Amy H Auchincloss1,2, Jingjing Li2, Kari Ab Moore2, Manuel Franco3, Mahasin S Mujahid4, Latetia V Moore5. 1. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA19104, USA. 2. Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA. 3. School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain. 4. Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA. 5. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Abstract
OBJECTIVE: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. DESIGN: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. SETTING: Urbanised areas in multiple regions of the USA, years 2000-2002 and 2010-2012. PARTICIPANTS: Participants aged 45-84 years were followed for 10 years (n 3567). RESULTS: Median HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46). CONCLUSIONS: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.
OBJECTIVE: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. DESIGN: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. SETTING: Urbanised areas in multiple regions of the USA, years 2000-2002 and 2010-2012. PARTICIPANTS: Participants aged 45-84 years were followed for 10 years (n 3567). RESULTS: Median HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46). CONCLUSIONS: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.
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