Fast food consumption among young adolescents aged 12–15 years in 54 low- and middle-income countries
Open accessAbstract
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.
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Adolescents in both low- and middle-income countries (LMICs) and high-income countries (HICs) frequently have diets that are calorie-dense yet nutrient-deficient, marked by excessive consumption of sugar-sweetened beverage (SSB), ultra-processed foods, and insufficient intake of FV.
“Adolescents in both low- and middle-income countries (LMICs) and high-income countries (HICs) frequently have diets that are calorie-dense yet nutrient-deficient, marked by excessive consumption of sugar-sweetened beverage (SSB), ultra-processed foods, and insufficient intake of FV [11–13].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [11]
The Background (page unavailable) describes fast food as energy-dense and nutrient-poor and links its consumption to more soft drinks and sweets and fewer fruits and vegetables. The Discussion (page unavailable) reports frequent fast-food consumption among 12–15-year-olds in 54 LMICs. The paper does not establish the same dietary pattern in HIC adolescents or specifically document excessive ultra-processed-food consumption. (LLM, conf=0.87)
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“These poor dietary practices are more pronounced in SSA, particularly among adolescents of low socio-economic status [12,13].”
Marinakou, E., Giousmpasoglou, C., & Sakulrungsap, K. (2023) · Tourism and hospitality management · doi:10.20867/thm.29.4.6 · Cited by 6 · see citing works
Yang, Y., Yang, H., Kusuma, J. D., & Shiao, S.-Y. P. K. (2022) · Nutrients · doi:10.3390/nu14153168 · Cited by 6 · see citing works
“Additionally, fast foods [25,26], high school foods [26], smoothies [27–29], pure liquids [27,30], and dozens of other diet types emerged following urbanization and growing aging populations.”
BackgroundMethodInfluentialSritart, H., Taertulakarn, S., & Miyazaki, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010626 · Cited by 6 · see citing works
“Thailand was found to have the highest fast-food consumption—at 4–7 days per week—among other low- and middle-income countries [60].”
BackgroundReligious Participation: Does It Shape Food Consumption?
He, Y., & Tian, W. (2023) · Religions · doi:10.3390/rel14030350 · Cited by 6 · see citing works
ÇOCUK VE ADOLESANLARDA HEDONİK AÇLIK İLE OBEZİTE İLİŞKİSİ
Bozkurt, O., & Yıldıran, H. (2022) · Gazi Sağlık Bilimleri Dergisi · doi:10.52881/gsbdergi.1034683 · Cited by 6 · see citing works
Kumari, G., Rathoria, E., Khan, F. A., Singh, S. K., Lahari, R., Rathoria, R., Bansal, U., & Singh, A. (2024) · International Journal of Contemporary Pediatrics · doi:10.18203/2349-3291.ijcp20243466 · Cited by 5 · see citing works
“22 Adity et al study reported a significant association of daily junk food intake with overweight and obesity (p 0.0001).”
InfluentialParra, K., Alaofè, H., Ehiri, J. E., Nuño, V. L., Mazariegos, M., García, B. T. R., Martinez, E., Junkins, A., & Jolly, P. E. (2021) · Food and Nutrition Bulletin · doi:10.1177/03795721211019638 · Cited by 5 · see citing works
“These foods are commonly consumed among Guatemala girls.(26,27) Each food item was assigned a score of 0 to 5 depending on frequency of food intake (0 being never/rarely and 5 being 2 or more times per day) so that the JFIM ranged from 0 to 25 (0 being no junk food consumed).”
BackgroundPing, T., Zheng, M., Zhang, P., Yan, T., Miao, X., Wang, K., & Lian, K. (2022) · RSC Advances · doi:10.1039/d2ra03423a · Cited by 5 · see citing works
Trans-Fatty Acids in Fast-Food and Intake Assessment for Yerevan’s Population, Armenia
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Fast Food Consumption Patterns Nutritional Status and Anemia Among Female
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“A study conducted by Li et al. (2020) found that 60.90% of female adolescents consumed fast food once a week, and 20.30% of female adolescents consumed fast food twice or more per week and the frequency of students consuming fast food was mostly twice a week at 31.70%.”
BackgroundInfluentialKlemm, J., Muli, S., Oluwagbemigun, K., Parlasca, M. C., Crentsil, A. O., Alangea, D. O., Quartey, P., Laar, A. K., Lartey, A. A., Borgemeister, C., et al. (2024) · Maternal and Child Nutrition · doi:10.1111/mcn.13775 · Cited by 5 · see citing works
“…observed particularly alongside a growing urban middle ‐ class in low ‐ and middle ‐ income countries (Colozza, 2022; Karanja et al. 2022; Landais et al. 2023; Li et al. 2020), parallels increased attention to indicators reflecting healthy and unhealthy elements of diets (Herforth et al. 2020).”
