The link between fast food and obesity is no secret. People who eat it regularly are more likely to be overweight. And when researchers compare neighborhoods, states or whole nations, the ones with more fast-food outlets tend to have higher rates of obesity. It stands to reason that obesity rates might rise and fall along with fast-food sales, and that policymakers could slow the epidemic by constraining the fast food industry.
Health advocates have long believed that, and new research suggests they’re onto something.
In a study published by the World Health Organization on Monday, researchers in the United States and Ireland analyzed fast-food sales in 25 high-income countries from 1999 to 2008. Per-capita purchases increased in all 25 countries during that period. So did the average person’s body-mass index (BMI), a measure of weight in relation to height.
But the countries in the study varied widely. And as the researchers predicted, those with the biggest increases in fast-food sales also experienced the most weight gain.
Between 1999 and 2008, the annual number of fast-food purchases increased buy just 1.5 per person in Italy, and the country’s average BMI rose by a modest 0.3%. In Australia, the annual number of purchases jumped by 15 per person over the same period, and the average BMI increased by 0.9%—three times more Italy’s. As a rule, the study found, every 1% increase in a country’s fast-food purchases yielded a .03% increase in its body-mass index.
As the study makes clear, there’s a reason that some countries—notably Australia, New Zealand, Ireland and Canada, as well as the United States and the United Kingdom—have experienced fast-food explosions while others (France, Italy, Belgium, Greece and the Netherlands) have seen smaller increases in fast-food consumption and obesity. Simply put, the hardest-hit countries have done the least to promote healthy, sustainable food systems.
Does public policy really affect people’s diets and health risks? To find out, the researchers ranked all 25 countries on the so-called Index of Economic Freedom, a scoring system developed by the Heritage Foundation and the Wall Street Journal to celebrate countries that impose few restrictions on commerce and industry. “In line with previous research,” the researchers write, “our study shows that countries adopting what are considered market-liberal policies experience faster increases in both fast food consumption and mean BMI.”
Specifically, the hard-hit countries were less likely to use trade restrictions, price controls and government regulations to keep multinational food companies from overtaking local markets. As the researchers observe, “market deregulation favors global food chains at the expense of smaller farmers and local food systems.”
The authors don’t claim to know how communities can best promote health without impeding commerce. “Trade protection might not always be a good thing, but our study found consumption of fast food was much lower in countries that have higher regulation,” lead author Roberto De Vogli of the University of California, Davis, told NBC News. “Unless governments take steps to regulate their economies, the invisible hand of the market will continue to promote obesity worldwide with disastrous consequences for future public health and economic productivity.”
American policymakers are slowly catching onto that insight. State and local officials have attempted a range of counter-strategies, from taxing sugary beverages to requiring chain restaurants to post calorie counts, and the federal government is slowly catching up. The Obama administration is going national with the calorie-posting initiative that New York City pioneered—and the nation’s new farm bill, while slashing food assistance to low-income people, doubles the value of food stamps redeemed for fresh produce at farmers’ markets.
It will take more than to reverse the global obesity epidemic, and it will take more research to pinpoint the best and fairest remedies. But the new findings confirm a simple truth. The food industry’s freedom to profit has serious consequences for other people’s health.