Super-sized citizens: The relationship between a country's fast-food outlets and its obesity rates

May 10, 2013

Many studies have linked the meals served at fast-food outlets to obesity, but is there a relationship between the number of restaurants in a country and the girth of its population?

To answer this question, an international team of looked at the number of Subway per 100,000 people in 26 economically advanced countries. They also considered other factors, including the number of men and women over 15 with a high , gross national income, a country's Gini coefficient (an indicator of ), urbanisation, motor-vehicle and internet use.

The conclusions, published in the journal Critical Public Health (De Vogli, Kouvonen & Gimeno, 2011), are clear: the density of Subway's outlets is positively associated with the prevalence of across 26 advanced economies in both men and women. Even after adjusting for the other factors, countries with the highest density of Subway restaurants (such as the United States and Canada) have a higher prevalence of obesity than countries with a low density (like Norway and Japan).

The recent explosion in the number of fast- is down to more than just their 'special sauce'. The authors suggest that the rapid global market integration and trade liberalisation promoted by organisations such as the World Trade Organization – which contribute to an increase in exports of domestic goods, imports of foreign products and the opening of markets to foreign investment – have also played a large part in expanding waistlines. The growth and power of transnational food companies, supermarkets and fast-food restaurants encouraged by such policies has had a dramatic impact on global diets.

The authors are quick to acknowledge the limits of their study. They do not state that the density of fast-food restaurants causes obesity – merely that it is associated with it. They also acknowledge that their study doesn't take into account the time lag between the appearance of such restaurants and a given country's obesity epidemic. The Critical Public Health study was also limited to just 26 advanced economies and one fast-food chain, albeit the largest: Subway now has more outlets than McDonald's.

Nevertheless, this study is an important contribution to the understanding of obesity as a global problem – what the authors themselves call 'globesization'. They also recommend further research into the connections between obesity, and trade liberalisation policies, and call for co-ordinated political action to stop the spread of 'globesization'.

Explore further: Supersized market economy, supersized belly: Wealthier nations have more fast food and more obesity

More information: De Vogli, R., Kouvonen, A. and Gimeno, D. 'Globesization': ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies, Critical Public Health, 21(4), 395-402. … 09581596.2011.619964

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1 / 5 (1) May 10, 2013
I would have thought that MacDonald's, Hungry Jack's, Burger King or KFC would have been more appropriate benchmarks benchmarks than Subways.Unless I am mistaken,those companies globalised a little bit sooner &faster than Subways.The amount of fat that some of these joints use for preparing their food is incredible.On the rare occasions that I have indulged myself in some of the fast-food chicken meals out there, I found said fat puddling into my container even as I tried to eat the food that was so saturated, that the absorbed fat became the main flavour(&the main aftertaste)That kind of experience is what MAKES my patronage at places such as KFC an infrequent choice.Don't get me wrong,I do like my fast-food.Subways at least,has the distinction that even choosing whether to include a sauce is a feature of the menu.The veggies are fat-free.Some of you might remember this guy: http://www.examin...-obesity ...
1 / 5 (1) May 10, 2013
...& then there is this 'thing' about routinely 'supersizing' one's meals.This might surprise some of the US posters,but the habit of routinely encouraging a client to upgrade their meal to a larger size, only became a habit in other countries much later on.I remember hearing about it long before being exposed to it, &in more than one country.What I particularly hate, is going into Macdonalds's, asking for a(eg)'Big mac meal',explicitely saying 'no upgrade please',not only do they still ask you whether you would like one AND THEN,when they repeat your order, it turns out that they are 'assuming'that you have just ordered a'medium' instead of a'small'!This happens every time now &I can only assume that it is now a part of that company's sales strategy. Ugh!Maddening!! Supersizing. Not one of the US's better exports.By the way,I am under the impression that all major globalised fast-food companies seem to have originated in the US of A.Can anybody name even one that started elsewhere?DH

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