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      Association between fast food purchasing and the local food environment


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          In this study, an instrument was created to measure the healthy and unhealthy characteristics of food environments and investigate associations between the whole of the food environment and fast food consumption.

          Design and subjects:

          In consultation with other academic researchers in this field, food stores were categorised to either healthy or unhealthy and weighted (between +10 and −10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy food environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole food environment on the fast food purchasing habits of 2547 individuals.


          Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32–0.83). Although a lower likelihood of frequent fast food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast food infrequently (OR 1.35; 95% CI 1.00–1.82) however no association was found for frequent purchasing.


          Our study provides some evidence to suggest that healthier food environments may discourage fast food purchasing.

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          Most cited references11

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          Obesity prevalence and the local food environment.

          Disparities in access to healthy foods have been identified particularly in the United States. Fewer studies have measured the effects these disparities have on diet-related health outcomes. This study measured the association between the presence of food establishments and obesity among 1295 adults living in the southern region of the United States. The prevalence of obesity was lower in areas that had supermarkets and higher in area with small grocery stores or fast food restaurants. Our findings are consistent with other studies showing that types of food stores and restaurants influence food choices and, subsequently, diet-related health outcomes.
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            Neighborhood Food Environment and Walkability Predict Obesity in New York City

            Background Differences in the neighborhood food environment may contribute to disparities in obesity. Objectives The purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability. Methods This study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject’s home address. Results Density of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively), but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI), 0.27–1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78–0.97). These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73–0.96) and for land-use mix was 0.91 (95% CI, 0.86–0.97). Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity. Conclusions Access to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity.
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              Epidemic obesity in the United States: are fast foods and television viewing contributing?

              This study examined the association between TV viewing, fast food eating, and body mass index. Associations between hours of TV viewing, frequency of eating at fast food restaurants, body mass index, and behaviors were assessed cross sectionally and longitudinally over 1 year in 1059 men and women. Fast food meals and TV viewing hours were positively associated with energy intake and body mass index in women but not in men. TV viewing predicted weight gain in high-income women. Secular increases in fast food availability and access to televised entertainment may contribute to increasing obesity rates in the United States.

                Author and article information

                Nutr Diabetes
                Nutr Diabetes
                Nutrition & Diabetes
                Nature Publishing Group
                December 2012
                03 December 2012
                1 December 2012
                : 2
                : 12
                : e53
                [1 ]Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood, Victoria, Australia
                [2 ]Centre for Women's Health, Gender and Society, Melbourne School of Population Health, The University of Melbourne , Parkville, Victoria, Australia
                Author notes
                [* ]Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , 221 Burwood Highway, Burwood, Victoria 3125, Australia. E-mail: lukar.thornton@ 123456deakin.edu.au
                Copyright © 2012 Macmillan Publishers Limited

                This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/

                Original Article

                Endocrinology & Diabetes
                food environment,fast food,eating behaviours,multilevel study,area-level disadvantage


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