Dataset Information

Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK.

ABSTRACT:

Background

Characteristics of the built environment, such as neighbourhood fast-food outlet exposure, are increasingly recognised as risk factors for unhealthy diet and obesity. Obesity also has a genetic component, with common genetic variants explaining a substantial proportion of population-level obesity susceptibility. However, it is not known whether and to what extent associations between fast-food outlet exposure and body weight are modified by genetic predisposition to obesity.

Methods

We used data from the Fenland Study, a population-based sample of 12,435 UK adults (mean age 48.6?years). We derived a genetic risk score associated with BMI (BMI-GRS) from 96 BMI-associated single nucleotide polymorphisms. Neighbourhood fast-food exposure was defined as quartiles of counts of outlets around the home address. We used multivariable regression models to estimate the associations of each exposure, independently and in combination, with measured BMI, overweight and obesity, and investigated interactions.

Results

We found independent associations between BMI-GRS and risk of overweight (RR?=?1.34, 95% CI 1.23-1.47) and obesity (RR?=?1.73, 95% CI 1.55-1.93), and between fast-food outlet exposure and risk of obesity (highest vs lowest quartile RR?=?1.58, 95% CI 1.21-2.05). There was no evidence of an interaction of fast-food outlet exposure and genetic risk on BMI (P =?0.09), risk of overweight (P =?0.51), or risk of obesity (P =?0.27). The combination of higher BMI-GRS and highest fast-food outlet exposure was associated with 2.70 (95% CI 1.99-3.66) times greater risk of obesity.

Conclusions

Our study demonstrated independent associations of both genetic obesity risk and neighbourhood fast-food outlet exposure with adiposity. These important drivers of the obesity epidemic have to date been studied in isolation. Neighbourhood fast-food outlet exposure remains a potential target of policy intervention to prevent obesity and promote the public's health.

SUBMITTER: Burgoine T

PROVIDER: S-EPMC7885578 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK.

Burgoine Thomas T Monsivais Pablo P Sharp Stephen J SJ Forouhi Nita G NG Wareham Nicholas J NJ

BMC medicine 20210215 1

<h4>Background</h4>Characteristics of the built environment, such as neighbourhood fast-food outlet exposure, are increasingly recognised as risk factors for unhealthy diet and obesity. Obesity also has a genetic component, with common genetic variants explaining a substantial proportion of population-level obesity susceptibility. However, it is not known whether and to what extent associations between fast-food outlet exposure and body weight are modified by genetic predisposition to obesity.<h ...[more]

PMID: 33588846

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Project description:BackgroundHousehold income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double burden of these factors is a matter of public health importance. The purpose of this study was to test associations of neighbourhood fast-food outlet exposure and household income, in relation to frequency of consumption of processed meat and multiple measures of adiposity, and to examine possible interactions.MethodsWe employed an observational, cross-sectional study design. In a cohort of 51,361 adults aged 38-72 years in Greater London, UK, we jointly classified participants based on household income (£/year, four groups) and GIS-derived neighbourhood fast-food outlet proportion (counts of fast-food outlets as a percentage of all food outlets, quartiles). Multivariable regression models estimated main effects and interactions (additive and multiplicative) of household income and fast-food outlet proportion on odds of self-reported frequent processed meat consumption (> 1/week), measured BMI (kg/m2), body fat (%), and odds of obesity (BMI ≥ 30).ResultsIncome and fast-food proportion were independently, systematically associated with BMI, body fat, obesity and frequent processed meat consumption. Odds of obesity were greater for lowest income participants compared to highest (OR = 1.54, 95% CI: 1.41, 1.69) and for those most-exposed to fast-food outlets compared to least-exposed (OR = 1.51, 95% CI: 1.40, 1.64). In jointly classified models, lowest income and highest fast-food outlet proportion in combination were associated with greater odds of obesity (OR = 2.43, 95% CI: 2.09, 2.84), with relative excess risk due to interaction (RERI = 0.03). Results were similar for frequent processed meat consumption models. There was no evidence of interaction on a multiplicative scale between fast-food outlet proportion and household income on each of BMI (P = 0.230), obesity (P = 0.054) and frequent processed meat consumption (P = 0.725).ConclusionsOur study demonstrated independent associations of neighbourhood fast-food outlet exposure and household income, in relation to diet and multiple objective measures of adiposity, in a large sample of UK adults. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, furthering our understanding of how these factors contribute jointly to social inequalities in health.

