Western pattern diet

Fast food is a typical example of food consumed in a Western pattern diet.

The Western pattern diet is a modern dietary pattern that is generally characterized by higher intakes of red and processed meat, butter, high-fat dairy products, eggs, refined grains, white potatoes, and high-sugar drinks.^[1] In contrast, a healthy diet found in the same populations has higher portions of fruits, vegetables, whole-grain foods, poultry, and fish.^[2][3] The modern Western pattern diet was brought about by fundamental lifestyle changes following the Neolithic Revolution, and later, the Industrial Revolution.^[4]

Obesity among various developed countries

Elements

This diet is "rich in red meat, dairy products, processed and artificially sweetened foods, and salt, with minimal intake of fruits, vegetables, fish, legumes, and whole grains."^[5] Various foods and food processing procedures that had been introduced during the Neolithic and Industrial Periods had fundamentally altered 7 nutritional characteristics of ancestral hominin diets: glycemic load, fatty acid composition, macronutrient composition, micronutrient density, acid-base balance, sodium-potassium ratio, and fiber content.^[6]

The typical American diet is about 50% carbohydrate, 15% protein, and 35% fat.^[7] These macronutrient intakes fall within the Acceptable Macronutrient Distribution Ranges (ADMR) for adults identified by the Food and Nutrition Board of the United States Institute of Medicine as "associated with reduced risk of chronic diseases while providing adequate intakes of essential nutrients," which are 45-65% carbohydrate, 10-35% protein, and 20-35% fat as a percentage of total energy.^[8] However, the nutritional quality of the specific foods comprising those macronutrients is often poor, as with the "Western" pattern discussed above. Complex carbohydrates such as starch are believed to be more healthy than the sugar so frequently consumed in the Standard American Diet.^[9][10]

A review of eating habits in the United States in 2004 found that about 75% of restaurant meals were from fast-food restaurants. Nearly half of the meals ordered from a menu were hamburger, French fries, or poultry — and about one third of orders included a carbonated beverage drink.^[11] From 1970 to 2008, the per capita consumption of calories increased by nearly one-quarter in the United States and about 10% of all calories were from high-fructose corn syrup.^[12]

Americans consume more than 13% of their daily calories in the form of added sugars. Beverages such as flavored water, soft drinks, and sweetened caffeinated beverages make up 47% of these added sugars.^[13]

Americans ages 1 and above consume significantly more added sugars, oils, saturated fats, and sodium than recommended in the Dietary Guidelines outlined by the Office of Disease Prevention and Health Promotion. 89% of Americans consume more sodium than recommended. Additionally, excessive consumption of oils, saturated fats, and added sugars is seen in 72%, 71%, and 70% of the American population, respectively.^[14]

Consumers began turning to margarine due to concerns over the high levels of saturated fats found in butter. By 1958, margarine had become more commonly consumed than butter, with the average American consuming 8.9 pounds of margarine per year.^[15] Margarine is produced by refining vegetable oils, a process that introduces trans elaidic acid not found naturally in food.^[16] The consumption of trans fatty acids such as trans elaidic acid has been linked to cardiovascular disease.^[17] By 2005, margarine consumption had fallen below butter consumption due to the risks associated with trans fat intake.^[18]

Vegetable consumption is low among Americans, with only 13% of the population consuming the recommended amounts. Boys ages 9 to 13 and girls ages 14 to 18 consume the lowest amounts of vegetables relative to the general population. Potatoes and tomatoes, which are key components of many meals, account for 39% of the vegetables consumed by Americans. 60% of vegetables are consumed individually, 30% are included as part of a dish, and 10% are found in sauces.^[19]

Whole grains should consist of over half of total grain consumption, and refined grains should not exceed half of total grain consumption. However, 85.3% of the cereals eaten by Americans are produced with refined grains, where the germ and bran are removed.^[20] Grain refining increases shelf life and softens breads and pastries; however, the process of refining decreases its nutritional quality.^[21]

Health concerns

Based on epidemiological studies, compared to a healthy diet, the Western pattern diet is positively correlated with an elevated incidence of obesity,^[3] death from heart disease, cancer (especially colon cancer),^[22] and other "Western pattern diet"-related diseases.^[9][23] There is an evolutionary mismatch between the ancient physiology of humans and a Western pattern diet; this underlies diseases of civilization, which include Type II diabetes, epithelial cell cancers, autoimmune disease, osteoporosis, hypertension, coronary artery disease, and obesity.^[4] There is also a correlation between a Western pattern diet and an increase in inflammatory diseases, which is particularly evident in relation to fiber and fat-content.^[24] The high level of omega-6 fatty acids compared to omega-3 fatty acids in the Western diet is believed to contribute to autoimmune and inflammatory diseases, as well as cancer and cardiovascular disease.^[25]

