Trends of Fast Food Consumption Among Adolescent and Young Adult Saudi Girls Living in Riyadh - ALFaris - Food & Nutrition Research

9/2/2016
TrendsoffastfoodconsumptionamongadolescentandyoungadultSaudigirlslivinginRiyadh|ALFaris|Food&NutritionResearch
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TRENDSOFFASTFOODCONSUMPTIONAMONGADOLESCENTAND
YOUNGADULTSAUDIGIRLSLIVINGINRIYADH
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NoraA.ALFaris 1*,JozaaZ.AlTamimi1,MoneeraO.AlJobair1andNaseemM.AlShwaiyat2
1NutritionandFoodScienceDepartment,CollegeofHomeEconomics,PrincessNourahBint
AbdulrahmanUniversity,Riyadh,SaudiArabia2DepartmentofClinicalNutrition,Collegeof
AppliedHealthSciencesinArrass,QassimUniversity,Buraydah,SaudiArabia
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AbouttheAuthors
ABSTRACT
Background:SaudiArabiahaspassedthroughlifestylechangestowardunhealthydietary
patternssuchashighfastfoodconsumption.Adolescentsandyoungadults,particularlygirls,are
themaingroupsexposedtoandaffectedbytheseadverseeatingbehaviors.
ArticleMetrics
Objective:Theaimofthisstudywastoexaminethetrendsoffastfoodconsumptionamong
adolescentandyoungadultSaudigirlslivinginRiyadh,andtocomparebetweenthem.
RelatedContent
Design:Inacrosssectionalsurvey,127adolescentSaudigirls(1318years)and69youngadult
Saudigirls(1929years)wererandomlyrecruitedtoparticipateinthisstudy.Weight,height,waist
circumference,andhipcircumferenceweremeasuredusingstandardizedmethods.Twentyfour
hourdietrecallandafacetofaceinterviewfoodquestionnairewereperformed.
Results:Mostoftheparticipantshadadequateintakeofprotein,riboflavin,iron,andsodium,but
exhibitedlowintakeforseveralothernutrients.Amongstudyparticipants,95.4%consume
restaurantsfastfoodand79.1%eatfastfoodatleastonceweekly.Burgersandcarbonatedsoft
drinkswerethemainkindsoffastfoodmealsandbeveragesusuallyeatenbygirls.Adolescent
girlswhousuallyatelargeportionsizesoffastfoodhadsignificantlyhighermeanwaist
circumferenceandhipcircumference.Participantseatfastfoodprimarilyforenjoyingthedelicious
taste,followedbyconvenience.Restaurantshygieneandsafetystandardswerethemainconcern
regardingfastfoodfor62.2%ofgirls.Finally,internationalrestaurantswerepreferableby
participantstobuyfastfoodcomparedwithlocalrestaurants(70.9%vs.29.1%).
Conclusion:Ourfindingsprovideevidenceonthehighprevalenceoffastfoodconsumption
amongSaudigirls,suggestinganurgentneedforcommunitybasednutritioninterventionsthat
considerthetrendsoffastfoodconsumptionandtargetedeatingbehaviorsofadolescentand
youngadultgirls.
Keywords:fastfoodrestaurantsadolescentyoungadultSaudiArabia
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ResponsibleEditor:SeppoSalminen,UniversityofTurku,Finland.
Received:1November2014Revised:29January2015Accepted:19February2015Published:
18March2015
Food&NutritionResearch2015.2015NoraA.ALFarisetal.ThisisanOpenAccessarticle
distributedunderthetermsoftheCreativeCommonsAttribution4.0InternationalLicense
(http://creativecommons.org/licenses/by/4.0/),allowingthirdpartiestocopyandredistributethe
materialinanymediumorformatandtoremix,transform,andbuilduponthematerialforany
purpose,evencommercially,providedtheoriginalworkisproperlycitedandstatesitslicense.
Citation:Food&NutritionResearch2015,59:26488http://dx.doi.org/10.3402/fnr.v59.26488
Adolescenceisacruciallifestagecharacterizedbydramaticmodificationsinlifestylepatterns.
Thesemodificationsincludemoreunhealthyfoodchoices,eatingoutsidethehome(mainlyatfast
foodrestaurants),sedentarybehaviors,andphysicalinactivity,especiallyamonggirls,allofwhich
putadolescentsatnutritionalrisk(1,2).Manyofteenagersdietarybehaviorsmayberelatedto
somedistortedperceptionsadoptedbythem.Astudyreportedthatadolescentgirlsassociated
consumptionoffastfoodwithpleasure,friends,andindependence,whiletheyassociated
consumptionofhealthyfoodwithparentsandbeingathome(3).Currentdataemphasizedthat
environmentalinfluences,especiallyfamily,hadimportanteffectsoneatinghabits,weightgain,and
physicalactivityduringthetransitionfromadolescencetoadulthood(4,5).Whenadolescentsform
certaindietarybehaviors,theywillmaintainthesebehaviorsevenafterbecomingadultsand
establishingnewhouseholdsthatareindependentoftheirparentsandfamily(5).Therefore,if
healthfuldietarybehaviorsarenotwellformedinadolescentsandundesirablelifestylepatterns
persistedduringthetransitiontoadulthood,thesebehaviorsmaycarryoutforalifetime,which
wouldincreasetheriskforchronicnoncommunicablediseasessuchasobesity(68).
