research paper on fast food industry

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• Published: 27 October 2020

Food and Health

Trends in the healthiness of U.S. fast food meals, 2008–2017

• Eleanore Alexander   ORCID: orcid.org/0000-0002-8998-4186 1 ,
• Lainie Rutkow 1 ,
• Kimberly A. Gudzune 2 , 3 ,
• Joanna E. Cohen 4 , 5 &
• Emma E. McGinty 1  

European Journal of Clinical Nutrition volume  75 ,  pages 775–781 ( 2021 ) Cite this article

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• Cardiovascular diseases
• Risk factors

This study aimed to examine trends in the healthiness of U.S. fast food restaurant meals from 2008 to 2017, using the American Heart Association’s Heart-Check meal certification criteria.

Data were obtained from MenuStat, an online database of the leading 100 U.S. restaurant chains menu items, for the years 2008 and 2012 through 2017. All possible meal combinations (entrées + sides) were created at the 20 fast food restaurants that reported entrée and side calories, total fat, saturated fat, trans fat, cholesterol, sodium, protein, and fiber. Chi-square tests compared the percent of meals meeting each American Heart Association (AHA) nutrient criterion; and the number of AHA criteria met for each year, by menu focus type.

Compared with 2008, significantly fewer fast food meals met the AHA calorie criterion in 2015, 2016, and 2017, and significantly fewer met the AHA total fat criterion in 2015 and 2016. Significantly more meals met the AHA trans fat criterion from 2012 to 2017, compared to 2008. There were no significant changes over time in the percent of meals meeting AHA criteria for saturated fat, cholesterol, or sodium.

Conclusions

Efforts to improve the healthiness of fast food meals should focus on reducing calories, total fat, saturated fat, and sodium.

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Acknowledgements

We thank the New York City Department of Health and Mental Hygiene for the MenuStat data.

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Department of Health Policy & Management, Department of Health & Public Policy, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, USA

Eleanore Alexander, Lainie Rutkow & Emma E. McGinty

Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, 733 N Broadway, Baltimore, MD, 21205, USA

Kimberly A. Gudzune

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, 2024 E Monument St, Baltimore, MD, 21205, USA

Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA

Joanna E. Cohen

Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA

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All authors contributed to the design of the study. EA led secondary data analysis and manuscript writing. EEM, LR, KG, and JEC contributed revisions to the manuscript and approved the final manuscript for submission.

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Correspondence to Eleanore Alexander .

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This study was deemed Exempt by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.

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Alexander, E., Rutkow, L., Gudzune, K.A. et al. Trends in the healthiness of U.S. fast food meals, 2008–2017. Eur J Clin Nutr 75 , 775–781 (2021). https://doi.org/10.1038/s41430-020-00788-z

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Received : 30 December 2019

Revised : 08 September 2020

Accepted : 13 October 2020

Published : 27 October 2020

Issue Date : May 2021

DOI : https://doi.org/10.1038/s41430-020-00788-z

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The effects of fast food restaurant attributes on customer satisfaction, revisit intention, and recommendation using dineserv scale.

1. Introduction

2. research background, 2.1. service quality, 2.2. food quality, 2.3. atmosphere, 2.5. customer satisfaction, 2.6. revisit intention and recommendation, 3. research model and methodology, 3.1. research model.

• Research Question 1: Which institutional DINESERV factors will have greater impacts on customer satisfaction?
• Research Question 2: Which institutional DINESERV factors will have greater impacts on revisit intention?
• Research Question 3: Which institutional DINESERV factors will have greater impacts on recommendations?
• Research Question 4: Do DINESERV factors and the customers’ overall satisfaction levels differ with respect to different restaurants (between global restaurants and local restaurants)?
• Research Question 5: Are there any significant relationships among customer satisfaction, revisit intention, and likelihood of recommendation?

3.2. Data Collection and Methods

4. results of the study and implications, 4.1. demographic profile of respondents, 4.1.1. frequency of visits of respondents to fast food restaurants, 4.1.2. comparison of mean for each item ( t -test), 4.2. factor analysis, 4.3. factors affecting customer satisfaction, revisit intention, and recommendation, 4.3.1. customer satisfaction, 4.3.2. revisit intention, 4.3.3. recommendation, 4.3.4. comparison of two restaurants, 4.4. the relationship between customer satisfaction, revisit intention, and recommendation, 4.5. discussion and implications, 5. conclusions, author contributions, conflicts of interest.

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Chun, S.-H.; Nyam-Ochir, A. The Effects of Fast Food Restaurant Attributes on Customer Satisfaction, Revisit Intention, and Recommendation Using DINESERV Scale. Sustainability 2020 , 12 , 7435. https://doi.org/10.3390/su12187435

Chun S-H, Nyam-Ochir A. The Effects of Fast Food Restaurant Attributes on Customer Satisfaction, Revisit Intention, and Recommendation Using DINESERV Scale. Sustainability . 2020; 12(18):7435. https://doi.org/10.3390/su12187435

Chun, Se-Hak, and Ariunzaya Nyam-Ochir. 2020. "The Effects of Fast Food Restaurant Attributes on Customer Satisfaction, Revisit Intention, and Recommendation Using DINESERV Scale" Sustainability 12, no. 18: 7435. https://doi.org/10.3390/su12187435

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Metrics details

Today, with the advancement of science, technology and industry, people’s lifestyles such as the pattern of people’s food, have changed from traditional foods to fast foods. The aim of this survey was to examine and identify factors influencing intent to use fast foods and behavior of fast food intake among students based on the theory of planned behavior (TPB).

A cross-sectional study was conducted among 229 university students. The study sample was selected and entered to the study using stratified random sampling method. Data were collected using a four-part questionnaire including Participants’ characteristics, knowledge, the TPB variables, and fast food consumption behavior. The study data were analyzed in SPSS software (version 16.0) using descriptive statistics (frequencies, Means, and Standard Deviation) and inferential statistics (t-test, Chi-square, correlation coefficient and multiple regressions).

The monthly frequency of fast food consumption among students was reported 2.7 times. The TPB explained 35, 23% variance of intent to use fast food and behavior of fast food intake, respectively. Among the TPB variables, knowledge ( r  = .340, p  < 0.001) and subjective norm ( r  = .318, p  < 0.001) were known as important predictors of intention to consume fast foods - In addition, based on regression analyses, intention ( r  = .215, p  < 0.05), perceived behavioral control ( r  = .205, p  < 0.05), and knowledge ( r  = .127, p  < 0.05) were related to fast food consumption, and these relationships were statistically significant.

Conclusions

The current study showed that the TPB is a good theory in predicting intent to use fast food and the actual behavior. It is supposed that health educators use from the present study results in designing appropriate interventions to improve nutritional status of students.

Peer Review reports

Over the past few decades, non-communicable diseases such as eczema, asthma, cancer, type 2 diabetes, obesity, etc. have increased in developed countries [ 1 , 2 ]. Also, these diseases are more prevalent with increasing urbanization in developing countries [ 3 , 4 , 5 ]. The occurrence of many non-communicable diseases is related to diet [ 6 ]. Food habits are rooted from cultural, environmental, economic, social and religious factors. An effective factor in the development of chronic diseases is lifestyle, dietary patterns and habits. Inappropriate food habits and unhealthy environments have increased the incidence of non-communicable diseases in the world [ 7 , 8 ].

Many developing countries with a tendency towards Western dietary culture go away from traditional and local diets [ 6 ]. Healthy foods with nutrients have been replaced by new foods called fast foods [ 9 ]. Fast food is the food prepared and consumed outside and often in fast food restaurants [ 10 ]. Fast food is often highly processed and prepared in an industrial fashion, i.e., with standard ingredients and methodical and standardized cooking and production methods [ 10 ]. In fast food, vitamins, minerals, fiber and amino acids are low or absent but energy is high [ 9 ]. Fast food consumption has increased dramatically in the last 30 years in European and American countries [ 11 ].

Previous studies reported patterns of inappropriate and harmful food consumption in Iranian children and adolescents [ 12 , 13 ]. Most fast food customers are adolescents and youth, as these products are quickly and easily produced and relatively inexpensive [ 14 ]. One Iranian study shows that 51% of children eat inappropriate snacks and drinks over a week [ 15 ]. It is also reported that adults today consume fast food more than previous generations [ 16 ]. Faqih and Anousheh reported that 20% of adolescents and 10% of adults consumed sandwiches 3 or more times a week [ 17 ].

According to two studies, children and adolescents who consume fast food have received more energy, saturated fat, sodium, carbohydrates and more sugar than their peers, but they have less fiber, vitamin A and C, and less fruit and vegetables [ 18 , 19 ]. Also, because of the use of oils to fry these foods at high temperatures, these types of foods may contain toxic and inappropriate substances that threaten the health of consumers [ 20 ].

In a study in the United States on young people between 13 and 17 years old, it was found that there is a significant relationship between weight gain and obesity with pre-prepared foods [ 21 ]. According to the Center for Disease Control and Prevention (2007–2008), 17% of children aged 2 to 19 years and 34% of those aged 20 years and older were obese [ 22 ]. Many Health problems were caused by human health behavior(e.g. exercising regularly, eating a balanced diet, and obtaining necessary inoculations, etc.) and studying behavior change theories/models provides a good insight into the causes and ways of preventing these problems [ 23 ]. One of these theories is the Theory of Planned Behavior (TPB), which is a developed form of the Theory of reasoned action (TRA), and describes a healthy behavior that is not fully under the control of a person [ 24 ]. This theory can successfully predict eating habits and behaviors, and recently this theory has received considerable attention from researchers in identifying norms and beliefs related to the use of fast food [ 25 ].

Based on the TPB, intention to conduct a behavior with following three concepts is controlled: 1. Attitudes (positive and negative evaluation of a behavior), 2. Subjective norms (social pressure received from peers, family, health care providers for doing or not doing a given health behavior), 3. Perceived behavior control (This refers to a person’s perception of the ease or difficulty of performing the behavior of interest.) [ 26 , 27 , 28 ].

The TPB has been tested on different behaviors such as healthy food choice [ 24 ], physical activity [ 29 ], and fast food consumption [ 30 ]. For instance, the study conducted by Seo et al. showed that fast food consumption behavior was significantly associated with behavioral intention and perceived behavioral control. In addition, their findings highlighted that behavioral intention was significantly related to subjective norm and perceived behavioral control [ 28 ].

Given that our study population has cultural diversity and nutritional behaviors different from the societies of other countries and According to the mentioned materials, the researchers decided to test the study with the aim of investigating and explaining the intention and behavior of fast food consumption and their related factors based on the TPB among Urmia University of Medical Sciences students. The results of this study will increase the awareness and knowledge about fast food and, in addition, its results can be used in research, hospitals and healthcare settings.

This cross-sectional study was performed on students of Urmia University of Medical Sciences located in northwest Iran in academic year of 2018–2019. The inclusion criteria for the study are females and males who studied at Urmia University of Medical Sciences, and students’ voluntary participation in the study and obtaining written consent from the students and University principals for the students’ participation in the study. The lack of willingness to continue participating in the study and not signing the informed consent form were considered as exclusion criteria.

According to the results of the study of Yar Mohammadi and et al. [ 31 ], with a 95% confidence interval and an error of 0.05, using the formula for estimating the proportion in society, taking into account the 10% drop rate, sample size was estimated 330students. A randomized stratified sampling method was used to select the study samples. The study sample was randomly selected from each of the strata based on the share of the total sample.

