Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA.
J Gen Intern Med. 2020 Jun;35(6):1743-1750. doi: 10.1007/s11606-020-05683-8. Epub 2020 Feb 14.
Prior research on the restaurant environment and obesity risk is limited by cross-sectional data and a focus on specific geographic areas.
To measure the impact of changes in chain restaurant calories over time on body mass index (BMI).
We used a first-difference model to examine whether changes from 2012 to 2015 in chain restaurant calories per capita were associated with percent changes in BMI. We also examined differences by race and county income, restaurant type, and initial body weight categories.
USA (207 counties across 39 states).
447,873 adult patients who visited an athenahealth medical provider in 2012 and 2015 where BMI was measured.
Percent change in objectively measured BMI from 2012 to 2015.
Across all patients, changes in chain restaurant calories per capita were not associated with percent changes in BMI. For Black or Hispanic adults, a 10% increase in exposure to chain restaurant calories per capita was associated with a 0.16 percentage-point increase in BMI (95% CI 0.03, 0.30). This translates into a predicted weight increase of 0.89 pounds (or a 0.53% BMI increase) for an average weight woman at the 90th percentile of increases in the restaurant environment from 2012 to 2015 versus an increase 0.39 pounds (or 0.23% BMI increase) at the 10th percentile. Greater increases in exposure to chain restaurant calories also significantly increased BMI for Black or Hispanic adults receiving healthcare services in lower-income counties (0.26, 95% CI 0.04, 0.49) and with overweight/obesity (0.16, 95% CI 0.04, 0.29).
Generalizability to non-chain restaurants is unknown and the sample of athenahealth patients is relatively homogenous.
Increased exposure to chain restaurant calories per capita was associated with increased weight gain among Black or Hispanic adults.
先前关于餐厅环境与肥胖风险的研究受到横断面数据和对特定地理区域关注的限制。
测量连锁餐厅卡路里含量随时间变化对体重指数（BMI）的影响。
我们使用差分模型来检验 2012 年至 2015 年连锁餐厅人均卡路里的变化是否与 BMI 的百分比变化相关。我们还按种族和县城收入、餐厅类型和初始体重类别进行了差异检验。
美国（39 个州的 207 个县）。
2012 年和 2015 年在 athenahealth 医疗提供者处就诊且 BMI 得到测量的 447873 名成年患者。
2012 年至 2015 年客观测量的 BMI 的百分比变化。
在所有患者中，连锁餐厅人均卡路里的变化与 BMI 的百分比变化无关。对于黑人和西班牙裔成年人，接触连锁餐厅卡路里的比例增加 10%，与 BMI 增加 0.16 个百分点相关（95%CI，0.03 至 0.30）。这意味着与 2012 年至 2015 年餐厅环境的增加相比，处于第 90 个百分点的平均体重女性的体重增加了 0.89 磅（或 BMI 增加了 0.53%），而处于第 10 个百分点的体重增加了 0.39 磅（或 BMI 增加了 0.23%）。接触连锁餐厅卡路里的比例增加也显著增加了低收入县（0.26，95%CI，0.04 至 0.49）和超重/肥胖患者（0.16，95%CI，0.04 至 0.29）黑人和西班牙裔成年人的 BMI。
未知连锁餐厅以外的餐厅的推广度，以及 athenahealth 患者样本相对同质。
连锁餐厅人均卡路里摄入量的增加与黑人和西班牙裔成年人的体重增加有关。