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“Fast food and pre-packaged snacks are major sources of energy-dense food intake, with their consumption increased significantly in both high and low-to-middle-income countries, including Malaysia [4].”
Hassan, R., Shamim, A. A., Ali, M., & Amin, M. R. (2025) · Public Health Challenges · doi:10.1002/puh2.70095 · Cited by 4 · see citing works
“[37], and Syria (43”
InfluentialAnalysis of the Lifestyle and Psychological Well-being of Adolescents: Age-related Differences
Boraita, R. J., Torres, J. M. D., Ibort, E. G., & Alsina, D. A. (2022) · Child Indicators Research · doi:10.1007/s12187-022-09977-7 · Cited by 4 · see citing works
“also coinciding with those obtained by another previously conducted study (Li et al., 2020).”
ResultLoh, V. H. Y., Poelman, M. P., Veitch, J., McNaughton, S. A., Leech, R. M., & Timperio, A. F. (2021) · Public Health Nutrition · doi:10.1017/s1368980021004298 · Cited by 4 · see citing works
“Fast food and pre-packaged snacks are major sources of energydense food intake, and consumption of these foods has increased substantially among adolescents in high-(4,7) and low-to-middle-income countries(8) in the past decades.”
BackgroundPlant-based Food in the Hospitality Industry: An Exploratory Case Study of Leading Fast Food Outlets
Jones, P. (2022) · Athens Journal of Tourism · doi:10.30958/ajt.9-2-1 · Cited by 4 · see citing works
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Health and income inequality: a comparative analysis of USA and Italy
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“These diseases are not equally distributed not only in USA where there is a great inequality in wealth but also in in low-and middle-income countries (LMICs) both in adults and adolescents (27–29).”
BackgroundGupta, P., Srivastava, R., Jain, S. P., & Jain, S. P. (2024) · American Business Review · doi:10.37625/abr.27.2.706-774 · Cited by 3 · see citing works
Upreti, Y. R., Acharya, D., Yogi, B. N., Devkota, B., & Bhandari, T. R. (2022) · Journal of Health Promotion · doi:10.3126/jhp.v10i1.50981 · Cited by 5 · see citing works
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“Price segmentation and value-based pricing have been widely adopted by fast-food chains to attract diverse customer segments (Li et al., 2020).”
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Nabila, S., Haque, M. J., Morshed, M. M., & Bari, M. S. (2024) · Saudi Journal of Medical and Pharmaceutical Sciences · doi:10.36348/sjmps.2024.v10i06.011 · Cited by 3 · see citing works
Alashmali, S. M. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1408145 · Cited by 3 · see citing works
“According to a recent Global School-Based Student Health Survey across 54 low-to-middle-income countries, over half of the adolescents consumed fast food weekly, with 10.3% consuming it four to seven times a week, the highest rates noted in Southeast Asia (7).”
BackgroundInfluentialInterconexiones entre cultura y seguridad alimentaria: Factores socioeconómicos y tradicionales
Zúñiga, E. J. L., Esponda-Pérez, J. A., Rateike, L. Á., Trujillo, A. M. Á., Ramos, P. A., & García, M. I. H. (2025) · LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades · doi:10.56712/latam.v6i2.3618 · Cited by 2 · see citing works
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Young Adolescent Health and Well-Being
Mertens, S. Β., & Caskey, M. M. (2023) · Emerald Group Publishing Limited eBooks · doi:10.1108/979-8-88730-203-420251004 · Cited by 2 · see citing works
Stravování a vztah k jídlu u českých adolescentů ve 21. století
Pipová, H., Dolejš, M., Suchá, J., Kostková, M., & Urešová, A. (2020) · doi:10.5507/ff.20.24458212 · Cited by 3 · see citing works
Generation Z's Perception of Fast Food's Product Safety, Nutrition, and Health
Tahir, N. S., Ahmad, Y., Bustami, M. R., Hamid, S. N. F. A., Zamri, N. E. M. M., & Mulyany, R. (2022) · Environment-Behaviour Proceedings Journal · doi:10.21834/ebpj.v7i20.3441 · Cited by 2 · see citing works
HEALTH EDUCATION BY PEER COUNSELORS INCREASES ADOLESCENT KNOWLEDGE ABOUT HEALTHY LIFESTYLES
Rachmawati, P. D., Kurnia, I. D., Arief, Y. S., Qur’aniati, N., Kristiawati, K., Krisnana, I., & Nastiti, A. A. (2023) · Jurnal Pengabdian Masyarakat Dalam Kesehatan · doi:10.20473/jpmk.v6i1.49590 · Cited by 2 · see citing works
Comparative determination of factors affecting attitude level towards healthy nutrition
Özdemir, S., & Baltacı, F. (2025) · Scientific Reports · doi:10.1038/s41598-024-80128-4 · Cited by 4 · see citing works