Questionnaire

The data gathering tool in this study was a self-reported questionnaire (Additional file  1 ), which was designed according to the existing measures in scientific literature [ 32 , 33 , 34 ]. The study instrument was translated from English to Persian using a standard forward-backward translation technique [ 35 ]. The original instrument was translated by a bilingual specialist. The Persian version was then retranslated into English by two independent bilingual professionals to assess retention of the original meaning in the source language. Subsequently, translators worked separately in the translation process and then prepared the final version of the Persian translation. Content validity of The Persian version of questionnaire was evaluated by a panel of experts such as 3 nutrition specialists, 3 health education specialists, and 2 instrument designers. After receiving their comments, crucial revisions were conducted in the study tool. Finally, validity of the study instrument was confirmed. The present questionnaire including four following sections:

General characteristics

The first part contains personal information such as age, gender, weight, height, field of study, student education, father’s education, mother’s education, father job, mother’s job, ethnicity, marital status, participating in nutrition educational classes, students’ monthly income, family’s monthly income, housing status, information resource for healthy nutrition.

Constructs of the TPB

The second part contains questions about the constructs of the theory of planned behavior (attitude, subjective norms, perceived behavioral control and behavioral intention). In general, attitudes, subjective norm and perceived behavioral control of students were measured using indirect items. The internal reliability of all subscales of the TPB variables was good, with a Cronbach’s alpha of 0.852.

Attitude toward fast food use

The attitude of the people was evaluated using 28 indirect items (14 items of behavioral beliefs, 14 items of expectations evaluation) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from very important to not at all important), and the score of each item varied from 1 to 5. The minimum and maximum score for the attitude subscale was 14 and 350, respectively. The internal reliability of attitude subscale was good, with a Cronbach’s alpha of 0.778.

Subjective norm

Subjective norms of students were measured by 10 indirect items (5 items of normative beliefs, 5 items of motivation to comply) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from very important to not at all important), and the score of each item varied from 1 to 5. The minimum and maximum score for the subjective norm subscale was 5 and 125, respectively. The internal reliability of subjective norm subscale was good, with a Cronbach’s alpha of 0.726.

Perceived behavioral control

Perceived behavioral control were measured by 18 indirect items (9 items of control beliefs, 9 items of perceive power) based on five-point the Likert scale (from strongly agree to strongly disagree) or (from extremely difficult to extremely easy), and the score of each item varied from 1 to 5. The minimum and maximum score for the perceived behavioral control subscale was 9 and 225, respectively. The internal reliability of subscale of perceived behavioral control was good, with a Cronbach’s alpha of 0.815.

Behavioral intention

Behavioral intention was evaluated by 8 items based on five-point the Likert scale (from strongly agree to strongly disagree), and the score of each item varied from 1 to 5. The minimum and maximum score for the Behavioral intention subscale was 8 and 40, respectively. The internal reliability of behavioral intention subscale was good, with a Cronbach’s alpha of 0.821.

Knowledge of participants

And the third and fourth parts are items related to food knowledge and fast food behavior. Students’ knowledge of fast food was evaluated by 14 items, and the score of each item varied from 0 to 2. The minimum and maximum score for the knowledge subscale was 0 and 28, respectively. The internal reliability of students’ knowledge was good, with a Cronbach’s alpha of 0.783.

Fast food use

Students’ fast food consumption was assessed by frequency of use in a past month. The term “Fast food” was defined as hamburgers, doughnuts, hot dog, snack, pizza, fried chicken and fried potatoes. The frequency of fast food use was analyzed for each food category.

Statistical analyses

All statistical analyzes were performed using SPSS 16.0 software. Descriptive statistics methods such as frequencies, means and standard deviations were used along with independent t and χ2 tests. Pearson correlation test was used to investigate the relationship between TPB variables with intent to use fast food and the real use of fast food. Multiple regressions were used for further analysis.

Descriptives

A total of 330 students were selected and recruited to the study, but some subjects (31 samples) were excluded from the study due to incomplete questionnaires (21cases), and no return of questionnaires (10 cases). Statistical analyses were performed on 229 students. Of these, 28.4% of the students were males and 71.6% were females. The results of the study showed that the average age for all the students was 22.10 ± 3.30 (the average age for male and female sexes were 22.66 ± 4.47 and 21.84 ± 2.50, respectively). The two sexes differed in terms of BMI, so that the mean of BMI was higher in boy students than in girls, and this difference was statistically significant. Almost more than 72% of the students had normal weight, and 28% of subjects were in other weights. Approximately 20.51, 54.50, 79.77% of the students reported the professional doctoral degree, Azeri ethnicity and single.

In addition, findings revealed that 64.90% of the participants lived in the dormitory, and 35.10% of them lived in personal or rental housing. The most common level of education for father (37.10%) and mother (44.10%) of students was diploma. Nearly, 46.50% of students gained food information (especially fast food) from health care providers, while 53.50% of them received their food information from other sources. Most students had zero monthly income, but 61.61% of the students reported their family’s monthly income more than 50 million Rials and 38.39% of their family had income lower than the mentioned amount. Table  1 provides detailed information on students’ characteristics.

Main analysis

Table 2 presents the mean score of knowledge and variables of the study-related theoretical framework. As the mean score of subjective norm, perceived behavioral control and behavioral intention in male students compared to female students was high, but those were not significant statistically( p  > 0.05).

Some variables of the TPB were significantly correlated with each other ( P  < 0.01, Table  3 ). In particular, fast food consumption behavior was highly ( r  = 0.382) correlated with behavioral intention. Multiple regression analyses were conducted to determine the relative importance of the variables of the TPB to behavioral intention and fast food consumption behavior (Tables  4 and 5 ). In these analyzes, when the attitude toward behavior, subjective norms, and perceived control was regressed to behavioral intention, the model was very significant ( P  = 0.000) and explained 0.347 of variance of behavioral intention. While attitude and perceived behavioral control were not significant, the subjective norms and students’ knowledge were significantly related to the intention to eat fast food. It seems that subjective norms and students’ knowledge to be the most important predictors of behavioral intent. Table  4 shows more information about predictors of behavioral intention.

The second model, using fast food consumption as a dependent variable, was also very significant ( P  = 0.000), and explained nearly a quarter of the variance (0.231) of fast food consumption. Both behavioral intention and perceived behavioral control were significantly associated with fast food consumption, of which behavioral intention appeared to be more important. Table  5 presents more information about predictors of fast food consumption.

This investigation was conducted on a sample of university students to assess the status of their fast-food consumption. It also examined the factors affecting behavioral intent and fast food consumption by applying the TPB. The results of the present study showed that students consumed fast food at an average of 2.7 times a month. Fast food in male students was often reported more than female students. A study on fast food consumption among students at Daejeon School reported monthly frequencies of fast food types: 2.7 for burgers, 2.1 for French fries, 1.8 for chicken [ 24 ]. Results of Kim study and other similar researches [ 31 , 36 ] approximately were in line with findings of the present study.

Given that most men do not have the time and skill to make traditional foods, and because of a lot of work, they prefer to turn to fast-foods, and so they are more likely to use fast foods. Meanwhile, the results of some studies indicate that most women are not very happy from high weight and are more likely to reduce their weight [ 37 ]. Therefore women do not have a positive attitude toward obesogenic foods compared to men [ 38 ], which can be a reason for consuming less fast food among women. Instead, the results of a study done by Seo et al. In Korea indicated that fast food consumption among high school students was 4.05 times a month and this consumption was reported among boys more than girls [ 28 ]. The results of the Korean study were contrary to the results of the study, meaning that fast food in Korean samples was more than Iranian. The reason for this difference can be traced to factors such as sample size, cultural, social, and economic characteristics of the samples.

Performing and not performing the behavior by a person is a function of several factors based on the theory of planned behavior. One of these factors is the person’s intention and desire to do the behavior. Behavioral intention itself is also affected by factors such as attitude, students’ knowledge, social pressure, and perceived behavioral control. In the present study, based on linear regression analysis, students’ knowledge and social pressure were both related to their intention and consume fast foods. That is, students who had the necessary information about nutrition, especially fast foods, had a high intent to choose and consume foods.

Several studies have examined the relationship between knowledge of foods and their contents and attitudes toward fast foods and processed foods or relationship between attitudes toward food additives and food choice behavior [ 39 , 40 , 41 , 42 ]. Aoki et al. [ 39 ] found that information about food and its contents positively or negatively affects attitudes and intentions towards food. They pointed out that food information was important for consumers in choosing food. Back and Lee [ 43 ] found that consumers had inadequate and incorrect information about foods, which could affect their attitudes or intent. These studies suggest that providing more information about foods and their compounds can help them to improve their attitude towards foods. Therefore, training on the performance, benefits and safety of foods, including positive and negative sides, should prevent misunderstandings about food supplements and reduce food safety concerns.

The findings of the present investigation showed that subjective norms of students were effective on intent to use fast foods. Friends had the most impact on the plan to eat fast foods, as expected. In addition, the normative beliefs of students were also more positive for friends than family and teachers. This conclusion suggests that most training programs should focus on their friends as a critical group that may affect intent to use fast foods.

Results of some previous studies were similar to findings of the current study. One study conducted by Mirkarimi et al. highlighted that subjective norms had the main role on students’ intent to use fast foods [ 44 ]. In the other words, they found that behavioral intention was affected by subjective norms. In addition, the study of Yarmohammadi and et al. showed that subjective norms predict intention and behavior [ 31 ].

In this study, TPB demonstrated to be a sound conceptual framework for explaining closely35% of the variance in students’ behavioral intention to consume fast-food. Among the TPB variables, subjective norm and knowledge of students were the most important predictors of intention to use fast foods. These findings are consistent with other results that identify that subjective norms have a significant effect on consuming fruits and vegetables [ 45 ]. In study of Lynn Fudge, Path analysis highlighted that TPB explained adolescent fast-food behavioral intention to consume fast food. The model identified subjective norms had the strongest relationship with adolescent behavioral intention to consume fast food [ 46 ].

The results of this study showed that the attitude toward fast food behavior did not predict intent and the behavior. However, some studies have reported contradictory findings with the study. For example, the findings of Stefanie and Chery’s study showed that attitude was a predictor for intent to use healthy nutrition [ 47 ]. Yarmohammadi and colleagues stated in their study that attitude was the most important predictor of behavioral intent [ 31 ]. In the study of determinants of fast food intake, Dunn et al. has identified attitude as a predictor of the intent of fast food consumption [ 32 ]. The results of studies by Seo et al., Ebadi et al., along with the findings of this study, showed that attitude toward fast food consumption is not significantly related to behavioral intention [ 28 , 48 ]. Based on the findings of the current study, fast-food consumption of students was also influenced by some the TPB variables. Multiple linear regression analyses revealed that the constructs of the TPB explained fast food use behaviors with R-squared (R 2 ) of 0.23. In these analyses, intention, perceived behavioral control, and knowledge were known as effective factors on fast-food consumption. Among the TPB constructs, behavioral intention was the most important predictor of fast-food consumption. The intention plays a fundamental role in the theory of planned behavior. The intentions include motivational factors that influence behavior and show how much people want to behave and how hard they try to do the behavior [ 49 ]. In study Ebadi et al., regression analysis showed the intention as a predictor of fast food consumption behavior [ 48 ]. In studies of Stefanie et al. and Seo et al., has reported intention as correlate of the behavior [ 28 , 47 ]. All these studies confirmed and supported this part of our study findings. In addition, the results indicated that perceived behavioral control directly influenced the behavior of fast-food consumption. Some investigations confirmed this portion of our results. For instance, the results of Dunn et al. showed that perceived behavioral control (PBC) and intent predicted the behavior of fast food consumption [ 32 ]. Also, in the study of Seo et al., regression analysis showed that fast food consumption behavior was correlated with perceived behavioral control [ 28 ]. Yarmohammadi et al. found that in predicting behavior, perceived behavioral control along with intention could predict 6% of behavior [ 31 ]. Although this study provides valuable knowledge regarding the relationships between behavioral intent and TPB variables, this study, like other studies, has a number of limitations. First, a cross-sectional study was used to examine the relationship between the variables. Due to the fact that in cross-sectional studies, all data are collected in a period of time, as a result, these studies do not have the necessary ability to examine the cause-and-effect relationships between variables. Second, the results of this type of study can only be generalized to populations with similar characteristics and have no generalizability beyond that. Third, since the data of this study were collected using the self-report questionnaire, the respondents may have errors and bias in completing the questionnaire and this can affect the results of the study.

