Fast food addiction – The junk enslavement

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P)Original Research Article ISSN: 2394-0034 (O)Fast food addiction – The junk enslavementBalaji Arumugam1*, Suganya A2, Saranya Nagalingam2, Suveka V21Associate Professor, Department of Community Medicine, Tagore Medical College and Hospital, Chennai, India 2MBBS Student, ACS Medical College and Hospital, Chennai, India *Corresponding author email: [email protected] to cite this article: Balaji Arumugam, Suganya A, Saranya Nagalingam, Suveka V. Fast foodaddiction – The junk enslavement. IAIM, 2015; 2(1): 62-70. Available online at www.iaimjournal.comReceived on: 24-12-2014 Accepted on: 30-12-2014AbstractResearch question: What extent do we crave for fast foods?Background: Fast foods are consumed in larger quantities intended with persistent desire or futileefforts to minimise or to cease the intake of these items; hence it is called as “FAST FOODADDICTION”. Nowadays, there is an uncontrollable craving for excess of quick foods that has lead tosignificant life style modifications in the society regardless of the age group. In spite of quantum ofthis problem, there are very few studies from India investigating the addiction towards fast foods.Material and methods: This study was done as a community based cross sectional study at theoutskirts of Chennai, India during November 2013 to January 2014 with the objectives of assessingthe prevalence and its risk factors of the quick food addiction among adults. Individuals of adult agegroup were randomly selected and the data’s were collected using direct questionnaire method withproper informed consent. The data was entered in MS excel sheet and analysis was done using SPSSsoftware.Results: Total 541 study participants were interviewed of which 58.8% were males with the meanage of 26 years. Among the study population 82.8% belonged to nuclear family and 65.1% were fromclass I socioeconomic status. The prevalence of quick food addiction was 30% (160). About 49.2% ofpeople liked KFC as their favourite quick food place. Fast food addiction was significantly associatedwith male gender (p=0.02), professionals (p=0.000), unmarried (p=0.000), who enjoys quick food(p=0.014), KFC (p=0.003).Conclusion: The prevalence of fast food addiction among adult population in our study wasmoderately high and hence interventions should be made to create cognizance among the generalpopulation about the risk factors and consequences in consuming large amount of fast foods.Key wordsFast food, Fast food addiction, Quick food, Junk food, Quick service industry, Fast food eateries.International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 62Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)Introduction ObjectivesFast foods are consumed in larger quantities • To assess the prevalence of fast foodintended with persistent desire or futile efforts addiction among adult population.to minimise or to cease the intake of theseitems; hence it is called as “FAST FOOD • To find out the factors associated withADDICTION”. Universally, consumption of fast fast food addiction.foods has become as an ineluctable part of ourdaily lives in spite of the cognizance of its Material and methodshazards. In India, Industrialization plays a majorrole in the process of manufacturing fast food This study was done as a community based crossaddicts. Additionally, increased subjection of sectional study among adult population residingfast food restaurants in the vicinage and in and around the areas of Poonamallee atappealing home delivery systems has brought a Chennai, India in between November 2013 todrastic life style modification among all the January - 2014. House to house to survey wasindividuals irrespective of their ages. Consumers done in the areas selected randomly around thehave redesigned their modern scullery with Poonamallee taluka. These areas were selectedmenu items of quick – service industry, which by simple random sampling method from theacts as a time saving agent in this fast – paced existing list of areas and the houses werelife and over – scheduled duties. Hence these surveyed randomly. The persons aged 18 yearsfoods are also known as “QUICK FOODS”. These and above were selected for the study afteralternatives to home – cooked foods also have a getting informed consent. The purpose of thebrighter side like Time saving, cost effective in study was completely explained to the partakerscase of an individual, Ready-made food being and strict confidentiality was ensured. Dataserved fast and right in front of us is like a collection was done by questionnaire and directblessing after a hard day's work, modern interview method using a standardizedinvention for hangouts with peer groups and a questionnaire. The questionnaire includeswide assortment of fast food styles lets you general socio demographic profiles, fast foodexperience foods from various cultures so that habits, favourite food items and restaurants,you can explore different tastes. Citing a few frequency of intake and risk factors like maritalpoints about the advantages of fast