Blog | Monday, July 9, 2012

QD: News Every Day--'Made in America' fast food associated with heart disease, diabetes

The export of American fast food restaurants to Singapore was associated with a spike in diabetes and cardiovascular diseases there, a study found.

Researchers studied the impact of fast food chains and the dietary habits of men and women ages 45 to 74 who enrolled in the Singapore Chinese Health Study from 1993 to 1998. The concurrent expansion of American fast food chains during this time let researchers study the impact of fast food introduced to a new population.

Results appeared in Circulation.

Chinese Singaporeans who ate Western-style fast food items twice or more per week had an increased risk of developing type 2 diabetes (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03 to 1.54) and dying from coronary heart disease (HR, 1.56; 95% CI, 1.18 to 2.06) compared to people with little or no reported intake. These associations were not materially altered by adjustments for overall dietary pattern, energy intake and body-mass index.

Contrary to American lifestyles, Chinese Singaporeans who ate Western-style fast food were younger, less likely to be hypertensive, more educated, smoked less and more likely to be physically active.

But, those who ate more fast food ate fewer vegetables (excluding white potatoes), dairy products, rice, and overall less carbohydrate and dietary fiber. They ate more noodles, eastern snacks and dim sum, and sugar-sweetened beverages, which carried with it more protein, saturated and polyunsaturated fatty acids, cholesterol, sodium and total energy intake.

"Current and preceding generations in the U.S. have been widely exposed to Western-style fast foods throughout their life course," the authors wrote. "Yet, Western-style fast food intake in east and southeast Asia only started becoming somewhat prominent in the late 80's and early 90's, providing a chance to participate in American culture, a much different culture from the historical dietary culture of these populations. ... This increase in availability may be desirable to some people from a cultural perspective, but as noted, this aspect of the nutrition transition may have downside due to acculturation and increased non-communicable disease risk as previously reflected."

An editorial commented that many Asian countries haven't yet caught up with public health policies, such as nutritional labeling and controls over trans fat content, found in Western societies. Regulatory actions seen in occidental countries would help Asian ones adapt to cultural changes.

"[S]such efforts can shift socio-cultural norms around food, influence eating behaviors, and ultimately, help curb the growing global diabesity epidemic," the editorial stated.