http://www.foodandnutritionresearch.net/index.php/fnr/article/view/26488
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Fastfoodtypicallyreferstofoodthatisquicklyprepared,purchasedinselfservicefrom
restaurantswithprecookedingredients,andservedinapackagedformtothecustomertotake
awaysuchasburgers,Frenchfries,andpizza(9).Fastfoodfirstpopularizedinthe1970sinthe
UnitedStates,whichhastodaythelargestfastfoodindustryintheworld.Americanconsumption
offoodpreparedoutsidehomeincreasedfrom18%within19771978to32%within19941996of
totalenergy.Inaddition,mealsandsnacksbasedonfoodpreparedoutsidehomecontainedmore
calories,andwerehigherintotalfatandsaturatedfatandlowerindietaryfiber,calcium,andiron,
thanhomemadefoods(10).Moreover,astrongpositiveassociationhasbeenreportedbetween
fastfoodconsumptionandbothweightgainandinsulinresistance,suggestingthatfastfood
increasestherisksofobesityandtype2diabetes(11).
Adolescentsandyoungadultsformthemainconsumersforfastfoodmealscomparedwitholder
people(2,12).Astaste,timeconsiderations,convenience,andcostaremajorfactorsthat
contributetoanadolescentsoryoungadultsfoodchoices,fastfoodrestaurantsserveaspopular
sitesfortheirmealseatenoutsidethehome(13,14).Fastfoodcontainsmorefat,saturatedfat,
addedsugars,addedsalt,andenergyandlessdietaryfibertherefore,eatingfastfoodseemsto
haveanadverseeffectondietquality(1517).Frenchetal.(18)investigatedfastfood
consumptionamong4,746schoolstudentsaged11to18yearsandreportedthatabout75%of
adolescentsateatfastfoodrestaurantsduringtheweekprevioustothesurvey.Moreover,
consumingfastfoodwasassociatedwithlowerintakesoffruits,vegetables,andmilk.Inthesame
way,MorseandDriskell(19)examinedthetrendsoffastfoodconsumptionamongcollege
students.Theirresultsclarifiedthatmostyoungadultshavereportedeatingmealsatfastfood
restaurants13timesweekly.Ina10yearlongitudinalstudy,Schmidtetal.(20)examinedthe
trendsoffastfoodconsumptionanditsrelationshiptodietqualityamongblackandwhite
adolescentgirls.Theyfoundthatfastfoodintakewaspositivelyassociatedwithintakeofenergy,
sodium,totalfat,andsaturatedfat.Inaddition,thefrequencyoffastfoodconsumptionincreased
withageinbothraces.
Saudicultureisstronglyreligious,conservative,andfamilyoriented.Whilewomensstatusishigh
inthefamily,especiallyintherolesofmothersandsisters,womenusuallyremainoutofpublic
viewandcontactonlywiththeirrelatedmen.Inthepublicrestaurants,womenarerequiredtouse
speciallydesignatedfamilysections.Consequently,forwomen,eatinginrestaurantsmeansmore
thanconsumingamealforhunger.Itisanopportunitytogooutsidethehomeandgatherwith
familyorfemalefriends.Inaddition,femalestudentsreportedahigherprevalenceofdieting,
greaterpositiveattitudestowardhealthyeating,andgreaterinterestintheirhealth,bodyweight,
andbodyimagethantheirmalecounterparts.Consequently,femalestudentsaremorelikelytobe
respondentsfornutritioneducationprograms(2123).Therefore,thepurposeofthisreportwasto
studythetrendsoffastfoodconsumptionofagroupofadolescentandyoungadultSaudigirlsand
tocomparebetweenthem.Itwasbasedontwohypotheses.First,fastfoodconsumptionis
commonamongSaudigirls.Second,adolescentsandyoungadultsmayhavedifferencesintrends
offastfoodconsumptionasfastfoodeatingmaychangewithage.
METHODS
Designandparticipants
ThecurrentstudyisacrosssectionalsurveyconductedduringMarchApril,2010inRiyadh,the
capitalcityofSaudiArabia.AlloftheparticipantsareSaudigirls,aged1329years,schoolor
collegestudents,andlivinginRiyadh,andtheywererandomlyselected.Theadolescentgirls(13
18years)wererecruitedfromtheintermediateandsecondaryschoolcomplexinPrincessNourah
BintAbdulrahmanUniversity,whereastheyoungadultgirls(1929years)wererecruitedfromthe
campusofPrincessNourahBintAbdulrahmanUniversity.Onehundredandninetysixgirlsagreed
toparticipateinthisstudyafterobtainingawrittenconsentinaccordancewiththeHelsinki
Declaration.ThestudywasapprovedbytheNutritionandFoodScienceDepartment,Collegeof
HomeEconomics,PrincessNourahBintAbdulrahmanUniversity,Riyadh,SaudiArabia.
Anthropometricmeasurements
Bodyweightwasmeasuredwithminimalclothingandwithoutshoestothenearest0.1kgusinga
calibratedportablescale.Heightwasmeasuredtothenearest1cmusingastadiometer,whilethe
subjectwasinafullstandingpositionwithoutshoes.Bodymassindex(BMI)wascalculatedasthe
ratioofweight(kg)toheight(m2).Waistcircumferencewasmeasuredathalfwaybetweenthe
lowerborderoftheribsandtheiliaccrestinahorizontalplane.Hipcircumferencewasmeasured
atthewidestpointoverthebuttocks.Bothwaistandhipcircumferencesweremeasuredusinga
nonstretchabletapetothenearest1cm.Thewaisthipratiowascalculatedastheratioofwaist
circumferencetohipcircumference.