food does status, socio economic status, opinion about fastnot mean that we are denying its dark side food, addiction scale questionnaire (Yale’s Foodwhich are very hazardous. Though, fast food addiction scale questionnaire) [1, 2, 3]. Theeateries strides to offer a healthier menu, these questionnaire was validated by Yale Universityfast foods are rich in saturated fat, salt, sugar by Gearhardt, et al. and concluded that YFASand calories which act as a major contributing scale is a sound tool in identifying eatingrole in developing obesity, cardio- vascular patterns and also behaviours related to fooddiseases, and hypertensive disorders. In spite of addiction [4]. Fast food addiction was assessedquantum of this problem, there are very few using this simplified version of 9 itemstudies from India investigating the addiction questionnaire which included nine questions,towards fast foods. Based on this perspective, based on which scoring was given and scoresthis study was conducted to assess the with 3 and above for first 7 questions and yesprevalence and risk factors associated with fast for the questions 8 or 9. Those scoring 4 andfood addiction among adults. above were considered to have had fast foodInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 63Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)addiction and the remaining were not. The data Addictive behaviorswere entered in MS excel sheet and analyzed Fast food addiction was self accepted by 37%using SPSS software – 17 and non parametric (200) of the study participants whereastest was used for assessing the test of according to the Yale’s questionnaire thesignificance. prevalence of fast food addiction was 30% (160), of which most of them were males,Results professionals, higher socioeconomic status, unmarried, from nuclear family, living in urbanSocio-demographic profile area than rural areas, and non-vegetarian eatingOut of total 541 study participants, 86.9% (470) population as per Table - 1 and Chart – 1.were from urban area and remaining 13.1% (71) Effects (fast food addiction scale)were from rural area. In both urban slum and The fast foods underwent the evolutionaryrural areas, the male gender constituted 58.8% change from “Requirement (Hunger) to Taste(318) and 41.2% (223) were constituted by addiction”, which our study identified 17.6% offemales. The mean age of the study population the study participants’ consumed fast foods twowas 26 years with the range of 18 to 45 years. to three times per week though they were noMajority of the study participants 76% (411) longer hunger. As the awareness about thewere professionals and 65.1% (352) of the study harmful effects of fast foods revolves around theparticipants belonged to socio- economic class I. community, people tries to avoid consuming fastApproximately 72.3% (385) were unmarried and foods yet, 114 adults (21.1%) and 31 adultsseparated, whereas 27.7% (150) were married (5.7%) worry about cutting down fast foods twoas per Table – 1. to three times per week and four or more timesEating pattern per week respectively. Sluggishness and fatigueAmong the study participants 80.4% were are effects of overeating fast foods which wasusually enjoyed the fast food and 50 to 60% of 22.6% (122) among the study participants. Wethem responded that their favorite fast food were also startled to know that 32 (5.9%) of theshop is KFC restaurant followed by Dominos and participants were interested in spending theirMc Donalds. Only 10.4% of them replied that time in eating quick foods at least two to threethey like road side shops. Frequency of eating times a week rather than spending time withfast food was almost every day by 2% of the family, friends, work or recreation. We definestudy population, whereas 20% of them certain partaker as fast food addicts as they areanswered that at least once a week. Surprisingly subjected physical outcomes like agitation and10% of the study population thinks that fast anxiety when they cut down fast foods whichfoods are healthy to them and that’s why they were 22.9% (124) in this study. Significanteat them more. When they were asked about distress was found in 23.7% (128) for two tothe opinion on fast food meals majority 46% said three times a week. About 123 (22.7%), two tothat it is delicious followed by easy take away, three times per week felt that their issueshygienic, Around 3% of the study population felt related to food and eating decreases their abilitythat fast foods are unhygienic and unhealthy to function effectively (Example: Daily routine,whereas 60% want more fast food shops in job/school, social or family activities, healthChennai as per Table – 1. difficulties). 