Abstract

Abstract Obesity is an important modifiable risk factor for many cancers. The prevalence of obesity has rapidly increased in the United States, with large disparities by age, sex, and race/ethnicity. In recent decades, increases in body mass index (BMI) have been highest among African American women. Concurrent with the increase in prevalence of obesity, the consumption of foods prepared away from home and of sugar-sweetened beverages has also increased. We prospectively assessed intake of restaurant foods and soft drinks in relation to weight gain and incident obesity in the Black Women's Health Study, an ongoing follow-up study of 59,000 African American women 21–69 years of age at enrollment in 1995. Because the greatest amount of weight gain occurs in young adulthood, we restricted the analysis to 19,172 non-obese women who were younger than age 40 years at baseline. Information on current weight and other lifestyle factors was ascertained every two years through mailed questionnaires, and dietary intake was assessed in 1995 and 2001 using a validated food frequency questionnaire. Participants were asked how often they had eaten the following specific types of foods at restaurants: burgers, fried chicken, fried fish, pizza, Chinese food, and Mexican food. Participants were also asked how often they drank “soft drinks,” a question that specified non-diet soda only. Based on follow-up data from 1995 through 2009, multivariable linear regression models were used to estimate mean weight gain and Cox proportional hazards models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for incident obesity according to consumption of restaurant foods and soft drinks. In these analyses, participants were censored when they reached age 40. The multivariable models were adjusted for age, physical activity, other lifestyle factors, and intake of vegetables, fruit, whole grains, and the other exposures of interest. During 14 years of follow-up, intake of burgers from restaurants was associated with increased weight gain and risk of obesity; compared with no consumption, women who ate burgers at restaurants at least once a week gained an additional 2.56 kg (95% CI: 1.60–3.52 kg) and were 30% more likely to become obese (IRR=1.30, 95% CI: 1.16–1.47). Restaurant consumption of fried chicken was associated with increased weight gain and obesity risk after adjustment for physical activity and other non-dietary covariates, but there was no significant association after adjustment for burger intake. Intake of other restaurant foods was not associated with weight gain or risk of obesity. Soft drink intake was not significantly associated with weight gain but was associated with increased risk of obesity (IRR=1.24, 95% CI: 1.10–1.40, for ≥2 drinks per day relative to <1 per month). The associations were stronger among women with BMI <25 than among women with BMI 25–29 at baseline. These results suggest that restaurant burger consumption and soft drink consumption are independently associated with increased risk of obesity among young African American women. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B3.

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