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WHO: Fast food regulations could slow prevalence of obesity
Government regulations could delay the spread of fast food consumption, thus affecting the prevalence of obesity, research published in the Bulletin of the World Health Organization suggests.
“Unless governments take steps to regulate their economies, the invisible hand of the market will continue to promote obesity worldwide with disastrous consequences for future public health and economic productivity,” Roberto De Vogli, MPH, PhD, of the department of public health and sciences at the University of California, Davis, said in a press release.
De Vogli and colleagues investigated the effect of fast food consumption on mean population BMI and assessed the role of government policies.
They used the number of per capita fast food transactions (local and transnational) among 25 high-income countries belonging to the Organization for Economic Cooperation and Development.
Between 1999 and 2008, the average number of annual fast food transactions per capita increased from 26.61 to 32.76, according to data. The age-standardized mean BMI increased from 25.8 to 26.4 during the same time period, researchers wrote.
After adjustments for covariates, each 1-unit increase in annual fast food transactions per capita was associated with an increase of 0.033 kg/m2 in age-standardized BMI (95% CI, 0.013-0.052), researchers wrote.
Furthermore, only consumption of soft drinks appeared to resolve this association by reducing the effect size of the association after covariates (beta level=0.03; 95% CI, 0.0101-0.0504), according to data.
Data indicate the index of economic freedom was an independent predictor of fast food consumption (beta level=0.27; 95% CI, 0.16-0.37), researchers wrote. When used as a variable, the association between fast food and BMI lessened but remained statistically significant (beta level=0.023; 95% CI, 0.001-0.045).
Further research is warranted to determine whether deregulation would contribute significantly to the body weight of a particular population and what types of government interventions would adequately address obesity.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Processed high energy-dense fast food — high in calories, fat, salt, sugar and caffeine, and in super-size portions — must be a driver of obesity, right? But if “a calorie is a calorie,” then why should it matter whether you get those calories at McDonald’s, Outback Steakhouse or as a home-cooked meal?
To address this question, De Vogli and colleagues regressed the change in age-adjusted BMI in Organization for Economic Cooperation and Development countries over 9 years against the number of fast food transactions (using the EuroMonitor database) while controlling for gross domestic product, urbanization and an index of economic freedom. They found a robust association between fast food transactions and BMI increase over time.
But it doesn’t stop there. They used the line items of each fast food transaction to determine the nutritional mediators of weight gain. When adjusted for either total calories or animal fats, the effect of fast food on BMI change disappeared. But when adjusted for soft drinks, the effect was reduced but not obviated. While this doesn’t prove anything, it argues that soft drinks were the prime mover of weight gain. Lastly, the authors found that the degree of economic freedom was also a modulator of BMI increase, arguing that economic policies of each country play a role in either fomenting or inhibiting weight gain.
While correlation cannot prove causation, this study nonetheless argues for directionality — that fast food “drives” the weight gain, rather than obese people eat fast food more often. And while not powered to determine mechanism that soft drinks and national economic policy appear to drive the effect certainly argue that public policy efforts to curb soft drink consumption (eg, taxation) are certainly well-placed.