Project description:BackgroundOnline food delivery services facilitate 'online' access to food outlets that typically sell lenergy-dense nutrient-poor food. Greater online food outlet access might be related to the use of this purchasing format and living with excess bodyweight, however, this is not known. We aimed to investigate the association between aspects of online food outlet access and online food delivery service use, and differences according to customer sociodemographic characteristics, as well as the association between the number of food outlets accessible online and bodyweight.MethodsIn 2019, we used an automated data collection method to collect data on all food outlets in the UK registered with the leading online food delivery service Just Eat (n = 33,204). We linked this with contemporaneous data on food purchasing, bodyweight, and sociodemographic information collected through the International Food Policy Study (analytic sample n = 3067). We used adjusted binomial logistic, linear, and multinomial logistic regression models to examine associations.ResultsAdults in the UK had online access to a median of 85 food outlets (IQR: 34-181) and 85 unique types of cuisine (IQR: 64-108), and 15.1% reported online food delivery service use in the previous week. Those with the greatest number of accessible food outlets (quarter four, 182-879) had 71% greater odds of online food delivery service use (OR: 1.71; 95% CI: 1.09, 2.68) compared to those with the least (quarter one, 0-34). This pattern was evident amongst adults with a university degree (OR: 2.11; 95% CI: 1.15, 3.85), adults aged between 18 and 29 years (OR: 3.27, 95% CI: 1.59, 6.72), those living with children (OR: 1.94; 95% CI: 1.01; 3.75), and females at each level of increased exposure. We found no association between the number of unique types of cuisine accessible online and online food delivery service use, or between the number of food outlets accessible online and bodyweight.ConclusionsThe number of food outlets accessible online is positively associated with online food delivery service use. Adults with the highest education, younger adults, those living with children, and females, were particularly susceptible to the greatest online food outlet access. Further research is required to investigate the possible health implications of online food delivery service use.

Project description:ObjectivesTo examine the association between environmental exposure to takeaway food outlets, takeaway food consumption, and body weight, while accounting for home, work place, and commuting route environments.DesignPopulation based, cross sectional study, using data on individual participants' diet and weight, and objective metrics of food environment exposure.ParticipantsWorking adults participating in the Fenland Study, Cambridgeshire, UK (n = 5442, aged 29-62 years), who provided home and work addresses and commuting preferences. Takeaway food outlet exposure was derived using data from local authorities for individual environmental domains (at home, at work, and along commuting routes (the shortest route between home and work)), and for exposure in all three domains combined. Exposure was divided into quarters (Q); Q1 being the least exposed and Q4 being the most exposed.Main outcome measuresSelf reported consumption of takeaway type food (g/day; pizza, burgers, fried foods, and chips) using food frequency questionnaires, measured body mass index, and cut-offs for body mass index as defined by the World Health Organization.ResultsIn multiple linear regression models, exposure to takeaway food outlets was positively associated with consumption of takeaway food. Among domains at home, at work, and along commuting routes, associations were strongest in work environments (Q4 v Q1; β coefficient = 5.3 g/day, 95% confidence interval 1.6 to 8.7; P<0.05), with evidence of a dose-response effect. Associations between exposure in all three domains combined and consumption were greater in magnitude across quarters of exposure (Q4 v Q1; 5.7 g/day, 2.6 to 8.8; P<0.001), with evidence of a dose-response effect. Combined exposure was especially strongly associated with increased body mass index (Q4 v Q1; body mass index 1.21, 0.68 to 1.74; P<0.001) and odds of obesity (Q4 v Q1; odds ratio 1.80, 1.28 to 2.53; P<0.05). There was no evidence of effect modification by sex.ConclusionsExposure to takeaway food outlets in home, work, and commuting environments combined was associated with marginally higher consumption of takeaway food, greater body mass index, and greater odds of obesity. Government strategies to promote healthier diets through planning restrictions for takeaway food could be most effective if focused around the workplace.

Project description:BACKGROUND:The built environment might be associated with development of obesity and related disorders. We examined whether neighbourhood exposure to fast-food outlets and physical activity facilities were associated with adiposity in UK adults. METHODS:We used cross-sectional observational data from UK Biobank. Participants were aged 40-70 years and attended 21 assessment centres between 2006 and 2010. Using linked data on environments around each participant's residential address, we examined whether density of physical activity facilities and proximity to fast-food outlets were associated with waist circumference, body-mass index (BMI), and body fat percentage. We used multilevel linear regression models adjusted for potential confounders, and conducted several sensitivity analyses. FINDINGS:Complete case sample sizes were 401 917 (waist circumference models), 401 435 (BMI), and 395 640 (body fat percentage). Greater density of physical activity facilities within 1000 m of home was independently associated with smaller waist circumference and lower BMI and body fat percentage. Compared with people with no nearby facilities, those with at least six facilities close to home had 1·22 cm smaller waist circumference (95% CI -1·64 to -0·80), 0·57 kg/m2 lower BMI (-0·74 to -0·39), and 0·81 percentage points lower body fat (-1·03 to -0·59). Living further from a fast-food outlet was weakly associated with waist circumference and BMI, mostly among women. Compared with people living fewer than 500 m from a fast-food outlet, those living at least 2000 m away had 0·26 cm smaller waist circumference (-0·52 to 0·01). INTERPRETATION:This study shows strong associations between high densities of physical activity facilities and lower adiposity for adults in mid-life. We observed weaker associations for access to fast food, but these are likely to be underestimated owing to limitations of the food environment measure. Policy makers should consider interventions aimed at tackling the obesogenic built environment. FUNDING:Commonwealth Scholarship Commission, Wellcome Trust Institutional Strategic Support Fund.

