Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis

Mark A. Pereira, Alex I. Kartashov, Cara B. Ebbeling, Linda Van Horn, Martha L. Slattery, Prof David R. Jacobs, David S. Ludwig

Research output: Contribution to journalArticlepeer-review

875 Scopus citations

Abstract

Background Fast-food consumption has increased greatly in the USA during the past three decades. However, the effect of fast food on risk of obesity and type 2 diabetes has received little attention. We aimed to investigate the association between reported fast-food habits and changes in bodyweight and insulin resistance over a 15-year period in the USA. Methods Participants for the CARDIA study included 3031 young (age 18-30 years in 1985-86) black and white adults who were followed up with repeated dietary assessment. We used multiple linear regression models to investigate the association of frequency of fast-food restaurant visits (fast-food frequency) at baseline and follow-up with 15-year changes in bodyweight and the homoeostasis model (HOMA) for insulin resistance. Findings Fast-food frequency was lowest for white women (about 1·3 times per week) compared with the other ethnic-sex groups (about twice a week). After adjustment for lifestyle factors, baseline fast-food frequency was directly associated with changes in bodyweight in both black (p=0·0050) and white people (p=0·0013). Change in fast-food frequency over 15 years was directly associated with changes in bodyweight in white individuals (p<0·0001), with a weaker association recorded in black people (p=0·1004). Changes were also directly associated with insulin resistance in both ethnic groups (p=0·0015 in black people, p<0·0001 in white people). By comparison with the average 15-year weight gain in participants with infrequent (less than once a week) fast-food restaurant use at baseline and follow-up (n=203), those with frequent (more than twice a week) visits to fast-food restaurants at baseline and follow-up (n=87) gained an extra 4·5 kg of bodyweight (p=0·0054) and had a two-fold greater increase in insulin resistance (p=0·0083). Interpretation Fast-food consumption has strong positive associations with weight gain and insulin resistance, suggesting that fast food increases the risk of obesity and type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalLancet
Volume365
Issue number9453
DOIs
StatePublished - Jan 1 2005

Bibliographical note

Funding Information:
This work was supported by the Charles H Hood Foundation, NIDDK grant 1R01DK59240, NCRR grant M01 RR02172, and NHLBI contracts N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050, and N01-HC-95095.

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