Personal and lifestyle characteristics predictive of the consumption of fast foods in Australia

Fast-Food Consumption, Dietary Quality, and Dietary Intake of Adolescents in Saudi Arabia

High fast-food consumption is a common public-health concern among adolescents, due to its link to a number of non-communicable diseases. Frequent consumption of fast food may also affect diets of individuals; however, research addressing this issue is lacking in Saudi Arabia. We aimed to investigate the association between fast-food consumption, dietary quality, and dietary intake of adolescents in Saudi Arabia. This is a cross-sectional study of 617 healthy adolescents aged 11-18 years, who were recruited randomly from 16 middle- and high-schools located in Jeddah and Madinah, Saudi Arabia. Sociodemographic data were collected from parents. Dietary data, including the frequency of fast-food consumption, dietary quality (assessed using the short-form food frequency questionnaire), and dietary intake (assessed using multiple 24 h diet recalls from a subsample), were collected from the adolescents. Approximately one-third of adolescents (28.5%) reported frequent fast-food consumption (>two times a week). Results showed that a higher proportion of male adolescents frequently consumed fast-food, compared with female adolescents (32.8% vs. 24.8%, p = 0.039). Adolescents with the highest monthly family-income (≥SAR 21,000 ) reported a significantly higher frequency of fast-food consumption compared with families with a lower monthly income (p = 0.009). Frequency of fast-food consumption predicted lower dietary-quality in adolescents (Beta (B) = -0.27 [95% confidence interval (CI): -0.35 to -0.18]) and higher carbohydrate and free-sugar intake (B = 6.93 [95% CI: 0.78 to 13.1], and B = 3.93 [95% CI: 1.48 to 6.38], respectively). In conclusion, nutrition-intervention programs aiming to limit fast-food consumption and enhance the dietary quality of adolescents in Saudi Arabia, are warranted.

The energy density of meals and snacks consumed by young Australian adults (18-30 years old) are influenced by preparation location but not screen use nor social interactions: findings from the MYMeals wearable camera study

The present study examined the association of contextual factors (social and food preparation location) with the energy density of meals and snacks consumed in a sample of young Australian adults (18-30 years old) identified using wearable camera technology. Over three consecutive days, a subsample of young adults wore a wearable camera that captured images in 30 s intervals. Eating episodes from 133 participants were annotated for preparation location and social context (covering social interaction and screen use). Over the same period, participants completed daily 24 h recalls. The nutritional composition of meals and snacks was calculated by matching the items identified in the camera to the 24 h recall using time and date stamps. Self-reported data (weight and height) was used to calculate body mass index and (residential postcode) to assign socio-economic status. The association of context and demographic factors with energy density was determined using a mixed linear regression model employing the bootstrap method with bias-corrected and accelerated. In total, 1817 eating episodes were included in the analysis (n 8 preparation unclear and n 15 food components could not be identified excluded). Food prepared within the home was 1⋅1 kJ/g less energy-dense than other preparation locations. Lunches (CI -1⋅7 to -0⋅3) and dinners (CI -1⋅6 to -0⋅5) were both 1⋅0 kJ/g lower in energy density than breakfasts. Snacks were 3⋅5 kJ/g (CI 2⋅8-4⋅1) more energy-dense than breakfasts. Food prepared outside the home and food consumption during snacking appear to be adversely contributing to energy-dense food intake.

The association between fast-food consumption and job-related factors among Russian adults

Time constraints contribute to individuals' dietary choices along with incomes, prices, and preferences. As fast food is prepared and served quickly, it is often preferred to other food options, especially when individuals are under time pressure. This paper focuses on a set of job-related characteristics that could potentially contribute to fast-food consumption choice, and controls for standard socio-demographic, economic, and lifestyle factors. This study uses data from a quantitative household survey on health behavior and medicine of Russian adults conducted in 2017 (n = 4006). The study applies simple probit, ordered probit, and zero-inflated ordered probit models to examine how job-related characteristics are connected to the probability and frequency of fast-food consumption among Russian adults. The results shows that employment is positively associated with both probability and frequency of fast-food consumption. However, for working adults, the decisions to eat fast food, and how frequently it is eaten, are affected by different factors. For example, working part time decreases the probability of fast-food consumption; having more than one job increases the frequency of its intake for fast-food consumers; having canteens with hot meals at work decreases the frequency of fast-food intake. Although job-related factors are significant in all models, marginal effects show that living in large cities, especially Moscow and Saint Petersburg, plays a larger role in the probability and frequency of fast-food consumption because access to various fast-food outlets increases in relation to the size of the settlement.