In sum, this study was conducted to identify factors influencing intention and behavior of fast-food consumption among students by using the theory of planned behavior. The findings revealed that changeability of students’ intention to use fast food and their real behavior is dependent on the TPB variables. As this theoretical framework explained 35, 23% of intent to consume fast-foods and fast-food consumption, respectively. Among the TPB constructs, knowledge and subjective norm were known as the most important predictors of intention to use fast foods. In addition, the results indicated that intention and perceived behavioral control were the most important factors influencing consumption of fast foods among participants. It is imperative that health educators and promoters use these results in designing suitable educational interventions to improve people’s nutritional behavior.

Availability of data and materials

The datasets generated during and/or analyzed during the current study are not publicly available due to confidentiality of data and subsequent research, but are available from the corresponding author on reasonable request.

Abbreviations

Theory of Planned Behavior

Theory of Reasoned Action

Statistical Package for Social Sciences

Body Mass Index

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Acknowledgements

The article authors hereby express their gratitude to Vice Chancellors for Research of Urmia University of Medical Sciences and Education Department for supporting this study.

This study is supported by Urmia University of Medical Science, grant number(No: 2017–2323) .

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Reproductive Health Research Center, Urmia University of Medical Sciences, the Province of Western Azarbaijan, Urmia, 5756115198, Iran

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Faculty of Paramedical Sciences, Urmia University of Medical Sciences, the Province of Western Azarbaijan, Urmia, 5756115198, Iran

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Department of Paramedical Science, School of Paramedical Sciences, Urmia University of Medical Sciences, Urmia, Iran

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Contributions

All authors contribute in conceive, design of this study. A.D, S.K, A.A,FTM and S.M contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. All authors revised the manuscript critically for important intellectual content and read and approved the final manuscript.

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Correspondence to Seyed Mortaza Mousavi .

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Research has been presented in the ethics committee of Urmia University of Medical Sciences and has received the code of ethics (IR. UMSU.REC.1397.43). written informed consent was obtained from all participants in this study, and all provisions of the Helsinki Statement on Research Ethics were considered.

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The questionnire used in the study to collect the data. The first part of the questionnaire included General characteristics. The second part of the questionnaire consisted of the Constructs of TPB. The third part consisted of knowledge of participants. The fourth part consisted of Fast food use.

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Didarloo, A., Khalili, S., Aghapour, A.A. et al. Determining intention, fast food consumption and their related factors among university students by using a behavior change theory. BMC Public Health 22 , 314 (2022). https://doi.org/10.1186/s12889-022-12696-x

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The Hidden Dangers of Fast and Processed Food *

The fundamental concern as we look to reform health in America is the known reality that most chronic diseases that afflict Americans are predominantly lifestyle induced; and the belief is that the vast majority of heart attacks and strokes could be prevented if people were willing to adopt healthy lifestyle behaviors. In addition, healthy lifestyles would impact a significant number of cancers which are also believed to be related to lifestyle exposures, especially to obesity, cigarettes, and other toxins.

Over the past 50 years, the health of Americans has gotten worse, and now 71% of Americans are overweight or obese—not 66%, which was reported 5 years ago. 1 That means a staggering 100 million people in America are obese. Today, eating processed foods and fast foods may kill more people prematurely than cigarette smoking. 2

Authorities determined the 71% figure by classifying people with a body mass index (BMI) over 25 kg/m 2 as overweight or obese. Yet in long-lived societies such as in the “Blue Zones” (Ikaria, Greece; Sardinia, Italy; Okinawa, Japan; the Nicoya Peninsula of Costa Rica; and Loma, Linda California) and wherever we find groups of centenarians, we observe a healthy BMI below 23 kg/m 2 , not 25 kg/m 2 . If we use above 23 kg/m 2 as the demarcation for overweight or obesity, then we find that 88% of Americans are overweight. And out of the approximately 10% that are of normal weight, the majority of those so-called “normal weight individuals” are either cigarette smokers, or suffer from alcoholism, drug addiction or dependency, autoimmune disease, occult cancers, inflammatory disorders, autoimmune conditions, digestive disorders, irritable bowel syndrome, and other illnesses that lower their body weight. Therefore, perhaps that only about 5% of the American population is at a normal weight as a result of eating healthy and living a healthy life. A recent study documented that only 2.7% of Americans adopt a relatively healthy lifestyle by combining exercise with healthy eating. 3 The Standard American Diet (SAD) is clearly not a healthy diet.

I use the term “Fast Food Genocide” because most don’t understand the depth and breadth of the harm as a large segment of our society eats a diet worse than the dangerous SAD. Many people recognize that junk food, fast food, processed food, white flour, sugar, maple syrup, honey, agave nectar, and all the junk people are eating contribute to in obesity, diabetes, heart attacks, strokes, dementia and cancer, but many don’t realize the strong causative role an unhealthy diet may have in mental illness. Currently, 1 in 5 Americans suffers from a psychiatric disorder. And many people don’t realize the harm that processed foods have on Americans living in urban areas where they don’t have easy access to whole, fresh foods.

These unfortunate folks live in what we call “food deserts,” with reduced availability to fresh fruits and vegetables. Because of the limited access to supermarkets, they eat more unhealthy fast and processed foods and end up having 7 times the risk of early-life stroke (before age 45), putting people in nursing homes in their 30s, 40s, and 50s. 4 - 7

The vulnerable poor in these areas also have double the risk of heart attack, double the risk of diabetes, and 4 times the risk of renal failure 8 - 10 ; Unfortunately, the decrease in life span due to food inequality is shocking but rarely discussed. A substantial proportion of people in these urban environments are overweight, prediabetic, or fully diabetic. Researchers determined that compared with other areas in America with easy access to supermarket food, that the YPLL (Years of Potential Life Lost) for an overweight diabetic living in a zone classified as a food desert was a shocking 45 years! 11 , 12

A link may even exist between fast food, processed food, commercial baked goods, and sweets and destruction of brain cell and a lowering of intelligence. Candy and sweetened baked goods may even stimulate the brain in an addictive fashion, which can lead to more serious illnesses.

The nutritional fundamentals accepted by the World Health Organization and most nutritional authorities today include vegetables, beans, nuts, seeds, and fruit as healthy foods; and salt, saturated fat, and excess sugar as disease causing. Excessive amounts of animal products may lead to premature aging, increased risk of chronic disease and higher all-cause mortality. Multiple studies have been published on hundreds of thousands of people, followed for decades showing that the objective endpoint of death is increased with higher amounts of animal product consumption. 13 - 17 Furthermore, refined carbohydrates may not just lead to being overweight and diabetic but also contribute to dementia, mental illness, and cancer. 18 - 21 There is considerable evidence today that heart disease is not only promoted by saturated fat and increased animal products but also by refined carbohydrates, including white rice, white bread, sugar, honey, maple syrup, and agave nectar. 22 - 25

Research has shown that excess calories shorten lifespan, whereas moderate caloric restriction slows the aging process and protects the body and brain. Americans consume more calories than any other population; and they consume foods, many of which have minimal or no nutritional value (soda and alcohol as examples). So let’s consider the individual who is consuming 50 excess calories per day. What will be the short- and long-term result? Fifty excess calories per day, over and above your basic metabolic needs, over a 10-year period, adds about 50 pounds of extra body weight. The excess weight increases the risk of multiple chronic illnesses, cancers, and also takes many years of life away from the individual simply as a result of consuming only 50 calories a day too many.

Conversely, if an individual consumed 50 calories a day less that their metabolic requirements what would happen then? Would he or she become too thin, anorexic, and unhealthy? Would their bones fall apart? Obviously not! When you moderately caloric-restrict, even a small amount such as 50 to 100 calories a day, weight remains about the same, the person is slim, not too thin, and healthy. He or she will have a lower body fat percentage, and the skeletal mass, bones, and muscle mass are strong. In this scenario, the metabolic rate would slow down accordingly. The respiratory quotient, (the number of calories lost through respiration) would decrease, the body temperature would lower, and thyroid function would decrease slightly, all lowering the metabolic rate, which overall may result in a slowing of the aging process. The secret to a long life and freedom from chronic disease may be simply to moderately reduce calories in order to slow down our metabolic rate. The only behavior proven scientifically to dramatically increase life span in every species of animals, including primates, is to lower caloric intake while maintaining an environment of micronutrient adequacy, assuring that we have exposure to every micronutrient humans need. The American diet is also deficient in antioxidants and phytochemicals that are needed for normal immune function, for maximizing brain health, protecting against dementia, chronic illness, cancer, and premature aging.

A nutritarian diet is designed to establish excellent micronutrient intake without excess calories . A nutritarian diet is designed to help prolong human life span, decrease the risk of cancer, and keep the brain functioning well for many years. This principle is represented by the equation I use: H = N /C, which means your healthy life expectancy (H) is proportional to the micronutrient (N) per calorie intake (C) over your life span. This means that we are encouraged to seek out foods that are rich in nutrients. We should try to limit or exclude empty-calorie foods and drinks. We should also limit or avoid calorically dense foods, and not eat for recreation or when we are not hungry.

A nutritarian diet is rich in phytochemicals and antioxidants. It is a vegetable-based, utilizing a wide assortment of colorful vegetables, root vegetables, green vegetables, peas, beans, mushrooms, onions, nuts, seeds, and some intact whole grains. While the standard American diet and most traditional diets are grain-based and lack sufficient exposure to the broad spectrum of antioxidants and phytochemicals (with their anticancer effects), it is important to note that not all plant-based diets are equally cancer-protective. As an example, a rice-heavy, macrobiotic diet limits phytochemical diversity, and brown rice produced in this country is contaminated with arsenic, extensively documented by Consumer Reports and white rice is refined, high glycemic food, and therefore not a healthy starch.

In comparison, the SAD is almost the opposite of a nutritarian diet. Over 55% of the SAD’s calories are processed foods, and about 33% of calories come from animal products. If we are looking at the amount of fresh produce (fruits and vegetables) consumed in America, the food consumption data reports about 10%; but in actuality, it is less than 5%, because they include French fries and ketchup in the definition of “produce!” The point here is that processed foods such as bread, pasta, salad oil, mayonnaise, doughnuts, cookies, rice cakes, breakfast bars, chips, soda, candy, and popcorn do not contain a significant micronutrient benefit. A piece of chicken is like a bagel, because they are both rich sources of macronutrients (calories), but neither one contains the necessary amounts of micronutrients, especially the antioxidants and phytochemicals only found in plants.

The high glycemic white flour products with added sweetening agents, flood the bloodstream with glucose without fiber, nutrients, or phytochemicals; and these baked goods are also high in acrylamides and advanced glycation end-products, further increasing the glycoproteins in our tissues. The resulting spike in glucose leads to abnormally high amounts of insulin, which will also promote angiogenesis, which fuels the growth of fat cells, increases cellular replication and tumor growth. The liberal amount of animal protein (including chicken which many incorrectly believe is the more healthy meat) consumed by most Americans promotes excessive insulin-like growth factor–1 (IGF-1), making a synergistic “sandwich” of insulin and IGF-1, which may accelerate aging of the brain, interfere with cellular detoxification and repair, and promote cancer. 26 The SAD has created a nutritional disaster and a significant health crisis that will not be solved by governmental “health care reform.”

Now when we think about “fast food” we’re not just referring to the food in fast food restaurants. Fast foods include chips, soda, cookies, candy, breakfast cereals, bars, French fries, burgers, pizza, white flour baked goods, and all other high-calorie, low-nutrient foods that people often eat multiple times per day. These are processed foods and for many, are the primary source of calories. These fast foods have certain characteristics: They can be accessed easily and quickly; they don’t need to be prepared; they come out of a bag or box ready to go right into your mouth. You can eat them rapidly and they’re absorbed very quickly into the bloodstream. These fast foods typically contain multiple chemicals and synthetic ingredients. They are calorically dense, highly flavored, and nutritionally barren. Fast foods typically contain extra corn syrup, sugar, artificial sweeteners, salt, coloring agents, and other potentially disease promoting chemicals.

