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Journal Article

Fast food consumption in Iranian adults; dietary intake and cardiovascular risk factors: Tehran Lipid and Glucose Study.

TL;DR: The results show that increased consumption of fast foods is associated with poor dietary intake and some of the CVD risk factors in Iranian adults.
Abstract: BACKGROUND: Although fast food consumption has drastically increased in Iran in recent years; there is a paucity of data in relation to the association between fast food consumption, dietary intake, and cardiovascular risk factors. This study aims to determine fast food consumption status among young and middle-aged Iranian adults, and to assess its impact on dietary intake and cardiovascular disease (CVD) risk factors. METHODS:This cross-sectional population-based study was conducted on 1944 young and middle-aged adults (840 men and 1104 women), who participated in the Tehran Lipid and Glucose Study (2006–2008). We collected dietary data by using a validated 168 item, semi-quantitative food frequency questionnaire. Total fast food consumption was calculated by summing up weekly consumption of the most commonly consumed fast foods in Iran. RESULTS: Mean consumption of fast food was 161g/week (95% CI: 147–175) for young adults and 108 g/week (95% CI: 101–115) for middle-aged adults. Mean dietary intakes of energy, fat, saturated fat, cholesterol, sodium, meat, and soft drinks increased significantly (P < 0.05), while carbohydrate and refined grain consumption decreased (P < 0.01) across tertiles of fast food in both age groups. In young adults, dietary energy density and protein intake increased significantly (P < 0.01) where as intake of non-starchy vegetables and carotenoids decreased (P < 0.05). In middle-aged adults dietary intakes of fiber, folate, calcium, and fruits significantly decreased across fast food tertiles (P < 0.05). After adjustment for confounders, there was an association between fast food consumption and body mass index (BMI; β = 0.104; P < 0.01) and waist circumference (WC; β= 0.083; P < 0.01) in young adults, and serum triglycerides (β = 0.072; P < 0.05), high density lipoprotein cholesterol (HDL-C; β = -0.051; P < 0.05), and atherogenic index of plasma (β = 0.056; P < 0.05) in middle-aged adults. CONCLUSION: The results show that increased consumption of fast foods is associated with poor dietary intake and some of the CVD risk factors in Iranian adults.
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Journal ArticleDOI
TL;DR: It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out of-home foods on public health.
Abstract: Out-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing 'nutrition transition' at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it 'fashionable' to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.

136 citations


Additional excerpts

  • ...middle-income countries including Brazil((29)), Chile((30)), India((31)), Iran((32)), Malaysia((33)), Kenya and Tanzania((34)), among others,...

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Journal ArticleDOI
TL;DR: Reporters of frequent AFH and fast-food meals had higher BMI and lower concentrations of HDL-cholesterol; however, profiles of other biomarkers did not indicate higher metabolic risk, and serum concentrations of nutrients with mostly plant foods as sources declined with increasing AFH meal frequency.
Abstract: Away from home (AFH) meals are known to be energy-dense and of poor diet quality. Both direct and indirect exposure (for example, neighborhood restaurant density) to AFH meals have been implicated as contributors to higher body weight and adverse health outcomes. To examine the association of frequency of eating AFH and fast-food meals with biomarkers of chronic disease and dietary intake. This cross-sectional study used frequency of AFH and fast-food meal and biomarker data from the NHANES 2005–2010. Information on weekly frequency of AFH and fast-food meals was collected via questionnaire during the household interview. The metabolic biomarkers examined included body mass index (BMI), serum cholesterol (total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL)), triglycerides, glycohemoglobin and fasting glucose (n=8314, age⩾20, National Health and Nutrition Examination Surveys (NHANES) 2007–2010). Biomarkers of dietary exposure included serum concentrations of vitamins A, D, E, C, B-6, B-12, folate and carotenoids (n=4162; 2005–2006). Multiple linear and logistic regression methods adjusted for complex survey methodology and covariates. American adults reported a mean of 3.9 (95% confidence interval 3.7, 4.0) AFH and 1.8 (1.6, 1.9) fast-food meals/week. Over 50% of adults reported ⩾3 AFH and >35% reported ⩾2 fast-food meals/week. The mean BMI of more frequent AFH or fast-food meal reporters was higher (Ptrend⩽0.0004). Serum concentrations of total, LDL and HDL-cholesterol were related inversely with frequency of AFH meals (P<0.05). Frequencies of fast-food meals and serum HDL-cholesterol were also related inversely (P=0.0001). Serum concentrations of all examined micronutrients (except vitamin A and lycopene) declined with increasing frequency of AFH meals (P<0.05); women and ⩾50-year olds were at higher risk. Reporters of frequent AFH and fast-food meals had higher BMI and lower concentrations of HDL-cholesterol; however, profiles of other biomarkers did not indicate higher metabolic risk. However, the serum concentrations of nutrients with mostly plant foods as sources declined with increasing AFH meal frequency.

