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

Hobbs, M, Green, M ORCID: 0000-0002-0942-6628, Roberts, K, Griffiths, C and Mckenna, J (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. ISSN 0143-005X, 1470-2738

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Abstract

Background 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. Methods 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. Results 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. Conclusion 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:	01 Mar 2026 03:13
DOI:	10.1136/jech-2018-211798
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3041488
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