When calories flood the bloodstream rapidly they have dramatic biological effects. Let’s compare 200 calories of white bread to 200 calories of beans. The white bread would be metabolized into simple sugars (glucose) which enters the bloodstream in 5 to 10 minutes. This requires a rapid increase in insulin; and the rapid insulin response will remain for hours. On the other hand, the carbohydrates from beans will take much more time to be digested and, as a result these calories enter the bloodstream slowly. Essentially, the calories will trickle in over hours. When eating beans, a small amount of glucose enters the blood each minute and therefore you won’t need much of an insulin response to deal with this amount of sugar. As mentioned above, the buildup of advanced glycation end products (AGEs) accelerates aging and chronic disease. 27 , 28 When a diabetic suffers from kidney failure, blindness, or a leg amputation, a major causative factor is the buildup of AGEs in the tissues. Interestingly, these same glycated end-products and glycoproteins build up in the tissues of people who are not diabetic but who continually expose themselves to excess sugar and white flour products.

Next, it is important to understand that oils are also processed foods. When consumed, oil enters the bloodstream rapidly similar to high glycemic carbohydrates. Anything cooked in oil should be considered a fast food. Beans, nuts, and seeds are whole foods whose calories are absorbed gradually over hours. In contrast, the calories from oil are absorbed rapidly, and are largely empty calories (with insignificant micronutrients and no fiber)—a combination that leads to obesity, disease, and premature aging.

If I set up a buffet dinner and I asked all the guests to form 2 lines and then gave everyone on the right side a tablespoon of olive oil, and each of those on the left side an apple to consume while they were waiting in line, those who ate the 65-calorie apple will generally eat 65 less calories from the buffet. But those who had the 120-calorie tablespoon of oil will not usually consume 120 calories less. The oil contains neither fiber, nor micronutrients and contains nothing to decrease the appestat. A matter of fact, if you put oil on food, it may actually increase one’s appetite. Not only will these individuals not eat fewer calories—they will eat even more than the 120 calories from the oil. 29 When added or mixed into food, oil drives overeating behavior.

Nutrients and fiber are needed to control the appestat, so you consume a healthy amount of calories. My experience has demonstrated with thousands of patients, the more nutrient and fiber dense your diet becomes the lower your drive to overeat. 30 This is extremely important, because even a moderate amount of extra fat on the body induces more rapid aging and increases the risk of diabetes, heart disease and cancer. A mild degree of caloric restriction becomes comfortable and achievable when the diet is high in micronutrients and fiber. When you have enough micronutrients and fiber in your diet, you don’t feel driven to overeat. But when you don’t have enough micronutrients and fiber in your diet, you become a food-craving, overeating machine.

Even worse is what happens when you eat food fried in oil because fried food may create carcinogenic and mutagenic aldehydes. 31 Food that is fried such as in a fast food restaurant is usually cooked in oil that has been heated and used multiple times. One serving of French fries or fried chicken that is cooked in a fast food restaurant has 100 times the level of aldehydes designated as safe by the World Health Organization. Even the fumes are so toxic they increase the risk of cancer. People working in restaurants that fry the food, or those working in a movie theater making popcorn, have a heighted risk of lung and other cancers, even if they don’t eat any of the fried foods. 32

The explosion of fast food restaurants has significantly increased the intake of fried foods, and people are now eating 1000 times the amount of soybean oil compared with the early 1900s. 33 Humans never ate 400 calories of oil a day the way people do in America, especially in the Southern states—which are known for the highest stroke and heart attack rates in the world. 34 When you use nuts and seeds as your source of fat as opposed to oil, we see the opposite effect.

The Physician’s Health Study, the Nurses’ Health Study, Iowa Women’s Health Study, the Adventist Health Study—any study with large numbers of people followed for decades—demonstrates the relationship between nut and seed consumption and longer life span. We always have to give more credence to clinical research studies that involve large numbers of people followed over decades using objective endpoints such as mortality. When you do that, you find that people who consume nuts and seeds regularly have lower cancer rates, lower cardiovascular death rates, lower sudden cardiac death, less irregular heartbeats, and an increase in life span.

A 2015 meta-analysis that included over 44 000 deaths demonstrated an almost 40% decrease in cardiovascular mortality for people eating nuts and seeds regularly (one serving a day). The European PreviMed study, which randomized 7216 individuals to nuts or olive oil as part of a Mediterranean diet showed a 39% decrease in all-cause mortality in the nut eaters. 35

When we look at the health implications of animal protein we should compare this type of nutrition with plant-based proteins, especially when an individual has cardiovascular disease, diabetes, obesity, or even cancer. When your protein comes from beans, nuts, seeds, and greens, the body more gradually assimilates a complete array of amino acids to make functional proteins and hormones, keeping IGF-1 production much lower. Adequate amounts of plant protein keep IGF-1 in that moderate range, between 100 and 175, which is where it should be. The average American’s IGF-1 level is around 225, which is a level which has been linked to cancer promotion. When we eat a variety of plants, we get a full balance of amino acids, which slowly enter the blood—and we also digest some of the bacteria in the digestive track and some of the cells that slough off of the villi endothelium, enabling the utilization of partially incomplete plant proteins, now made complete. Conversely, when you eat large portions of meat, eggs, or cheese, the amino acid mix enters the bloodstream faster and because it is already biologically complete, it stimulates excessive amounts of IGF-1, again increasing the risk of cancer. 36 - 43

The average American consumes 10 to 20 ounces a day of animal products, whereas the safe level of consumption is likely less than 10 ounces per week . My estimate of 10% of calories as an upper limit of safe consumption is for a person with favorable genetics and is still likely more animal products than ideal for the nonelderly adults. It may be the case that under 5% of calories from animal products would be more ideal for life span and for facilitating disease reversal. Of course, any diet designed to optimize health should include a broad array of colorful plants with phytochemicals and antioxidants, which have been shown to increase life span and prevent cancer.

The animal products served at fast food restaurants are making the health of the population much worse, creating dangerous carcinogens from the food being grilled, barbecued, and fried at high temperatures. The World Health Organization has classified processed meats (hot dogs, sausage, bacon, and lunch meats) a class 1 carcinogen. AGEs are also highest in barbecued and fried animal products which also contain cancer-causing chemicals such as heterocyclic amines, polycyclic aromatic hydrocarbons, and lipid peroxidases, which are mutagenic.

There are 2 phases of the digestive cycle: the anabolic phase, when you are eating and digesting, and the catabolic phase, when digestion has ceased. When you are eating and digesting food, the body turns those calories into stored glycogen, increasing fat storage and the storage of waste. During this phase of the digestive cycle, growth hormones and fat storage hormones are activated.

When your body is finished digesting, you enter the catabolic phase, where the stored glycogen and fat are utilized for energy. This is the phase when your body can most effectively detoxify and enhance cellular repair. It is the time when the liver and kidneys work together to remove aldehydes, AGEs, and other toxic metabolites. Repair and healing is enhanced during the catabolic phase when you are not eating food.

Most Americans have made their bodies so toxic, that when they enter the catabolic phase of the digestive cycle, they feel uncomfortable. That means they feel fatigue, headache, stomach cramping or fluttering, anxiety, or other uncomfortable symptoms when they stop digesting food and the body starts to mobilize waste and repair the damage. They typically interpret these symptoms as hunger or low blood sugar, because they feel better if they eat again—even though there is no biological need for calories at this time; and so they just get fatter and sicker. Every addiction has a “high” during the caloric rush and a “low” during withdrawal and repair from the disease-causing diet and resultant metabolic wastes and toxins that accrue from it. The American diet results in withdrawal symptoms and discomfort which promotes overeating and too-frequent eating. The lower the quality of the food consumed, the more discomfort felt when not eating and digesting, which makes it very difficult to maintain a healthy body weight.

If you’re healthy and eating nutritious food, you feel nothing when you enter the catabolic phase, with no desire to eat again until glycogen stores are nearly exhausted. True hunger is a mild sensation felt in the throat and base of the neck. True hunger heightens taste sensitivity too, making eating more pleasurable. True hunger directs when you should eat and therefore it’s more difficult to become overweight if you pay attention to the signs your body sends to your brain. Being overweight requires eating outside of the demands of true hunger, either recreationally or because of withdrawal symptoms from improper eating, stimulating the overconsumption of calories.

Enhanced detoxification—reduction of metabolic waste, aldehydes, and AGEs—occurs most effectively in the catabolic phase. That means the longer you live in the catabolic phase of the digestive cycle, the longer you live. If you finish dinner earlier or have a lighter dinner, and you have a 13-hour window between the end of dinner and the start of breakfast, you are going to live longer. A recent study had women with breast cancer followed for 10 years and found that those who finished dinner earlier and had a 13-hour window before the start of breakfast had a 26% reduction in the risk of death or recurrence from breast cancer. 44 , 45 The increased nighttime window was also linked to improved glycemic control and a lower HbA1c (glycated hemoglobin). They had no better diet, no different number of calories, no better food; they just finished dinner earlier.

The goal for excellent health is to eat as infrequently as possible. Many people believe just the opposite and eat frequent small meals that increase endothelial dysfunction leading to an increased risk for arteriosclerosis and cardiovascular disease. In addition, all the fad diets encourage people to make the wrong choices about what and when to eat. Many suggest the use of frequent high-protein meals so as not to feel the effects of normal detoxification. When the digestive track is continually busy, it results in accelerated aging.

Processed and fast foods are also high in salt. The fast and processed food manufacturers don’t just put salt on the French fries and on the meat, they also put salt in the French fry batter and inside the chopped meat. They also include high fructose corn syrup in most foods. The added fat, sugar, and salt create a taste that makes people crave these foods, a sensation that many describe as an addiction. Both sugar and salt intake increase stroke risk, especially when consumed daily for years. Additionally, what is generally not appreciated is that the regular consumption of artificially sweetened soda creates more of a stroke risk. 46 High salt does not merely raise blood pressure; it also causes microvascular hemorrhaging, which damages the interior walls of the blood vessels in the brain and increases permeability and the propensity for hemorrhagic stroke. 47 , 48

Over the past 30 years, we’ve also seen an explosion of diabetes in Japan, Korea, and China, occurring at a lower body weight than we typically see in America, likely because the cumulative effects of eating more fast food, more oil and sugar, along with all of the white rice (a refined, high glycemic food), which they already had in their diet.

We know that people have the power to change when significant effort and attention is directed to the problems at hand. With good information, emotional support, increased food availability and food preparation instruction, we have found people enthused and willing to work together for change. They don’t have to be convinced of the tragic dangers of fast food; they see the obesity, diabetes, leg amputations, strokes, and blindness all around them. But if people don’t have good information, then they don’t have a choice. If they don’t have access to healthy, affordable food, and they don’t know how to make it taste good, then they are not given a chance to change.

The goal for physicians and other health care professionals is to work to transform America’s inner cities into zones of nutritional excellence. Our nation’s pride and heritage are based on the equal opportunity to achieve the American dream of prosperity and happiness. This critical information needs to be spread and put into action by community activists, teachers, educators, celebrities, health professionals, athletes, and politicians. The more people who know the critical importance of eating healthfully, and the more they take a stand, the greater the effect will be on transforming the health of all in America. By working together, we can save millions of lives.

Acknowledgments

This work was presented at Lifestyle Medicine 2017, October 22-25; Tucson, AZ.

Authors’ Note: The opinions presented in this article are those of the author and may not represent those of the Guest Editor, Editor, or the American Journal of Lifestyle Medicine.