45.7% (247) of the partakers kept consuming the same amount of food despite significant emotional and or physical problemsInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 64Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)related to their eating and 52.5%(284) told that Our study showed males gender, professionals,eating the same amount of food doesn’t reduce unmarried persons, increased frequency ofnegative emotions or increase pleasurable eating fast food were significantly associatedfeelings the way it used to as per Table – 2. with fast food addiction. Similarly a study done by Farzan Yahya et al. [8] demonstrated higherAnalysis socioeconomic status, higher education wereThere are some significant factors associated associated with increased likeness towards fastwith fast food addiction which was analysed food. Fast food addiction was significantly highusing chi square test. The factors are: in our country compared to our neighborhood• Male gender (p=0.022) country Pakistan which showed 21% of them self• Professionals (p=0.000) agreed that they were addicted to fast food• Unmarried (p=0.000) which is a growing concern in developing• Who enjoys fast food (p=0.014) countries. Similarly study done in Canada among• Favourite fast food place (p=0.003) 652 adults, the overall prevalence of food• More frequency of eating fast food addiction was 5.4% and significantly more in(p=0.000) female population and increased with obesity [9]. In contrast to this, our study showed thatDiscussion males are more significantly associated with fast food addiction than females and there was noOur study had explored that fast food addiction correlation with BMI and fast food addiction. Inwas moderately high in this study population, no addition to this, studies like Merlo, et al. [10]such large scale studies were done especially on and Gearhardt, et al. [4] showed that thefast food addiction in India. According to a study prevalence of food addiction was 15.2% inconducted Guthrie, et al. in USA on food intake children and 11.4% in adults using YFAS butby individuals showed that compared to 1953 Gearhardt, et al. supported our study with thethere were 8 times more sales of food outside result of normal weight adults has got fast foodthe home by 1997 and fast food expenditure addiction equal to obese individuals. So towas doubled to 40% by 1995. But as a conclude, as developing countries already facingpercentage of total energy intake, fast food 5 the health problems like increasing trends oftimes increased from 2% in the 1970s to 10% in non communicable diseases of which the major1995 [5]. One-third of US adults report having risk factor is obesity. Our concern is that theeaten at a fast food outlet on any given day; 7% trend of fast food eating pattern and obesity andof Americans eat at a fast food restaurant daily other risk factors goes hand in hand which[6]. In comparison to this study, our research needs to be at the policy level to stop theshowed only 2% eats fast food daily. Studies addictive behavior on fast food.have shown that a typical fast food meal Conclusioncontains 1400 kcal, 85% of recommended dailyfat intake, 73% of recommended saturated fat, Fast food industry has undergone an expeditiousbut only 40% of recommended fiber and 30% of augmentation in a short period of time. In India,recommended calcium [7]. In spite of this the trend of eating fast foods was initiated asawareness, significant proportion (3%) of our there were no time for women in the workforcestudy population consumes and 60% feel that earning as a part of modern phenomenon. Butmore fast food shops should be opened in India. they have encompassed and transfigured theInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 65Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)entire life-style of the personage. Requirement Appetite 52 (2009) 430–436. Elseviertransformed into sophistication that led to publishers.craving for quick foods. At this point of time, 5. Guthrie JF, Lin B-H, Frazao E. Role ofintroduction of fast food eateries in the food prepared away from home in theneighbourhood processed the formation of fast American diet, 1977–78 versus 1994–96:food addicts. Our study was conducted with an Changes and consequences. J Nutr Educintention to uncover certainty of the condition. Behav., 2002; 34: 140 –150.The study revealed that, about 29.6% (160) of 6. USDA Continuing survey of food intakesthe partakers were addicted to fast foods which by individuals, 1994–1996. USare threatening indication for taking necessary Department of Agriculture, Economicactions to create cognizance among the general Research Service: Washington DC; 1997.population about the risk factors and harmful 7. Elvira Isganaitis, Robert H. Lustig. Fasteffects of fast foods. Food, Central Nervous System Insulin Resistance, and Obesity. ArteriosclerAcknowledgments Thromb Vasc Biol., December 2005; 25: 2451–2462.We are thankful to the Dean (Brig) Dr. Dutta 8. FarzanYahya, Rabbia Zafar, SoamShafiq.Gupta, ACS Medical College and Hospital, Trend of Fast Food Consumption and itsProfessor and Head Dr. Daisy Dharmaraj, Effect on Pakistani Society. Food ScienceDepartment of Community Medicine, ACS and Quality Management, 2013; 11: 1-7.Medical College and Hospital for immense www.iiste.org. Accessed on 30-11-2014.support in conducting this research. 9. Pardis Pedram, et al. Food Addiction: Its Prevalence and Significant AssociationReferences with Obesity in the General Population. PLOS online. September 04, 2013. 