Fast food consumption among young adolescents aged 12–15 years in 54 low- and middle-income countries

BACKGROUND: Most countries worldwide, especially low- and middle-income countries (LMICs), are facing an increasing prevalence of fast-food consumption and multiple burdens of malnutrition among young adolescents. OBJECTIVE: To compare the prevalence of fast-food consumption among young adolescents in LMICs. METHODS: We used data from the most recent Global School-Based Student Health Survey (2009–2015), which had been collected using a standardized questionnaire. The weighted prevalence and 95% confidential intervals of fast-food consumption were calculated overall and in subgroups stratified by age, sex, and nutritional status. The pooled overall and regional estimates were obtained using a random-effects model. Heterogeneity was assessed using the I2 statistic. The associated risk factors for fast-food consumption were explored using logistic regression analysis. RESULTS: Our study comprised 153,496 young adolescents (46.90% boys) from 54 LMICs. Overall, approximately 55.2% (51.3–59.1%) of the adolescents consumed fast food at least 1 day per week, and 10.3% (8.3–12.4%) did so 4–7 days per week. The prevalence of fast-food consumption 4–7 days per week was lowest in the Americas (8.3%; 6.7–9.9%) and highest in Southeast Asia (17.7%; 2.3–33.2%). At a country level, the prevalence was lowest in Pakistan (1.5%; 1.0–2.0%) and highest in Thailand (43.3%; 40.4–46.1%). Furthermore, in subgroups stratified by nutritional status, the prevalence was lowest in the obesity group (6.6%; 4.5–8.7%). Factors such as age, sex, BMI, food insecurity, fruit consumption, vegetable consumption, soft-drink consumption, smoking, physical activity level, and sedentary behavior level were found to be correlated with fast-food consumption. CONCLUSIONS: The identified high prevalence of fast-food consumption among young adolescents in LMICs indicates the urgent need to prioritize the implementation of healthy-diet promotion programs to improve adolescent health in these countries.