Exploring the Relation of Spatial Access to Fast Food Outlets With Body Weight: A Mediation Analysis

Mackenbach, Joreintje D.; Charreire, Hélène; Glonti, Ketevan; Bárdos, Helga; Rutter, Harry; Compernolle, Sofie; Bourdeaudhuij, Ilse De; Nijpels, Giel; Brug, Johannes; Oppert, Jean Michel; Lakerveld, Jeroen

doi:10.1177/0013916517749876

Cited by 34 publications

(30 citation statements)

References 56 publications

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“…Our study may lack power to detect such distal effects or unobserved effects or a suppressor variable could be operating. 23 However, previous studies detecting associations may result from residual confounding through social disadvantage; these associations are consistent throughout the literature between location of fast-food outlets and deprivation 6 and between deprivation and BMI. 24 25 This suggests that focusing on the role of social disadvantage rather than the fast-food outlets may yield more effective policy gains.…”

Section: Discussionsupporting

confidence: 82%

Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach

Hobbs

Green

Roberts

et al. 2019

J Epidemiol Community Health

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background Internationally, the prevalence of adults with obesity is a major public health concern. Few studies investigate the explanatory pathways between fast-food outlets and body mass index (BMI). We use structural equation modelling to explore an alternative hypothesis to existing research using area-level deprivation as the predictor of BMI and fast-food outlets and diet quality as mediators. Methods Adults (n=7544) from wave II of the Yorkshire Health Study provided self-reported diet, height and weight (used to calculate BMI). Diet quality was based on sugary drinks, wholemeal (wholegrain) bread and portions of fruit and vegetables. Fast-food outlets were mapped using the Ordnance Survey Points of Interest within 2 km radial buffers around home postcode which were summed to indicate availability. Age (years), gender (female/male) and long-standing health conditions (yes/ no) were included as covariates. results There was little evidence linking fast-food outlets to diet or BMI. An independent association between fast-food outlet availability and BMI operated counterintuitively and was small in effect. There was also little evidence of mediation between fast-food outlet availability and BMI. However, there was more evidence that area-level deprivation was associated with increased BMI, both as an independent effect and through poorer diet quality. Conclusion This exploratory study offers a first step for considering complexity and pathways linking fastfood outlets, area-level deprivation, diet quality and BMI. Research should respond to and build on the hypothesised pathways and our simple framework presented within our study.

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Section: Discussionsupporting

confidence: 82%

Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach

Hobbs

Green

Roberts

et al. 2019

J Epidemiol Community Health

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“…Increasing our understanding of the mechanisms through which the physical and social neighbourhood environment may influence body weight and obesity is crucial to effectively combat the current obesity epidemic [4]. There is some evidence that physical neighbourhood environmental characteristics such as limited access to sidewalks [5, 6], low aesthetics [5], low walkability areas [7, 8], larger distance to recreational facilities [6, 9] and higher fast food density [10, 11] are linked to higher body weights and obesity [12, 13]. Conversely, one longitudinal study conducted in Canada found that higher neighbourhood walkability was associated with lower prevalence of overweight and obesity [14].…”

Section: Introductionmentioning

confidence: 99%

The Moderating Role of Social Neighbourhood Factors in the Association between Features of the Physical Neighbourhood Environment and Weight Status

Hoenink¹,

Lakerveld²,

Rutter

et al. 2019

Obes Facts

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Background: This paper investigated the independent and joint associations between aspects of the physical neighbourhood environment and social neighbourhood factors with BMI and overweight status in European adults. Methods: Data from 5,199 participants in the SPOTLIGHT survey were analysed. Participants reported on their height, weight and perceptions of the neighbourhood. Objectively measured aspects of the physical neighbourhood environment included: presence of recreational facilities, features of the active transportation environment, neighbourhood aesthetics and presence of different types of food outlets. Social factors included the self-reported variables social network, social cohesion, social trust and perceived crime and the census variable neighbourhood socioeconomic status. Outcome measures were BMI and overweight status. Main associations between physical and social factors and BMI/overweight status were analysed using multilevel regression analyses adjusted for confounders. Moderation analysis was conducted by adding the interaction terms between physical and social neighbourhood factors one by one to the multivariable models. Significant interaction terms were then stratified. Results: Significant associations with BMI/overweight status were found for features of the active transportation environment and all social factors, except perceived crime. Several significant interaction terms were detected, but no significant associations between the physical neighbourhood environment and BMI/overweight status were found after stratification. Conclusion: We did not find consistent interactions between physical and social neighbourhood factors to explain BMI and overweight status.

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“…The impossibility of using data related to school and workplace food environment is a limitation, considering that 76.2% and 22.3% of the adolescents were studying and working, respectively (data not shown). As a result, adolescents may consume foods sold by food establishments beyond the vicinity of their homes, which might explain the lack of association with other establishments 60 . Therefore, the use of a 500m buffer near adolescents' residence may not be the best approach to assess their food environment.…”

Section: Discussionmentioning

confidence: 99%

Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil?

et al. 2020

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The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.

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Exploring the Relation of Spatial Access to Fast Food Outlets With Body Weight: A Mediation Analysis

Cited by 34 publications

References 56 publications

Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach

Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach

The Moderating Role of Social Neighbourhood Factors in the Association between Features of the Physical Neighbourhood Environment and Weight Status

Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil?

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