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

Ethical Approval: Not applicable, because this article does not contain anystudies with human or animal subjects.

Informed Consent: Not applicable, because this article does not contain anystudies with human or animal subjects.

Trial Registration: Not applicable, because this article does not contain anyclinical trials.

Minimum Wages and Employment: A Case Study of the Fast Food Industry in New Jersey and Pennsylvania

On April 1, 1992 New Jersey's minimum wage increased from $4.25 to $5.05 per hour. To evaluate the impact of the law we surveyed 410 fast food restaurants in New Jersey and Pennsylvania before and after the rise in the minimum. Comparisons of the changes in wages, employment, and prices at stores in New Jersey relative to stores in Pennsylvania (where the minimum wage remained fixed at $4.25 per hour) yield simple estimates of the effect of the higher minimum wage. Our empirical findings challenge the prediction that a rise in the minimum reduces employment. Relative to stores in Pennsylvania, fast food restaurants in New Jersey increased employment by 13 percent. We also compare employment growth at stores in New Jersey that were initially paying high wages (and were unaffected by the new law) to employment changes at lower-wage stores. Stores that were unaffected by the minimum wage had the same employment growth as stores in Pennsylvania, while stores that had to increase their wages increased their employment.

• Acknowledgements and Disclosures

MARC RIS BibTeΧ

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Customer Retention in Fast Food Industry

Indus Journal of Management Sciences, Volume 1, Issue 1, 2013

7 Pages Posted: 10 Jul 2014

Usman Ali Warraich

Indus University

Nawaz Ahmad

RTS (Research, Trainings, and Solutions); Mehran University of Engineering & Technology

Faisal Qureshi

IQRA University

Date Written: December 20, 2013

This research investigates the relationship between dining attributes, customer satisfaction and customer retention in the fast food industry. This research has brought out how to gain customer retention to the services and the factors that influence the customer retention. For this research sample size of 164 consumers from different fast food restaurant has been taken randomly on the basis of convenience sampling. Multiple Regressions were used as the statistical tool. Results obtained from the analysis corroborate that there is a significant impact of service quality on the customer retention.

Keywords: Customer Retention, Service Quality, Fast food industry.

JEL Classification: C12, L80, M31

Suggested Citation: Suggested Citation

Indus University ( email )

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In need of a sustainable and just fashion industry: identifying challenges and opportunities through a systematic literature review in a Global North/Global South perspective

• Open access
• Published: 08 August 2024
• Volume 5 , article number  186 , ( 2024 )

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• Francesca Bonelli 1 ,
• Rocco Caferra 1 &
• Piergiuseppe Morone 1  

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Since the late twentieth century, the global fashion industry has been increasingly embracing the business model known as fast fashion. Characterised by rapid production cycles, fleeting trends, low-cost garments and large-scale production, fast fashion seems to meet consumer demand for affordable and trendy clothing. However, its environmental impact as a major polluter poses significant challenges to sustainability and circularity initiatives. This article presents the results of a systematic literature review, exploring the unsustainable consequences of fast fashion, focusing on both demand and supply side, from a geographical perspective. Using a Global North–Global South framework, it explores differences in socio-economic structures, consumption and production patterns, access to resources and environmental impacts. The analysis suggests that a fair and equitable transition towards a sustainable and circular fashion industry will require the links between business, society and nature to be reconsidered, to avoid perpetuating the inequalities associated with the global linear capitalist economy. The findings highlight the importance of both markets and institutions in sustainable growth. In the Global North, the most frequently discussed topics relate to investment and research and development with respect to new technologies or system innovations often with the support of well-structured political guidance. Conversely, in the Global sustainable initiatives tend to be scattered, country-specific and intricately tied to particular socio-economic and cultural contexts.

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1 Introduction

As Payne outlines [ 1 ], fashion is both an industrial and a cultural phenomenon that is deeply intertwined with the converging environmental, social and economic challenges of the twenty-first century. Following World War II, when production shifted from the home or small workshops to factories orientated towards mass production, fashion became one of the world’s largest industries. Today, it is a major global and globalised industry, characterised by ‘low predictability, high impulse purchase, shorter life cycle, and high volatility of market demand’ [ 2 ].

The term ‘fast fashion’ was coined in the 1990s, when the Spanish brand Zara first opened a store in New York and quickly emerged as a standout and highly imitable model of efficiency and speed.

The rise of fast fashion was primarily driven by changes in consumer behaviour and increased fashion consciousness, coupled with the transition of mass-production globalised retailers from a production—to a market-centric approach [ 3 ]. Direct engagement between retailers and consumers was essential for maintaining the industry pace. In particular, the late 1990s saw a surge in demand for fashion, fuelled by the popularity of fashion shows and the shift to shopping as a form of entertainment [ 4 ]. Mass-production retailers such as Zara, H&M, UNIQLO, GAP and Primark Forever 21 and Topshop expanded rapidly, due to globalisation, and met growing demand by swiftly delivering ‘high fashion at a low price’, within a ‘throw-away market’ paradigm [ 3 , 5 ]. Vertical integration was adopted to reduce production times and promote flexibility, collaboration and communication in accordance with more complex global supply chains [ 6 ]. The late 1990s also marked the advent of e-commerce, with fast fashion retailers such as H&M entering the digital arena [ 4 ]. E-commerce furthered the globalisation and democratisation of fast fashion, making products and services more accessible across diverse and international markets [ 7 ]. Retailers leveraged e-commerce to reduce purchasing and supply management costs, improve communication strategies and enhance competitiveness through innovation. For consumers, e-commerce simplified purchasing decisions, leading to time and cost savings [ 8 ]. The 2020 pandemic, resulting in a significant economic downturn for fashion companies [ 9 ], accelerated the adoption of e-commerce as a crucial business solution and primary source of market innovation [ 10 ]. Chinese fashion retailers such as Temu and Shein pushed this model a step further, with nearly exclusive online sales.

Notwithstanding the advantages of this new business model, it also presented significant disadvantages. In particular, the technological innovations, GDP growth, globalisation and shifts in retail markets that have arisen as a result of fast fashion have introduced several adverse environmental and ecological impacts [ 11 ]. Considering climate change, the fashion industry is accountable for 8–10% of global greenhouse gas emissions –a figure projected to increase by 60% by 2030, according to the United Nations Framework Convention on Climate Change [ 12 ]. The UNEP has also blamed fast fashion for triggering the ‘triple planetary crisis’ [ 6 ]. In more detail, it is responsible for the consumption of vast quantities of raw materials, including farmland and fossil fuels (especially oil), and the conversion of plastic fibres [ 13 ]. Other impacts relate to water depletion and pollution. For instance, the extensive use of chemical compounds and the incineration of synthetic plastic fibres (i.e., polyester, nylon, acrylic), make fashion the second-largest contributor to water pollution after agriculture [ 14 ].

Fast fashion’s linear model of production shows a contrasting dynamic when viewed from a Global North–Global South perspective. Derived from the ‘Third World’ model introduced by the United Nations in the 1940s, the terms ‘Global North’ and ‘Global South’ describe regions that are socio-economically and politically opposed [ 15 ]. The Global South encompasses economically unstable and underdeveloped countries characterised by a low average per capita income, high disparity in living standards and limited access to resources (leading to a heavy reliance on primary product exports). Conversely, the Global North encompasses countries with a high average per capita income, advanced technology and infrastructure, and macroeconomic and political stability [ 15 , 16 , 17 ]. Footnote 1 These differences stem from a global capitalist economy that relies on the ‘economy-first model of development’. The integration of the Global South (formerly referred to as the Third World) into this model began in the 1950s, with the emergence of decolonisation movements. However, the enduring social and economic effects of colonialism, coupled with continuous dependency on former colonial ties and development strategies emulating the virtuous model of developed countries according to the path-dependency principle, have led to the perpetuation and sharpening of inequalities in global governance, economic development and international relations [ 18 , 19 , 20 , 21 ]. As highlighted by Hurrell and Kingsbury (1992) [ 22 ], this imbalance has become a significant source of conflict between the Global North and the Global South, especially concerning the environment. The COP27 (2022) stands as a stark example of the concerns expressed by the Global South regarding the unequal distribution of responsibilities and burdens in climate change mitigation efforts. Such political and socio-ecological inequalities also contribute to shaping production-consumption patterns [ 23 ].

These considerations extend to the global fashion industry, representing a crucial player in the global economy whose hazardous make-take-waste paradigm yields cumulative negative effects that are unevenly distributed across world regions.

Fast fashion’s high pace of overproduction and ‘purchase-discard’ consumption model result in an abundance of unwanted clothes, contributing to a significant mass of textile waste [ 24 ]. According to the US Environmental Protection Agency, the average American consumer generates 82 pounds of textile waste each year [ 25 ].

To address the issue of overproduction, efforts have been made to implement circular economic principles, resulting in a proliferation of global exports of second-hand clothing from the Global North to the Global South [ 24 , 26 ]. However, this practice of reuse, known as the ‘international second-hand clothing trade’ [ 27 ], represents the human tendency to merely ‘export or displace ecological problems, rather than truly solve them’ [ 28 ]. In fact, the flow of international second-hand clothing from the affluent Global North to the developing Global South constitutes a form of pollution shifting or waste dumping, potentially inflicting damage on the receiving nations. Evidence of this phenomenon lies in the qualitative difference in donated garments between international markets: high-quality garments are acquired by charities or companies in the Global North and resold locally, while medium-quality garments are exported to Eastern European retail shops and low-quality items find their way to Africa, Asia and South America [ 29 , 30 ]. Indeed, much of the used clothing that is exported from the Global North to the Global South lacks market value and ends up as waste in water streams, landfills, oceans or incinerators. This troubling issue was reported by ‘Trashion’ [ 31 ], which discovered that approximately 50% of the 600,000 kg of used clothing exported by Belgium to Kenya in 2021 was waste that could be neither resold or recycled.

Furthermore, challenges may arise even when high-quality clothes are traded in Global South markets. The volume and low prices of exported clothing, facilitated by political agreements on the trade of used clothing (i.e., the new post-Cotonou agreement, the ‘Everything but Arms’ initiative), hinder the growth of local textile industries. Rather than promoting employment opportunities, local product consumption and economic development, this fosters a heavy reliance on the Global North and contributes to the marginalisation of residents in the poorest countries [ 32 , 33 ].

The extensive asymmetries in the fast fashion industry between the Global North and the Global South, particularly in terms of sourcing and the generation and disposal of waste, hinder sustainable environmental and economic development and the transition towards a circular economic model [ 34 ]. Therefore, to prevent the perpetuation of colonialist-like power dynamics (as evident in the global waste trade often referred to as ‘ecological imperialism’ [ 35 ]), discussions of sustainable development and circularity must prioritise justice and address inequalities, to meet diverse needs and visions across the globe [ 34 , 36 ]. Echoing Boenhhert’s (2015) [ 37 ] perspective on the circular economy as a comprehensive approach to redesigning economic and social relations, a rebalancing of relations between the Global North and the Global South cannot overlook power dynamics. These dynamics are evident in not only the economic imperative to reduce and improve the quality of production and consumption, but also the circular economy's endeavour to ‘close the loop’, merging economic growth with sustainability [ 38 ].

The present analysis delves into the unequally distributed environmental impacts associated with the fast fashion industry, considering market interactions between consumers (i.e., demand side) and producers (i.e., supply side). Furthermore, it situates these interactions within the broader context of Global North–Global South power dynamics, as reflected in the economy-first model of development. The analysis not only uncovers the unsustainable and geographically diverse impacts of fast fashion, but it also sheds light on emerging strategies and initiatives in the discourse on fashion and sustainability. Within this context, the Global North and the Global South are considered two poles in which exchanges (or a lack thereof) of initiatives, knowledge and strategies may occur among consumers and producers.