Project description:BackgroundFood choices are often determined by stimuli from our immediate surroundings, including strategic placement in shops to encourage impulse purchases. One example of this is food in shop checkout areas. Recently a number of UK supermarkets have voluntarily committed to providing healthier checkout foods. The aim of this study was to document the nature of current UK supermarket checkout food policies; determine whether there are any differences in the healthfulness and type of food displayed at checkouts in supermarkets according to the presence or nature of policies; and determine whether supermarkets are adhering to their checkout food policies.MethodsSurvey of checkout food policies. Cross-sectional observations in 69 supermarkets (covering 14 store formats) in the East of England in Feb-May 2017 of the number and type of checkout foods on each 'checkout journey' (each possible route through the checkout area). Checkout foods were categorised as less healthy or healthier, using the UK Food Standard's Agency's Nutrient Profile Model, and into food groups. Checkout food policies were categorised as clear and consistent, vague or inconsistent, or absent.ResultsCheckout food policies differed between store formats in some supermarket groups. Across the 14 store formats included, two had no checkout food policy, six had 'clear and consistent' policies, and six 'vague or inconsistent' policies. In supermarkets with clear and consistent policies there were a median of 13 products per checkout journey, of which 35% were less healthy. Comparable figures for supermarkets with vague or inconsistent, and absent policies were 15 (57%) and 39 (90%) respectively (ps for trend < 0.001). Whilst most supermarkets with a clear and consistent checkout food policy were fully adherent to their policy, those with vague or inconsistent policies were not.ConclusionsMost UK supermarkets have checkout food policies, but not all are clear and consistent. Supermarkets with clear and consistent policies display fewer checkout foods and a lower proportion of these are less healthy than in other supermarkets. Supermarkets with clear and consistent policies adhere well to these. More stores should be encouraged to develop a clear and consistent checkout food policy. This may require non-voluntary intervention.

Project description:BackgroundUnhealthy food environments may contribute to unhealthy diets and risk of overweight and obesity through increased consumption of fast-food. Therefore, we aimed to study the association of relative exposure to fast-food restaurants (FFR) with overall diet quality and risk of overweight and obesity in a sample of older adults.MethodsWe analyzed cross-sectional data of the EPIC-NL cohort (n = 8,231). Data on relative FFR exposure was obtained through linkage of home address in 2015 with a retail outlet database. We calculated relative exposure to FFR by dividing the densities of FFR in street-network buffers of 400, 1000, and 1500 m around the home of residence by the density of all food retailers in the corresponding buffer. We calculated scores on the Dutch Healthy Diet 2015 (DHD15) index using data from a validated food-frequency questionnaire. BMI was categorized into normal weight (BMI < 25), overweight (25 ≤ BMI < 30), and obesity (BMI ≥ 30). We used multivariable linear regression (DHD15-index) and multinomial logistic regression (weight status), using quartiles of relative FFR exposure as independent variable, adjusting for lifestyle and environmental characteristics.ResultsRelative FFR exposure was not significantly associated with DHD15-index scores in the 400, 1000, and 1500 m buffers (βQ4vsQ1= -0.21 [95 %CI: -1.12; 0.70]; βQ4vsQ1= -0.12 [95 %CI: -1.10; 0.87]; βQ4vsQ1 = 0.37 [95 %CI: -0.67; 1.42], respectively). Relative FFR exposure was also not related to overweight in consecutive buffers (ORQ4vsQ1=1.10 [95 %CI: 0.97; 1.25]; ORQ4vsQ1=0.97 [95 %CI: 0.84; 1.11]; ORQ4vsQ1= 1.04 [95 %CI: 0.90-1.20]); estimates for obesity were similar to those of overweight.ConclusionsA high proportion of FFR around the home of residence was not associated with diet quality or overweight and obesity in this large Dutch cohort of older adults. We conclude that although the food environment may be a determinant of food choice, this may not directly translate into effects on diet quality and weight status. Methodological improvements are warranted to provide more conclusive evidence.

Dataset Information

Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK.

Background

Methods

Results

Conclusions

Publications

Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK.

Similar Datasets

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