Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-Food Consumption: A Meta-Analysis of Global School-Based Student Health Surveys

Abstract

Background: Adolescence presents an opportunity to influence diet, which impacts present and future health outcomes, yet adolescent diets globally are poorly understood. Objective: We generate evidence on adolescent diets globally and explore patterns and trends by subpopulation. Methods: We estimated mean frequency of consumption and prevalence of less-than-daily fruit and vegetable consumption, at-least-daily carbonated beverage consumption, and at-least-weekly fast-food consumption among school-going adolescents aged primarily 12 to 17 years from the Global School-based Student Health Surveys in Africa, Asia, Oceania, and Latin America between 2008 and 2015. Random-effects meta-analysis was used to pool estimates globally and by subgroup. Results: On average, adolescents consumed fruit 1.43 (95% confidence interval [CI] 1.26–1.60) times per day, vegetables 1.75 (1.58–1.92) times per day, carbonated soft drinks 0.99 (0.77–1.22) times per day, and fast food 1.05 (0.78–1.32) times per week. Overall, 34.5% (95% CI 29.4–39.7) consumed fruit less than once per day, 20.6% (15.8–25.9) consumed vegetables less than once per day, 42.8% (35.2–50.7) drank carbonated soft drinks at least once per day, and 46.1% (38.6–53.7) consumed fast food at least once per week. Mean daily frequency of fruit consumption was particularly low in South and East Asia (1.30 [1.02–1.58]); carbonated soft drink consumption high in Latin America (1.54 [1.31–1.78]), high-income countries (1.66 [1.29–2.03]), and modern food system typologies (1.44 [0.75–2.12]); and mean weekly fast food consumption high in mixed food system typologies (1.29 [0.88–1.71]). Conclusions: School-going adolescents infrequently consume fruits and vegetables and frequently consume carbonated soft drinks, but there is wide variability by subpopulation.

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

“…The overall prevalence of fast-food consumption for at least 1 day per week found in our study was much higher than that reported in the literature (55.2% vs. 49.1%) [5,12]. Only adolescents with complete data on height, weight, and fast-food consumption were included in our study, therefore the prevalence obtained in our study may be more realistic and reliable.…”

“…All of these findings indicate that the confounding factors, such as SES, should be considered in the analysis between obesity and fast food consumption. Unhealthy eating patterns formed in adolescence have lasting effects on future health [12]. Considering the popularity of fast food among young adolescents in LMICs, there is an urgent need for policies, strategies, and recommendations to develop a healthy dietary environment in these countries.…”

“…Unhealthy eating patterns formed in adolescence have lasting effects on future health [ 12 ]. Considering the popularity of fast food among young adolescents in LMICs, there is an urgent need for policies, strategies, and recommendations to develop a healthy dietary environment in these countries.…”

“…Notably, fast-food consumption among young adolescents in LMICs has increased significantly in recent decades [11]. For example, one multinational study found that 49% of 12-15-year-old adolescents had consumed fast food at least once in the past week, while another study reported that 46.1% of adolescents consumed fast food at least once per week; however, the mean frequency (per week) of fast-food consumption and an age-and sex-specific analysis were not reported in the first study [5], and the adolescents in the second study were aged 12-17 years [12].…”

“…The prevalence and mean frequency of fast-food consumption are reported as weighted estimates and 95% confidence intervals using the Statistical Analysis System (SAS) SURVEYMEANS procedure. The pooled overall and regional estimates were calculated by meta-analysis with a random-effects model using STATA [ 12 ]. Heterogeneity was assessed using I2 statistics.…”