In the following section (Sect.  2 ), we present our research questions and explain our methodological choice of a systematic literature review (SLR). We also outline the protocol used to answer our research questions, which resulted in the creation of analytical clusters. Section  3 delves into the qualitative findings of the SLR, dedicating specific subsections to the key narratives that emerged from the cluster analysis. Section  4 provides a thorough discussion of the results obtained, drawing insights for the multilevel gap between the Global North and the Global South. Finally, Sect.  5 presents concluding remarks regarding the shaping of a future discourse aimed at achieving a globally equitable and sustainable fashion industry, encompassing both production and consumption.

2 Research question

In the present study, we analysed the phenomenon of fast fashion through two distinct yet complementary lenses: (i) consumer and producer perspectives, rooted in (ii) a macro geographical focus distinguishing between the Global North and the Global South. Starting with a review of the literature, our exploration mainly centred on the environmental impact and unsustainability of the growing fast fashion industry, emphasising regional disparities. The research question explored both production and consumption, addressing the widening gap between the Global North and the Global South fostered by the fast fashion industry. Specifically, the literature review aimed at answering the following questions:

How does the empirical divide between the Global North and the Global South manifest in the economic literature on fast fashion, particularly in analyses of consumers and producers?

Are producers from the Global North and the Global South concerned about the unsustainable environmental impacts of fast fashion? Are they making efforts to transition their businesses towards more circular models? What factors influence consumer awareness, intentions and behaviours towards fast fashion? Are there notable differences or similarities between the Global North and the Global South regarding these aspects? Are there ongoing initiatives promoting sustainable consumption patterns?

What does the revised literature reveal about the role of globally adopting circular consumption and production practices in the fashion industry in bridging the Global North–Global South divide?

2.1 Methodology

The core of the qualitative-quantitative analysis was an SLR. The SLR methodology, as outlined by Moher et al. [ 39 ], relies on a ‘clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review’ [ 39 ]. This method is particularly useful for revealing the current state of the art on a topic and identifying gaps and areas requiring further research [ 40 ]. Given the complexity and novelty of the selected topic, we deemed an SLR most suitable for addressing our research questions, as it would allow us to determine a literary and bibliographic framework within which to identify relevant emerging narratives. Papers were identified following the PRISMA protocol, which outlines a specific flow of information across four research stages.

The flow diagram depicted in Fig.  1 outlines the methodological steps (i.e., identification, screening, eligibility, inclusion) [ 20 ] of the SLR. These steps, starting with identification, enabled us to select relevant publications to address our research questions.

Systematic review flow diagram

2.2 Identification

The identification process relied on the electronic database of scholarly publications Scopus, which allowed us to search across titles, abstracts and keywords in the literature. After deeming search terms such as ‘fast fashion AND Global North AND Global South’ too narrow in scope, and terms such as ‘fast fashion AND global value chain’ too broad, we ultimately selected the keyword search ‘fast fashion AND sustainability’.

The research spanned the years 2009–2023, with 2023 chosen as the end date in order to include the most recent studies. However, due to the temporal limitations of the 2023 dataset, for which collection ceased in March of that year, its representativeness in the graph is inherently limited. The year 2009 was chosen as the starting point as it marked the onset of the effects of the first globalisation crisis (beginning in October 2008), bringing to light the uneven development of the economy, the consequences of sourcing goods and services globally and the flow of capital [ 41 ]. Figure  2 depicts the annual growth in fast fashion and sustainability publications over the study period.

Annual scientific production, 2009–2023

Ultimately, our search resulted in a set of 293 publications, which we transferred to a Microsoft Excel file for the purposes of manual screening.

2.3 Screening

Screening and selection were performed manually, through a title and abstract review of the 293 papers. Eighty-one papers were excluded on the basis of their irrelevance to the subject matter. Specifically, to answer our research question and narrow the scope of the review our focus was on economic publications, addressing the impact of the fast fashion linear versus circular production and consumption model, and centred on: consumer awareness and/or behaviour and/or preferences, producer/retailer/brand marketing strategies and/or circular business models, and the interaction between consumers and producers. Systematic reviews were also included, as these offered an overview of the publishing landscape [ 42 , 43 ].

2.4 Eligibility

Each of the remaining 212 papers were assessed for eligibility, with the aim of rooting the SLR within Global North–South dynamics. Only those publications that had a clear geographical focus, i.e., context set in either Global South or Global North countries, or in a comparative approach were included. Papers that addressed mere consumers’/producers’ trends or advancement patterns and strategies towards sustainability, without discerning differences between the Global North and the Global South, or without rooting their analysis in a certain geographical context were excluded.

A set of 117 eligible papers was identified, comprised of publications focused on: (i) consumers, producers, or consumers and producers; and (ii) the Global North, the Global South or a Global North–Global South comparison.

The dataset was further sorted according to countries’ unique contributions to the scientific literature on fast fashion and sustainability, providing an overview of the distribution of geographical areas present in our identified publication set. The 117 research articles originated from 37 countries, representing both the Global North and the Global South. However, as Fig.  3 shows, certain countries contributed more significantly, as indicated by the dark blue colour (e.g., the UK with 32 articles; the US with 25; China with 14; South Korea with 9; Australia with 8; Brazil with 7), while the contribution of other countries was less significant (e.g., Japan with 3 articles, Ecuador with 2; Chile, Saudi Arabia, Tanzania, the Philippines, Croatia, Ireland and the Czech Republic with 1).

World map showing countries’ unique contributions to the scientific literature on fast fashion and sustainability

2.5 Inclusion

The 117 papers were categorised into four clusters, according to their focus: (i) consumers in the Global North, (ii) producers in the Global North, (iii) consumers in the Global South and (iv) producers in the Global South. These analytical clusters were not created using algorithms or inferential methods, but established qualitatively, with the results interpreted at two levels: (i) market dynamics and interactions (consumers and/or producers; (ii) geographical dynamics and interactions (i.e., Global North and/or Global South). Some papers were assigned to more than one of the abovementioned clusters.

Subsequently, the abstract of each paper was read in order to identify emerging narrative for each cluster of articles.

The following section reports the findings from the qualitative analysis of the 117 identified papers, organised according to each conceptual cluster. The first subsection reports the narratives of papers concerning the Global North and consumers (n = 28 publications from 2014–2023). The second subsection describes the narratives of papers discussing the Global North and producers (n = 24 publications from 2009–2023). Subsections 3 and 4 analyse Global South narratives. Section  3 focuses on consumers (n = 11 publications from 2017–2022) and Sect.  4 focuses on producers (n = 11 publications from 2017–2021).

The final subsection explores the narratives of papers pertaining to more than one of the abovementioned clusters. The content of these papers determined five further clusters of analysis: (i) the Global North and producers and consumers (n = 15 from 2016–2023); (ii) the Global South and producers and consumers (n = 5 publications from 2016–2022); (iii) the Global North versus the Global South and consumers (n = 3 from 2011–2022; (iv) the Global North versus the Global South and producers (n = 14 publications from 2016–2022); and (v) the Global North versus the Global South and consumers and producers (n = 6 from 2018–2022).

Figure  4 depicts the distribution of articles among the conceptual clusters, showing the frequency of articles per cluster.

Distribution of articles in each conceptual cluster

Figure  5 provides a visually concise summary of the SLR findings that shall be reported and discussed in the following sections. The vertical axis depicts upstream and downstream issues, while the horizontal axis represents the Global North and the Global South. Within each quadrant, the identified narratives are displayed. The upper left quadrant focuses on Global North consumer narratives, while the upper right quadrant represents the Global South consumer cluster. The lower left quadrant reflects Global North producer narratives, and the lower right quadrant pertains to Global South producers. The axes delineate overlapping narratives. The vertical axis (i.e., upstream and downstream) contains cross-cutting narratives for consumers (i.e., upstream) and producers (i.e., downstream), for both the Global North (up) and Global South (down). The horizontal axis (Global North and Global South) represents narratives cross-cutting the producer and consumer categories in the Global North (left) and Global South (right). The circle in the centre regroups the narratives encompassing all four quadrants: the Global North, the Global South, consumers and producers.

Emerging narratives grouped by conceptual cluster

3.1 Global North and consumers

The most frequent narrative in this category explored socio-cognitive aspects of consumer behaviour within the framework of the rational economic agent. Terms such as 'consciousness’, ‘knowledge’, ‘cognition’, ‘intentions’, ‘attitude’ and ‘behaviour’ frequently underscored the significance of the socio-cognitive sphere in matters of consumer preference. The central question usually revolved around how ‘consumers’ level of environmental consciousness impacts their purchase decisions and consumption behaviour’ [ 44 ], investigating potential value-action gaps or intention-behaviour gaps.

Papers [ 45 , 46 , 47 , 48 , 49 , 50 ] often analysed empirical data obtained through interviews, surveys and consumer questionnaires. These methods were applied not only to determine consumer preferences, but also explored existing knowledge and attitudes, providing empirical evidence to support initiatives to promote more environmentally friendly purchasing behaviors. Specifically, considering the environmental risks associated with the fast fashion industry, the focus on raising consumer consciousness was found to align with the theme of responsible consumption within a circular bioeconomy perspective. However, external factors (e.g., stressful events such as COVID-19) can impact consumer behaviour, encouraging impulsive buying [ 49 ]. The data indicated a consumer preference for sustainable fashion items, while revealing a lack of accurate and transparent knowledge among consumers about all stages of the supply chain [ 51 ]. Additionally, some papers found that consumer preferences did not automatically translate into purchasing behaviour, as consumer willingness to pay also played a key role in determining such decisions, alongside with cognitive and behavioural factors [ 45 , 52 ]. Despite this complexity, consumers were found to exhibit a willingness to pay higher prices for sustainable products, suggesting a potential for sustained market volume [ 50 ].

The studies in this group also explored consumers’ demographic characteristics, focusing particularly on generational cohort and gender. Concerning generational cohort, the papers primarily centred on Generation X, whose members (i.e., millennials) are most exposed to the intention-behaviour gap: while overconsuming fast fashion, they are also increasingly sensitive to sustainability issues [ 53 ]. Thus, education about sustainable production and responsible consumerism in the clothing industry was identified as a key factor for this cohort, as highlighted by a case study about an educational project conducted in Germany [ 54 ]. With respect to gender, women were identified as more ‘careful’ about their responsible consumption, showing a preference for slow fashion apparel and garments [ 45 , 51 ], or at least appearing ‘more knowledgeable about this topic than men’ [ 55 ].

Within the analysis of consumer purchasing choices, slow fashion also emerged as an intriguing research trend [ 52 ]. Some papers presented interesting case studies. For instance, Holgar [ 56 ] used wardrobe research to empirically test consumers’ everyday clothing practices, and Polajnar and Šrimpf Vendramin explored textile waste management among Ljubljana residents and the waste-management network in Slovenia [ 57 ].

3.2 Global North and producers

The most explored narrative in this cluster pertained to the identification of solutions and alternatives concerning circular business models, sustainability, transparent global value chains, and waste and emission reductions, aimed at a paradigm shift in the fashion industry towards more conscientious and circular business practices. For instance, rethinking production modes and supply chains could occur by embracing a multi-echelon closed-loop supply chain (CLSC) [ 58 ]. Such an approach would aim at maintaining market competitiveness while promoting sustainable development [ 58 ]. Studies analysed major global fashion companies, in—both the luxury and mass market sectors. Transformation was recognised as necessary for meeting evolving consumer demands (characterised by a growing sensitivity to environmentally friendly products), to comply with supranational and international strategies (e.g., the UN Fashion Charter and the Fashion Pact, the EU Strategy for Sustainable and Circular Textiles) and to participate in sustainability initiatives (e.g., European Textile Network) [ 59 , 60 , 61 , 62 ].

