Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Int J Behav Nutr Phys Act. 2024 Mar 14;21(1):31. doi: 10.1186/s12966-024-01577-8.
Evidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline.
We used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p < 0.10.
Participants who had an increase in the number of fast-food outlets within 1 km had a greater BMI increase (B(95% CI): 0.003 (0.001,0.006)). Decreases in fast-food outlet exposure were not associated with BMI change (B(95% CI): 0.001 (-0.001,0.004)). No clear moderation pattern by age or fast-food outlet exposure at baseline was found.
Increases in residential fast-food outlet exposure are associated with BMI gain, whereas decreases in fast-food outlet exposure are not associated with BMI loss. Effect sizes of increases in fast-food outlet exposure on BMI change were small at individual level. However, a longer follow-up period may have been needed to fully capture the impact of increases in fast-food outlet exposure on BMI change. Furthermore, these effect sizes could still be important at population level considering the rapid rise of fast-food outlets across society. Future studies should investigate the mechanisms and changes in consumer behaviours underlying associations between changes in fast-food outlet exposure and BMI change.
有关快餐销售点暴露与体重指数（BMI）之间关联的证据仍然不一致，主要基于横断面研究。我们调查了快餐销售点暴露变化与 BMI 变化之间的关联，以及这些关联在多大程度上受到年龄和基线时快餐销售点暴露的调节。
我们使用 Lifelines 成人队列的 4 年纵向数据（N=92211）。参与者在基线和随访时的居住地址通过地理编码与包含快餐销售点位置的登记册相链接。快餐销售点暴露的变化定义为随访时居住地址 1 公里范围内的快餐销售点数量减去基线时居住地址 1 公里范围内的快餐销售点数量。BMI 根据客观测量的体重和身高计算。固定效应分析在调整了协变量和潜在混杂因素的变化后进行。如果 p<0.10，则进行暴露-调节因素相互作用检验和分层分析。
在 1 公里范围内快餐销售点数量增加的参与者 BMI 增加更多（B（95%CI）：0.003（0.001，0.006））。快餐销售点暴露减少与 BMI 变化无关（B（95%CI）：0.001（-0.001，0.004））。没有发现年龄或基线时快餐销售点暴露的明显调节模式。
居住快餐销售点暴露增加与 BMI 增加有关，而快餐销售点暴露减少与 BMI 减少无关。个体水平上，快餐销售点暴露增加对 BMI 变化的影响大小较小。然而，可能需要更长的随访时间才能完全捕捉到快餐销售点暴露增加对 BMI 变化的影响。此外，考虑到快餐销售点在社会中的快速增长，这些影响大小在人群水平上仍可能很重要。未来的研究应调查快餐销售点暴露变化与 BMI 变化之间关联的潜在机制和消费者行为变化。
