School of Biological and Population Health, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
J Nutr. 2021 Feb 1;151(2):387-394. doi: 10.1093/jn/nxaa364.
For decades, Americans have increasingly relied on food away from home (FAFH) despite its association with negative health outcomes. Little is known about FAFH frequency and expenditures of adults with lower food security (FS) and their association with health outcomes, such as BMI.
We evaluated patterns of adults' FAFH purchases by FS status and other demographic characteristics, and examined the association between FAFH frequency and BMI in adults of varying levels of FS.
This cross-sectional study used data from the Consumer Behavior Survey, Food Security Survey, and anthropometric measurements to assess FAFH frequency and expenditures, FS, and calculated BMI of adults (≥18 y) who participated in the NHANES 2007-2014 (n = 20,733). We used multinomial logistic regression to examine the association between FAFH frequency quartiles (quartile 1: 0 n/wk; quartile 2: 1-2 n/wk; quartile 3: 3-4 n/wk; quartile 4: ≥5 n/wk) and BMI by FS category.
Although FAFH frequency was similar across FS levels, adults with high FS spent more dollars (${$}$213.60) and a greater proportion (29.4%) of their food budget on FAFH compared with adults with marginal, low, and very low FS (${$}$133.00, ${$}$116.20, ${$}$103.30 and 21.4%, 19.7%, 20.0%, respectively). Obesity prevalence was highest in adults with low FS (42.9%) and very low FS (41.5%), and lowest in adults with high FS (33.7%). FAFH frequency and BMI were positively associated in adults with high (P < 0.001), marginal (P = 0.025), and low (P = 0.024) FS, but not in adults with very low FS (P = 0.589).
FAFH is frequent in adults regardless of FS status. The positive association between FAFH and BMI is the strongest in adults with high FS, the group with the lowest prevalence of obesity. Conversely, BMI was not associated with FAFH in adults with very low FS, despite their higher prevalence of obesity.
尽管外出就餐与负面健康结果有关，但几十年来，美国人越来越依赖外出就餐。对于食物不安全程度较低的成年人的外出就餐频率和支出，以及它们与健康结果（如 BMI）的关系，人们知之甚少。
我们评估了成年人根据食物安全状况和其他人口统计学特征的外出就餐购买模式，并研究了不同食物安全程度成年人的外出就餐频率与 BMI 之间的关系。
本横断面研究使用来自消费者行为调查、食物安全调查和人体测量数据来评估成年人（≥18 岁）的外出就餐频率和支出、食物安全和计算 BMI，这些成年人参加了 NHANES 2007-2014 年调查（n=20733）。我们使用多变量逻辑回归来研究外出就餐频率四分位数（四分位数 1：0 次/周；四分位数 2：1-2 次/周；四分位数 3：3-4 次/周；四分位数 4：≥5 次/周）与食物安全类别的 BMI 之间的关联。
尽管外出就餐频率在食物安全水平上相似，但高食物安全水平的成年人在外出就餐上的花费更多（${$}$213.60），并且他们的食物预算中用于外出就餐的比例也更高（29.4%），而食物安全水平处于边缘、低和极低水平的成年人则分别花费${$}$133.00、${$}$116.20、${$}$103.30 和 21.4%、19.7%、20.0%。低食物安全水平（42.9%）和极低食物安全水平（41.5%）的成年人肥胖率最高，而高食物安全水平（33.7%）的成年人肥胖率最低。在高（P<0.001）、边缘（P=0.025）和低（P=0.024）食物安全水平的成年人中，外出就餐频率和 BMI 呈正相关，但在极低食物安全水平的成年人中（P=0.589）则没有相关性。
无论食物安全状况如何，外出就餐在成年人中都很普遍。在高食物安全水平的成年人中，外出就餐与 BMI 的正相关性最强，而这组成年人的肥胖率最低。相反，尽管极低食物安全水平的成年人肥胖率较高，但外出就餐与 BMI 之间没有相关性。
