Fast food refers to food that can be
served ready to eat. The terms fast food and junk food are often used
interchangeably. Most of the junk foods are fast foods as they are
prepared and served fast, but not all fast foods are junk foods,
especially when they are prepared with nutritious contents [1]. The
definitions of various food items are described in Table I.
Table I
Definitions Related to Fast Foods
Type of Food |
Definition |
Examples |
Fast food |
Foods sold in a restaurant or store which |
Burgers, pizzas, fries, hamburgers, patties, nuggets. |
|
are rapidly prepared and quickly served |
Indian foods like pakora, samosa, namkeen etc. |
|
in a
packaged form for take away |
|
Junk food |
Energy dense foods with high sugar/ fat/ salt |
Chips, chocolate, icecream, soft drinks, burgers, pizzas |
|
content and low nutrient value in terms of |
etc. |
|
protein,
fiber, vitamin and mineral content. |
|
Instant foods |
Foods that undergo special processing that |
Noodles, corn flakes, soup powder. |
|
are ready to be served once dissolved or |
|
|
dispersed
in a liquid with low cooking time |
|
Street foods |
Ready to eat foods and beverages prepared and |
Chaat, gol guppa, samosa, tikki, noodles, chowmein, |
|
sold by hawkers or vendors in streets or other |
burgers etc |
|
public
places |
|
Fast food culture is an emerging trend among the
younger generation. The ready availability, taste, low cost, marketing
strategies and peer pressure make them popular with children and
adolescents. Fast food restaurants are primed to maximize the speed,
efficiency and conformity. The menu is kept limited and standardized
essentially to minimize the waiting time so that the customers eat quickly
and leave. This perspective delineates the emerging fast food culture in
India, its impact on children and strategies to counter it.
Fast Food Promotion
Fast food sale is promoted among children through
sponsorship of sports or cultural competitions with attractive free gifts.
The sponsors offer discounts on purchase of their brand of fast food. Film
celebrities and sports stars are often involved for marketing their
products. Fast foods are marketed to children through television
advertisements by use of animation and favorite cartoon characters [2].
Television advertisement has an important role in promoting unhealthy
dietary practices among children, including diets which are high in fat,
sodium or added sugar [3]. Apart from advertising through television,
other media like newspaper, magazines, billboards, radio and cinemas are
also used for marketing [4].
Factors Related to Fast Food Consumption
Fast food chains are gaining popularity with nuclear
families as working parents have less time for meal preparation at home.
The vast majority of working parents with school going children are
labored with exhausting commutes, other household chores and stress. While
their children spend most of their time away from home by attending
tuition classes after their school hours or engaged in recreational
activity.
For children skipping breakfast at home, fast food
comes handy in school. A positive correlation of increased fast food
consumption, skipped breakfasts and increased body mass index was found
among adolescents [5]. Socio economic status is an important factor
related to fast food consumption among children. In a study conducted in
Hyderabad, children from high socio-economic status preferred fast foods
to traditional foods despite their better nutritional knowledge [6].
Proximity of fast food joints to households could also predispose to
increased consumption.
Fast Foods and School
Junk foods are widely available in schools through
variety of outlets. Cafeterias at the schools offer sodas, cold drinks,
chips and many other foods of low nutritional value. Sale of junk foods in
school cafeteria often competes with more nutritious school lunch schemes.
Most of western countries and few schools in India have banned the sale of
junk foods in the school cafeteria. Akshaypatra foundation, a
nongovernmental organization in India has introduced school mid-day meal
programs in government aided schools, where healthy Indian foods are
offered to children [7].
In United Kingdom and many European countries, all
commercial activities in primary schools are restricted as per the
directive of Union of European Beverages Association (UNESDA). According
to these, secondary school students may be offered full range of beverages
including water, 100% juice, sports drink, and low calorie drinks in
different portion sizes in active participation with educators and parents
[8]. However, there is lack of stringent laws and regulation pertaining to
fast food sale in Indian schools.
