Abstract
IntroductionEating meals away from home has been associated with the consumption of unhealthy foods and increased body weight. However, more rigorous assessment of the contribution of different types of away-from-home food establishments to overall diet quality and obesity is minimal. This study examined usage of these food establishments, accordance to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and obesity status in a nationally representative sample of adults in the United Kingdom.MethodsA cross-sectional analysis of data from a national survey (N=2,083 aged ≥19 years, from 2008 to 2012) with dietary intake measured using a 4-day food diary, and height and weight measured objectively. Exposures included usage of (i.e., by proportion of energy) all away-from-home food establishments combined, and fast-food outlets, restaurants, and cafés separately. Outcomes included accordance with the DASH diet, and obesity status. Multivariable logistic regressions were conducted in 2016 to estimate associations between food establishments, diet quality, and obesity.ResultsPeople consuming a higher proportion of energy from any away-from-home food establishment had lower odds of DASH accordance (OR=0.45, 95% CI=0.31, 0.67) and increased odds of obesity (OR=1.48, 95% CI=1.10, 1.99). After adjustment, only use of fast-food outlets was significantly associated with lower odds of DASH accordance (OR=0.48, 95% CI=0.33, 0.69) and higher odds of obesity (OR=1.30, 95% CI=1.01, 1.69).ConclusionsAlthough a greater reliance on eating away-from-home is associated with less-healthy diets and obesity, dietary public health interventions that target these food establishments may be most effective if they focus on modifying the use of fast-food outlets.
Highlights
Eating meals away from home has been associated with the consumption of unhealthy foods and increased body weight
In the United Kingdom (UK), diet is the leading behavioral contributor to disease burden,[2] with poor diet quality associated with an increased risk of cardiovascular disease,[3] diabetes,[4] certain types of cancer,[5] and other chronic conditions, such as overweight and obesity.[6]
The aim of this work is to employ a prospective assessment of energy intake from all away-from-home food establishments, and restaurants, fast-food outlets, and cafés to examine independent association(s) with overall diet quality and obesity
Summary
Eating meals away from home has been associated with the consumption of unhealthy foods and increased body weight. More rigorous assessment of the contribution of different types of away-from-home food establishments to overall diet quality and obesity is minimal. P oor diet and obesity are global epidemics that present a significant challenge for public health and the prevention of chronic disease.[1] In the United Kingdom (UK), diet is the leading behavioral contributor to disease burden,[2] with poor diet quality associated with an increased risk of cardiovascular disease,[3] diabetes,[4] certain types of cancer,[5] and other chronic conditions, such as overweight and obesity.[6] Obesity (a BMI Z30kg/m2) in particular is considered a global epidemic with a doubling of prevalence worldwide since 1980, reaching approximately 600 million adults as of 2014.7 In the UK, approximately 26% of men (up from 13.2% in 1993) and 23.8% of women (up from 16.4%) are living with obesity.[8].
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