Dietarydatacollection
Habitualnutrientsintakewasassessedusing24hdietrecallforthepreviousday.Anutrient
analysissoftwareprogramwasused(FoodProcessorforWindows,version7.71,ESHA
Research,Salem,OR,USA)toestimatethedailyintakeofseveralnutrientsforeachparticipantin
theformofthenutrientadequacyratio(NAR),whichistheratioofactualnutrientintaketothe
recommendedintakeofthatnutrientbasedondietaryreferenceintakes(DRIs)(24).
Adescriptivefoodquestionnairewasdesignedbytheresearcherstostudythetrendsoffastfood
consumption.Facevalidityforthequestionnairewasassessedbyusingapilottestedgroupof20
participantsfromthetargetpopulationtoensurethatthequestionsareunderstandable.Afaceto
faceinterviewquestionnairewasperformedwiththerespondentsafterdefiningfastfoodandgiving
themanoverviewaboutthestudy.Thesociodemographicvariableswerecollectedfrom
participants,whichincludedagegroup,familysizeandincome,andparentseducationallevel.The
questionnaireinvestigatedthetrendsoffastfoodconsumptionbyusing16items,dividedintothree
partsfastfoodconsumptionpattern(7items),attitudetowardfastfood(5items),andfastfood
restaurantuse(4items).
Dataanalysis
TheStatisticalPackageforSocialSciences(SPSSInc.,Chicago,IL,USA)version21wasused
fordataanalysis.Categoricalvariableswereexpressedasnumbersandpercentages,and
analyzedusingachisquaretest.Continuousvariableswereexpressedasmeansandstandard
deviations,andanalyzedusingaonewayANOVAtest.Allreportedpvaluesweremadeonthe
basisoftwotailedtests.Differenceswereconsideredstatisticallysignificantatp<0.05.
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RESULTS
Sociodemographicandanthropometriccharacteristics
Thisstudyincludes196Saudigirls64.8%ofthemwereadolescentschoolstudentsaged1318
years,andtherestofthemwereyoungadultcollegestudentsaged1929years(Table1).Mostof
theparticipantshavealargefamilysizeconsistingofatleastsixmembers,andhighfamilyincome
exceeds2,000USD.Furthermore,43.4%ofmothersand67.9%offathersearnedacollege
educationorhigher.However,therearenosignificantdifferencesbetweenbothagegroups
regardinganyoftheabovementionedcharacteristics.ThemeanBMIofyoungadultgirls(23.6)
washigherthanthatofadolescentgirls(22.4)butnotsignificantly.However,meanwaist
circumferenceandhipcircumferenceweresignificantlyhigheramongyoungadultgirlscompared
toadolescentgirls.
Table1.Thesociodemographicandanthropometriccharacteristicsofparticipants
Adolescents(1318 Youngadults(1929 Total(1329
Variables
years)
years)
years)
p
Agegroup
127(100%)
69(100%)
196(100%)
Familysizea
5membersorless
22(17.3%)
15(21.7%)
37(18.9%) 0.450
6membersormore
105(82.7%)
54(78.3%)
159(81.1%)
Familyincomea
2,000USDorless
38(29.9%)
21(30.4%)
59(30.1%) 1.000
Morethan2,000USD
89(70.1%)
48(69.6%)
137(69.9%)
Motherseducationlevela
Secondaryschooleducation
72(56.7%)
39(56.5%)
111(56.6%) 0.706
orless
Collegeeducationorhigher
55(43.3%)
30(43.5%)
85(43.4%)
Fatherseducationlevela
Secondaryschooleducation
42(33.1%)
21(30.4%)
63(32.1%) 0.982
orless
Collegeeducationorhigher
85(66.9%)
48(69.6%)
133(67.9%)
Anthropometric
measurements b
Height(cm)
157.9(6.5)
159.5(6.0)
158.4(6.4) 0.085
Weight(kg)
55.7(11.3)
60.0(11.9)
57.2(11.7) 0.013
22.4(4.4)
23.6(4.6)
22.8(4.5)
0.074
Bodymassindex(kg/m2)
Waistcircumference(cm)
73.1(11.7)
78.9(13.4)
75.1(12.6) 0.002
Hipcircumference(cm)
96.3(14.2)
101.5(18.2)
98.1(15.9) 0.029
Waisthipratio
0.77(0.11)
0.78(0.10)
0.77(0.11) 0.236
aCategoricalvariableswereexpressedasnumbersandpercentages,andanalyzedusingachi
squaretest.bContinuousvariableswereexpressedasmeansandstandarddeviations,and
analyzedusingaonewayANOVAtest.
Nutrientsintake
ThemeanNARofproteinwas1.84and1.58foradolescentandyoungadultgirls,respectively,
whichindicatesthatproteinintakemetthedietaryrequirementinmostsubjects(Table2).
Riboflavinwastheonlyvitaminforwhichmostoftheparticipantsachievedadequateintake(mean
NARwas2.41).Similarly,mostgirlsintakeofiron,sodium,andphosphorus(foradolescentgirls
only)wasadequate.However,mostgirlsexhibitlowintakeofseveralothervitaminsandminerals,
especiallypantothenicacid,biotin,folicacid,vitaminD,vitaminE,selenium,andmanganese,as
meanNARwaslowerthan1.0.Moreover,meanNARsofvitaminC,calcium,phosphorus,
potassium,andsodiumweresignificantlyhigheramongadolescentgirlscomparedtoyoungadult
girls.
