Relationship between unhealthy food consumption and sedentary behaviors is well described in literature. Relationship with BMI was also described. Few doubts arise around the question whether normal weight healthy children, that showed to be more exposed to junk food consumption than overweight and obese children are at risk in adulthood for metabolic or dyslipidemic syndrome, or simply at risk for BMI increase.
Has someone knowledge about the evidence to support such information?
The issue is a complex one, and as I will suggest below, we cannot casually assume that the perceived relationship between fast food consumption and overweight/obesity is primarily due to fast food consumption in and of itself, and recent data in fact suggests that it is not; only when we appreciate this, can we tackle the underlying etiology of overweight/obesity, and implement effective and properly targeted public health interventions for reducing the causal forces in play.
To understand this, it is important to recognized that until late (Jan, 2014) in the study of the health effects of fast food consumption, a core unanswered question has been whether associations of fast food consumption with total diet and overweight/obesity are actually attributable specifically to foods consumed from fast food restaurants or to poor dietary choices at other times. This recognizes a confounder in virtually all studies in this domain, namely that fast food consumption might not be directly associated with increased energy intake and weight gain, but rather might be a surrogate marker for other unhealthy behaviors associated with these outcomes [1]. Otherwise if studies do not control for confounding by food choices outside the fast food restaurant, then associations between fast food consumption on the one hand and overweight/obesity might be overestimated [2].
But finally, the recent (Jan, 2014) UNC study [3] compared the independent associations of fast food consumption for overweight/obesity or dietary outcomes, with dietary pattern for the remainder of intake (the "diet remainder"), to determine whether obesity and the poor dietary outcomes linked with fast food consumption are more strongly associated with the actual fast food or the remainder of diet. The UNC study set out to answer this question for the first time, using nationally representative sample, finding that both low and high fast food consumers ate less healthfully outside the fast food restaurant and were 1.5 (low fast food consumers) and 2.2 (fast food consumers) times as likely to consume a Western dietary pattern for the remainder of diet, compared with nonconsumers. This shows that it is the remainder of the diet, but not fast food in and of itself, that was associated with overweight/obesity; indeed, the diet outside the fast food restaurant had a stronger relation with poor dietary outcomes than did fast food consumption itself.
These breakthrough findings are confirmative with previous studies that used within-person analysis [2;4,5,6] that found that high fast food consumption was associated with poor dietary outcomes, even after adjustment for Western diet for the remainder of intake. Of the two associations: (1) between fast food and poor diet, and (2) between consuming a Western diet outside the fast food restaurant and poor dietary outcomes, the second association (2) was significantly stronger than the first.
These lines of evidence converge to clearly suggest:
(1) that fast food consumers in general exhibit less healthy dietary patterns outside the fast food restaurant; and
(2) that a Western dietary pattern for the remainder of intake is more strongly associated with overweight/obesity than fast food consumption itself.
REFERENCES
1. Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev 2008;9:535–47.
2. Mancino L, Todd J, Guthrie J, Lin B-H. How food away from home affects childrenaposs diet quality. Washington, DC: US Department of Agriculture, Economic Research Service, 2010. (Economic Research Report Number 104.).
3. Poti JM, Duffey KJ, Popkin BM. The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet? Am J Clin Nutr 2014; 99(1):162-71.
4. Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. Arch Pediatr Adolesc Med 2012;167:14–20.
5. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics 2004;113:112–8.
6. Paeratakul S, Ferdinand DP, Champagne CM, Ryan DH, Bray GA. Fast-food consumption among US adults and children: dietary and nutrient intake profile. J Am Diet Assoc 2003;103:1332–8.
The issue is a complex one, and as I will suggest below, we cannot casually assume that the perceived relationship between fast food consumption and overweight/obesity is primarily due to fast food consumption in and of itself, and recent data in fact suggests that it is not; only when we appreciate this, can we tackle the underlying etiology of overweight/obesity, and implement effective and properly targeted public health interventions for reducing the causal forces in play.
To understand this, it is important to recognized that until late (Jan, 2014) in the study of the health effects of fast food consumption, a core unanswered question has been whether associations of fast food consumption with total diet and overweight/obesity are actually attributable specifically to foods consumed from fast food restaurants or to poor dietary choices at other times. This recognizes a confounder in virtually all studies in this domain, namely that fast food consumption might not be directly associated with increased energy intake and weight gain, but rather might be a surrogate marker for other unhealthy behaviors associated with these outcomes [1]. Otherwise if studies do not control for confounding by food choices outside the fast food restaurant, then associations between fast food consumption on the one hand and overweight/obesity might be overestimated [2].
But finally, the recent (Jan, 2014) UNC study [3] compared the independent associations of fast food consumption for overweight/obesity or dietary outcomes, with dietary pattern for the remainder of intake (the "diet remainder"), to determine whether obesity and the poor dietary outcomes linked with fast food consumption are more strongly associated with the actual fast food or the remainder of diet. The UNC study set out to answer this question for the first time, using nationally representative sample, finding that both low and high fast food consumers ate less healthfully outside the fast food restaurant and were 1.5 (low fast food consumers) and 2.2 (fast food consumers) times as likely to consume a Western dietary pattern for the remainder of diet, compared with nonconsumers. This shows that it is the remainder of the diet, but not fast food in and of itself, that was associated with overweight/obesity; indeed, the diet outside the fast food restaurant had a stronger relation with poor dietary outcomes than did fast food consumption itself.
These breakthrough findings are confirmative with previous studies that used within-person analysis [2;4,5,6] that found that high fast food consumption was associated with poor dietary outcomes, even after adjustment for Western diet for the remainder of intake. Of the two associations: (1) between fast food and poor diet, and (2) between consuming a Western diet outside the fast food restaurant and poor dietary outcomes, the second association (2) was significantly stronger than the first.
These lines of evidence converge to clearly suggest:
(1) that fast food consumers in general exhibit less healthy dietary patterns outside the fast food restaurant; and
(2) that a Western dietary pattern for the remainder of intake is more strongly associated with overweight/obesity than fast food consumption itself.
REFERENCES
1. Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev 2008;9:535–47.
2. Mancino L, Todd J, Guthrie J, Lin B-H. How food away from home affects childrenaposs diet quality. Washington, DC: US Department of Agriculture, Economic Research Service, 2010. (Economic Research Report Number 104.).
3. Poti JM, Duffey KJ, Popkin BM. The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet? Am J Clin Nutr 2014; 99(1):162-71.
4. Powell LM, Nguyen BT. Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. Arch Pediatr Adolesc Med 2012;167:14–20.
5. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics 2004;113:112–8.
6. Paeratakul S, Ferdinand DP, Champagne CM, Ryan DH, Bray GA. Fast-food consumption among US adults and children: dietary and nutrient intake profile. J Am Diet Assoc 2003;103:1332–8.
That is a very well referenced answer I really appreciate.
Thanks a lot.