115 citations

Journal ArticleDOI
TL;DR: Higher frequency of FAFH was associated with higher BMI, after adjusting for age, income, education, race, smoking, marital status, and physical activity, and there was a negative association between frequency ofFAFH and FV consumption.
Abstract: Introduction. Consumption of foods prepared away from home (FAFH) has grown steadily since the 1970s. We examined the relationship between FAFH and body mass index (BMI) and fruit and vegetable (FV) consumption. Methods. Frequency of FAFH, daily FV intake, height and weight, and sociodemographic data were collected using a telephone survey in 2008-2009. Participants included a representative sample of 2,001 adult men and women (mean age years) residing in King County, WA, with an analytical sample of 1,570. Frequency of FAFH was categorized as 0-1, 2–4, or 5

110 citations

Journal ArticleDOI
TL;DR: Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress, and further evidence warning us against the irreparable effects of fast food consumption on public health.
Abstract: Background: There are growing concern globally regarding the alarming trend of fast food consump­tion and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa­bolic risk factors. Methods: Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Results: Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. Conclusion: 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.

100 citations


Cites background from "Fast food consumption in Iranian ad..."

  • ...2%).(19) Postprandial 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 signifi-...

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  • ...01) was observed among Iranian young adults.(19) In Mediterranean adults, the association of fast food con-...

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Journal ArticleDOI
TL;DR: It is hypothesized that diets with very different nutrient composition are able to change gut microbiome composition and metabolites in a very short period, and an animal fat-rich, low-fiber FF diet v. a high-fibre Med diet altered human gut microbiota composition and its metabolites after just 4 days.

63 citations

References
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Journal ArticleDOI
TL;DR: The authors consider the feasibility and potential implications of reducing or eliminating the consumption of trans fatty acids from partially hydrogenated vegetable oils in the United States.
Abstract: The intake of trans fat has been associated with coronary heart disease, sudden death from cardiac causes, and diabetes. This article reviews the evidence for physiological and cellular effects of trans fatty acids, unsaturated fatty acids with at least one double bond in the trans configuration. The authors consider the feasibility and potential implications of reducing or eliminating the consumption of trans fatty acids from partially hydrogenated vegetable oils in the United States.

1,582 citations

Journal ArticleDOI
TL;DR: Consumption of fast food among children in the United States seems to have an adverse effect on dietary quality in ways that plausibly could increase risk for obesity.
Abstract: Background. Fast food has become a prominent feature of the diet of children in the United States and, increasingly, throughout the world. However, few studies have examined the effects of fast-food consumption on any nutrition or health-related outcome. The aim of this study was to test the hypothesis that fast-food consumption adversely affects dietary factors linked to obesity risk. Methods. This study included 6212 children and adolescents 4 to 19 years old in the United States participating in the nationally representative Continuing Survey of Food Intake by Individuals conducted from 1994 to 1996 and the Supplemental Children’s Survey conducted in 1998. We examined the associations between fast-food consumption and measures of dietary quality using between-subject comparisons involving the whole cohort and within-subject comparisons involving 2080 individuals who ate fast food on one but not both survey days. Results. On a typical day, 30.3% of the total sample reported consuming fast food. Fast-food consumption was highly prevalent in both genders, all racial/ethnic groups, and all regions of the country. Controlling for socioeconomic and demographic variables, increased fast-food consumption was independently associated with male gender, older age, higher household incomes, non-Hispanic black race/ethnicity, and residing in the South. Children who ate fast food, compared with those who did not, consumed more total energy (187 kcal; 95% confidence interval [CI]: 109–265), more energy per gram of food (0.29 kcal/g; 95% CI: 0.25–0.33), more total fat (9 g; 95% CI: 5.0–13.0), more total carbohydrate (24 g; 95% CI: 12.6–35.4), more added sugars (26 g; 95% CI: 18.2–34.6), more sugar-sweetened beverages (228 g; 95% CI: 184–272), less fiber (−1.1 g; 95% CI: −1.8 to −0.4), less milk (−65 g; 95% CI: −95 to −30), and fewer fruits and nonstarchy vegetables (−45 g; 95% CI: -58.6 to −31.4). Very similar results were observed by using within-subject analyses in which subjects served as their own controls: that is, children ate more total energy and had poorer diet quality on days with, compared with without, fast food. Conclusion. Consumption of fast food among children in the United States seems to have an adverse effect on dietary quality in ways that plausibly could increase risk for obesity.