Table2.Participantsnutrientadequacyratio(NAR)ofseveralnutrients
Nutrients
Adolescents,mean(SD) Youngadults,mean(SD) Total,mean(SD) pa
Protein
1.84(1.40)
1.58(1.05)
1.75(1.29)
0.192
Thiamin
0.68(1.15)
0.42(0.45)
0.59(0.97)
0.071
Riboflavin
2.56(3.72)
2.14(3.34)
2.41(3.59)
0.427
Niacin
0.72(1.80)
0.40(0.65)
0.61(1.50)
0.152
Pantothenicacid
0.04(0.09)
0.06(0.14)
0.05(0.11)
0.355
Biotin
0.02(0.04)
0.03(0.11)
0.02(0.07)
0.229
Folicacid
0.03(0.08)
0.03(0.08)
0.03(0.08)
0.797
VitaminB6
0.16(0.65)
0.09(0.22)
0.13(0.54)
0.399
VitaminB12
0.27(0.46)
0.35(0.73)
0.30(0.58)
0.328
VitaminC
0.33(0.53)
0.17(0.31)
0.27(0.47)
0.029
VitaminA
0.45(0.49)
0.39(0.39)
0.43(0.46)
0.449
VitaminD
0.0004(0.004)
0.01(0.03)
0.002(0.02)
0.078
VitaminE
0.02(0.04)
0.02(0.04)
0.02(0.04)
0.947
Iron
1.21(1.10)
1.04(0.98)
1.14(1.06)
0.289
Calcium
0.55(0.74)
0.28(0.21)
0.46(0.62)
0.003
Phosphorus
1.72(3.37)
0.74(0.63)
1.37(2.77)
0.018
Potassium
0.71(1.61)
0.27(0.27)
0.55(1.32)
0.024
Magnesium
0.33(1.09)
0.16(0.26)
0.27(0.89)
0.211
Zinc
0.18(0.39)
0.18(0.35)
0.18(0.37)
0.877
Sodium
2.18(3.82)
1.18(1.01)
1.83(3.17)
0.035
Selenium
0.05(0.30)
0.02(0.11)
0.04(0.25)
0.436
Manganese
0.02(0.10)
0.05(0.12)
0.03(0.10)
0.210
aContinuousvariableswereexpressedasmeansandstandarddeviations,andanalyzedusinga
onewayANOVAtest.
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Fastfoodconsumptionpattern
Resultsshowedthatthevastmajorityoftheparticipants(95.4%)eatrestaurantfastfood(Table3).
Fastfoodwasconsumedonceperweekby52.8%ofadolescentgirlsand60.9%ofyoungadult
girls.Moreover,25.2%ofadolescentgirlsand20.3%ofyoungadultgirlsconsumedfastfoodtwice
ormoreweekly.Intotal,79.1%ofthesampleeatsfastfoodatleastonceweekly.Beeforchicken
burgerswerethemainkindsoffastfoodmealsusuallyeatenbythesamplesubjects(70.4%),
followedbypizza(32.7%)andFrenchfries(29.6%).Asignificantlyhigherrateofyoungadultthan
adolescentgirlsreportedeatingpizzausually(49.3%vs.23.6%).Ontheotherhand,only4.1%of
theparticipantsusuallyconsumehotdog.Regardingportionsize,mostoftheparticipantsusually
orderedeithersmall(37.2%)ormedium(44.9%)portionsizesoffastfoodmeals.However,the
largeportionsizewasthechoicefor17.9%ofparticipants.Adolescentgirlswhousuallyeatthe
largeportionsizeoffastfoodhadsignificantlyhighermeanwaistcircumference(p=0.006)and
meanhipcircumference(p=0.001)(Fig.1).Interestingly,carbonatedsoftdrinkswerethemain
beveragesusuallyconsumedwithfastfoodmealsbybothadolescentandyoungadultgirls(89
and75.4%,respectively),butotherbeveragessuchascoffee,tea,sweetenedfruitdrinks,or
energydrinkswererarelyconsumedwithfastfood.Finally,weekendsandeveningswerethe
frequenttimeswhentheparticipantsoftenconsumedfastfoodmeals.
Fig.1.Thismeansplotsdiagramillustratestherelationshipbetweenthemeanofwaist
circumference(A)andmeanofhipcircumference(B)ofadolescentgirlsandusuallyordered
portionsizeoffastfood.
Table3.Participantsresponsesforpart1ofthefastfoodquestionnaire(regardingfastfood
consumptionpatterns)
Adolescents, Youngadults, Total,N
Questionsaskedandanswerlevels
N(%)
N(%)
(%)
pa
1.Doyoueatrestaurantsfastfoodregularly?
A.Yes
121(95.3%)
66(95.7%)
187
0.904
(95.4%)
B.No/sometimes
6(4.7%)
3(4.3%)
9(4.6%)
2.Howoftendoyouconsumefastfood?
