title: Western-style fast food intake and cardiometabolic risk in an Eastern country.
abstract: BACKGROUND
  Western-style fast food contributes to a dietary pattern portending poor cardiometabolic health in the United States. With globalization, this way of eating is becoming more common in developing and recently developed populations.
  
  
  RESULTS
  We examined the association of Western-style fast food intake with risk of incident type 2 diabetes mellitus and coronary heart disease mortality in Chinese Singaporeans. This analysis included men and women 45 to 74 years of age who enrolled in the Singapore Chinese Health Study from 1993 to 1998. For CHD mortality, 52 584 participants were included and 1397 deaths were identified through December 31, 2009, via registry linkage. For type 2 diabetes mellitus, 43 176 participants were included and 2252 cases were identified during the follow-up interview (1999-2004) and validated. Hazard ratios for incident type 2 diabetes mellitus and coronary heart disease mortality were estimated with thorough adjustment for demographic, lifestyle, and dietary factors. Chinese Singaporeans with relatively frequent intake of Western-style fast food items (≥2 times per week) had an increased risk of developing type 2 diabetes mellitus (hazard ratio, 1.27; 95% confidence interval, 1.03-1.54) and dying of coronary heart disease (hazard ratio, 1.56; 95% confidence interval, 1.18-2.06) relative to their peers with little or no reported intake. These associations were not materially altered by adjustments for overall dietary pattern, energy intake, and body mass index.
  
  
  CONCLUSIONS
  Western-style fast food intake is associated with increased risk of developing type 2 diabetes mellitus and of coronary heart disease mortality in an Eastern population. These findings suggest the need for further attention to global dietary acculturation in the context of ongoing epidemiological and nutrition transitions.
authors: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, 55454, USA. odeg0025@umn.edu
authors: Andrew O
authors: AO
authors: Odegaard
authors: Woon Puay
authors: WP
authors: Koh
authors: Jian-Min
authors: JM
authors: Yuan
authors: Myron D
authors: MD
authors: Gross
authors: Mark A
authors: MA
authors: Pereira
mesh_terms: D044466:Asian People / Q000208:ethnology*; D015992:Body Mass Index; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D002149:Energy Intake / Q000502:physiology; D057140:Fast Foods / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D019366:Western World