The people cannot avoid this focus but there are many problems (Sakeholderdoce, 2014).Mc Donald’s need to do decision-making about the strategies that how should they promote their food; they need to promote food, with the label of fresh and health with less calories.
All these measures were taken from the World Bank’s World Development Indicators database.
We also included as confounders time-invariant measures (2008) of the percentage of the population doing insufficient physical activity (i.e.
Such data were missing for Estonia, Iceland, Luxembourg and Slovenia.
To limit biases in international comparisons between Asians and Caucasians due to different interpretations of BMI in Asian populations, we excluded Japan and the Republic of Korea.
Department of Public Health Sciences, School of Medicine, University of California Davis, One Shields Avenue, Med Sci 1-C, Davis, CA 95616, United States of America (USA).b.
School of Sociology, Social Policy and Social Work, Queen’s University Belfast, Belfast, Northern Ireland.c.The first two values were obtained from the Statistics Division of the Food and Agriculture Organization; Our regression models included corrections for fixed aspects of initial country conditions and other characteristics that could influence the level of fast food consumption – and hence average BMI – in a given country.By assessing within-country annual variations in fast food and obesity over time and adjusting for fixed, country-level characteristics, these conservative models effectively address the problem of confounding of study results.However, we ran additional analyses including these countries as robustness checks.We also developed separate models excluding Anglo-Saxon economies (Australia, Canada, Ireland, New Zealand, the United Kingdom of Great Britain and Northern Ireland and the United States of America) that, as previous studies showed, have a higher prevalence of obesity and easier access to fast food.The index is calculated as the mean of 10 subcomponents measuring different aspects of economic freedom, as determined from national laws and regulations as well as written questionnaires completed by experts and investors (Appendix C, available at: We included in our analyses several potential confounders of the association between fast food and BMI: gross domestic product (GDP) per capita (expressed logarithmically in constant 2005 United States dollars, adjusted for purchasing power parity for comparability between countries); the proportion of the population living in urban areas; national population size; openness to trade (imports and exports as a percentage of GDP); foreign direct investment (FDI, or net inflows as a percentage of GDP); and a time-invariant (2008) measure of motor vehicles per 1000 people.Sources: Age-standardized mean BMI: Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group; Table 2 presents the results of multivariate panel analyses in which age-standardized mean BMI was the dependent variable.Fast food consumption was positively and significantly associated with BMI (unadjusted : 0.0657; 95% confidence interval, CI: 0.0433–0.0881).After correcting for income, urbanization, population size, openness to trade and FDI, the estimated relationship weakened but remained strongly significant (Before analysing the influence of market deregulation and the possible mediators between fast food consumption and BMI, we performed a series of robustness checks.When we excluded Anglo-Saxon economies from the model while controlling for the same confounders, we found no significant differences in the magnitude of the association between fast food consumption and BMI ( 0.05 when testing effect heterogeneity).