A.Oncepermonthorless
28(22%)
13(18.8%)
41
0.547
(20.9%)
B.Onceperweek
67(52.8%)
42(60.9%)
109
(55.6%)
C.Twiceperweekormore
32(25.2%)
14(20.3%)
46
(23.5%)
3.Doyouusuallyeateachofthefollowingfast
foods?(Yesorno)
A.Beeforchickenburger(yes)
93(73.2%)
45(65.2%)
138
0.241
(70.4%)
B.Pizza(yes)
30(23.6%)
34(49.3%)
64
<0.001
(32.7%)
C.Frenchfries(yes)
33(26%)
25(36.2%)
58
0.133
(29.6%)
D.Hotdog(yes)
5(3.9%)
3(4.3%)
8(4.1%) 0.890
E.Doughnuts(yes)
13(10.2%)
14(20.3%)
27
0.051
(13.8%)
F.Croissant(yes)
9(7.1%)
7(10.1%)
16
0.455
(8.2%)
4.Whichportionsizeoffastfooddoyouusually
eat?
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A.Small(regular)
44(34.6%)
29(42%)
B.Medium
58(45.7%)
30(43.5%)
C.Large
25(19.7%)
10(14.5%)
5.Whatkindofbeveragesdoyouusuallydrink
withfastfood?
A.Carbonatedsoftdrinks
113(89%)
52(75.4%)
B.Coffeeortea
C.Freshfruitjuices
1(0.8%)
10(7.9%)
2(2.9%)
12(17.4%)
D.Sweetenedfruitdrinks
E.Energydrinks
6.Whendoyouusuallyconsumefastfoodduring
theweek?
A.Beginningoftheweek
B.Middleoftheweek
C.Weekend
2(1.6%)
1(0.8%)
2(2.9%)
1(1.4%)
1(0.8%)
6(4.7%)
76(59.8%)
1(1.4%)
3(4.3%)
38(55.1%)
D.Nospecifictime
44(34.6%)
27(39.1%)
7.Whendoyouusuallyconsumefastfoodduring
theday?
A.Morning
B.Afternoon
C.Evening
0(0%)
2(1.6%)
83(65.4%)
2(2.9%)
2(2.9%)
39(56.5%)
73
0.502
(37.2%)
88
(44.9%)
35
(17.9%)
165
0.167
(84.2%)
3(1.5%)
22
(11.2%)
4(2%)
2(1%)
2(1%) 0.890
9(4.6%)
114
(58.2%)
71
(36.2%)
2(1%) 0.179
4(2%)
122
(62.2%)
D.Nospecifictime
42(33.1%)
26(37.7%)
68
(34.7%)
squaretest.
Attitudetowardfastfood
AsmentionedinTable4,theparticipantseatfastfoodprimarilyforenjoyingthedelicioustaste,
followedbyconvenience.Adolescentgirlshadgreaterinterestintastecomparedwithyoungadult
girls(55.9%vs.42%).Incontrast,youngadultgirlsweremoreconcernedaboutconveniencethan
adolescentgirls(34.8%vs.19.7%).Restaurantshygieneandsafetystandardswerethemain
concernregardingfastfoodfor62.2%ofgirls,andtherestaurantslocationwasthemainconcern
foranother19.9%ofthem.Asexpected,mostparticipantsevaluatedthetasteoffastfoodas
excellent(80.6%)andthepriceoffastfoodasacceptable(82.7%).Asignificantlyhigher
percentageofadolescentgirls(85.8%)thanyoungadultgirls(71%)foundthatfastfoodmealsare
ofexcellenttaste.Surprisingly,morethanhalfofthegirls(53.1%)believedthatfastfoodhaseither
highoracceptablenutritionalvalue.Inaddition,27.6%ofparticipantshadnoideaaboutthe
nutritionalvalueoffastfood.Finally,ahigherrateofyoungadultgirls(27.5%)thanadolescentgirls
(15%)believedthatfastfoodhaslownutritionalvalue.
Table4.Participantsresponseforpart2ofthefastfoodquestionnaire(regardingattitudetoward
fastfood)
Adolescents,N Youngadults,N Total,N
(%)
(%)
(%)
pa
1.Whydoyoueatfastfood?
A.Delicioustaste
71(55.9%)
29(42%)
100
0.188
(51%)
B.Attractiveadvertisements
12(9.4%)
7(10.1%)
19(9.7%)
C.Diversityoffastfoodtypes
13(10.2%)
7(10.1%)
20
(10.2%)
D.Convenience
25(19.7%)
24(34.8%)
49(25%)
E.Availabilityoffastfoodrestaurants
6(4.7%)
2(2.9%)
8(4.1%)
2.Whichissueconcernsyouthemostregarding
fastfood?
A.Restaurantshygieneandsafety
79(62.2%)
43(62.3%)
122
0.788
(62.2%)
B.Restaurantslocation
27(21.3%)
12(17.4%)
39
(19.9%)
C.Restaurantsstaff
6(4.7%)
4(5.8%)
10(5.1%)
D.Price
1(0.8%)
2(2.9%)
3(1.5%)
E.Quality
11(8.7%)
5(7.2%)
16(8.2%)
F.Nutritionalvalue
3(2.4%)
3(4.3%)
6(3.1%)
3.Howdoyoufindthetasteoffastfood?
A.Excellent
109(85.8%)
49(71%)
158
0.021
(80.6%)
B.Acceptable
15(11.8%)
19(27.5%)
34
(17.3%)
C.Bad
3(2.4%)
1(1.4%)
4(2%)
4.Howdoyoufindthepriceoffastfood?