Socio-Psychological Factors Associated with Young Australian Adults' Consumption of Energy Dense and Nutrient Poor (EDNP) Foods

Young Australian adults' exhibit high consumption of Energy Dense and Nutrient Poor (EDNP) foods; however, there is limited research concerning the factors influencing their consumption. This study aimed to explore socio-psychological factors associated with young Australian adults' (18-30 years) consumption of EDNP foods with consideration of the Food Related Lifestyle Model (FRLM) as a potential framework. Through qualitative descriptive research methodology, 38 young adults were interviewed. Data were thematically analyzed. Participants were classified into three groups based on their living arrangements namely, parental, shared and independent households. Five themes emerged, (1) psychological factors (2) intrinsic qualities of EDNP foods, (3) social factors, (4) accessibility and affordability and (5) health related beliefs. The FRLM takes into consideration some of the factors reported in this study as influencers of EDNP food intakes. However, the FRLM omits important psychological factors (motivation, restraint, cravings, coping strategies and habits) identified by participants as influencers over their EDNP food intakes. The FRLM may need to be extended in its application to EDNP food intakes of young Australian adults. Social marketing campaigns highlighting health risks, addressing social and environmental factors are suggested. The social desirability of healthier alternatives in social gatherings of young adults could be increased.

Food Classifications by Brazilian Amazon Mothers: Interactions With Eating Practices

OBJECTIVE

To assess how mothers classify foods and how their eating practices interact with these classifications, with special attention to meanings and uses given to ultra-processed foods.

DESIGN

Qualitative research with in-depth interviews and pile sorts.

SETTING

Urban Brazilian Amazon.

PARTICIPANTS

A sample of 34 mothers were selected through theoretical sampling.

ANALYSIS

Content analysis for in-depth interviews and multidimensional scaling and cluster analysis for pile sorts.

PHENOMENON OF INTEREST

Food classification.

RESULTS

Classifications were based on context (ie, a time or a situation in which the food is eaten) and foods' healthiness. Five food groupings based on mothers' classifications were defined: (1) main meal foods, (2) fruits and fruit juices, (3) convenient foods, (4) leisure foods, and (5) canned sardines. Ultra-processed foods were classified differently from non-ultra-processed foods and considered unhealthy, consumed on special occasions or when there was no time or desire to cook.

CONCLUSIONS AND IMPLICATIONS

Results highlight the potential of incorporating context-based categories and personal experiences to guide nutrition interventions and the potential of pile sorts to tailor messages to target populations.

Is fast-food consumption a problem among adolescents in Malaysia? An analysis of the National School-Based Nutrition Survey, 2012

BACKGROUND

Fast-food consumption is an unhealthy dietary behaviour because it increases the risk of diet-related chronic diseases. We aimed to investigate factors associated with fast-food consumption, namely sociodemographic characteristics, body mass index-for-age, meal away from home habit, and intake of various food groups among adolescents in Malaysia.

METHODS

We analysed data from the National School-Based Nutrition Survey (NSNS). The NSNS was a nationwide, cross-sectional survey. Multiple-stage stratified cluster random sampling method was applied to obtain a representative sample of adolescents' population. This study recruited adolescents aged 10-18 years who were attending schools. Pre-tested self-administered questionnaires in Malay language were used to obtain relevant information. Frequency of fast-food consumption per week was classified into three groups: "consumed fast-food four to seven days", "consumed fast-food one to three days", and "did not consume fast-food". Intake of food groups was assessed by self-administered food frequency questionnaire. Descriptive and complex sample multinomial logistic regression analyses were performed in data analysis.

RESULTS

A total of 26,383 from 40,012 selected adolescents completed all the relevant questions for this study. Of those surveyed, 13.5% of the respondents consumed fast-food 4 to 7 days, 69.3% of the respondents consumed fast food 1 to 3 days, and 17.2% of them did not consume fast-food in a typical week. Frequency of fast-food consumptions (4 to 7 days and 1 to 3 days per week) was significantly associated with age; sex; ethnicity; locality of schools; frequency of eating out; and not consuming recommended intake of cereals or grains, vegetables, and meat or poultry or eggs.

CONCLUSION

In conclusion, age; sex; ethnicity; locality of schools; frequency of eating out per week; imbalanced intake of cereals or grains, meat, or poultry or eggs; and inadequate vegetable intake were significantly associated with fast-food consumption among adolescents in Malaysia. The findings of this study will be useful for policy makers in promoting healthy food choices among adolescents in Malaysia.

