Abstract
BackgroundOutside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes.MethodsData from a population health survey of 2900 adults (18 years or older) conducted in 2002 was linked with geographic measures of access to food retailers. Based upon a ratio of the number of fast-food restaurants and convenience stores to supermarkets and specialty food stores, a Retail Food Environment Index (RFEI) was calculated for 800 m and 1600 m buffers around people's homes. In a series of logistic regressions, associations between the RFEI and the level of obesity among adults were examined.ResultsThe median RFEI for adults in Edmonton was 4.00 within an 800 m buffer around their residence and 6.46 within a 1600 m buffer around their residence. Approximately 14% of the respondents were classified as being obese. The odds of a resident being obese were significantly lower (OR = 0.75, 95%CI 0.59 – 0.95) if they lived in an area with the lowest RFEI (below 3.0) in comparison to the highest RFEI (5.0 and above). These associations existed regardless of the covariates included in the model. No significant associations were observed between RFEI within a 1600 m buffer of the home and obesity.ConclusionThe lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near people's homes, the lower the odds of being obese. Thus the proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity.
Highlights
Outside of the United States, evidence for associations between exposure to fastfood establishments and risk for obesity among adults is limited and equivocal
In this study we explored whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes
We found that the lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near the home, the lower the odds of being obese
Summary
Outside of the United States, evidence for associations between exposure to fastfood establishments and risk for obesity among adults is limited and equivocal. Food eaten away from home, especially fast-food, is associated with weight gain and the obesity epidemic [1,2,3,4]. Adolescents are obtaining less of their energy intake at home and more at restaurants and fast food places [7]. This behaviour is reasonable considering that fast-food is cheaper and more energy-dense per measure of weight than other healthier foods such as fruits and vegetables that are purchased in a grocery store [8]. The prices of fast-food and fruit and vegetables are differentially associated with dietary quality and adiposity among people living in the United States [9]. The location of fast-food restaurants in urban areas may contribute to the obesogenic environment [10]
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