A.High
17(13.4%)
9(13%)
26
0.989
(13.3%)
B.Acceptable
105(82.7%)
57(82.6%)
162
(82.7%)
C.Low
5(3.9%)
3(4.3%)
8(4.1%)
5.Howdoyoufindthenutritionalvalueoffast
food?
5/10
9/2/2016
A.High
18(14.2%)
7(10.1%)
25
0.097
(12.8%)
B.Acceptable
50(39.4%)
29(42%)
79
(40.3%)
C.Low
19(15%)
19(27.5%)
38
(19.4%)
D.Dontknow
40(31.5%)
14(20.3%)
54
(27.6%)
squaretest.
Fastfoodrestaurantuse
Ourresultsrevealedthatthevastmajorityofthesubjects(92.9%)purchasedfastfoodmealsfrom
severalrestaurants(Table5).However,asignificantlyhigherrateofadolescentgirls(10.2%)than
youngadultgirls(1.4%)usuallypurchasedfastfoodmealsfromaspecificrestaurant.International
restaurantswerepreferablebyparticipantsforbuyingfastfoodcomparedwithlocalrestaurants
(70.9%vs.29.1%).Enjoyingthedelicioustasteoffastfoodmealsservedbyinternational
restaurantswasthemajorreasonforpreferringtheserestaurantsbybothagegroups(44.9%).On
theotherhand,girlswhopreferredlocalrestaurantshadmainlytworeasons:delicioustaste
(11.2%)andethicalissuesrelatedtoensuringthattheofferedfoodsareHalal(13.8%).
Table5.Participantsresponseforpart3ofthefastfoodquestionnaire(regardingtheuseoffast
foodrestaurants)
Adolescents,N Youngadults,N Total,N
(%)
(%)
(%)
pa
1.Didyoubuyfastfoodfromaspecific
restaurant?
A.Yes
13(10.2%)
1(1.4%)
14(7.1%) 0.023
B.No
114(89.8%)
68(98.6%)
182
(92.9%)
2.Fromwheredoyouusuallybuyfastfood?
A.Localrestaurants
34(26.8%)
23(33.3%)
57(29.1%) 0.334
B.Internationalrestaurants
93(73.2%)
46(66.7%)
139
(70.9%)
3.Ifyoupreferlocalrestaurants,why?
A.Cheaperprice
3(2.4%)
0(0%)
3(1.5%) 0.367
B.Ethicalissues
15(11.8%)
12(17.4%)
27(13.8%)
C.Encouragenationalproduction
2(1.6%)
3(4.3%)
5(2.6%)
D.Delicioustaste
14(11%)
8(11.6%)
22(11.2%)
4.Ifyoupreferinternationalrestaurants,
why?
A.Delicioustaste
57(44.9%)
31(44.9%)
88(44.9%) 0.754
B.Originalsourceofproduct
11(8.7%)
4(5.8%)
15(7.7%)
C.Betterservices
25(19.7%)
11(15.9%)
36(18.4%)
squaretest.
DISCUSSION
ThisstudyhighlightedthehighprevalenceoffastfoodrestaurantuseamongSaudigirlswhoare
eitheradolescentsoryoungadults.Overthepastfewdecades,SaudiArabianshavepassed
throughdramaticlifestylechanges.Thesechangeshavebeenrepresentedintwoforms:dietary
patternsandsedentarylifestyles.Dietarypatternstodayhavemoreenergydensefoodssuchas
fastfoodandsugarsweetenedbeveragesattheexpenseofnutrientdensefoodssuchasfruits
andvegetables,especiallyamongadolescentsandyoungadults(25,26).Furthermore,sedentary
lifestylesarebecomingparticularlyprevalentamongSaudipeople,especiallyfemales,asmostof
themdonotengageinphysicalactivityofsufficientdurationandfrequency(27).Recently,Al
Hazzaaetal.(28)reportedthatabout25%ofSaudiadolescentgirlsconsumedfastfoodsmore
thanthreetimesperweek,whereas6%ofthematefastfoodsonadailybasis.Likewise,Alfawaz
(29)investigatedfastfoodconsumptionpatternsamongfemalecollegestudentsinSaudiArabia
andreportedthatabout75%ofthemconsumedfastfoods12timesweekly.
HamburgersandFrenchfriesaretheproductsmostsoldbyfastfoodindustryleadersinwestern
countries(30).BecauseporkmeatconsumptionisprohibitedinIslamicsociety,hamburgermade
ofporkmeatisnotavailableintheSaudimarket.However,otherburgers(beeforchicken)not
onlywereavailablebutalsowerethemainkindsoffastfoodusuallyeatenbySaudigirls,asour
resultssuggested.Similarly,burgerswerereportedamongpopularchoicesforAmericancollege
studentsatfastfoodrestaurants(31).Asexpected,carbonatedsoftdrinkswerethemain
beveragesusuallyconsumedwithfastfoodmealsbySaudigirls.Thisfindingagreedwithprevious
studies.Driskelletal.(31)foundthatcarbonatedsodahasbeenreportedtobethemostfrequently
orderedbeveragewithfastfoodmealsbyfemalecollegestudents.Bowman(32)reportedthatfast
foodrestaurantsprovided25%ofthecarbonatedsodaconsumedbyadolescentgirls.InSaudi
Arabia,AlHazzaaetal.(28)revealedthatabout60%ofSaudiadolescentgirlsconsumedsugar
sweeteneddrinksmorethan3daysperweek,and31%ofgirlsconsumedthemonadailybasis.
