Nutritional Pearls: Fast Food Availability
Robert is a 33-year-old overweight man struggling to lose weight. At his latest check-up, Robert tells you that he is moving across town next month and is concerned about the number of fast food restaurants near his new home, and how the availability of fast food will affect his weight loss efforts.
How would you advise your patient?
(Answer and discussion on next page)
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Answer: There is a difference between the absolute number and location of fast food restaurants and people's perceptions of how convenient they are.
A 2011 study examined 2 things: how often people ate fast food when compared to the number of fast food joints within a specific number of miles, and people's overall diet quality when compared to the number of supermarkets and grocery stores within the same area.1
This study hoped to link poor dietary quality with the low availability of fresh food (i.e., "food deserts") as well as linking greater availability of fast food with a poorer diet (some call areas with greater numbers of fast food joints "food swamps"). Somewhat surprisingly, neither theory was proved true.
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In an article in Appetite, a team at the University of South Carolina noted that people's perceptions of what is convenient to them in their neighborhood might be very different from actual, map-measured distances from their home. Could this be the reason previous studies found little association?2
The Research
To find out, the researchers polled over 800 adult men and women living in 8 counties in South Carolina. These counties were chosen because the locations of commercial food outlets had previously been established. The participants were asked to think about the area within a 20-minute walk from their home (about 1 mile) and to express how strongly they agreed with the statement, "There are many opportunities to purchase fast foods in my neighborhood, such as McDonald's, Taco Bell, KFC and take-out pizza places, etc.."
The authors then asked how often the respondents typically ate from such a fast food place, whether eat-in or take-out. The responses were compared both to the individual's perception of how many fast food places there were in their neighborhood as well as the actual, map-based numbers of such places.
The Results
The results are really quite interesting. Two-thirds of the respondents were overweight or obese, and most of those who had at least 1 fast food restaurant in their neighborhood were white and had a college education. Those who believed that fast food restaurants were more available in their neighborhood were indeed more likely to consume fast food, but the association was not statistically significant. Similarly, when looking at the location of fast food restaurants on a map, having a fast food restaurant in the individual's neighborhood meant they were slightly less likely to consume fast food on a weekly basis.
What’s The “Take Home”?
This study adds weight to the idea that there is a difference between the absolute number and location of fast food restaurants and people's perceptions of how convenient they are—which makes it very difficult to blame obesity simply on the number and location of fast food restaurants. What this study did not address was the location and availability of fresh ingredients—the other side of the food availability coin.
References:
- Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, et al. Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study. Arch Intern Med. 2011;171(13):1162-1170.
- Oexle N, Barnes TL, Blake CE, et al. Neighborhood fast food availability and fast food consumption. Appetite. 2015;92:227-232.