In contrast, practices such as ‘greenwashing’ and ‘greenhushing’ were recognised as limiting fashion firms' sustainable production opportunities and market competitiveness, as well as positive consumers perception towards them. Therefore, to achieve a truly circular approach, these practices must be replaced by genuine green marketing strategies [ 63 , 64 , 65 ]. Strategies such as waste management, recycling, by-products reduction, the use of green technologies, and rental platforms were recommended. For instance, rental platforms in Canada were found to be positively linked to sustainable fashion [ 66 ]. To reverse the make-take-waste paradigm, the Swedish fashion industry adopted circular economy principles in its supply chain [ 67 ]. Additionally, the German second-hand clothing industry used digitalisation to establish a competitive business model [ 68 ]. Given the need to close the loop of the linear fashion scheme, new processes and transaction schemes were also explored. The transition towards a slow-fashion production paradigm was recognized to entail a radical redefinition of value propositions, emphasising craftsmanship, nature and localism [ 60 , 69 ], guided by transparent business practices and commercial sustainability [ 70 ], following the 3Rs (i.e., reduce, reuse, recycle) [ 71 ]. This aligns with the approach developed by the French national program for managing post-consumer textiles and clothing, which, promoted innovation in recycling practices through extended producer responsibility policies [ 72 ].

Other papers focused on specific business trends, such as those observed in the luxury fashion sector, which has embraced ethical and sustainable measures prioritizing distinction and recycling [ 73 , 74 ]. Moreover, the emerging ‘eco-chic’ trend highlights that long-lasting and environmentally friendly garments are not restricted to luxury brands, but may also be produced by mass retailers [ 75 ].

3.3 Global South and consumers

The environmental challenges and repercussions of the fast fashion industry are located and widespread throughout the Global South. It is in this region that Western companies typically concentrate their fast fashion production processes and discard their used clothing. These issues were addressed from the perspective of consumers in this region, analysing their concerns and engagement. One effective strategy highlighted for mitigating the negative impacts of excessive clothing production and disposal was the establishment of a new sustainable consumption model to prolong product life cycles. Such models might be achieved through the promotion of reuse, recycling and resale activities among consumers, which have already gained traction within the second-hand clothing market. In Africa, for instance, many individuals were found to wear second-hand garments exported from the Global North [ 76 ]. Additionally, in the Global South, the embrace of authentic elements inherent to small village settings and local communities (i.e., nature, history, culture, traditions) was recognised as a viable approach to combatting consumerism and fostering sustainable practices [ 77 , 78 ], highlighting a key difference from the narratives focused on the Global North. In the context of the Global North and consumers, the acknowledgment of sustainability practices influenced by cultural collectivist values was observed within a specific community with ties to the Global South: African Americans, whose heritage is marked by specific cultural values contributing to these practices [ 79 ].

Another avenue for minimising the environmental impact of the clothing industry while extending garment lifetimes was identified as the promotion of sustainable purchasing behaviours and intentions [ 80 , 81 , 82 ]. In this regard, slow fashion and eco-fashion emerged as promising approaches. These trends encourage environmentally conscious and responsible consumers by promoting greater product knowledge, active involvement in the clothing creation and design process, and the adoption of circular textile products [ 80 , 81 , 82 ]. Ultimately, the adoption of these paradigms may also enhance consumer well-being.

3.4 Global South and producers

The first key narrative in this category surrounded the unethical working conditions and sourcing practices within the fast fashion industry. Countries in this region bear the most significant socio-economic consequences of the fashion value chain, as they not only receive the majority of global textile waste, but they also host the most resource-intensive manufacturing processes, as a result of outsourcing [ 83 ]. Thus, economic and environmental factors assume greater significance.

The transition towards sustainable business models in the Global South may be hindered by information deficiency. While enterprises in the Global South were found to make significant effort to comply with corporate social responsibility (CSR) models [ 84 ], a comparative analysis among young designers based in China, India, Bangladesh and Pakistan showed that producers in the Global South often lack information about sustainability practices and how to implement them [ 85 ]. Interestingly, a significant disparity between the Global North and the Global South emerged in the papers, showing that Generation X individuals in the Global North tend to be notably concerned about sustainability issues, while the same is not true for their counterparts in the Global South.

As outlined in the preceding subsection, culture and perceptions play important roles, also among producers. For instance, Remu Apparel, a slow fashion company in Ecuador, promoted the adoption of slow fashion by reconceptualising traditional masculinity [ 86 ]. Filipino ukay-ukay culture (i.e., ‘digging up of piles of used clothes until finding a desirable item’ [ 87 ]) provides another intriguing example of the importance of the cultural factor.

To foster sustainable growth, producers must focus on the developing circular economic practices in Global South markets. Given the immense scale of some of these markets, (e.g., the textile and garment industry in Brazil [ 88 , 89 ] and China [ 90 ]) businesses must develop a strategic vision for sustainable economic growth.

3.5 Overlapping narratives

Various factors intersect with the categories of consumers and producers in the fashion industry. Through their primary activities of (over)consumption and (over)production, both contribute significantly to environmental degradation, via the generation of waste and the depletion of raw materials, respectively.

In papers examining consumer–producer dynamics in the Global North, a central narrative revolved around the development of a holistic circular business model for fashion, to allow both producers and consumers to embrace the benefits of a circular economy within the fashion industry [ 91 ]. Initiatives such as the Dutch circular textile mission and the European Union-funded Horizon 2020 project TCBL (Textile and Clothing Business Labs) were recognised as an example of system innovations in this direction [ 92 , 93 ]. The simultaneous engagement of producers and consumers was stated to occur through bottom-up and top-down processes [ 94 ]. With respect to top-down processes, producers must prioritise the provision of transparent and easily understandable information to consumers [ 95 ], while developing products with clear sustainable attributes, in order to demonstrate their commitment to socio-environmental responsibility. Such an approach would not only enhance consumer loyalty and satisfaction, but it would also increase willingness to pay for sustainable product [ 96 , 97 ]. The brand ECOALF is exemplar in this regard, with a focus on sustainable fashion and effective communication strategies aimed at consumers [ 98 ]. Regarding bottom-up processes, papers described that local consumers should actively propose sustainable initiatives for local and/or global implementation [ 1 , 99 ]. In particular, social manufacturing, which involves consumers directly in the production process through do-it-yourself (DIY) and do-it-together (DIT) practices, was recognised as facilitating the transfer of environmental knowledge and promoting green innovations [ 100 ]. Additionally, unsuccessful aspects of consumer–producer interaction were considered, particularly with respect to textile waste management strategies and recycling technology. A case study comparing the UK and Korean recycling systems revealed the latter’s lesser preparedness to address textile waste streams [ 101 ]. Moreover, geographical location was found to play a relevant role, as Portugal produces more textile waste than Croatia, leading to a higher environmental impact [ 102 ].

Narratives considering consumer–producer interactions in the Global South underscored how the rise of fast fashion in emerging economies has created both sustainability concerns and opportunities. Economic agents in these regions were found to be positively supporting the concept of sustainable fashion and the idea of transformable garments; attitudes, subjective norms and perceptions, and again cultural factors, were considered influential factors in the adoption of sustainable behaviours, such as recycling activities or secondhand [ 103 , 104 , 105 ], even among distinct sectors, like secondhand luxury fashion [ 105 ]. Transparent and informative communication about sustainable practices was found to enhance consumer trust, foster positive feelings and mitigate perceptions of producer hypocrisy [ 106 , 107 ]. Despite acknowledging the room for improvement in sustainability practices, studies focused on producers and consumers in the Global South highlighted the substantial work required to effectively transform aspirations into feasible solutions. For example, a study in Brazil revealed consumer reluctance, even among those claiming environmental consciousness, to pay a premium for eco-friendly products [ 107 ]. Similarly, concerns about production costs, practicality, adaptability, and marketability were found on the production side [ 103 ].

Among the papers adopting a comparative geographical perspective (i.e., Global North vs. Global South) with respect to consumers, the analysis aimed at bridging the gap in consumer perceptions and behaviours across the different global regions. On the one hand, consumers from both the Global North and the Global South were found to be positively influenced by eco-fashion in their decision-making and behaviour [ 108 ]. However, a notable disparity persists between consumers in the Global North and those in the Global South regarding purchasing intentions, perceptions, and adoption of circular apparel behaviour, with consumers in the Global South facing more significant challenges in this regard [ 109 ]. However, similarities were also detected between consumers in different geographical regions, irrespective of their affiliation to the Global North or the Global South. Specifically, individuals residing in certain natural geographies (e.g., islands) tend to be more nature-friendly in comparison to residents in corresponding continental areas, as shown in a study comparing the residents of an island regions in the US and in Ecuador [ 110 ].

Papers comparing producers in the Global North with those in the Global South considered the uneven distribution of environmental, ecological and social consequences, recognising the greater impacts suffered by the weaker region (i.e., the Global South), due to the extensive use of petroleum-based fibres and the offshoring of production by fast fashion companies in the Global North. The papers showed that recent business strategies have begun to integrate social and sustainability aspects, emphasising the importance of transparent, circular business practices [ 111 , 112 ]. This shift was also recognised in Global North firms that have adopted social and environmental sustainability as a selection criterion for their sourcing locations [ 113 ] or relocating specific stages of the supply chain [ 114 ]. Transnational and multilevel perspectives and localized, cross-border initiatives aimed at tackling unequal ecological consequences (worldwide) are necessary [ 115 ]. These initiatives were thought to emerge when supply chains would cease to be organised solely around large retailers and brand-name firms in the Global North, and extend into the Global South. In this regard, the media could play a prominent role in the provision of transparent information aimed at establishing a sustainable global supply chain [ 116 ]. Feasible strategies were identified, including: (i) reusing and remanufacturing unwanted second-hand clothing by incorporating local craft and design, as seen among retailers and artisans in Tanzania and fashion remanufacturers and retailers in the UK [ 117 ]; and (ii) implementing effective sustainable supply chain management (SSCM) through investments in decarbonisation and energy infrastructure, engagement with suppliers and consumers, and the revaluation of product design standards [ 118 ].

In papers taking an all-encompassing approach, initial considerations regarding the fashion industry’s polluting production model, in terms of environmental degradation, are followed by more specific differences concerning ‘onshoring’ versus ‘offshoring’ dynamics: from textile waste to working conditions. These dynamics were investigated by using different research methods: LCA methods to compare global impacts [ 119 ], and systematic literature reviews [ 120 , 121 ] to highlight gaps and themes in the academic literature on global fashion. More advanced areas of research development have also been explored: immersive technologies aimed at educating and sensitizing global audiences about traditional textile companies and responsible consumption of goods, also in countries such China where Generation Z consumers are showing a growing willingness to purchase sustainable clothes [ 122 ]. Finally, studies directed attention to all three sustainability pillars (i.e., environmental, social, economic) as important areas for future research and action. In summary, the papers emphasize the need for joint action involving industry, policymakers, consumers and scientists to promote sustainable production and ethical consumption practices, aimed at achieving equity and the UN Sustainable Development Goals [ 119 , 120 , 121 , 122 , 123 , 124 ].

4 Discussion

This paper has explored the different dynamics of fast fashion in two major regions of the world, based on an SLR. The findings reveal a gap at various levels, in terms of both bibliographic attributes and content. This aspect suggests the existence of differing scholarly attentions and framings in covering the topic.

First, there is a time-lag in the research. Figure  2 illustrates a significant scarcity of relevant research during the years 2009–2015. However, from 2015 onwards, a gradual increase in publications is evident, with a modest peak in 2017. The period 2017–2022 demonstrates exponential growth in the number of annual publications, with a high peak in 2022. These turning points coincide with significant shifts and transformations in the fashion industry, as echoed in the literature. For instance, 2016 was labelled as one of the most ‘disruptive’ years for the fashion market, characterised by shocks, challenges and uncertainty [ 125 ]. Moreover, the year 2017 marked a significant shift in the fashion industry, characterised by organic growth and digitalisation, signalling the end of the West's dominance, particularly in European and North American countries, and the emergence of Asia–Pacific and Latin American regions as new leading players in the industry [ 125 , 126 ]. Interestingly, our dataset reveals that Global South narratives focusing on consumers, producers and consumer–producer interactions began to emerge in the years 2016–2017, whereas narratives focusing on the Global North emerged as early as 2009. In the aftermath of the COVID-19 pandemic in 2021–2022, there was a notable increase in awareness and action against the impacts of climate change and resource overconsumption [ 127 ]. This shift also influenced the discourse around fast fashion, resulting in a specific scholarly focus on sustainable business models, overconsumption, overproduction, unsustainable practices and sustainable consumption behaviours [ 128 , 129 ]. Notably, each cluster within this specified timeframe spanned 2021 or 2022.

