Adjusting for Spatial Autocorrelation in Assessing Access to Fast Food Outlets by Neighbourhood Deprivation.

The aim of our study is to utilise longitudinal data to explore if the association between the retail fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n = 13,469) and 6 (ages 14/15; 2014/15; n = 11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations and test for observed confounding. A small positive association was initially detected between fast food outlets and overweight (e.g., at age 11/12, Odds Ratio (OR) = 1.0006, 95% Confidence Intervals (CI) = 1.0002–1.0009). Following adjusting for the confounding role of neighbourhood deprivation, this association was non-significant. Individuals who resided in the most deprived neighbourhoods had higher odds of overweight than individuals in the least deprived neighbourhoods (e.g., at age 11/12 OR = 1.95, 95% CIs = 1.64–2.32). Neighbourhood deprivation was also positively associated to the density of fast food outlets (at age 11/12 Incidence Rate Ratio = 3.03, 95% CIs = 2.80–3.28).

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The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study

10.20944/preprints202109.0434.v1 ◽

2021 ◽

Author(s):

Mark Green ◽

Matt Hobbs ◽

Ding Ding ◽

Michael Widener ◽

John Murray ◽

...

Keyword(s):

Cohort Study ◽

Fast Food ◽

Structural Equation ◽

Structural Equation Models ◽

Task Force ◽

Outcome Variable ◽

Millennium Cohort Study ◽

Neighbourhood Deprivation ◽

Food Outlets ◽

The Social

The aim of our study is to utilise longitudinal and representative national data to explore the extent that the association between the fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Longitudinal data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n=13,469) and 6 (ages 14/15; 2014/15; n=11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations at both ages and explicitly test for confounding. While we found some evidence for an association between the number of fast food outlets and overweight, any associations disappeared following accounting for the confounding nature of neighbourhood deprivation. Neighbourhood deprivation was consistently associated to overweight, with adolescents who resided in deprived areas more likely to be overweight. Results were largely consistent depending on different methodological decisions. Our findings suggest that policy efforts should prioritise focusing on tackling the social determinants of excess body mass which will be more effective than interventions aimed at the built environment.

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Obesity, equity and choice

Journal of Medical Ethics ◽

10.1136/medethics-2018-104848 ◽

2018 ◽

Vol 45 (5) ◽

pp. 323-328 ◽

Cited By ~ 3

Author(s):

Timothy M Wilkinson

Keyword(s):

Public Health ◽

Socioeconomic Status ◽

Fast Food ◽

Point Of View ◽

Health Crisis ◽

Public Health Crisis ◽

Food Outlets ◽

Rich Countries

Obesity is often considered a public health crisis in rich countries that might be alleviated by preventive regulations such as a sugar tax or limiting the density of fast food outlets. This paper evaluates these regulations from the point of view of equity. Obesity is in many countries correlated with socioeconomic status and some believe that preventive regulations would reduce inequity. The puzzle is this: how could policies that reduce the options of the badly off be more equitable? Suppose we distinguish: (1) the badly off have poor options from (2) the badly off are poor at choosing between their options (ie, have a choosing problem). If obesity is due to a poverty of options, it would be perverse to reduce them further. Some people in public health say that preventive regulations do not reduce options but, I shall argue, they are largely wrong. So the equity case for regulations depends on the worst off having a choosing problem. It also depends on their having a choosing problem that makes their choices against their interests. Perhaps they do. I ask, briefly, what the evidence has to say about whether the badly off choose against their interests. The evidence is thin but implies that introducing preventive regulations for the sake of equity would be at least premature.