Crohn's disease and inflammatory bowel disease

A Western pattern diet consisting of refined sugars and polyunsaturated fatty acids has been associated with Crohn's disease.^[26] Crohn's disease has its effects on the symbiotic bacteria within the human gut that show a positive correlation with a Western pattern diet.^[26] Crohn's is an inflammatory disease that is associated with immunological responses.^[26] Symptoms can range from severe abdominal pain to diarrhea and fever^[26] Inflammatory bowel disease has shown increased development with the Western pattern diet, and high consumption of sugar and low plant-based intake is directly correlated with an increase Crohn's disease.^[27] Inflammatory bowel disease showed no increase in risk factors only in relation to development of disease associated with the Western pattern diet.^[27]

Obesity

A Western pattern diet is associated with an increased risk of obesity.^[28] There is a positive correlation between a Western pattern diet and several plasma biomarkers that may be mediators of obesity, such as HDL cholesterol, fasting insulin, and leptin.^[28] Meta-analyses have also shown that, compared to a healthy diet, a Western pattern diet is linked to increased weight gain among females.^[29] Relative to a diet high in fruits, vegetables, legumes, and fish, a Western diet is associated with increased risk of being overweight among adolescents.^[30]

Diabetes

Several studies have shown that there is a positive correlation between adoption of a Western pattern diet and incidence of type 2 diabetes among both men^[28] and women.^[31] A strong adoption of a Western pattern diet, when coupled with obesity and decreased physical activity, is associated with an especially elevated risk of type 2 diabetes.^[28] In addition, genetic predisposition to diabetes interacts cooperatively with a Western pattern diet to increase risk of diabetes.^[31]

Cancer

The Western pattern diet has been generally linked to increased risk for cancer.^[32][33] Meta-analyses have found that diet patterns consistent with those of the Western pattern diet are positively correlated with risk for prostate cancer.^[32] Additionally, a 1998 case review found that the Western pattern diet is directly associated to heightened risks for colon cancer [2]. This conclusion has been verified by several other studies, which also indicate an increased rate of rectal cancer in cases who maintained a primarily Western pattern diet^[33]. No significant relation has been established between the Western pattern diet and breast cancer. ^[34] Breast cancer epidemiologists have found that women with a more Western diet have a nominally increased risk of breast cancer that is not statistically significant.^[35] A recent study led by the National Institute of Health indicates that the Western pattern diet can actually lead to increased levels of free estradiol in women, which has benefits in regards to breast cancer prevention^[34].

Heart disease

There are multiple studies associating the Western pattern diet with heart disease. ^[36][37][38] In 2008, the INTERHEART study, funded by the Canadian Institute of Health Research, concluded that risk of a myocardial infarction is 30% higher for individuals who consume a Western pattern diet than individuals who consume a prudent diet. ^[36] A second study conducted in 2008 by Circulation also concluded that the Western pattern diet increases the risk of cardiovascular mortality in healthy US women. ^[38] With that, meta-analyses and surveys in the Journal of the American College of Cardiology have associated cardiovascular disease and/or coronary heart disease with refined carbohydrates, sugar-sweetened beverages, and red and processed meats, three major components of the Western pattern diet. ^[37]

Prevalence

The western-versus-eastern dichotomy has become less relevant as such a diet is no longer "foreign" to any global region (just as traditional East Asian cuisine is no longer "foreign" to the west), but the term is still a well-understood shorthand in medical literature, regardless of where the diet is found. Other dietary patterns described in the medical research include "drinker" and "meat-eater" patterns.^[22] Because of the variability in diets, individuals are usually classified not as simply "following" or "not following" a given diet, but instead by ranking them according to how closely their diets line up with each pattern in turn. The researchers then compare the outcomes between the group that most closely follows a given pattern to the group that least closely follows a given pattern.

History

The Western diet present in today’s world is a consequence of the Neolithic revolution and Industrial revolutions.^[39] The Neolithic revolution introduced the staple foods of the western diet, including domesticated meats, sugar, alcohol, salt, cereal grains, and dairy products.^[39][40] The modern Western diet emerged after the Industrial Revolution, which introduced new methods of food processing including the addition of cereals, refined sugars, and refined vegetable oils to the Western diet, and also increased the fat content of domesticated meats. More recently, food processors began replacing sugar with high-fructose corn syrup.^[39]

See also

• European cuisine (also called Western cuisine)
• Fast food
• Healthy diet
• Junk food
• Mediterranean diet
• Metabolic syndrome
• Nutritional gatekeeper

References

External links

• Report on Obesity 2014
• USQ Obesity Study 2017