Southeast Asians regularly eating hamburgers, hot dogs, French fries and pizza are increasing their risk of dying from coronary heart disease and developing type 2 diabetes, according to new research in the American Heart Association’s journal Circulation.

Chinese adults living in Singapore who reported eating American-style fast food twice a week were 56 percent more likely to die of heart disease and 27 percent more likely to develop diabetes compared to those eating none, researchers found. Furthermore, Chinese-Singaporeans eating fast food four times or more each week had nearly an 80 percent increased risk of dying from coronary heart disease, researchers said.

“Western style fast food intake in East and Southeast Asia started becoming more prominent in the late 1980s into the 1990s,” said Andrew Odegaard, Ph.D., M.P.H., study lead author and Research Associate in the Division of Epidemiology and Community Health at the University of Minnesota School of Public Health. “This provided an avenue to participate in American culture, which is very different from the historical dietary culture of these populations.”

Study participants were 45- to 74-years-old when they enrolled in the Singapore Chinese Health Study. In the 16-year study (1993-2009) of 52,584 Chinese-Singaporeans, 1,397 died from coronary heart disease and 2,252 new cases of diabetes occurred.

At the start of the study, researchers used in-person interviews and a specially designed food frequency questionnaire tailored for this population assessing 165 food items commonly consumed. The questionnaire inquired on six fast food items: hamburgers and cheeseburgers, French fries, pizza, deep fried chicken, hot dogs, and other fast food sandwiches.

American or Western-style fast foods are typically high in calories and served in large portions, featuring meat, processed meat and highly refined carbohydrates. They are also usually high in sodium and cholesterol and have a poor dietary fat profile.

Those with more frequent intake of American-style fast food ate less vegetables (excluding white potatoes), dairy products, rice, carbohydrates and dietary fiber. They were also younger, less likely to have high blood pressure, better educated, smoked less and more likely to be physically active.  

U.S.-based fast food companies are growing most quickly in recently developed or developing countries, bringing them restaurant-based, western-style fast food. The study’s results suggest the need for more attention to global behavioral and dietary changes that occur as cultures interact with one another, Odegaard said. 

Co-authors are Woon Puay Koh, Ph.D.; Jian-Min Yuan, M.D., Ph.D.; Myron D. Gross, Ph.D.; and Mark A. Pereira, Ph.S., M.P.H., M.S.