Indian Fast Foods
India has rich heritage of foods and recipes. Popular
north Indian fast foods include aloo tikki, bhel puri,
chaat, pakora, chole bhature, pav bhaji,
dhokla, samosa and pani puri. Calorie and fat content in
Indian fast food depends on the cooking method. Most of Indian fast foods
are prepared by deep frying in fats especially trans fat and saturated
fats [9]. Foods which are baked, roasted or cooked in tandoor have
lower fat content.
Hydrogenated oil used in Indian cooking are rich in
trans fats and have been replaced in many restaurants by refined vegetable
oil. Trans fat content in Indian fast food are far higher than western
foods. Trans fat content in bhatura, parantha and puris is
9.5%, 7.8% and 7.6%, respectively as compared to 4.2% in regular French
fries [10]. South Indian foods like idli and uthappam are
better as they are rich in carbohydrates and proteins rather than fat.
Consequences of Excessive Fast Food Consumption
Consumption of diet high in sugar, saturated fat, salt
and calorie content in children can lead to early development of obesity,
hypertension, dyslipidemia and impaired glucose tolerance [10]. The
concerns with fast food consumption in developing countries also include
poor hygiene during preparation storage and handling leading to
microbiological contamination.
Fast foods have high level of fat and sugars that are
not only unhealthy but addictive and that creates a vicious cycle making
it hard for children to choose healthy food. High content of trans fat in
commercially available fast foods predispose children to risk of future
heart diseases [12]. Energy density of fast food is more than twice the
recommended daily allowance for children [13]. Fast food intake leads to
higher proportion of calories being derived from total and saturated fat
[14]. Moreover, the micronutrient content (carotene, vitamin A, vitamin C)
of the fast food is also low [15]. Low levels of calcium and magnesium in
the diet can contribute to osteoporosis. Diets rich in free sugars can
lead to increased risk of dental caries.
Junk foods often contain colors that are inedible,
carcinogenic and harmful to the body. Food coloring may result in
hyperactivity and lapses of concentration in children. Poor nutritional
habits can undermine these pre-requisites of learning, as well as decrease
the strength that children need for making friends, interacting with
family, participating in sports and games or simply feeling good about
themselves.
Fast food consumption and globalization of diet has
lead to loss of traditional healthy food practices. One of the
consequences of ready availability of cheap food outside the home is
devaluation of cooking skills.
Strategies to Reduce the Trend of Fast Food
Considering the burden of non communicable diseases
among adults and its origin to childhood dietary habits, fast food
consumption needs to be curtailed among children and adolescents.
Strategies for healthy food intake include availability of healthy
standard foods, information campaigns and surveillance of diets and
disease burden. Health education and school based intervention programs
can improve the dietary pattern of children [16].
Price reduction is one of the most effective strategies
to increase the purchase of healthy foods among children and adolescents
[17]. Price reduction on low fat snacks (fresh fruits and salad) and
placement of low fat label were associated with significant increase in
their consumption among adolescent population [18]. In a study by Powell,
et al., it was observed that a 10% increase in the cost of fast
food meal led to 3% increase in consumption of fruits and vegetables [20].
Healthy lifestyle and eating among children and
adolescents should be presented through televisions, newspapers and
effective school education campaigns. Children should be encouraged to
consume foods with high nutritious value like food grains, pulses,
legumes, fruits and vegetables. In developing country like India where
poverty still prevails in major part of country, government has taken
measure to liberalize the international trade to reduce the cost of food
grains. However, trade liberalization has led to massive infiltration of
Indian market with fast food joints. Imposing heavy tax on imported and
manufactured readymade food items might control this encroachment.
Nutritional Labeling
Nutritional labeling refers to disclosure of
nutritional content (calories, added sugar, total fat, Trans fat,
saturated fat, sodium and protein content) in product labels. Nutritional
value should be provided in menu, menu boards, food wrappers and
containers in fast food restaurant. This might restrict the quantity and
choice of food among children of educated parents.