Oktavia, A. D., & Prasetya, G. (2022) · JURNAL MUTIARA KESEHATAN MASYARAKAT · doi:10.51544/jmkm.v7i2.3525 · Cited by 2 · see citing works
Junk Food Consumption Among Adolescents in IbadanPreprint
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Cross-Sectional Study on Overweight and Obesity Associated with Fast-Food Consumption in Bangladesh
Sultana, F., Siddiqui, S. A., Islam, M. A., Muktadir, M. A., Millat, M. S., Islam, M. M., Tareq, A. M., Afroz, N., Rahman, M., Amin, M. N., et al. (2022) · Makara Journal of Health Research · doi:10.7454/msk.v26i2.1347 · Cited by 1 · see citing works
A Comparison between Attitudes and Knowledge Towards Fast-Food and Probiotics of Undergraduates
CEBİRBAY, M. A., & EKİNOĞLU, E. (2024) · Mutiara Medika: Jurnal Kedokteran dan Kesehatan · doi:10.18196/mmjkk.v24i1.21032 · Cited by 1 · see citing works
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Role of Food and Dietary Choices in Shaping Health Behavior of Chinese Families
Shi, Q. (2024) · American Journal of Health Behavior · doi:10.5993/ajhb.48.2.15 · Cited by 1 · see citing works
Kamil, N. Z. I. A., Mokhtar, A. H., Yahya, A., Zain, F. M., Selamat, R., Ishak, Z., & Jalaludin, M. Y. (2025) · BMC Public Health · doi:10.1186/s12889-024-20725-0 · Cited by 1 · see citing works
Fast food consumption has a great impact on the aging process — A review
Awlqadr, F. H., Altemimi, A. B., Qadir, S. A., Alkanan, Z. T., Faraj, A. M., ALKaisy, Q. H., & Abedelmaksoud, T. G. (2025) · Theory and practice of meat processing · doi:10.21323/2414-438x-2025-10-1-11-31 · Cited by 1 · see citing works
AI-Based Health Assistant for Young Adults
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“Previous study [23] reported the rates of fast food consumption among adolescents varied from countries to countries, such as Pakistan had the lowest prevalence (1.5”
InfluentialObesity in Children and Socioeconomic Factors: Thailand Perspectives
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“In addition to the in fl uence of lifestyle and medical resources (38, 39), factors such as a high prevalence of metabolic syndrome (40) and changes in population demographics are major reasons for the increasing disease burden in this region (41, 42).”
Self-citationHeartrending Contention of Processed Food
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Fast-Food Consumption among Children According to Shari'ah Perspective
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“Meanwhile, vegetable consumption was linked with higher fast-food consumption which associated with poor kind of diet (23,24).”
BackgroundIdentification of a Social Problem: Fast-food Intake among Youth – An Interactive Narrative Review
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RISING FAST FOOD CONSUMPTION AMONG ADOLESCENT GIRLS IN URBAN AREA : CALL FOR CONCERN
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- Authors
- Li, L., Sun, N., Zhang, L., Xu, G., Liu, J., Hu, J., Zhang, Z., Lou, J., Deng, H., Shen, Z., & Han, L.
- Affiliations
- Ningbo University (CN)
- Ningbo College of Health Sciences (CN)
- Harbin Medical University (CN)
- Weifang Medical University (CN)
- Nutrition Department, Yuyao People’s Hospital, Yuyao, Zhejiang, PR China
- Ningbo Medical Center Lihuili Hospital (CN)
- Ningbo No. 2 Hospital (CN)
- Corresponding author
- Shen, Zhisen
- Han, Liyuan
- ORCID
- Venue
- Global Health Action
- Publisher
- Informa UK Limited
- Published
- 2020-08-07
- Volume
- 13
- Issue
- 1
- Pages
- 1795438-1795438
- ISSN
- 1654-9716 (ISSN-L)
- 1654-9880
- PMC
- PMC7480506
- OpenAlex
- W3047735631
- Cited by
- 135
- References
- 31
- Citations by year
- 2026: 17 · 2025: 22 · 2024: 33 · 2023: 19 · 2022: 30 · 2021: 12 · 2020: 2
- FWCI
- 9.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Health Action (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Key R&D Program of China (2017YFC1310902)
- National Natural Science Foundation of China (U1503223)
- Ningbo Health Branding Subject Fund (PPXK2018-02)
- Sanming Project of Medicine in Shenzhen (SZSM201803080)
- K.C. Wong Magna Fund of Ningbo University
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
- Keywords
- fast food consumption, early adolescents, low- and middle-income countries, prevalence, nutritional status, obesity, food insecurity, soft drink consumption, fruit and vegetable intake, sedentary behavior, physical activity, smoking, healthy eating promotion, adolescent nutrition
- MeSH terms
- Adolescent, Child, Developing Countries, Diet, Female, Health Surveys, Humans, Male, Nutritional Status, Risk Factors, Prevalence, Fast Foods
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