Local fast-food environment, diet and blood pressure: the moderating role of mastery

D Gibson-Smith,B W J H Penninx,J Lakerveld,J D Mackenbach,J W J Beulens,E Generaal

doi:10.1007/s00394-018-1857-0

Abstract

PurposeTo examine the moderating role of mastery in the association of local fast-food restaurants (FFR) with diet quality and systolic blood pressure (SBP).MethodsWe used cross-sectional data from 1543 adults participating in wave six of the Netherlands Study of Depression and Anxiety (NESDA). Data were collected between 2013 and 2016. Diet quality was defined by adherence with the dietary approaches to stop hypertension (DASH) diet. Individuals reported on their food consumption through a food frequency questionnaire and SBP was measured. Density of FFR in 1600 m, 800 m and 400 m circular buffers around the home postal code was calculated using Geographic Information Systems. We assessed the association between density of FFR, diet and SBP using linear regression analyses, testing for moderation by mastery.ResultsMean age was 52 years and 32.2% of the sample were men. Exposure to FFR ranged from 0 to 35 FFR per km2. Density of FFR was not significantly associated with DASH adherence or SBP. Only one out of the six interaction terms was significant, suggesting that for individuals with lower levels of mastery, higher density of FFR in an 800-m buffer was negatively associated with DASH adherence, while for individuals with higher levels of mastery, this association was positive.ConclusionsExposure to FFR was not associated with diet quality and SBP, and we observed little evidence for moderation by level of mastery. This research question should be further explored in a large sample of healthy adults.

Highlights

The consumption of a healthy diet is a priority for reducing obesity and risk of chronic diseases [1]
We present Model 1, which is adjusted for age, gender, marital status, years of education, household income, depression status and presence of food outlets other than fast-food restaurants (FFR), and Model 2, which is adjusted for total energy intake or for total energy intake, current smoking status, body mass index, and alcohol consumption
Individuals with a current depression reported lower levels of mastery compared to individuals without a current depression (mean = 15.8 (4.5) vs. 20.2 (4.1), F = 9.1, p < 0.001), but the cross-product terms of FFR density and depression status were non-significant, so analyses were not stratified by depression status

Summary

Introduction

The consumption of a healthy diet is a priority for reducing obesity and risk of chronic diseases [1]. For individuals living in environments where FFR are ubiquitous, reliance on perceived internal sources of control, such as sense of mastery, may provide the necessary resources to resist the cues from the (fast-)food environment [10]. Mastery (or ‘locus of control’) is a personality attribute that reflects the extent to which individuals perceive events to be under control [11]. This has been associated with a healthier diet [12,13,14], better cardiometabolic health and reduced risk for disease and death [15]. The one study that investigated a similar research question concluded that mastery was only protective against

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