health status. A main factor describing the obesity-induced properties of fast foods is a
high-energy dense modality. Most fast foods have an extremely high energy density,
approximately 158 to 163 kcal per 100 gram of food; it also has been estimated that a fast
food meal typically has an energy density twice the recommended a healthy diet and contains
approximately 236 kcal/100 g.33
High energy density of foods may have adverse effects.34 In children, consumption of fast
foods compared to non-consumers, led to greater intake of energy (>187 kcal/day), energy
density (0.3 kcal/g), total fat (9g/d), carbohydrate (24 g/d), and added sugar (26g/d). 35 In
adults, participants in the highest compared to the lowest quartile of fast food consumption
also had more energy intake (>460 kcal/d), total fat (>2.5% of total energy), and cholesterol
(>30 mg/d).8 The difference of calorie intake in fast food days, compared with non-fast food
days was estimated to be within 400 kcal in overweight adolescents.36
High-fat content and inappropriate composition of fatty acids of fast foods is a main dietary
risk for chronic disease. Mean total fat percent of beef hamburgers, chips, chicken
hamburgers and hot dogs has been reported within 35.8310.68%, 35.848.66%,
23.025.07%, and 34.0213.49%, respectively; 28-52% of total fat was estimated as
saturated fat.37
Large portion size, high amount of refined carbohydrates and added sugar, and high glycemic
load are other characteristics that could explain the threatening properties of fast food
meals.38 In some of the most popular fast foods, trans fats were up to 24g/serving.4Higher
content of industrially produced trans fatty acids in fast foods is an important component
leading to weight gain, abdominal fat accumulation, development of insulin resistance and
cardiovascular events.39Furthermore, sodium content of fast foods is often higher than
recommended amounts; in some common fast food meals, salt content was reported to range
from 4.4 to 9.1 gr per meal;40 a high-salt diet besides increasing blood pressure also
intensifies insulin resistance and metabolic syndrome features.41
Some of the mechanisms that could explain the metabolic outcomes of fast foods have been
investigated in clinical and experimental studies. Postprandial adverse metabolic disorders
including lipemia, oxidative stress and pro-inflammatory processes after eating a fast food
meal observed in a human study are other possible explanations for cardiometabolic
outcomes of fast foods.26 Compared to a healthy fast food meal (fiber rich sourdough rye
bread, salad with vinegar, orange juice), a hamburger meal (hamburger, bacon, cola drink)
was associated with higher postprandial serum levels of glucose and insulin.42,43
In animal models, fast food diet induced a phenotype of non-alcoholic fatty liver and
steatohepatitis;43 in this study, fast food diet was accompanied with higher liver weight,
serum concentration of aspartate aminotransferase, intra-acinar inflammation and
development of steatosis. Higher expression of genes related to fibrosis, inflammation,
endoplasmic reticulum stress, and lipoapoptosis also was induced by fast food diets; activated
pathways of hepatocellular oxidative stress, profibrotic and pro-inflammatory pathways were
observed.44 After a fast food meal, a severe decrease in plasma antioxidant vitamins including
vitamin A, E and C, and zinc, as well as iron accumulation was observed in rats; decreased
levels of superoxide dismutase, reduced gluthathione, and higher levels of thiobarbituric acid
reactive substances, lipoprotein oxidation susceptibility, C reactive protein and tumor
necrosis factor-alpha were also observed.44
This study was a narrative review and had some limitations, which should be considered;
subjective nature of the search method, potential selection bias of the articles, probable
missing of unpublished data and lack of using Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) to design and report of the study were the mains
limitations. Further researches especially meta-analysis of current studies may provide a
comprehensive and accurate picture for undesirable outcomes of fast food patterns.
Moreover, further assessment of nutritional behaviors and social determinants of fast foods
intakes among different populations could help to development of efficient health strategies.
Go to:

Conclusion
Considering to growing interest to out-of-home meals and high prevalence of fast food
consumption, food policies with an emphasis on providing healthy foods, and making
nutritional information at fast-food restaurants may help consumers to order more healthful or
lower-calorie foods.
Go to:

Acknowledgments
The authors wish to thank Ms. N.Shiva for critical editing of English grammar and syntax.