Inourstudy,mostgirlsusuallyorderedeithersmall(37.2%)ormedium(44.9%)portionsizesof
fastfoodmeals.Apreviousstudyfoundthat53%ofcollegegirlsreportedconsideringsmaller
portionsizesoffastfood(31).However,17.9%oftheparticipantstypicallyeatthelargeportion
size.Largefoodportionsavailableatfastfoodrestaurantsareaconsiderableconcernduetotheir
highenergycontent(33),forexamplelargeorderofFrenchfries(7.0ounces)provides610
kcaloriescomparedwith210kcaloriesinasmallportionsize(2.4ounces)(34).Therefore,ithas
beenrecommendedthatattentionshouldbepaidtotheportionsizeoffoodsandbeveragesoffered
atrestaurants(35).Additionally,policyapproachesandgovernmentregulationsareneededto
reduceenergyintakefromfastfoodasmostfastfoodchainsdonotrespondeffectivelytohealth
authoritiescallstoreducetheportionsizeoftheirmenuitems(36,37).Saudigirlsoftenconsumed
fastfoodintheweekendsandevenings.Thismaybeduetogatheringswithfamilyandfriends.
6/10
9/2/2016
Driskelletal.(31)clarifiedthatmostfemalecollegestudentsreportedtypicallyeatingfastfoodat
leastonceweeklyatlunch(about60%)anddinner(about75%),butrarelyatbreakfast.
Uniquely,adolescentandyoungadultgirlsagreedthatrestauranthygieneandsafetycomprised
themainissueofconcernregardingfastfoodmeals.InSaudiArabia,therehasbeenasteady
increaseinfoodpoisoningaccidentsassociatedwithfastfoodrestaurants,especiallyinthe
warmerclimateduringthesummermonths.Meatandchickenwerereportedasthemainitemsto
causetheseaccidents(38,39).Severalstudiesreportedthatfoodhandlersinrestaurantsoften
hadalackofknowledgeandnotrainingregardingfoodhygieneandsafety(40,41).Thatsuggests
aneedforeducationtrainingcoursestargetingfoodhandlerstoincreasetheirawareness
regardingsafefoodhandlingpractices(42).
Saudigirlseatfastfoodprimarilyforenjoyingthedelicioustaste,followedbyconvenience.The
sameprimaryreasonswerereportedamongAmericancollegestudentswithreverseorder,as
theywerechoosingtoeatfastfoodforlimitedtime,followedbyenjoymentofthetaste(31).Ina
nationalrepresentativesampleofAmericans,astudyrevealedthattasteisthemostimportant
influenceonfoodchoices.Equallyimportant,nutritionalconcernsareoflessrelevancetomost
peoplesfoodchoicesthantaste(43).Only19.4%ofparticipantsbelievedthatfastfoodhaslow
nutritionalvalue.Inthesamefashion,35%ofAmericancollegegirlsindicatedthatnutrition
informationinfluencedthechoicestheymaderegardingfastfood(31).Currentapproaches
suggestthatfastfoodrestaurantsshouldberequiredtoclarifynutritioninformationsuchasenergy
andfatcontentontheirmenuboardsandonproductpackaging.Thisisimportanttohelpthe
consumertomakebetterfoodchoicesbeforepurchasing(44).TheNewYorkCityBoardofHealth
wasthefirstgovernmentauthoritytoapproveacalorielabelingregulation,in2006.Thisregulation
requireschainrestaurantsmenustocontaindetailsoftheenergycontentofallmenuitems(45).
Dumanovskyandcolleagues(46)assessedtheimpactofaddingcalorielabelingtomenuitemsby
fastfoodrestaurantsontheenergycontentofindividualpurchasesbeforeandafterfull
implementationofthementionedregulation.Theyfoundthatseveralmajorchainsreported
significantreductionsafterregulationoneinsixlunchtimecustomersusedthecalorieinformation
provided,andthesecustomersmadelowercaloriechoices.
Today,internationalfastfoodrestaurantsarelocatedinover90countriesworldwide,including
SaudiArabia.Forexample,McDonaldsisnowoperatingachainofbranchesin21Saudicities,
with62branchesinRiyadhalone(http://www.mcdonaldsarabia.com).Thebrandnameoffoods
andbeveragesinfluencesconsumerstasteperceptionsandconsequentlytheirfoodchoices(47,
48).ThismayexplainwhySaudigirlspreferredinternationalrestaurantstobuyfastfood,asthey
determinedenjoyingthedelicioustasteasamainreasontochoosefromtheirmenuitems.Onthe
otherhand,localfastfoodrestaurantshaveahugediversityinmenusandsize,fromrestaurants
withasmallsinglebranchtorestaurantchainswithmultiplebranches.Forexample,KuduinSaudi
Arabiahasbranchesin38cities,with50branchesinRiyadhalone(http://www.kudu.com.sa).The
culturalandethicalbackgroundsofconsumersaffecttheirperceptionsandfoodchoices(48).
Saudigirlswhopreferredlocalrestaurantsexhibitedconcernsaboutethicalissuestoensurethat
thefastfoodisHalalinadditiontoenjoyingthedelicioustaste.
