Fast foods under scrutiny

Inappropriate dietary patterns together with a sedentary lifestyle are major contributors to obesity and lifestyle diseases.

The topic of fast foods has been highlighted in this paper and other local press this past week. Several reporters have called me to seek information and explanation on the issue. Questions were mainly related to the ill effects of consuming fast foods and how to educate the consumer.

I feel it would be appropriate and timely for me to talk about fast foods in this installment of NutriScene. Through this article, would like to address several issues that would serve to educate the public regarding fast foods.

What are fast foods?

I do not believe there is an officially recognised definition of fast foods. What often comes to mind when we mention such foods is the Western franchised fast foods such as fried chicken, burger, hot dog, pizza and so on.

Taken more generally, fast foods can be taken to include meals that can be prepared in a short time and can be taken "on the go". They can also include a variety of local dishes and meals such as several noodle meals (for example,.fried, .soup or curry), several rice dishes (for example fried rice, chicken rice, nasi lemak, barbeque meat rice), and numerous others sold in hawker stalls and mamak restaurants.

The press write-ups these past few days have been referring to the Western franchised fast foods. The concept of "fast food" perhaps originated in the 1950s. The intense competition in the fast food industry brought about the concept of franchising these meals and the subsequent mushrooming of franchised fast food outlets in theUnited States and elsewhere in the world.

Fast foods probably made its first appearance in this country in the 1970s in the form of a bugger. The industry grew rapidly, spreading to even small towns throughout the Country.

What are the potential ill effects of consuming fast foods?

Non-communicable diseases, especially diet-related chronic diseases, have become the major disease burden and main causes of death in the country. These diseases include obesity, hypertension, diabetes, cardiovascular disease and certain cancers, It is now evident that the increase in these diseases is related to the changes in the lifestyle of the people. Major changes have taken place in the dietary pattern of Malaysians over the years. There has been a shift towards an "affluent" diet characterised by a reduced intake of starchy staples; decrease intake of fruits and vegetables; increased intakes of fats and oils, refined carbohydrates, meat/ fish/eggs; increased percentage of energy derived from fat; andincreased availability of animal sources of protein, fat and calories.

Western franchised fast foods have often been blamed for the increase in these chronic diseases.

Indeed, excessive consumption of fast foods does contribute to the increased risk of these diseases.

More correctly, the excessive consumption of ALL foods that arehigh in energy, fat, sugar, cholesterol, sodium and the insufficient intake of fruits and vegetables increases this risk. It is therefore inappropriate dietary pattern together with a sedentary lifestyle that are major contributors to these diseases.

Many of the risk factors for these diseases can be controlled. They can be prevented. It is thus imperative that all efforts be made to prevent these diseases. It is vital that we recognise the root causes of these problems and tackle them appropriately.

Empowering the people with knowledge to enable them to adopt healthy eating habits and an active lifestyle has been recognised as the long-term solution to reducing risk to these diseases.

Providing nutrition information on fast foods

As part of the effort to educate consumers on making food choices, the public should be informed of the nutrient content of fast foods. Fast food chains should contribute towards these efforts. The nutritional content of each type of food and drink sold in their outlets should be clearly and prominently displayed.

I find that at least one fast food chain is providing the content of several nutrients in a booklet that customers can pick up from the outlets. Such information is also available on the website of the chain. The serving size for each meal is provided, as well as the amount of calorie, protein, fat, carbohydrate and calcium.

I would urge that all fast food chains provide such information to the consumer. It should include

nutrient content for sample meals to be consumed, comprising several food items, such as a burger, chips and a soft drink. The industry and health professionals should help consumers understand and use such information to enable informed choices.

For example, the menu in a fast food outlet should inform a 20-year-old woman that consuming a meal comprising two pieces of fried chicken, a packet of French fries and a soft drink has 800 kcal and 36 grams of fat (which makes up 41% of the total energy). She should be aware that energy intake from this meal alone is already slightly more than half (40%) of her daily requirement of 2000 kcal:

Consumption of fast foods

There is no good data on consumption of fast foods by population groups in the country. But looking at the increasing number of outlets in the country over the years, fast foods are certainly gaining in popularity.

There is thus the concern that these fast foods may be gaining too strong a foothold in the dietary pattern of communities. I do understand and share such concerns.

Indeed it is important ~o address the issue in a comprehensive manner. The strategies should include providing education to the consumer on the role of such foods in the diet.

In addition to providing nutrition information of fast foods, the industry should be encouraged to provide healthier alternatives in these outlets. There could be greater scrutiny to reduce misleading advertising by these foods.

At the same time, it is important to be mindful that there are a number of other foods out there that may play a role in increasing risk to diet-related chronic diseases. There are some local dishes and meals that contain high fat and calorie. Several of these dishes also contain coconut milk (santan). These may also be called fast foods and they feature prominently in the daily diet of the community.

As more families eat out, the dependence of the population on these foods for meeting their nutritional needs become even more important.

Information to the people should include nutrient content of such local fast foods. The same young woman Should also be informed that eating a bowl of curry mee with a soft drink gives her 700 kcal and 37 grams of fat (47% of total energy)*. This energy intake is about 35% of her daily caloric need and the dish may contain a fair amount of santan.

There is of course a large variety of local fast foods, with widely differing nutrient content*. There are dishes and meals that have a nutritional profile and can be encouraged. There are also healthier ways of preparing these local dishes. 1 am of the opinion that we should tackle the problem by looking at the broader picture, i fear that focusing on one single type of foods may not achieve the intended objectives.

I realise I am repeating myself, but I have to say that the solution lies in promoting overall healthy eating to the people. Strategies are already identified in the National Plan of Action for Nutrition II, including working with the fast food industry. Let us activate those plans.

Promoting fast foods to children

Intense marketing and advertising are certainly important reasons for the success of the fast food chains. In view of this lack of knowledge and the inability of children to choose wisely, it is certainly not right to be pushing such foods to young children without some form of guidance. Considerations could be given by the authorities to curb advertising to this group of the population.

Parents have an important role to play by understanding the nutritional value of these foods and providing appropriate guidance to their children. Parents themselves should serve as good examples and eat sensibly. School authorities can also play effective roles in these efforts. In this respect, inter-ministry coop: eration should be enhanced to have effective educational programmes,commencing from primary schools.

To ear or not to eat

No one single food or type of food can be said to be the cause of obesity or other diet-related chronic diseases. It all depends on how much of these foods you are eating. It depends on how frequent you are eating these foods. The answer lies in what else you are eating for the day.

There is no simple guideline for eating fast foods. There is no guide on what is the "safe" number of fast food meals that can be taken in a week or a month. There are however guidelines on healthy eating (information available on: www.nutriweb.org.my).

All this sounds too complicated? Not really. As I have often emphasised, remember the key points: be disciplined in your eating, eat in moderation, go for variety.