Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults

Abstract

Background Mixed findings have been reported on the association between Western fast-food restaurants and body weight status. Results vary across study contexts and are sensitive to the samples, measures and methods used. Most studies have failed to examine the temporally dynamic associations between community exposure to fast-food restaurants and weight changes. Methods Bayesian hierarchical regressions are used to model changes in body mass index, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR) as a function of changes in Western fast-food restaurants in 216 communities for more than 9000 Chinese adults followed up multiple times between 2000 and 2009. Results Number of Western fast-food restaurants is positively associated with subsequent increases in WHtR and WHpR among rural population. More fast-food restaurants are positively associated with a future increase in WHpR for urban women. Increased availability of fast food between two waves is related to increased WHtR for urban men over the same period. A past increase in number of fast-food restaurants is associated with subsequent increases in WHtR and WHpR for rural population. Conclusions The associations between community exposure to Western fast food and weight changes are temporally dynamic rather than static. Improved measures of exposure to community environment are needed to achieve more precise estimates and better understanding of these relationships. In light of the findings in this study and China’s rapid economic growth, further investigation and increased public health monitoring is warranted since Western fast food is likely to be more accessible and affordable in the near future.

Social determinants and health behaviors: conceptual frames and empirical advances

“…Thus, integrating social structural processes with psychological constructs such as planful competence and risk aversion is fundamental for more accurately predicting people’s health behaviors. Overall, the life course perspective emphasizes the dynamic nature of social circumstances and health, which is reflected in emerging research [88, 98–101]. For example, research on migration emphasizes dynamic processes of “acculturation” after arriving in a new place [102].…”

A Review of the Growth of the Fast Food Industry in China and Its Potential Impact on Obesity

“…The majority were conducted in Western countries and have demonstrated a positive association [9,10,11,12,13,14]. Similar research is growing in China, but is still limited [7,15,16,17,18,19,20,21,22,23,24]. …”

Integrating Space With Place in Health Research: A Multilevel Spatial Investigation Using Child Mortality in 1880 Newark, New Jersey

“…Sociologists, demographers, and epidemiologists have conceptualized place as a source of area-level health access or exposure (Arcaya et al 2012) such as neighborhood socioeconomic resources (Montgomery and Hewett 2005), social capital (Sampson et al 1999), environmental hazard (Downey 2003), food quality (Xu et al 2012), and health and family planning policy (Short et al 2000; Xu and Short 2011). This “place” perspective often lacks careful “spatial thinking” (Logan 2012) and ignores both the important role of spatial process in affecting health and the spatial pattern of individual-level risks.…”