Mehta Neil K, Chang Virginia W
Graduate Group in Demography, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Am J Prev Med. 2008 Feb;34(2):127-33. doi: 10.1016/j.amepre.2007.09.031.
Empiric studies find that contextual factors affect individual weight status over and above individual socioeconomic characteristics. Given increasing levels of obesity, researchers are examining how the food environment contributes to unhealthy weight status. An important change to this environment is the increasing availability of away-from-home eating establishments such as restaurants.
This study analyzed the relationship between the restaurant environment and weight status across counties in the United States. Individual data from the 2002-2006 Behavioral Risk Factor Surveillance System (N=714,054) were linked with restaurant data from the 2002 U.S. Economic Census. Fast-food and full-service restaurant density, along with restaurant mix (the ratio of fast-food to full-service restaurants), were assessed.
Fast-food restaurant density and a higher ratio of fast-food to full-service restaurants were associated with higher individual-level weight status (BMI and the risk of being obese). In contrast, a higher density of full-service restaurants was associated with lower weight status.
Area-level restaurant mix emerged as an important correlate of weight status, with components of the restaurant environment exhibiting differential associations. Hence, it is the availability of fast-food relative to other away-from-home choices that appears salient for unhealthy weight outcomes. Areas with a high density of full-service restaurants were indicative of a more healthful eating environment, suggesting a need for research into the comparative healthfulness of foods served at different types of restaurants. Future prospective studies are required to delineate causal pathways.
实证研究发现，情境因素对个体体重状况的影响超过个体社会经济特征。鉴于肥胖水平不断上升，研究人员正在研究食物环境如何导致不健康的体重状况。这种环境的一个重要变化是外出就餐场所（如餐馆）的数量不断增加。
本研究分析了美国各县餐馆环境与体重状况之间的关系。将2002 - 2006年行为危险因素监测系统的个体数据（N = 714,054）与2002年美国经济普查的餐馆数据相联系。评估了快餐店和全方位服务餐厅的密度，以及餐厅组合（快餐店与全方位服务餐厅的比例）。
快餐店密度以及快餐店与全方位服务餐厅的较高比例与个体层面较高的体重状况（体重指数和肥胖风险）相关。相比之下，全方位服务餐厅的较高密度与较低的体重状况相关。
地区层面的餐厅组合成为体重状况的一个重要相关因素，餐厅环境的各个组成部分表现出不同的关联。因此，相对于其他外出就餐选择而言，快餐的可获得性似乎对不健康的体重结果至关重要。全方位服务餐厅高密度的地区表明饮食环境更健康，这表明需要研究不同类型餐厅所提供食物的相对健康程度。未来需要进行前瞻性研究来阐明因果途径。