In a recent study conducted on parents of children aged
3-6 years, it was observed that parents who were offered the nutritional
value menu card ordered food of lesser calorie [20]. However in a study by
Yamamota et al., it was observed that provision of nutritional
value did not modify the food ordering behavior among the enrolled
adolescents [21]. It has been often debated that labeling might result in
financial loss to fast food industry, but it has been shown that
restaurants which project lower fat menu have a better customer
satisfaction [22].
Regulation of Marketing
International bodies which regulate the media
advertisements include confederation of food and drink industries of
Europe (CIAA) and Union of European beverages association (UNESDA). CIAA
is a body governing the food and drink sector in Europe. It facilitates
the development of an environment where all the European food and drink
companies can meet the needs of consumers and society [23]. It has laid
down principles for food and beverage product advertisement. The key
features of CIAA principles include: advertisement should depict size,
content, nutritious and health benefits; nutritious benefits must provide
scientific basis; should not encourage excessive consumption or large
portion size; it should not undermine the promotion of healthy lifestyle
and balanced diet [24].
Union of European beverages association (UNESDA), in
addition has laid down guidelines to restrict marketing communication to
be placed in printed media, web sites, or programs aimed at children. It
directs not to directly appeal to children to persuade parents to buy
their products, nor should the promotional activities encourage children
to consume larger quantities for participation [8].
In India, media advertisement and publicity is under
the control of ministry of information and broadcasting (Government of
India). A committee has been set up by the ministry to review the
complaints, decide whether the advertisement violates the rules and issue
a notice to TV channels in case of violation. Media rules and regulation
are set in India cable television network act 1994 and advertising
standard council of India (ASCI) [24]. Guidelines related to quality of
food products advertised in Indian media should be urgently formulated.
Some suggestions related to encouraging healthy food habits and decreasing
unhealthy fast foods consumption are outlined in Box.
Conclusions
Fast foods have become an important part of dietary
menu for most children and adolescents. Children are lured by convincing
marketing strategies and peer pressure. Consumption of diet high in sugar,
saturated fat, salt and calorie content in childhood can lead to early
development of obesity and cardiovascular diseases. Fast food intake among
children can be reduced by implementation of stringent laws to regulate
the marketing of fast foods in Indian market. Nutritional labeling of food
might restrict the quantity of food ordered and choice of low fat menu
among children of educated parents. Promotion of healthy eating habits and
education about junk foods needs to be strengthened.
Box: Promoting Healthy Food Intake In Children
-
Child
should be offered with a plate filled with plenty of brightly
colored vegetables, fruits and sprouts.
-
Ice-cream, chocolates and other heavy desserts can be replaced by
low fat fresh yogurt.
-
Fresh
lime juice, coconut water and fresh fruit juices should be
preferred to sodas and soft drinks as beverages.
-
Prefer
grilled fresh sandwiches to fried ones. Similarly, when choosing
the meat or poultry select baked, broiled, grilled items rather
than fried ones.
-
Avoid
giving chocolate bars as gifts or reward to the children for their
good habits or academic achievements.
-
Limit
the portion size of the food ordered. Regular size meal may be
opted against ‘mega meal offer’ or ‘combo meal offer’.
-
While
eating away from home, avoid opting for dishes with rich creamy
layers and lots of spices.
-
Replace
naan with tandoori roti as low fat option breads in
Indian menu.
-
Dishes
can be stir fried rather than deep fry to decrease the fat
content.
-
Dough
used for preparing poori/pakoras should be thick and
avoid using ghee or oil for making the dough as this might
increase oil absorption.
|
Contributions: JK, MN and AP: Literature searches,
writing of the manuscript. MN: conceptualized the idea and approved the
final version. JK would act as the guarantor.
Funding: None.
Competing interests: None stated.
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