Neighborhood food typologies, fast food outlet visitation and snack food purchasing among adolescents in Melbourne, Australia

Objective: Despite the increased attention on neighborhood food environments and dietary behaviors, studies focusing on adolescents are limited. This study aims to characterize typologies of food environments surrounding adolescents and their associations with fast food outlet visitation and snack food purchasing to/from school. Design: The number of food outlets (supermarket; green grocers; butcher/seafood/deli; bakeries; convenience stores; fast food/takeaways; café and restaurants) within a 1km buffer from home were determined using a Geographic Information System. Adolescents self-reported frequency of fast food outlet visitation and snack food purchasing to/from school. Latent Profile Analysis was conducted to identify typologies of the food environment. Cross-sectional multilevel logistic regression analyses were conducted to examine the relationships between food typologies, fast food outlet visitations and snack food purchasing to/from school. Setting: Melbourne, Australia Participants: 410 adolescents (mean age= 15.5 (SD=1.5) years) Results: Four distinct typologies of food outlets were identified: 1) limited variety/low number; 2) some variety/low number; 3) high variety/medium number; 4) high variety/high number. Adolescents living in Typologies 1 and 2 had three times higher odds of visiting fast food outlets ≥1 per week (Typology 1: OR= 3.71, 95%CI 1.23, 11.19; Typology 2: OR= 3.65, 95% CI 1.21, 10.99) than those living in Typology 4. No evidence of association was found between typologies of the food environments and snack food purchasing behavior to/from school among adolescents. Conclusion: Local government could emphasize an overall balance of food outlets when designing neighborhoods to reduce propensity for fast food outlet visitation among adolescents.

Influential Factors on Customer Satisfaction: Case of Branded Fast Food Outlet in Jammu City

The paper entitled “Influential Factors on Customer Satisfaction: Case of Branded Fast Food Outlet in Jammu City” was carried out in Jammu city of J&K (UT). The research adopted a convenience sampling technique to carry out the survey. The primary data was collected from 100 respondents by filling up the pre-tested schedule-cum-questionnaire. The major findings of the study show that the factors like hospitality, advertisement, and price of the food at the branded retail outlets influence the overall customer satisfaction.

Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK

Background Characteristics of the built environment, such as neighbourhood fast-food outlet exposure, are increasingly recognised as risk factors for unhealthy diet and obesity. Obesity also has a genetic component, with common genetic variants explaining a substantial proportion of population-level obesity susceptibility. However, it is not known whether and to what extent associations between fast-food outlet exposure and body weight are modified by genetic predisposition to obesity. Methods We used data from the Fenland Study, a population-based sample of 12,435 UK adults (mean age 48.6 years). We derived a genetic risk score associated with BMI (BMI-GRS) from 96 BMI-associated single nucleotide polymorphisms. Neighbourhood fast-food exposure was defined as quartiles of counts of outlets around the home address. We used multivariable regression models to estimate the associations of each exposure, independently and in combination, with measured BMI, overweight and obesity, and investigated interactions. Results We found independent associations between BMI-GRS and risk of overweight (RR = 1.34, 95% CI 1.23–1.47) and obesity (RR = 1.73, 95% CI 1.55–1.93), and between fast-food outlet exposure and risk of obesity (highest vs lowest quartile RR = 1.58, 95% CI 1.21–2.05). There was no evidence of an interaction of fast-food outlet exposure and genetic risk on BMI (P = 0.09), risk of overweight (P = 0.51), or risk of obesity (P = 0.27). The combination of higher BMI-GRS and highest fast-food outlet exposure was associated with 2.70 (95% CI 1.99–3.66) times greater risk of obesity. Conclusions Our study demonstrated independent associations of both genetic obesity risk and neighbourhood fast-food outlet exposure with adiposity. These important drivers of the obesity epidemic have to date been studied in isolation. Neighbourhood fast-food outlet exposure remains a potential target of policy intervention to prevent obesity and promote the public’s health.

The interplay between fast-food outlet exposure, household food insecurity, and diet quality in disadvantaged districts

Objective The current study aimed to explore the interplay between food insecurity, fast-food outlet exposure, and dietary quality in disadvantaged neighbourhoods. Design In this cross-sectional study, main associations between fast-food outlet density and proximity, food insecurity status and dietary quality were assessed using Generalized Estimating Equation analyses. We assessed potential moderation by fast-food outlet exposure in the association between food insecurity status and dietary quality by testing for effect modification between food insecurity status and fast-food outlet density and proximity. Setting A deprived urban area in the Netherlands. Participants We included 226 adult participants with at least one child below the age of 18 years living at home. Results Fast-food outlet exposure was not associated with experiencing food insecurity (fast-food outlet density: b=-0.026, 95%CI=-0.076; 0.024; fast-food outlet proximity: b=-0.003, 95%CI=-0.033; 0.026). Experiencing food insecurity was associated with lower dietary quality (b=-0.48 per unit increase, 95%CI=-0.94; -0.012). This association was moderated by fast-food outlet proximity (p-interaction=0.008), and stratified results revealed that the adverse effect of food insecurity on dietary quality was more pronounced for those with the nearest fast-food outlet located closer to the home. Conclusions Food insecurity but not fast-food outlet density is associated with dietary quality. However, the association between food insecurity and dietary quality may be modified by the food environment. These findings could inform policy-makers to promote a healthier food environment including less fast-food outlets, with particular emphasis on areas with high percentages of food insecure households.

Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants

Background Elevated Body Mass Index (BMI) is a key risk factor for numerous non-communicable diseases, such as cardiovascular diseases, cancer, diabetes type II and dementia. Previous studies showed associations between fast-food outlet exposure and BMI, but contained methodological shortcomings. Particularly within the Netherlands, evidence is scarce. We aimed to examine the association between fast-food outlet exposure and BMI among the Dutch adult general population, and whether this association was mediated by daily caloric intake. Methods Cross-sectionally linking baseline adult data (N = 124,286) from the Lifelines cohort to fast-food outlet location (LISA: employer register) data, we regressed fast-food outlet density (within distances of 500 metre(m), and 1, 3, and 5 kilometre (km)) and fast-food outlet proximity around participants’ residential address on BMI. We used multilevel regression and multilevel mediation models, adjusting for age, sex, partner status, education, employment, neighbourhood deprivation and neighbourhood address density. We stratified analyses for urban and rural areas, as these involve different living environments and study populations. Results More than half (56%) of participants was overweight (BMI ≥ 25.0). The average BMI in urban and rural areas was 25.9 (SD 4.4) and 26.3 (SD 4.3), respectively. In rural areas, having at least three fast-food outlets within 500 m was associated with higher BMI (B = 0.17, 95% confidence interval (CI): 0.06, 0.28). In urban areas, having at least five fast-food outlets within 1 km was associated with higher BMI (B = 0.42, 95% CI: 0.20, 0.63). Having the nearest fast-food outlet within 100m was associated with higher BMI (B = 0.43, 95% CI: 0.19, 0.67). The associations were partly explained by daily caloric intake. Conclusions Fast-food outlet exposure may be an important environmental determinant of BMI. Policy-makers should consider intervening upon the fast-food environment. Key messages Fast-food outlets within 500 metres in rural areas and 1 kilometre in urban areas may play a fundamental role in the rise of BMI. Targeting fast-food outlets may be key to reduce BMI on a population level.

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

BackgroundInternationally, 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.MethodsAdults (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.ResultsThere 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.ConclusionThis exploratory study offers a first step for considering complexity and pathways linking fast-food 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.