1,190 citations

Journal ArticleDOI
TL;DR: The FFQ developed for the TLGS has reasonable relative validity and reliability for nutrient intakes in Tehranian adults.
Abstract: Objective: To describe the relative validity and reliability of the FFQ used for assessing nutrient intakes of participants in the Tehran Lipid and Glucose Study (TLGS). Design: A total of 132 subjects (sixty-one males and seventy-one females) were included in the study. Dietary data were collected monthly by means of twelve 24h dietary recalls (24hDR). Subjects completed two, 168-item semi-quantitative FFQ. Blood and urine samples were taken every season for measurement of plasma biomarkers and urinary N and K. Results: Mean age and BMI of the participants were 35? 5( SD 16?8) years and 25? 5( SD 5?2) kg/m 2 , respectively. The mean energy-adjusted and deattenuated correlation coefficients for overall nutrient intake between the 24hDR and FFQ2 were 0?44 and 0?37 in #35-year-olds and .35-year-olds, respectively, and for individual nutrients ranged from 0?24 to 0?71 in men (mean r 50?53) and from 0?11 to 0?60 in women (mean r 50?39). The mean energy-adjusted reliability coefficients varied from 0?48 in #35-year-olds to 0?65 in .35-year-olds, and ranged from 0?41 to 0?79 in men (mean r 50?59) and from 0?39 to 0?74 in women (mean r 50?60). The FFQ2 and 24hDR produced exact agreement rates ranging between 39?6% and 68?3% in men and between 39?6% and 54?1% in women. The ranges of questionnaire validity coefficients, with the sample correlation between the questionnaires and biochemical marker as the lower limit and the estimate obtained by the method of triads as the upper limit, were 0?21‐0?56 (protein) and 0?37‐0?61 (K). Conclusions: The FFQ developed for the TLGS has reasonable relative validity and reliability for nutrient intakes in Tehranian adults.

809 citations

Journal ArticleDOI
TL;DR: Adults and children who reported eating fast food had higher intake of energy, fat, saturated fat, sodium, carbonated soft drink, and lower intake of vitamins A and C, milk, fruits and vegetables than those who did not reported eatingfast food.
Abstract: Objective To examine the dietary profile associated with fast-food use. To compare the dietary intake of individuals on the day that they ate fast food with the day that fast food was not eaten. Design Cross-sectional study design. The dietary intake of individuals who reported eating fast food on one or both survey days was compared with those who did not report eating fast food. Among the individuals who reported eating fast food, dietary intake on the day when fast food was eaten was compared with the day when fast food was not eaten. Weighted comparison of mean intakes and pairwise t-test were used in the statistical analysis. Subjects/setting Data from 17,370 adults and children who participated in the 1994-1996 and 1998 Continuing Survey of Food Intakes by Individuals. Dietary intake data were collected by 2 non-consecutive 24-hour dietary recalls. Results Fast-food use was reported by 37% of the adults and 42% of the children. Adults and children who reported eating fast food had higher intake of energy, fat, saturated fat, sodium, carbonated soft drink, and lower intake of vitamins A and C, milk, fruits and vegetables than those who did not reported eating fast food ( P Conclusions Consumers should be aware that consumption of high-fat fast food may contribute to higher energy and fat intake, and lower intake of healthful nutrients.

795 citations

Journal ArticleDOI
TL;DR: Recommendation to increase whole-grain intake may reduce the risk of developing the metabolic syndrome and dietary glycemic index, largely attributed to the cereal fiber, is inversely associated with HOMA-IR and a lower prevalence of the metabolic Syndrome.
Abstract: OBJECTIVE —The aim of this study was to examine the relation between carbohydrate-related dietary factors, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. RESEARCH DESIGN AND METHODS —We examined cross-sectional associations between carbohydrate-related dietary factors, insulin resistance, and the prevalence of the metabolic syndrome in 2,834 subjects at the fifth examination (1991–1995) of the Framingham Offspring Study. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the following formula (fasting plasma insulin × plasma glucose)/22.5. The metabolic syndrome was defined using the National Cholesterol Education Program criteria. RESULTS —After adjustment for potential confounding variables, intakes of total dietary fiber, cereal fiber, fruit fiber, and whole grains were inversely associated, whereas glycemic index and glycemic load were positively associated with HOMA-IR. The prevalence of the metabolic syndrome was significantly lower among those in the highest quintile of cereal fiber (odds ratio [OR] 0.62; 95% CI 0.45–0.86) and whole-grain (0.67; 0.48–0.91) intakes relative to those in the lowest quintile category after adjustment for confounding lifestyle and dietary factors. Conversely, the prevalence of the metabolic syndrome was significantly higher among individuals in the highest relative to the lowest quintile category of glycemic index (1.41; 1.04–1.91). Total carbohydrate, dietary fiber, fruit fiber, vegetable fiber, legume fiber, glycemic load, and refined grain intakes were not associated with prevalence of the metabolic syndrome. CONCLUSIONS —Whole-grain intake, largely attributed to the cereal fiber, is inversely associated with HOMA-IR and a lower prevalence of the metabolic syndrome. Dietary glycemic index is positively associated with HOMA-IR and prevalence of the metabolic syndrome. Given that both a high cereal fiber content and lower glycemic index are attributes of whole-grain foods, recommendation to increase whole-grain intake may reduce the risk of developing the metabolic syndrome.

790 citations