Sodium still high in fast food and

processed foods

POSTED MAY 16, 2013, 11:22 AM

Daniel Pendick, Former Executive Editor, Harvard Men's Health Watch

Fast-food restaurants deliver filling, inexpensive meals and snacks. But theres usually a
hidden added cost: a wallop of salt (sodium) that isnt good for cardiovascular health. Even
with the current clamor for reducing sodium in the American diet, and industry promising to
do just that, the amount of sodium in prepared foods hasnt changed much since 2005,
according to a report published in the latest issue of JAMA Internal Medicine.

Why does sodium matter? Too much of it can increase blood pressure and make the kidneys
work harder. High blood pressure is a leading cause of stroke, heart attack, heart failure,
kidney disease, and more. Current recommendations urge us to consume less than 2,300
milligrams (mg) of sodium a day, equivalent to about a teaspoon of table salt. The bar is set
lower1,500 mg a dayfor those with cardiovascular disease or high blood pressure. Yet
the average American takes in about 3,400 mg a day.
 Harvard researchers recently conducted a study that assessed the cumulative health effects of
excess sodium. They estimated that excess sodium accounts for the 2.3 million deaths each
year around the world. The U.S. ranked 19th out of the 30 largest countries, with 429 deaths
per million adults due to taking in too much sodium. That represents one in 10 U.S. deaths
due to heart attack, stroke, and other cardiovascular diseases.

Counting the milligrams

For the JAMA Internal Medicine study, researchers with the Center for Science in the Public
Interest (CSPI) in Washington, DC, evaluated the sodium in 78 foods served at fast food and
chain restaurants between 2005 and 2011, collecting nutritional information from the
company websites. They did the same for foods plucked from shelves at stores in
Washington, DC, and at one Walmart in Elverston, Pennsylvania.

The average sodium in chain restaurant items increased 2.6% between 2005 and 2011. In
packaged foods, it fell on average 3.5%. The sodium in some products fell as much as 30%,
although a greater number increased by more than 30%.

Food manufacturers have developed lower-sodium foodsnone of which were included in

the JAMA Internal Medicine studyand have reduced sodium in other products. So far these
efforts, plus continuing public education campaigns, have failed to change this sobering fact:
the average American still takes in far more sodium that their bodies need.

CSPI, which sponsored the study, has called for tighter government regulation on the sodium
content in processed and restaurant foods, including phasing in ever-stricter limits on how
much sodium foods may contain.

Stronger actionis needed to lower sodium levels and reduce the prevalence of
hypertension and cardiovascular diseases, wrote Michael F. Jacobson, Ph.D., and
colleagues, the authors of the JAMA Internal Medicine study.

When applied to millions of people, even small changes in sodium consumption can save
lives. The evidence is convincing that substantially reducing sodium intakes from current
levels will have significant population benefits, says Dr. Dariush Mozaffarian, associate
professor of medicine at Harvard-affiliated Brigham and Womens Hospital. The data justify
government intervention to reduce sodium levels in all processed, pre-prepared, restaurant,
and other commercial foods.

How to reduce your sodium

You dont need to wait for more government regulations to keep the sodium in your diet in
check. There is the obvious solution, says Dr. Helen Delichatsios, an assistant professor of
medicine at Harvard Medical School. Eat out less and cook at home more. There is much
less sodium in home cooking than in prepared or restaurant foods. Here are some other
options:

When shopping, check nutrition labels and limit foods that deliver a lot of sodium. The five top
processed food sources of sodium are bread and rolls, cold cuts and cured meats, pizza, poultry, and
soups. Better yet, avoid foods with labels, and instead eat real food like fruits, vegetables, legumes,
and whole grains, says Dr. Delichatsios.
 When dining out, ask for information on calories, fat, and sodium. Chain restaurants commonly post
the nutritional profile of their products online.
Cook more. Base your meals on fresh and whole foods that you cook yourself, not processed warm-
and-serve products, since they tend to be loaded with sodium.
https://www.health.harvard.edu/blog/sodium-still-high-in-fast-food-and-processed-foods-
201305166267