Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach



Hobbs, Matthew, Green, Mark ORCID: 0000-0002-0942-6628, Roberts, Kath, Griffiths, Claire and McKenna, Jim
(2019) Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 73 (9). pp. 861-866.

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Abstract

<h4>Background</h4>Internationally, the prevalence of adults with obesity is a major public health concern. Few studies investigate the explanatory pathways between fast-food outlets and body mass index (BMI). We use structural equation modelling to explore an alternative hypothesis to existing research using area-level deprivation as the predictor of BMI and fast-food outlets and diet quality as mediators.<h4>Methods</h4>Adults (n=7544) from wave II of the Yorkshire Health Study provided self-reported diet, height and weight (used to calculate BMI). Diet quality was based on sugary drinks, wholemeal (wholegrain) bread and portions of fruit and vegetables. Fast-food outlets were mapped using the Ordnance Survey Points of Interest within 2 km radial buffers around home postcode which were summed to indicate availability. Age (years), gender (female/male) and long-standing health conditions (yes/no) were included as covariates.<h4>Results</h4>There was little evidence linking fast-food outlets to diet or BMI. An independent association between fast-food outlet availability and BMI operated counterintuitively and was small in effect. There was also little evidence of mediation between fast-food outlet availability and BMI. However, there was more evidence that area-level deprivation was associated with increased BMI, both as an independent effect and through poorer diet quality.<h4>Conclusion</h4>This exploratory study offers a first step for considering complexity and pathways linking fast-food outlets, area-level deprivation, diet quality and BMI. Research should respond to and build on the hypothesised pathways and our simple framework presented within our study.

Item Type: Article
Uncontrolled Keywords: Humans, Obesity, Body Mass Index, Diet, Cohort Studies, Cross-Sectional Studies, Residence Characteristics, Socioeconomic Factors, Food Supply, Aged, Middle Aged, Female, Male, Fast Foods, United Kingdom, Latent Class Analysis
Depositing User: Symplectic Admin
Date Deposited: 16 May 2019 07:40
Last Modified: 19 Jan 2023 00:45
DOI: 10.1136/jech-2018-211798
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3041488