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Frequency of Restaurant, Delivery and Takeaway Usage Is Not Related to BMI among Adults in Scotland

10.20944/preprints202008.0004.v1 ◽

2020 ◽

Author(s):

Ahmad Albalawi ◽

Catherine Hambly ◽

John R. Speakman

Keyword(s):

Fast Food ◽

Online Survey ◽

New Technology ◽

Cross Sectional ◽

Food Outlets ◽

Total Food ◽

Frequency Of Use ◽

Fast Food Restaurants ◽

Widespread Belief ◽

Individual Use

Background: The frequency of visits to restaurants has been suggested to contribute to the pandemic of obesity. However, few studies have examined how individual use of these restaurants is related to BMI using new technology of reminding to avoid memory error. Aim: To investigate the association between the usage of different types of food outlets and BMI among adults in Scotland. Method: The study was cross-sectional. Participants (n = 681) completed an online survey for seven consecutive days where all food purchased at food outlets was reported each day. We explored the relationship between BMI and usage of these restaurants using auto-reminder text system. Results: Body Mass Index (BMI) of both males and females was not related to frequency of use of Full-Service Restaurants (FSRs), Fast Food Restaurants (FFRs), delivery or takeaways, when assessed individually, or combined (TFO= Total Food Outlet). Conclusion: These data do not support the widespread belief that consumption of food out of the home at fast-food and full-service restaurants, combined with that derived from deliveries and takeaways, is a major driver of obesity in UK.

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Local institutions in Peru and the presence and number of fast-food outlets

Management Research The Journal of the Iberoamerican Academy of Management ◽

10.1108/mrjiam-06-2017-0755 ◽

2017 ◽

Vol 15 (3) ◽

pp. 338-376

Author(s):

Esteban Colla-De-Robertis ◽

Sandro Navarro Castañeda

Keyword(s):

Principal Component Analysis ◽

Urban Development ◽

Fast Food ◽

Institutional Quality ◽

Principal Component ◽

Local Institutions ◽

Urban District ◽

Content Type ◽

Food Outlets

Purpose The paper aims to study the role of local institutions in the establishment of fast-food outlets in urban districts of Peru. In most urban districts, there are no fast-food outlets. The authors, therefore, study the effect of institutional quality on the presence or absence of these outlets and the number of outlets if these are present. Design/methodology/approach The theoretical framework in which this paper is based on is the theory of agglomeration, which establishes that firms benefit from being close to each other. In particular, the paper builds on a model of market entry and competition in geographically independent local markets. An explicit expression was found for the equilibrium number of outlets (including zero) as a function of exogenous determinants of the demand for fast-food in each market, available infrastructure and institutional quality of the district’s government. Principal component analysis was used to construct measures of institutional quality based on administrative and organizational characteristics of district’s municipalities. These measures were incorporated as explanatory variables in a zero-inflated Poisson model, which is appropriate to handle count data and to accommodate excess zeros and which also allows the specification of different models for the zero part and the positive part. Findings Institutional quality mainly affects the presence of fast-food outlets in a district. The quality of urban development management and use of information systems are relevant. An institutional variable particularly relevant in explaining the number of outlets is the presence of an investment programming office in the municipality. The authors confirm the general hypothesis of the paper: institutions have a role in explaining both the presence and number of fast-food outlets in a district. Overall, the results of this paper suggest that institutional quality of a municipal district is related to better infrastructure, which lowers the costs of establishing outlets. Research limitations/implications Limitations in the availability of data at the regional and urban district level did not allow the authors to analyze other factors that affect entry decisions in the fast-food industry in Peru, such as controls to prevent corruption, legal uncertainty or crime. Another limitation was the lack of data on entry costs for each franchisee in each urban district. This forced the authors to use public infrastructure characteristics of the district as (imperfect) proxies of the entry costs. Practical implications The instruments of urban development management and information systems can be effective at attracting investment to a district. These tools operate partly through an indirect effect, namely, the improvement of district infrastructure, which is necessary to reduce the costs of establishing companies. There is also synergy between national government’s programs to attract investment and the good institutional quality in local governments. On the contrary, poor local institutions can be an obstacle to the successful implementation of those national programs. Social implications Foreign direct investment has a positive impact on the economic development of a country through knowledge spillovers. Therefore, any administrative reform to make local government practices more efficient can have an indirect impact on development. Originality/value Principal component analysis is a statistical tool that can be important in building good measures of institutional quality by allowing the combination of different observable characteristics into one component that can be interpreted as an operational restriction. The count model allows the use of the primary, easily observable, dependent variable, namely, the number of outlets. Finally, the two-part model makes it possible to discern the effect of institutional quality on the presence or absence of outlets and the number of outlets if these are present.