Anadequate,nutritious,andbalanceddietisessentialtomaintainhealthforoneslifetime.To
achievethishealthydiet,fastfoodconsumptionshouldbelimited.Hence,nutritionrelated
educationalinterventionsareimportanttoimprovethedietaryhabitsandfoodchoicesof
adolescentoryoungadultgirls.Interestingly,currentevidenceemphasizedthatsignificantand
beneficialchangesindietaryhabitshavebeenexperiencedbyschoolandcollegestudentsafter
theimplementationofinteractiveandeffectivenutritioninterventionprograms(49,50).Schoolsand
collegesareappropriatesettingsforcontactingmostadolescentsandyoungadultscontinuously
andinaconcentratedway.Therefore,theyareconsideredoneofthebestavenuesfornutrition
educationinterventionstargetingthesetwoagegroups(50,51).Severaltechniquesofnutrition
interventionsweresuggestedaseffectivedeliverymedia.Thesetechniquesincludeusing
educationallectures,usingwebbasededucation,andprovidingdietarysupplements(50).Some
nutritioninterventionscouldbetraditionallecturescombinedwithhandsonactivitiesthatfocuson
selectinghealthiermenuoptionsfromafastfoodrestaurant.Othernutritioninterventionscanuse
debatelecturesonnutritionaltreatmentsandcookingclassestoteachstudentshowtoprepare
tasty,convenient,andnutritiousalternativestofastfood(49,50).TheInternetisbecoming
increasinglycentraltoadolescentsandyoungadultslifestylepatterns.Webapplicationsand
socialmediamakeitpossibleforhealthpromotioninitiativestoreachalargeaudienceinashort
time.Therefore,theInternetisanimportantvehicletodelivermessagesconcerningnutrition
informationofhealthierfoodchoicesanddifferenttypesoffastfoodmeals(52).Dietary
supplementscanbeincorporatedwithnutritioneducationprogramsinordertoenhancehealth
outcomes,especiallyamonggroupsatnutritionalrisk(50).
Limitationstothisstudyincludetherelativelysmallsamplesizeandcrosssectionaldesign.
However,ourstudyhasanumberofstrengths.Thisisthefirstattempt,toourknowledge,to
investigatethetrendsoffastfoodconsumptionamongadolescentandyoungadultSaudigirlsin
onestudyunderthesameprocedureandbyusingthesametools.Furthermore,usingafaceto
faceinterviewquestionnaireinsteadofaselfreportedquestionnairehelpstoclarify
misunderstanding,enhancetheresponserate,andreducepossiblebias.
CONCLUSION
Insummary,fastfoodhasbecomeanimportantcomponentofthedietarypatternforSaudigirls,
whetheradolescentsoryoungadults,andtheirfastfoodeatingislikelytocontinueandrise.The
growingwidespreaduseoffastfoodamongadolescentsandyoungadultsisofconcernduetothe
highfatandenergyintake,whichmaycauseobesityandsubsequentlyobesityrelatedchronic
diseases.Communitybasednutritioneducationinterventionstargetingtheeatingbehaviorsof
adolescentandyoungadultgirlsareurgentlyneeded.Theseinterventionsshouldincorporate
specificcomponentsthataddressthetrendsoffastfoodconsumptionoftheseagegroups.Itis
moreeffectivetotargetissuesrelatedtothepreparationoftasty,convenient,andnutritious
alternativestofastfoodandtheselectionofhealthiermenuoptionsfromafastfoodrestaurant
ratherthantosolelytargettheunhealthinessoffastfood.Portionsizeselectionandfrequencyof
fastfoodeatingmightalsobetargetedbynutritioneducationcampaignsthatareconcernedabout
controllingdailyintakefromfatandcalories.Also,itisadvisedtomakeadolescentsandyoung
adultsawareoftheimportanceofmakinghealthierfoodchoicescomposedofnutrientdensefoods
suchasfruitandvegetablesoneatingoccasionsotherthanthoseatfastfoodrestaurants.Finally,
governmentlegislationisneededtoregulatethemarketingoffastfoodandtoeliminatefastfood
fromschoolsandcolleges.
7/10
9/2/2016
ACKNOWLEDGEMENTS
Theauthorswouldliketothankallstudentswhoparticipatedinthisstudy.
CONFLICTOFINTERESTANDFUNDING
Theauthorsdeclarenoconflictofinterestandfunding.
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*NoraA.ALFaris
NutritionandFoodScienceDepartment
CollegeofHomeEconomics
PrincessNourahBintAbdulrahmanUniversity
P.O.Box27938
Riyadh11427
SaudiArabia
Email:naalfaris@pnu.edu.sa
AboutTheAuthors
NoraA.ALFaris
NutritionandFoodScienceDepartment,CollegeofHomeEconomics,PrincessNourahBint
AbdulrahmanUniversity,Riyadh,SaudiArabia
SaudiArabia
JozaaZ.AlTamimi
SaudiArabia
9/10
9/2/2016
MoneeraO.AlJobair
SaudiArabia
NaseemM.AlShwaiyat
DepartmentofClinicalNutrition,CollegeofAppliedHealthSciencesinArrass,QassimUniversity,
SaudiArabia
SaudiArabia
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Trends of Fast Food Consumption Among Adolescent and Young Adult Saudi Girls Living in Riyadh - ALFaris - Food & Nutrition Research

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Trends of Fast Food Consumption Among Adolescent and Young Adult Saudi Girls Living in Riyadh - ALFaris - Food & Nutrition Research

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9/2/2016

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