Socioeconomic Inequalities in Food Consumption: A Cross-Sectional Study in Portuguese Adults

<b><i>Background:</i></b> Food is a major determinant of chronic noncommunicable diseases. Because of this, social inequalities in food consumption will likely produce social inequalities in disease and life expectancy. <b><i>Objectives:</i></b> This study analyses the social inequalities in food consumption in Portugal and whether they differ between men and women and between younger and older people. <b><i>Methods:</i></b> Following a cross-sectional observational study, we analyzed data from 11,085 individuals aged 25–64 years who participated in the 2014 National Health Interview Survey (NHIS). Logistic regression models were used to measure the association between socioeconomic conditions, i.e., education and income, and food consumption. The analysis was then stratified by sex and age. <b><i>Results:</i></b> A positive gradient for income and education was observed in the consumption of fish, cakes, natural juices, and dairy products. The consumption of legumes and soft drinks was inversely related to income and education. A socioeconomic gradient for fruits and vegetables was observed only among women and older people. Worse-off people consumed less soup, and underprivileged women consumed fewer fast-food products. <b><i>Conclusion:</i></b> The food consumption patterns of Portuguese adults are related to their socioeconomic condition, with few variations across demographic categories.

Food insecurity (hunger) and fast-food consumption among 180 164 adolescents aged 12-15 years from sixty-eight countries

Food insecurity has been shown to be associated with fast-food consumption. However, to date, studies on this specific topic are scarce. Therefore, the aim of the present study was to investigate the association between food insecurity and fast-food consumption in adolescents aged 12-15 years from sixty-eight countries (seven low-income, twenty-seven lower middle-income, twenty upper middle-income, fourteen high-income countries). Cross-sectional, school-based data from the Global School-based Student Health Survey were analysed. Data on past 30-d food insecurity (hunger) and fast-food consumption in the past 7 d were collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. Models were adjusted for age, sex and BMI. There were 180 164 adolescents aged 12-15 years (mean age 13·8 (sd 1·0) years; 50·8 % boys) included in the analysis. Overall, severe food insecurity (i.e. hungry because there was not enough food in home most of the time or always) was associated with 1·17 (95 % CI 1·08, 1·26) times higher odds for fast-food consumption. The estimates pooled by country-income levels were significant in low-income countries (adjusted OR (aOR) = 1·30; 95 % CI 1·05, 1·60), lower middle-income countries (aOR = 1·15; 95 % CI 1·02, 1·29) and upper middle-income countries (aOR = 1·26; 95 % CI 1·07, 1·49), but not in high-income countries (aOR = 1·04; 95 % CI 0·88, 1·23). The mere co-occurrence of food insecurity and fast-food consumption is of public health importance. To tackle this issue, a strong governmental and societal approach is required to utilise effective methods as demonstrated in some high-income countries such as the implementation of food banks and the adoption of free school meals.

Obesity: a sociological guide for health practitioners

Obesity is a condition of excess body fat that has been identified as one of the most serious public health problems of the 21st century. Obesity is a leading preventable cause of death globally and increases the likelihood of cardiovascular disease, diabetes and various cancers. Obesity worldwide has tripled in the adult population over the past 40 years, with 13% of the world's adult population now obese, leading to calls for control of a global obesity epidemic. Causes of obesity can be delineated at individual, societal and systemic levels, highlighting the need for analysis that transcends the biomedical paradigm to explore the sociological influences of this condition. The pathophysiology of why obesity occurs has not changed within recent history, but the way that people live their lives and the cultural understandings that evolve within communities have. This article describes the interaction between obesity and the social environment, explores the meaning of obesity within the context of health and considers the social determinants of obesity within the community. It also discusses the influences of the professional-patient exchange in obesity, the comprehension of obesity as a disease and the challenges of addressing obesity within the healthcare system.

Using wearable cameras to monitor eating and drinking behaviours during transport journeys

PURPOSE

Young adults are vulnerable to weight gain and dietary behaviours such as 'eating on the run' are likely contributors. The objective of this study was to examine eating and drinking behaviours during transport journeys in a sample of young adults using wearable cameras that take continuous images every 30 s.

METHODS

Seventy-eight 18-30 year olds wore an Autographer wearable camera for three consecutive days. Image coding schedules were designed to assess physical activity (included transportation) and diet. For the general description of data, frequency analysis was calculated as image number (percentage) and mean (± SD) or median (IQR) when appropriate.

RESULTS

A total of 281,041 images were coded and 32,529 (14%) of images involved transport. The median (IQR) camera wear time was 8 h per day (7-9 h). The camera images identified 52 participants (67%) either eating or drinking during transport (excluding water). A total of 143 eating and drinking occasions were identified, averaging 3 occasions per person over the three study days. Fifty five (38%) eating episodes were identified by the camera images of which 27 (49%) were discretionary and 88 (62%) drinking episodes were identified of which (45%) were discretionary.