1. http://www.drpeeke.com/fa_results_fal http://www.plosone.org/article/info%3 se.htm. Accessed on 30-11-2014. Adoi%2F10.1371%2Fjournal.pone.00743 2. Accessed on 30-11-2014. 2. http://www.eatingwell.com/nutrition_h 10. Merlo L.J., Klingman C., Malasanos T.H., ealth/nutrition_news_information/are_ Silverstein J.H. Exploration of food you_addicted_to_food. Accessed on 30- addiction in pediatric patients: A 11-2014. preliminary investigation. J. Addict. Med., 2009; 3(1): 26–32. 3. http://www.more.com/quiz-are-you- food-addict. Accessed on 30-11-2014. 4. Ashley N. Gearhardt, William R. Corbin, Kelly D. Brownell. Preliminary validation of the Yale Food Addiction Scale.Source of support: Nil Conflict of interest: None declared.International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 66Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P)Table – 1: Frequency distribution of the study participants. ISSN: 2394-0034 (O)Variable Frequency (n = 541) %GenderMale 318 58.8%Female 223 41.2%Education classDegree/Diploma 126 23.3%Higher secondary 4 0.7%Professional 411 76%Socio-economic statusClass 1 352 65.1%Class 2 139 25.7%Class 3 34 6.3%Class 4 15 2.8%Class 5 1 0.2%Relationship statusMarried 150 27.7%Separated 6 1.1%Unmarried 385 71.2%Type of familyJoint 93 17.2%Nuclear 448 82.8%LocationRural 71 13.1%Urban 470 86.9%DietNon vegetarian 493 91.1%Vegetarian 48 8.9%Do you usually enjoy fast food?No 106 19.6%Yes 435 80.4%Which is your favorite fast food place?Dominos 38 7%KFC 266 49.2%Marybrown and Mcdonalds 40 7.39%Ordinary restaurant 36 6.7Pizza hut 47 8.68%Road side shops 57 10.4%Others 57 10.6%How often do you eat fast food?Everyday 11 2%Few times a month 73 13.5%International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 67Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)Never 17Once a month 124 3.1%Once a week 107 22.9%Three or more times a week 80 19.8%Twice a week 67 14.8%Two or more times a week 1 12.4%Whenever I absolutely must 61 0.2%Do you think fast food meals are healthy? 11.3%No 489Yes 52 90.4%What is your opinion on fast food meals? 9.6%Delicious 250Easy takeaway 114 46.2%Hygienic 52 21.1%Just spicy 1 9.6%Not good 1 0.2%Speedy 103 0.2%Tasty 1 19%Unhealthy 16 0.2%Unhygienic 2 2.95%Waste of money 1 0.4%Do you think there should be more fast food shops in India? 0.2%No 218Yes 323 40.3%Do you feel you are addicted to fast food? 59.7%No 341Yes 200 63% 37%Chart – 1: Prevalence of fast food addiction. Fast Food Addiction Addiction present (30%) Addictionabsent (70%)International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 68Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)Table – 2: Addictive behaviors towards fast food among the study participants.Behavior pattern Frequency %I find myself consuming fast foods even though I am no longer hungry.0 – Never 224 41.4%1 – Once per month 111 20.5%2 – Two to three times per month 88 16.3%3 – Two to three times per week 95 17.6%4 – Four or more than four times per week 23 4.3%I worry about cutting down on fast foods.0 – Never 174 32.2%1 – Once per month 142 26.2%2 – Two to three times per month 80 14.8%3 – Two to three times per week 114 21.1%4 – Four or more than four times per week 31 5.7%I feel sluggish or fatigued (tired) from over eating.0 – Never 184 34%1 – Once per month 105 19.4%2 – Two to three times per month 103 19%3 – Two to three times per week 122 22.6%4 – Four or more than four times per week 27 5%I prefer eating fast foods more than spending time with family, friends,work, or recreation. 393 72.6%0 – Never 76 14%1 – Once per month 31 5.7%2 – Two to three times per month 32 5.9%3 – Two to three times per week 9 1.7%4 – Four or more than four times per weekI have had physical symptoms such as agitation and anxiety when I cut down 214 39.6%on fast foods. 95 17.6%0 – Never 56 10.4%1 – Once per month 124 22.9%2 – Two to three times per month 52 9.6%3 – Two to three times per week4 – Four or more than four times per week 203 37.5%My behaviour with respect to food and eating causes me significant distress. 99 18.3%0 – Never 65 12%1 – Once per month 128 23.7%2 – Two to three times per month 46 8.5%3 – Two to three times per week4 – Four or more than four times per week 170 31.4%Issues related to food and eating decreases my ability to function effectively(e.g. daily routine, job/school, social or family activities, health difficulties).0 – NeverInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 69Copy right © 2015, IAIM, All Rights Reserved.

Fast food addiction – The junk enslavement ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)1 – Once per month 117 21.6%2 – Two to three times per month 76 14%3 – Two to three times per week 123 22.7%4 – Four or more than four times per week 55 10.2%I kept consuming the same type or amount of food despite significantemotional and or physical problems related to my eating. 294 54.3%No 247 45.7%YesEating the same amount of food doesn’t reduce negative emotions or 257 47.5%increase pleasurable feelings the way it used to. 284 52.5%NoYesInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 70Copy right © 2015, IAIM, All Rights Reserved.