Key Centre for Women's Health in Society, Melbourne School of Population Health, The University of Melbourne, Victoria, 3010, Australia.
Int J Behav Nutr Phys Act. 2009 May 27;6:28. doi: 10.1186/1479-5868-6-28.
While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) - a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003.
The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant.Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics.
Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 - 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors.
Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.
尽管之前有关快餐获取和购买的研究并未发现两者之间存在关联的证据，但这些研究存在方法学问题，包括聚合误差、暴露和结果之间缺乏特异性以及缺乏对潜在混杂因素的调整。在本文中，我们试图使用来自澳大利亚墨尔本大都市的维多利亚生活方式和邻里环境研究（VicLANES）的横断面多层次研究的数据来解决这些方法学问题。
本分析中使用的 VicLANES 数据包括来自澳大利亚墨尔本大都市的 49 个普查收集区的 2547 名参与者。感兴趣的结果是过去一个月内在家中消费的五种主要快餐连锁店（红鸡，麦当劳，肯德基，汉堡王和必胜客）购买的快餐的总频率（从不，每月和每周）。创建了三种快餐获取措施：密度和多样性，定义为 3 公里道路网络距离内的快餐店数量和不同快餐连锁店的数量，以及接近度，定义为距离最近的快餐店的道路网络距离。使用多层次多项模型来估计快餐餐厅的接近程度与购买之间的关联，从不购买作为参考类别。模型调整了混杂因素，包括影响食物购买决策的需求决定因素（态度和口味）以及个人和地区社会经济特征。
在调整个人和地区特征后，每月购买快餐与快餐餐厅的多样性有关（优势比 1.13；95％置信区间 1.02-1.25）。在调整个人社会经济预测因素后，密度和接近度并不是快餐购买的重要预测因素。
尽管我们发现快餐购买与更广泛的快餐餐厅之间存在独立的关联，但密度和接近度并不是重要的预测因素。我们研究中使用的方法是对以前分析的改进。
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