Is fast food driving Singapore's obesity problem?

For decades, an increasing number of Singaporeans have been struggling with expanding waistlines and the associated health risks. In 1992, just 5.2 per cent of adults were obese and 21.1 per cent were overweight. By 2017, 8.7 per cent of Singaporeans were obese and 36.2 per cent were overweight.

But just what is leading to this dramatic increase in obesity? ValueChampion tested a number of variables that are regularly linked with obesity, including the number of workers in sedentary white collar jobs, smoking rates, regular participation in sports, and the size of the fast food industry.

Our research demonstrates a strong correlation between the fast food industrial index and increasing overweightness in Singapore, and some ethnic groups feel the impact more severely than others.

Key findings:

• The fast food industry sales index is 95.7 per cent correlated with Singapore’s overweight trend
• On the other hand, other factors like smoking and an increasingly white collar workforce didn't seem to have as strong a correlation with
• In fact, obesity and overweightness increased despite rising levels of participation in sports among both males and females in Singapore
• Ethnic Malays consume fast food more often than Chinese and Indians, and are more likely to be overweight or obese

Fast food far outshadows other factors in correlating with overweightness

Most people are aware that eating excessive calories and not getting enough exercise can lead to weight gain, but it is not totally clear which variable is the most associated with obesity. Research indicates that smoking and body weight are interrelated, but the relationship is complex and poorly understood.

Sedentary behaviour is also linked to obesity in advanced economies, as a result of an increase in white collar jobs. Last but not least, the consumption of fast food also seems like a logical contributor to increase in overweightness. But which one of these is the most important contributor to increasing obesity in Singapore?

ValueChampion used a correlation coefficient to determine which factor is most associated with overweightness and obesity in Singapore. What we found was that the fast food industry sales index is the most strongly correlated with Singapore’s rising rate of overweightness with a correlation factor of 95.7 per cent.

The growing percentage of workers in white collar roles was also somewhat correlated to overweightness, but significantly less than the fast food sales index at 79.5 per cent. Lastly, the percentage of Singaporeans who smoke, which has fluctuated up and down for two decades, was somewhat negatively correlated with overweightness.

Has participation in an active lifestyle helped?\

While the transition to a white collar workforce is one aspect of a more sedentary society, it can be offset by an increase in activity lifestyle and exercise, since it's actually insufficient physical activity that is associated with obesity and overweightness.

Indeed, the percentage of men and women in Singapore who regularly participated in sports increased dramatically from 30-45 per cent in 2001 to almost 70 per cent by 2019. But did this help fight the increasing waistlines?

The evidence suggests the answer is no. Despite the rapid increase in sports participation, the proportion of Singaporean men who were obese or overweight increased from 33.9 per cent in 1998 to 43.4 per cent in 2017. The proportion of overweight or obese women also increased from 27 per cent to 29.4 per cent in the same period.

Because Singaporeans became more overweight despite playing more sports, it is likely that fast food consumption played a greater role in rising BMIs than a sedentary lifestyle. It seems that spending an extra $100-200/month on a gym membership may help us feel better about ourselves, but what's more important for our health is really our eating habits.

Fast food, obesity and demographics: Malays impacted most significantly by fast food consumption

In 2013, Cambridge University researchers conducted a cross-sectional survey of Singaporeans to determine the demographic profile of fast food consumers and investigate whether fast food consumption is associated with an unhealthy weight.

The survey found that 40 per cent of ethnic Chinese do not consume fast food, compared with 34 per cent of Indians and just 27 per cent of Malays. Fast food customers were classified as occasional and frequent consumers, combined into a single column in the graph below.

What's really concerning is that the ethnic groups that consumed fast food more frequently also reported higher levels of overweightness and obesity. Ethnic Chinese, who consume fast food the least frequently, had an obesity rate of 10.7 per cent.

On the other hand, ethnic Malays who consumed fast food the most frequently had a 19.6 per cent rate of obesity. The Cambridge University study concluded that frequent fast food consumption in Singapore is associated with poor dietary and nutrient profiles and abdominal obesity.

Conclusion:

The growth of Singapore’s fast food industry is strongly correlated with increasing levels of overweightness. The over $1 billion-per-year fast food industry was significantly more associated with unhealthy BMIs than a growing white collar workforce, the prevalence of smoking, and rates of sports participation.

Finally, ethnic Malays, who are more likely to be occasional or frequent fast food consumers than ethnic Chinese and Indians, were also more likely to be obese and overweight.

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The 2010 National Health Survey found that having a high body mass is the largest single contributor to the national disease burden of diabetes, and other obesity-linked diseases like cardiovascular disease are becoming increasingly prevalent. With healthcare costs in Singapore on the rise, it is in the interest of the government to investigate the impact of fast food consumption on public health and the healthcare system.

Methodology:

Findings were analyzed by correlating growth of obesity and overweightness with multiple datasets. Data on the prevalence of obesity was accumulated from the World Obesity Federation. The growth of the fast food industry is measured by the sales index, accumulated by the Singapore Department of Statistics.

The smoking rate is polled in the National Health Surveillance Survey. ValueChampion defined white collar workers as employees in the services sector (as opposed to construction and manufacturing).

Year	per cent Overweight	Fast Food Sales Index	Smoking Rate	per cent White Collar Workers
1992	21.1	51.03	18.3	n/a
1995	n/a	67.23	n/a	n/a
1998	24.0	74.24	15.2	n/a
2000	n/a	83.06	n/a	n/a
2001	n/a	80.03	13.8	39.8
2004	25.6	73.05	12.6	40.8
2005	25.6	72.36	12.6	40.7
2007	n/a	76.24	13.6	40.4
2010	29.3	88.04	14.3	41.3
2013	34.4	98.79	13.3	41.2
2015	n/a	96.40	n/a	41.7
2017	36.2	100.00	12.0	42.4

A more accurate picture of the relationship between fast food consumption and overweightness could be made by more thorough data on consumption habits of Singaporeans over time.

Furthermore, the survey data on smoking rates, BMIs, and physical activity is less consistent prior to the 2000s and 2010. In recent years, the Ministry of Health surveyed health issues with increasing consistency, which will help build a more comprehensive understanding of the relationship between fast food and overweightness in the future.

ALSO READ: Combat obesity with 'fat' tax

This article was first published in ValueChampion.