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Moderation by Neighborhood Food Outlets on Relationships between Meal Sources and Diet

American Journal of Health Behavior ◽

10.5993/ajhb.45.2.9 ◽

2021 ◽

Vol 45 (2) ◽

pp. 290-308

Author(s):

Jessica L. Thomson ◽

Alicia S. Landry ◽

Tameka I. Walls ◽

Melissa H. Goodman

Keyword(s):

Dietary Intake ◽

Fast Food ◽

Linear Models ◽

Grocery Store ◽

Grocery Stores ◽

Food Outlet ◽

Added Sugars ◽

Food Outlets ◽

Food And Beverage ◽

Fast Food Restaurants

Objectives: In this study, we tested for moderation by neighborhood food outlet presence on relationships between food outlet shopping or meal sources and dietary intake. Methods: We used generalized linear models to analyze parent-adolescent (12-17 years) dyad data from the 2014 Family Life, Activity, Sun, Health and Eating. Questions included food outlet presence in home (parent) and school (adolescent) neighborhoods (yes or no), shopping at food outlets (parent) (never, rarely, sometimes, often or always), and sources of food consumed away from and at home (weekly frequency). We captured food and beverage intakes via a dietary screener. Results: Relationships between adolescent added sugar intake and scratch cooked evening meals and meals away from home were found only when grocery stores and fast food restaurants, respectively, were present in adolescents' school neighborhoods. Shopping at fruit and vegetable (FV) markets and scratch cooked evening meals were associated with the largest increases in parent and adolescent FV intakes, respectively. Meals away from home at convenience stores were associated with the largest increases in parent and adolescent intakes of added sugars. Conclusions: Neighborhood grocery store and fast food restaurant presence moderated relationships between meal sources and dietary intake only in adolescents.

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Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario’s School Food and Beverage Policy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16142563 ◽

2019 ◽

Vol 16 (14) ◽

pp. 2563

Author(s):

Rhona M. Hanning ◽

Henry Luan ◽

Taryn A. Orava ◽

Renata F. Valaitis ◽

James K. H. Jung ◽

...

Keyword(s):

Fast Food ◽

Easy Access ◽

Urban Region ◽

Healthy Foods ◽

School Food ◽

Food Retail ◽

Food Outlets ◽

Food And Beverage ◽

Fast Food Restaurants ◽

Access To Food

Background: Canadian provincial policies, like Ontario’s School Food and Beverage Policy (P/PM 150), increasingly mandate standards for food and beverages offered for sale at school. Given concerns regarding students leaving school to purchase less healthy foods, we examined student behaviours and competitive food retail around schools in a large urban region of Southern Ontario. Methods: Using a geographic information system (GIS), we enumerated food outlets (convenience stores, fast-food restaurants, full-service restaurants) within 500, 1000 and 1500 m of all 389 regional schools spanning years of policy implementation. Consenting grade 6–10 students within 31 randomly selected schools completed a web-based 24-h diet recall (WEB-Q) and questionnaire. Results: Food outlet numbers increased over time (p < 0.01); post-policy, within 1000 m, they averaged 27.31 outlets, with a maximum of 65 fast-food restaurants around one school. Of WEB-Q respondents (n = 2075, mean age = 13.4 ± 1.6 years), those who ate lunch at a restaurant/take-out (n = 84, 4%) consumed significantly more energy (978 vs. 760 kcal), sodium (1556 vs. 1173 mg), and sugar (44.3 vs. 40.1 g). Of elementary and secondary school respondents, 22.1% and 52.4% reported ever eating at fast food outlets during school days. Conclusions: Students have easy access to food retail in school neighbourhoods. The higher energy, sodium and sugar of these options present a health risk.

