Association between Availability of Neighborhood Fast Food Outlets and Overweight Among 5⁻18 Year-Old Children in Peninsular Malaysia: A Cross-Sectional Study.

Kee Chee Cheong,Ahmad Yusoff,Cheong Yoon Ling,Noor Ahmad,Cheong Siew Man,Mohd Che Ibrahim,Teh Chien Huey,Lim Kuang Hock,Cheah Yong Kang,Azli Baharudin,Sumarni Mohd Ghazali

doi:10.3390/ijerph16040593

Abstract

A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children’s residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.

Highlights

Metabolic syndrome is a health condition where there is a clustering of cardiovascular risk factors namely central obesity, dyslipidemia, impaired glucose tolerance, high blood pressure, and insulin resistance
It consisted of the population of Malaysia divided into states, followed by Enumeration Blocks (EBs) and Living Quarters (LQ)
Our results showed that the availability of at least one fast-food outlet within 1000 m from the reported residential address was significantly associated with overweight among children aged

Summary

Introduction

Metabolic syndrome is a health condition where there is a clustering of cardiovascular risk factors namely central obesity, dyslipidemia, impaired glucose tolerance, high blood pressure, and insulin resistance. There is growing evidence that obesity increases the risk of metabolic syndrome in children [1]. Data from the National Health Morbidity Surveys (NHMS) showed that the prevalence of obesity among Malaysian children aged less than 18 years had increased dramatically from 6.1% in. Res. Public Health 2019, 16, 593; doi:10.3390/ijerph16040593 www.mdpi.com/journal/ijerph

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