Fast food chains of America are growing in emerging local markets. While the opportunities can be healthy for business, that may not be true for local consumers. India, which has become a popular destination for American fast food chains. Subway and Domino’s, among many others, have hundreds of outlets on the subcontinent. The chains sell a brand of Western cool that appeals to an upwardly mobile middle class. But the items fast-food chains tend to sell – high in calories, fat, carbohydrates, sodium and sugar – are also associated with obesity, diabetes and cardiovascular disease.
“When this Western diet gets exported to places where it hasn’t previously been, all the health problems associated with it follow,” Julia Wolfson, assistant professor at the University of Michigan School of Public Health.
India faces a growing obesity problem. A study published in the medical journal The Lancet last year that compared the body mass index of adults around the world from 1975 to 2014 showed a spike in obesity rates in middle- and lower-income countries like India, China and Brazil.
“If you take India, there’s been a huge rise in fast food,” said Vasanti Malik, a research scientist in the nutrition department at Harvard’s T.H. Chan School of Public Health. “China and India have the greatest number of people with diabetes worldwide.”
In 1975, India ranked 19th in the number of obese people out of 186 countries, according to the study, but jumped to fifth place for men and third place for women in 2014.
Not only are middle and lower income countries like India dealing with rising obesity, but they’re also grappling with under nutrition and infectious diseases, a phenomenon Malik called “the double burden.”
“Healthcare systems are really taxed at this point,” she said.
To be sure, fast food isn’t the only reason for rising obesity rates in developing countries. In a study by the FAO, the UN’s food and agriculture branch, other factors include a shift from an agrarian to an urban society, sedentary lifestyles, longer working hours, and the increased availability of cheaper and higher calorie convenience foods at supermarkets.
Most large fast food companies have also defined corporate social responsibility strategies.
Yum! Brands Inc., parent to KFC, Pizza Hut and Taco Bell, says it’s focusing on “the success and diversity of our associates, feeding people, health and nutrition, our supply chain, the environment, and community engagement and impact.
Dunkin’ Brands Group Inc., which owns Dunkin’ Donuts and Baskin-Robbins, states on its website: “We are passionate about offering our guests delicious products they will enjoy, giving them plenty of menu options, and providing accurate nutrition information so they can make the best choices for themselves.”
And Subway, noting its reputation for healthful options, says it’s committed to offering nutritious items, providing nutrition information, and marketing healthy foods to adults and children.
While these chains and many others have made progress developing and marketing healthy options in the U.S., internationally they are only required to follow local laws, which may be more lax or nonexistent.
Wolfson likened fast food’s overseas growth to the tobacco industry. “When sales slumped in the U.S., or they were subject to stronger regulations for labeling and marketing, they go overseas where they have an untapped market and less stringent regulations,” she said. “It’s a tried and true model.”
While Wolfson acknowledged that the rise of fast-food in developed nations isn’t the only factor in rising obesity rates, that doesn’t mean it should be ignored. “It doesn’t have to be proven to be the one and only thing at fault for us to take action to limit its influence or help companies be more motivated to reformulate to be healthier,” she said.
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