Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: An exploratory structural equation modelling approach (2019)
Type of ContentJournal Article
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 (SEM) 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=7,544) from wave two of the Yorkshire Health Study provided self-reported diet, height and weight (used to calculate BMI). Diet quality was based on sugary drinks, wholemeal (whole grain) bread, and portions of fruit and vegetables. Fast-food outlets were mapped using the Ordnance Survey Points of Interest (PoI) within 2km radial buffers around home postcode which were summed to indicate availability. Age (years), gender (female/male) and longstanding 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.
CitationHobbs M, Green M, Roberts K, Griffiths C, 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). 861-866.
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Keywordshealth inequalities; obesity; preventive medicine; area-level deprivation; fast-food outlets; diet quality
ANZSRC Fields of Research40 - Engineering::4013 - Geomatic engineering::401302 - Geospatial information systems and geospatial data modelling
42 - Health sciences::4206 - Public health::420606 - Social determinants of health
44 - Human society::4406 - Human geography::440605 - Health geography
RightsCreative Commons Attribution Non-Commercial License
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