Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants

Abstract Background Household income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double b...

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Main Authors: Thomas Burgoine, Chinmoy Sarkar, Chris J. Webster, Pablo Monsivais
Format: Article
Language:English
Published: BMC 2018-07-01
Series:International Journal of Behavioral Nutrition and Physical Activity
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12966-018-0699-8
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spelling doaj-a478c322d6db47f5b5214d9c5ad90e932020-11-25T01:51:58ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682018-07-0115111210.1186/s12966-018-0699-8Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participantsThomas Burgoine0Chinmoy Sarkar1Chris J. Webster2Pablo Monsivais3UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic ScienceHealthy High Density Cities Lab, HKUrbanLab, University of Hong KongHealthy High Density Cities Lab, HKUrbanLab, University of Hong KongUKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic ScienceAbstract Background Household income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double burden of these factors is a matter of public health importance. The purpose of this study was to test associations of neighbourhood fast-food outlet exposure and household income, in relation to frequency of consumption of processed meat and multiple measures of adiposity, and to examine possible interactions. Methods We employed an observational, cross-sectional study design. In a cohort of 51,361 adults aged 38–72 years in Greater London, UK, we jointly classified participants based on household income (£/year, four groups) and GIS-derived neighbourhood fast-food outlet proportion (counts of fast-food outlets as a percentage of all food outlets, quartiles). Multivariable regression models estimated main effects and interactions (additive and multiplicative) of household income and fast-food outlet proportion on odds of self-reported frequent processed meat consumption (> 1/week), measured BMI (kg/m2), body fat (%), and odds of obesity (BMI ≥ 30). Results Income and fast-food proportion were independently, systematically associated with BMI, body fat, obesity and frequent processed meat consumption. Odds of obesity were greater for lowest income participants compared to highest (OR = 1.54, 95% CI: 1.41, 1.69) and for those most-exposed to fast-food outlets compared to least-exposed (OR = 1.51, 95% CI: 1.40, 1.64). In jointly classified models, lowest income and highest fast-food outlet proportion in combination were associated with greater odds of obesity (OR = 2.43, 95% CI: 2.09, 2.84), with relative excess risk due to interaction (RERI = 0.03). Results were similar for frequent processed meat consumption models. There was no evidence of interaction on a multiplicative scale between fast-food outlet proportion and household income on each of BMI (P = 0.230), obesity (P = 0.054) and frequent processed meat consumption (P = 0.725). Conclusions Our study demonstrated independent associations of neighbourhood fast-food outlet exposure and household income, in relation to diet and multiple objective measures of adiposity, in a large sample of UK adults. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, furthering our understanding of how these factors contribute jointly to social inequalities in health.http://link.springer.com/article/10.1186/s12966-018-0699-8Fast-food outlet exposureHousehold incomeAdiposityProcessed meat consumptionInteractionUK biobank
collection DOAJ
language English
format Article
sources DOAJ
author Thomas Burgoine
Chinmoy Sarkar
Chris J. Webster
Pablo Monsivais
spellingShingle Thomas Burgoine
Chinmoy Sarkar
Chris J. Webster
Pablo Monsivais
Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
International Journal of Behavioral Nutrition and Physical Activity
Fast-food outlet exposure
Household income
Adiposity
Processed meat consumption
Interaction
UK biobank
author_facet Thomas Burgoine
Chinmoy Sarkar
Chris J. Webster
Pablo Monsivais
author_sort Thomas Burgoine
title Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
title_short Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
title_full Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
title_fullStr Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
title_full_unstemmed Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants
title_sort examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 uk biobank participants
publisher BMC
series International Journal of Behavioral Nutrition and Physical Activity
issn 1479-5868
publishDate 2018-07-01
description Abstract Background Household income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double burden of these factors is a matter of public health importance. The purpose of this study was to test associations of neighbourhood fast-food outlet exposure and household income, in relation to frequency of consumption of processed meat and multiple measures of adiposity, and to examine possible interactions. Methods We employed an observational, cross-sectional study design. In a cohort of 51,361 adults aged 38–72 years in Greater London, UK, we jointly classified participants based on household income (£/year, four groups) and GIS-derived neighbourhood fast-food outlet proportion (counts of fast-food outlets as a percentage of all food outlets, quartiles). Multivariable regression models estimated main effects and interactions (additive and multiplicative) of household income and fast-food outlet proportion on odds of self-reported frequent processed meat consumption (> 1/week), measured BMI (kg/m2), body fat (%), and odds of obesity (BMI ≥ 30). Results Income and fast-food proportion were independently, systematically associated with BMI, body fat, obesity and frequent processed meat consumption. Odds of obesity were greater for lowest income participants compared to highest (OR = 1.54, 95% CI: 1.41, 1.69) and for those most-exposed to fast-food outlets compared to least-exposed (OR = 1.51, 95% CI: 1.40, 1.64). In jointly classified models, lowest income and highest fast-food outlet proportion in combination were associated with greater odds of obesity (OR = 2.43, 95% CI: 2.09, 2.84), with relative excess risk due to interaction (RERI = 0.03). Results were similar for frequent processed meat consumption models. There was no evidence of interaction on a multiplicative scale between fast-food outlet proportion and household income on each of BMI (P = 0.230), obesity (P = 0.054) and frequent processed meat consumption (P = 0.725). Conclusions Our study demonstrated independent associations of neighbourhood fast-food outlet exposure and household income, in relation to diet and multiple objective measures of adiposity, in a large sample of UK adults. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, furthering our understanding of how these factors contribute jointly to social inequalities in health.
topic Fast-food outlet exposure
Household income
Adiposity
Processed meat consumption
Interaction
UK biobank
url http://link.springer.com/article/10.1186/s12966-018-0699-8
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