Gender difference in the association between food away-from-home consumption and body weight outcomes among Chinese adults

Abstract

Objective: The present study aimed to explore the associations between food away-from-home (FAFH) consumption and body weight outcomes among Chinese adults. Design: FAFH was defined as food prepared at restaurants and the percentage of energy from FAFH was calculated. Measured BMI and waist circumference (WC) were used as body weight outcomes. Quantile regression models for BMI and WC were performed separately by gender. Setting: Information on demographic, socio-economic, diet and health parameters at individual, household and community levels was collected in twelve provinces of China. Subjects: A cross-sectional sample of 7738 non-pregnant individuals aged 18-60 years from the China Health and Nutrition Survey 2011 was analysed. Results: For males, quantile regression models showed that percentage of energy from FAFH was associated with an increase in BMI of 0·01, 0·01, 0·01, 0·02, 0·02 and 0·03 kg/m 2 at the 5th, 25th, 50th, 75th, 90th and 95th quantile, and an increase in WC of 0·04, 0·06, 0·06, 0·04, 0·06, 0·05 and 0·07 cm at the 5th, 10th, 25th, 50th, 75th, 90th and 95th quantile. For females, percentage of energy from FAFH was associated with 0·01, 0·01, 0·01 and 0·02 kg/m 2 increase in BMI at the 10th, 25th, 90th and 95th quantile, and with 0·05, 0·04, 0·03 and 0·03 cm increase in WC at the 5th, 10th, 25th and 75th quantile. Conclusions: Our findings suggest that FAFH consumption is relatively more important for BMI and WC among males rather than females in China. Public health initiatives are needed to encourage Chinese adults to make healthy food choices when eating out. China has experienced a significant increase in the prevalence of obesity during recent decades (1,2) , with increasing BMI and waist circumference (WC) over time, particularly for those at the highest BMI and WC levels (3) . The increasing obesity epidemic has also shown gender disparities in terms of sociodemographic characteristics. For example, obesity prevalence was higher in lower educated women, but in men with higher education (4) .One of the major factors underlying the obesity epidemic is considered to be the dramatic transition in dietary intake and eating behaviours in China. Previous work has identified higher fat and sodium intakes, accompanied by increasing consumption of edible oils and animal-source foods, and prevalent snacking and eating out (5) . Typically, food away from home (FAFH) is defined as food eaten or prepared outside the home, including restaurant food, which comprises the majority of FAFH, as well as foods obtained from canteens and fixed or mobile stalls. In China, consumption of FAFH has increased substantially. The share of urban food expenditure on FAFH rose from 14·7 % in 2000 to 20·6 % in 2008 (6) . A large body of literature has shown that FAFH consumption is associated with high intakes of energy and saturated fat, and low micronutrient intakes (7)(8)(9)(10) .Meanwhile, other studies in developed countries have reported a relationship between increased FAFH consumption and higher BMI o...

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