A skewed trend was evident in the distribution of research contributions, whereby the majority of contributions centred on the Global North, with 28 out of 117 focusing on consumers and 24 out of 117 focusing on producers. In contrast, a smaller number of contributions explored the Global South, with 11 out of 117 focusing on consumers and 11 out of 117 focusing on producers. A dual focus on consumers and producers within the same region was more frequently observed than Global North versus Global South comparisons. In fact, the most fruitful space for comparison was that of the Global North, particularly regarding consumer–producer interactions (15 out of 117 papers vs. 5 out of 117 for the Global South). Moreover, only 6 out of 117 papers were comprehensively comparative.

This trend is corroborated by Fig.  3 , which illustrates the scientific production by country. In the figure, there is a notable disparity in academic publishing between countries, particularly in the Global South. Unsurprisingly, Brazil and China appear among the top contributors. Both countries are experiencing a demographic megatrend characterised by an expanding middle class [ 130 , 131 ], leading to increased purchasing power. This megatrend is also likely to impact trends in production and consumption, including demand for apparel [ 131 , 132 ]. Perhaps for this reason, in the narratives, these two countries were the only ones mentioned as ‘big markets’ where attention was being given to strategic business strategies [ 88 , 89 , 90 ]. Conversely, more extensive contributions stemmed from countries in the Global North, encompassing countries from Europe, America, Oceania and Asia.

Considering the identified narratives and themes, our findings show that consumers and producers, both in the Global North and the Global South, are identified in literature as sharing concerns about the present and future condition of the fast fashion industry. The narratives explored solutions at various stages of the fashion supply chain, aimed at enhancing environmental awareness; pro-environmental behaviours; and green, circular and transparent economic principles. Notwithstanding the significant challenges required to effectively translate these efforts into viable solutions (due to information asymmetries between the Global North and the Global South; intra-regional and inter-regional interactions between economic actors; differing levels of awareness; and economic, environmental and social interventions in ‘onshoring’ versus ‘offshoring’ dynamics), literature addressing a commitment to achieving a socially, economically and environmentally sustainable fashion industry is evident in the analysis of the literature of both regions, with respect to both consumers and producers. However, the extent of the identified efforts appears to vary.

The development of sustainable production and consumption systems occurs within social and ecological frameworks, and is affected by technological change, information technologies, market and business strategies, and behavioural change [ 23 , 133 , 134 ]. A common trend may be observed in this regard, with slow fashion and eco-fashion (emphasising social responsibility and sustainability) valued in both the Global North and the Global South. These alternatives prioritise the use of local resources, distributed economies, transparent production systems connecting producers directly with consumers, and sustainable products [ 135 , 136 ], and they have been identified as important avenues for current and future sustainability in both regions [ 52 , 60 , 69 , 70 , 72 , 75 , 80 , 81 , 82 , 86 ].

However, in this eco-humanistic perspective, Footnote 2 different levels of importance are attributed to the two dominating systems [ 134 ]—that of values (used here as a proxy for social, environmental, traditional and historical elements) and that of economics (used here as a proxy for business strategies, economic principles, digitalization, behavioral and cognitive characteristics).

In the Global South, waste management initiatives (e.g., those aimed at reuse, recycling and resale), the development of green technologies and circular principles, the adoption of contemporary models of corporate social responsibility (CSR) to address the growing second-hand clothing market, and the exploration of certain behavioural and cognitive characteristic informing environmentally conscious and responsible consumers with strong product knowledge who receive transparent and informative information from producers, may be investigated as economic patterns. Notably, these considerations are embedded in discussions of social and ecological factors, highlighting locality, culture, traditional values and nature. Significantly, change is proposed to stem from local values and social structures, reflecting a bottom-up approach. Such initiatives, originating in local communities, may pertain to producers—as highlighted in the case studies from Ecuador and the Philippines [ 86 , 87 ]—and/or consumers—as seen in the practice of hand-me-down clothing and sharing [ 76 , 77 , 78 ], with the aim of promoting green economic development with respect to the environment (social and natural).

Conversely, in the Global North, circular and sustainable initiatives are more strictly aligned with economic considerations, with market strategies informing a circular transition driven by competitiveness and profitability [ 1 , 58 , 70 ]. Thus, efforts are directed towards the abandonment of communicative, business and marketing practices such as greenwashing or greenhushing, in favour of circular economy principles in the supply chain [ 58 , 67 ], digitalization [ 68 ], transparent business practices, the development of commercial sustainability, and the 3Rs principle [ 71 ], even when the goal is to promote new values and a localist, collectivistic attitude [ 60 , 69 ]. Similarly, consumer preferences are explored using cognitive and behavioural components and social characteristics, alongside market considerations (e.g., willingness to pay) [ 45 , 50 , 52 ]. While, only when analysing a specific community interestingly rooted in the cultural heritage of the Global South, the potential and effective role of traditional community values is mentioned [ 79 ]. Interactions between producers and consumers with respect to the adoption of sustainability are explored through examples of transparent business models that are openly committed to social and environmental responsibility [ 96 , 98 ] (i.e., systemic innovations [ 92 , 93 ]), and consumers' active involvement in production processes [ 1 , 99 ], rather than attitudes, subjective norms, and perceptions [ 104 , 107 ]. Even when explored at a national policy level [ 72 ], these transformations find their rationale in the necessity to comply with supranational and international strategies (e.g., the UN Fashion Charter and the Fashion Pact, EU Strategy for Sustainable and Circular Textiles) and sustainability initiatives (e.g., European Textile Network) [ 59 , 60 , 61 , 62 ].

Existing inequalities in global governance and economic relations among the Global North and the Global South relations [ 18 , 19 , 20 , 21 , 22 ] are mirrored in the analysis of the approaches each region is taking to achieve sustainability in the fashion industry.

In 2018 Wu et al. [ 137 ] observed that the decoupling of developing countries from unsustainable practices was fluctuating and lacking in regularity—a trend echoed in our discussion. In fact, the shift in the fashion industry towards sustainable development predominantly occurs within the developed and politically active Global North. Conversely, in the Global South, this transition is contingent upon country-specific factors, including socio-economic and cultural contexts. In the Global North, structured, innovative and transparent market strategies for sustainable consumption and production patterns are implemented under political guidance. It is imperative that these strategies be adopted globally, extending to the Global South. This may be achieved, for instance, through an active commitment to corporate social and environmental responsibility in sourcing decisions and the integration of the Global South into sustainable supply chain management through investment in decarbonisation and energy infrastructure [ 111 , 112 , 113 , 114 , 118 ]. Furthermore, there is a need for joint action between the Global South and the Global North at a governmental level, within an inclusive framework [ 115 , 119 , 120 , 121 , 122 , 123 , 124 ]. This is due to the differing capacities of developed and developing countries to address the challenges of unsustainable consumption and production. In the Global North, sustainable development is already reliant on structural systemic innovations and policy guidance [ 137 , 138 ].

5 Conclusions

If, on the one hand, the present SLR acknowledges that the analysed existing literature on the topic underlines a genuine commitment to the long-term development of a sustainable fashion industry, with attention given to Global North–Global South dynamics (as particularly evident with respect to, e.g., waste and outsourcing), it is notable that this landscape remains fragmented, as highlighted by the discussed temporal and geographical distribution of research.

Emphasising the need to achieve all three pillars of sustainability, and broadening the scope of the investigation to encompass the Global South, future research should employ comparative approaches centred on the creation of a common good (i.e., common interests and solutions) between developed and developing countries [ 139 ]. This may involve recognising the unequal consequences of global trends and combining green digitalisation and new technologies with the preservation of local and cultural values to encourage mindful consumption and production (as emphasised, for instance, in the concepts of slow fashion and eco-fashion). Envisioning a comprehensive eco-humanistic vision, the integration of growth and development with the social and natural environment, alongside advancements in science and technology (including ICT and immersive technologies), may result in a sustainable development system worldwide [ 134 ].

While our analysis adopted an economic perspective, focusing on the disparity between the Global North and the Global South, we recognise the importance of directing scholars’ attention in challenging existing power dynamics within the traditional economic paradigm, starting with acknowledging the literature gap evident in the differing bibliographic attributes and content narratives according to world region. To strengthen the development of a sustainable and circular fashion industry, while fostering sustainable and socio-ecologically equitable production and consumption patterns, future research must address the gap in environmental responsibility, global governance and economic relations between the Global North and the Global South [ 21 , 23 , 138 , 140 ]. Although our research questions did not explicitly address governance, this topic emerged as an interesting analytical thread. Thus, future research could explore the role played by governance in consumer–producer interactions, and its impact on the imbalanced Global North–Global South dynamic. Reflecting on this aspect could yield valuable insights for empirical applications to further progress towards global sustainability targets, emphasising social and ecological considerations alongside economic dynamics of production and consumption. This, in turn, may actively support collaborative initiatives such as the United Nations Sustainable Development Goals and the United Nations Alliance for Sustainable Fashion, while also contributing to the creation of new ones.

Data availability

Data are available from the authors upon reasonable request.

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This study was carried out within the PEACE (Protecting the Environment: Advances in Circular Economy) which received funding from the “Fondo per il Programma Nazionale di Ricerca e Progetti di Rilevante Interesse Nazionale (PRIN)” Investimento 1.1-D.D. 104.02-02- 2022, 2022ZFBMA4. This manuscript reflects only the authors' views and opinions, and can be considered responsible for them.

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Bonelli, F., Caferra, R. & Morone, P. In need of a sustainable and just fashion industry: identifying challenges and opportunities through a systematic literature review in a Global North/Global South perspective. Discov Sustain 5 , 186 (2024). https://doi.org/10.1007/s43621-024-00400-5

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Britain’s Violent Riots: What We Know

Officials had braced for more unrest on Wednesday, but the night’s anti-immigration protests were smaller, with counterprotesters dominating the streets instead.

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By Lynsey Chutel

After days of violent rioting set off by disinformation around a deadly stabbing rampage, the authorities in Britain had been bracing for more unrest on Wednesday. But by nightfall, large-scale anti-immigration demonstrations had not materialized, and only a few arrests had been made nationwide.

Instead, streets in cities across the country were filled with thousands of antiracism protesters, including in Liverpool, where by late evening, the counterdemonstration had taken on an almost celebratory tone.

Over the weekend, the anti-immigration protests, organized by far-right groups, had devolved into violence in more than a dozen towns and cities. And with messages on social media calling for wider protests and counterprotests on Wednesday, the British authorities were on high alert.

With tensions running high, Prime Minister Keir Starmer’s cabinet held emergency meetings to discuss what has become the first crisis of his recently elected government. Some 6,000 specialist public-order police officers were mobilized nationwide to respond to any disorder, and the authorities in several cities and towns stepped up patrols.

Wednesday was not trouble-free, however.

In Bristol, the police said there was one arrest after a brick was thrown at a police vehicle and a bottle was thrown. In the southern city of Portsmouth, police officers dispersed a small group of anti-immigration protesters who had blocked a roadway. And in Belfast, Northern Ireland, where there have been at least four nights of unrest, disorder continued, and the police service said it would bring in additional officers.

But overall, many expressed relief that the fears of wide-scale violence had not been realized.

Here’s what we know about the turmoil in Britain.

Where arrests have been reported

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