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Weight Status and Restaurant Availability

A Multilevel Analysis
  • Neil K. Mehta
    Correspondence
    Address correspondence and reprint requests to: Neil K. Mehta, MSc, Population Studies Center, 239 McNeil Building, University of Pennsylvania, 3718 Locust Walk, Philadelphia PA 19104.
    Affiliations
    Graduate Group in Demography, University of Pennsylvania, Philadelphia, Pennsylvania

    Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for articles by this author
  • Virginia W. Chang
    Affiliations
    Graduate Group in Demography, University of Pennsylvania, Philadelphia, Pennsylvania

    Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania

    Department of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania

    Philadelphia Veterans Affairs Medical Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

    Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for articles by this author

      Background

      Empiric studies find that contextual factors affect individual weight status over and above individual socioeconomic characteristics. Given increasing levels of obesity, researchers are examining how the food environment contributes to unhealthy weight status. An important change to this environment is the increasing availability of away-from-home eating establishments such as restaurants.

      Methods

      This study analyzed the relationship between the restaurant environment and weight status across counties in the United States. Individual data from the 2002–2006 Behavioral Risk Factor Surveillance System (N=714,054) were linked with restaurant data from the 2002 U.S. Economic Census. Fast-food and full-service restaurant density, along with restaurant mix (the ratio of fast-food to full-service restaurants), were assessed.

      Results

      Fast-food restaurant density and a higher ratio of fast-food to full-service restaurants were associated with higher individual-level weight status (BMI and the risk of being obese). In contrast, a higher density of full-service restaurants was associated with lower weight status.

      Conclusions

      Area-level restaurant mix emerged as an important correlate of weight status, with components of the restaurant environment exhibiting differential associations. Hence, it is the availability of fast-food relative to other away-from-home choices that appears salient for unhealthy weight outcomes. Areas with a high density of full-service restaurants were indicative of a more healthful eating environment, suggesting a need for research into the comparative healthfulness of foods served at different types of restaurants. Future prospective studies are required to delineate causal pathways.
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