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. 2008 Feb;34(2):127-33.
doi: 10.1016/j.amepre.2007年09月03日1.

Weight status and restaurant availability a multilevel analysis

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Weight status and restaurant availability a multilevel analysis

Neil K Mehta et al. Am J Prev Med. 2008 Feb.

Abstract

Background: Empiric studies find that contextual factors affect individual weight status over and above individual socioeconomic characteristics. Given increasing levels of obesity, researchers are examining how the food environment contributes to unhealthy weight status. An important change to this environment is the increasing availability of away-from-home eating establishments such as restaurants.

Methods: This study analyzed the relationship between the restaurant environment and weight status across counties in the United States. Individual data from the 2002-2006 Behavioral Risk Factor Surveillance System (N=714,054) were linked with restaurant data from the 2002 U.S. Economic Census. Fast-food and full-service restaurant density, along with restaurant mix (the ratio of fast-food to full-service restaurants), were assessed.

Results: Fast-food restaurant density and a higher ratio of fast-food to full-service restaurants were associated with higher individual-level weight status (BMI and the risk of being obese). In contrast, a higher density of full-service restaurants was associated with lower weight status.

Conclusions: Area-level restaurant mix emerged as an important correlate of weight status, with components of the restaurant environment exhibiting differential associations. Hence, it is the availability of fast-food relative to other away-from-home choices that appears salient for unhealthy weight outcomes. Areas with a high density of full-service restaurants were indicative of a more healthful eating environment, suggesting a need for research into the comparative healthfulness of foods served at different types of restaurants. Future prospective studies are required to delineate causal pathways.

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Figures

Figure 1
Figure 1
Trends in restaurant expenditures and obesity in the United States, 1940–2004. Sources: Obesity estimates obtained from Flegal et al. and Ogden et al. Food expenditure data are from U.S. Department of Agriculture Food Expenditure Tables.

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