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Deprivation matters: understanding associations between neighbourhood deprivation, unhealthy food outlets, unhealthy dietary behaviours and child body size using structural equation modelling

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-213159 ◽

2020 ◽

Vol 74 (5) ◽

pp. 460-466 ◽

Cited By ~ 2

Author(s):

Victoria Egli ◽

Matthew Hobbs ◽

Jordan Carlson ◽

Niamh Donnellan ◽

Lisa Mackay ◽

...

Keyword(s):

Body Size ◽

New Zealand ◽

Structural Equation Modelling ◽

Structural Equation ◽

Unhealthy Food ◽

Neighbourhood Deprivation ◽

Food Outlets ◽

Dietary Behaviours ◽

Equation Modelling ◽

Home And School

BackgroundChildren residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked.MethodsThis study involves children aged 8–13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-to-height ratio (WtHR). Geographic Information Systems mapped neighbourhood deprivation and unhealthy food outlets within individual, child-specific neighbourhood buffer boundaries (800 m around the home and school). Associations between neighbourhood deprivation (calculated using the New Zealand Index of Deprivation 2013), unhealthy food outlets, unhealthy dietary behaviours and WtHR were investigated using structural equation modelling in Mplus V.8.0. Age, sex and ethnicity were included as covariates, and clustering was accounted for at the school level.ResultsStructural equation models showed that unhealthy food outlets were unrelated to unhealthy dietary behaviours (estimate 0.029, p=0.416) and excess body size (estimate −0.038, p=0.400). However, greater neighbourhood deprivation and poorer dietary behaviours (estimate −0.134, p=0.001) were associated with greater WtHR (estimate 0.169, p<0.001).ConclusionExcess child body size is associated with neighbourhood deprivation and unhealthy dietary behaviours but not unhealthy outlet density or location of these outlets near home and school.

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Children’s Intake of Food from Non-Fast-Food Outlets and Child-Specific Menus: A Survey of Parents

Children ◽

10.3390/children6110123 ◽

2019 ◽

Vol 6 (11) ◽

pp. 123

Author(s):

Li Kheng Chai ◽

Sze Lin Yoong ◽

Tamara Bucher ◽

Clare E Collins ◽

Vanessa A Shrewsbury

Keyword(s):

Childhood Obesity ◽

Healthy Child ◽

Fast Food ◽

Sociodemographic Characteristics ◽

Fast Food Restaurant ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Food Outlets ◽

High Prevalence ◽

Eating Out

Eating out-of-home is associated with higher energy intakes in children. The continued high prevalence of childhood obesity requires a greater understanding of child menu options and eating out frequency to inform appropriate regulatory initiatives. The majority of studies to date have focused on menus from fast-food outlets with few focused on non-fast-food outlets. This study aimed to describe parents’ reports of their child(ren)’s (aged up to 6 years) frequency of consuming foods at non-fast-food outlets, observations of child menus at these outlets, and their purchasing behaviours and future preferences regarding these menus; and if their responses were influenced by sociodemographic characteristics. Ninety-five parents completed a 15-item cross-sectional survey. Overall, children from 54% of families consumed food from non-fast-food outlets at least monthly. Of the 87 parents who reported that their child eats at a non-fast-food restaurant, 71 had children who ordered from child menus every time (7%, n = 5), often (29%, n = 22), sometimes (42%, n = 32) or rarely (16%, n = 12), with a further 7% (n = 5) never ordering from these menus. All parents indicated that they would like to see a higher proportion of healthy child menu items than is currently offered. Parents’ responses were not influenced by sociodemographic characteristics. Parents’ views support implementation of initiatives to increase availability of healthy options on child menus at non-fast-food outlets.

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