Monday, July 09, 2012

Fast Westernized Food, Not Fitness or Weight, Increases Diabetes and Heart Disease Risk

What cool data.

Researchers from the Universities of Minnesota, Singapore and Pittsburgh joined together to explore the impact of westernized eating on the incidence of type 2 diabetes and fatal heart attacks in Chinese Singaporeans between the years 1993-1998.

It was a unique study population in that the authors report that western-style fast food intake in east and southeast Asia only became somewhat prominent in the very late 80s and early 90s.  The authors also had data on the subjects' age, smoking habits, alcohol, education, BMI, total caloric intake, exercise and sleep duration.

The final analysis involved 43,176 participants and self-reported incidence of type 2 diabetes and death from coronary heart disease were scored against fast food intake (derived from a food frequency questionnaire specifically designed to discern between western style fast food and traditional Asian fast food) and controlled for those variables listed above.

Individuals who reported eating western style fast food more than twice weekly had a 27% increased risk of developing type 2 diabetes and a 56% increased risk of a fatal heart attack compared with those who reported not eating western style fast food. Things were worse for those who reported eating western style fast food more than 4x weekly with their risk of fatal heart attack being increased by 80%.

But that's not the fascinating part, this is. Not only were those risks independent of the various potential confounding controls, but according to the authors and contrary to what you might expect, participants who reported more frequent westernized fast food were younger, less likely to be hypertensive, more educated, smoked less and were more likely to be physically active - and those behaviours still didn't protect them from the risks of junk food.

Now of course there are real and dramatic limitations to this study with the two largest being that food frequency questionnaires stink as a whole and in this case were only administered once and that self reported diabetes rates may miss many who had diabetes at the outset of the study. That said, if these results are valid it would suggest that the denormalization of restaurants and processed convenience foods and the renormalizing of our kitchens and true whole ingredient transformative cooking are important public health targets - independent of any concerns or interventions geared to tackle obesity. 

Fast food's bad for everyone, regardless of their weights.  This week, if it's not something you do regularly, how about one from scratch homemade meal?

[Free PDF of the paper by clicking here]

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  1. I love this article (and your blog)...but as someone who cooks virtually everything my family eats "from scratch" (that means no boxes, although I do use canned tomatoes and pumpkin, plus some frozen vegetables) -- I always find your calls to action to cook ONE meal from scratch this week very intriguing. What's the data on how many people are eating prepared food / restaurant food for virtually every meal? Are people really eating take-out/prepared/restaurant food every single day for nearly every meal?

    1. Anonymous9:42 am

      I can answer that question - the answer is yes - I used to have "help" from a packet (be it noodles and sauce or hamburger helper or a tin of spaghetti sauce) for virtually every meal I cooked at home (breakfast may have been an exception but was rarely eaten at home - usually a drive through bagel and coffee). I don't even have a good reason why I ate out and cooked from boxes so much - I could say that it is because I live alone except that cooking from a box gives me just as many left overs as cooking from scratch does. Cooking from scratch is not that much harder and tastes so much better.

      Why did I change? Partly from reading this blog, partly from being tired of feeling bloated and yucky after most meals and actually craving something that tasted like "mom used to make". Now armed with real health reasons to change my habits and a heat sealer I am a full convert. I make my own frozen diners and heat seal them into individual portions so I always have quick, healthy meals on hand. I keep real food in the fridge and I buy spices instead of boxes.

      I still have many friends who live the way I used to. I realize this is purely anecdotal, but I am reasonably confident that if a study were done and people answered honestly that you would be surprised by the results.

    2. Have seen data to suggest North American average on the order of one meal out a day and that purchases of processed foods for at home use have doubled since 1982.

      I think people need a starting point and to suggest everyone should always cook from scratch is unrealistic for most (including for my family) and probably foreboding for all.

    3. I did not mean to suggest that everyone should make everything from scratch (although I'm not certain that's what your response is saying!)

  2. The problem i have with this is, what exactly is it they mean by fast food? You can by baked potato, salad, grilled chicken etc. Studies like this need to be more specific in those regards in my opinion. Most likely is the deep fried foods & not say the meats & breads. Not to say we should be including people to rest at these places but people will do let's show them that worse choices have benefits.

    1. Better choices, not worse..... problem with typing on a smart phone always auto correcting

  3. There are studies suggesting that the average american eats out 4-5 times a week.

  4. Anonymous10:33 am

    Cool reporting. Is it slanderous to suggest that the largest restaurant company in the US is also likely the largest culprit of childhood obesity? Their karmic payback should be to filter 20% of their profits into CON.

    1. Anonymous11:01 am

      I understand the point but said largest restaurant is not forcing people into their establishments at gunpoint.

      The kids are eating too much crappy food because their parents are buying it. 5 year olds don't pull up to the drive-thru, adults do.

      I've heard parents say, 'But Timmy screams if he sees a ___ and I don't get him some fries!" that may be started by marketing, but it is ended by parenting.

      If people don't want the government telling them how to raise their children, they can't look elsewhere for a scapegoat when junior is a chubby brat.

    2. Alexie5:37 pm

      Blaming the parents is very easy, but fast food is so ubiquitous it's hard for a parent to keep it away. Apart from the relentless advertising to children so that they nag their parents (it's called 'pester power' by advertising executives and it's very effective on harassed parents). Junk food advertising is worth billions of dollars and no company would pay the money if it didn't work. Ad agencies have vast amounts of potent psychological data to draw upon to construct their messages.

      Even if parents can resist, there is junk food at school. Junk food at other kids' houses. Junk food everywhere.

  5. This is really interesting. For years, I've thought that maintaining at least a moderate level of fitness - walking briskly for half an hour a day, as a minimum - was the key to good health, with both BMI and diet hugely overrated as risk factors. However, I enjoy cooking and have always eaten a balanced diet of mostly whole foods (with occasional treats, of course). I always considered myself a food snob more than a "healthy eater."

    Maybe diet matters more than I thought.

    On the other hand, it's important to note that there IS a safe level of fast food consumption. You just don't want to have it more than once a week. I also suspect that not all 'junk food' is created equal - and that the amount of it you eat and what you eat it with is key.