While consumption of takeaway foods has been linked to poor diet and increase in weight, identifying the association between the exposure to food environments, diet and body weight has been challenging for a variety of reasons. Researchers at the University of Cambridge analyse the extent to which exposure to takeaway outlets in home, work and commuting environments was associated with its consumption, body mass index and the likelihood of being overweight and obese in Cambridgeshire, UK. The study reveals that exposure to food outlets in the home and work environments was strongly associated with consumption of takeaway food. While policy initiatives limiting neighbourhood access to unhealthy foods are in place, the researchers suggest that such policies would be most effective if targeted around workplaces.
Objectives: To examine the association between environmental exposure to takeaway food outlets, takeaway food consumption, and body weight, while accounting for home, work place, and commuting route environments.
Design: Population based, cross sectional study, using data on individual participants’ diet and weight, and objective metrics of food environment exposure.
Participants: Working adults participating in the Fenland Study, Cambridgeshire, UK (n=5442, aged 29-62 years), who provided home and work addresses and commuting preferences. Takeaway food outlet exposure was derived using data from local authorities for individual environmental domains (at home, at work, and along commuting routes (the shortest route between home and work)), and for exposure in all three domains combined. Exposure was divided into quarters (Q); Q1 being the least exposed and Q4 being the most exposed.
Main outcome measures: Self reported consumption of takeaway type food (g/day; pizza, burgers, fried foods, and chips) using food frequency questionnaires, measured body mass index, and cut-offs for body mass index as defined by the World Health Organization.
Results: In multiple linear regression models, exposure to takeaway food outlets was positively associated with consumption of takeaway food. Among domains at home, at work, and along commuting routes, associations were strongest in work environments (Q4 v Q1; β coefficient=5.3 g/day, 95% confidence interval 1.6 to 8.7; P<0.05), with evidence of a dose-response effect. Associations between exposure in all three domains combined and consumption were greater in magnitude across quarters of exposure (Q4 v Q1; 5.7 g/day, 2.6 to 8.8; P<0.001), with evidence of a dose-response effect. Combined exposure was especially strongly associated with increased body mass index (Q4 v Q1; body mass index 1.21, 0.68 to 1.74; P<0.001) and odds of obesity (Q4 v Q1; odds ratio 1.80, 1.28 to 2.53; P<0.05). There was no evidence of effect modification by sex.
Conclusions: Exposure to takeaway food outlets in home, work, and commuting environments combined was associated with marginally higher consumption of takeaway food, greater body mass index, and greater odds of obesity. Government strategies to promote healthier diets through planning restrictions for takeaway food could be most effective if focused around the workplace.
Burgoine T., Forouhi N. G., Griffin S. J., Wareham N. J., Monsivais P., 2014. Associations between exposure to takeaway food outlets, takeaway food consumption, and body weight in Cambridgeshire, UK: population based, cross sectional study. BMJ, DOI: 10.1136/bmj.g1464