CONCLUSION

This study confirms that transport is a potential setting for intervention. Young adults are consuming discretionary food and beverages during transport which may contribute to energy-dense diets and compromise diet quality. Substituting unhealthy with healthy food advertising and potentially prohibiting eating and drinking whilst on public transport is suggested.

Exploring University Food Environment and On-Campus Food Purchasing Behaviors, Preferences, and Opinions

OBJECTIVE

Cross-sectional observation of a university food environment and a survey of food purchasing preferences, behaviors, and opinions of students and staff to formulate strategies for interventions.

DESIGN

A modified food environment-quality index was used to assess food outlets. A cross-sectional survey with closed (n = 42) and open-ended (n = 2) questions assessing students and staff purchasing, choice determinants, and opinions about the food environment.

SETTING

Six campuses of 1 large urban university.

PARTICIPANTS

Food outlets (eg, convenience stores, restaurant and café, takeout, vending machines) (n = 57). University students and staff (n = 1,954).

ANALYSIS

The researchers calculated descriptive statistics and Pearson chi-square tests to compare the percentages of healthy and/or unhealthy products in high- vs low-scoring outlets. Kruskal-Wallis H test was used to determine differences in healthiness between outlet types. Pearson chi-square tests were used to examine the influence of gender, and student and staff differences in survey responses.

RESULTS

Median food environment-quality index was 79 out of 199 (interquartile range = 7). Six food outlets were categorized as healthy and 2 as unhealthy; the rest were intermediate. Overall, healthy items were less available, accessible, and promoted and cost more than unhealthy items. The majority of respondents in the survey (79%) purchased food and beverages on campus; males consuming them more frequently than did females (P = .001) and students consumed them more frequently than did staff (P = .001). Value for money, healthfulness, and taste determined the choice. Respondents suggested increasing value for money and healthy options.

CONCLUSIONS AND IMPLICATIONS

Interventions that improve food availability, accessibility, prices, and promotions through policies are warranted and would be well-received among both university students and staff.

"Doing a good thing for myself": a qualitative study of young adults' strategies for reducing takeaway food consumption

BACKGROUND

Increasingly the population is eating meals and snacks prepared outside the home, especially younger adults. Takeaway foods can be energy-dense, high in saturated fat and sodium, and deleterious to health. Extending studies examining the barriers to healthy eating, this paper explores strategies employed by young adults who report reducing consumption of unhealthy takeaway foods.

METHODS

Young adults aged 18 to 35 years in paid employment were recruited to participate in eight semi-structured focus groups. In response to initial findings, recruitment for the final four groups refocused on participants who either wanted, were in the process of, or had changed their takeaway food habits. Focus group recordings were transcribed verbatim and coded by two researchers for recurrent themes using an inductive method.

RESULTS

Forty-eight participants with a mean BMI of 23.4 kg/m² and mean age of 25 years took part, of which 34 were female, and 27 were born outside Australia. Four broad strategies emerged: altering cognitions about consumption/reduction of takeaway food; practical changes to behaviours; finding external support; and, reconfiguring social events. In detail, participants cognitively recast takeaway food consumption as negative (expensive and unhealthy) and reducing consumption of such foods or consuming healthy alternatives as a (positive) self-care action. Setting goals and making personal rules around consumption, and consciously making practical changes, such as planning for food shopping, were other strategies. Externally derived support including supportive food environments and friends and family passively reduced exposure to unhealthy takeaway food. Finally, some participants actively created social environments supportive of healthy choices.

CONCLUSIONS

Our participants reported strategies they believed led to them successfully reduce their takeaway food consumption by matching the attractions (e.g., convenience) and countering apparent disincentives for reducing consumption (e.g., losing a reward) of takeaway food. They reported eschewing more short-term rewards and costs, to prioritise their health, believing that avoiding these foods would benefit them personally and financially. The identified strategies are consistent with documented techniques for successful behaviour change and corresponded to all levels in the social-ecological model from intrapersonal factors to public policy. The findings could underpin health promotion strategies to support this at-risk group.

Relative Validity of the Eat and Track (EaT) Smartphone App for Collection of Dietary Intake Data in 18-to-30-Year Olds

(1) Background: Smartphone dietary assessment apps can be acceptable and valid data collection methods but have predominantly been validated in highly educated women, and none specifically measured eating-out habits in young adults. (2) Methods: Participants recorded their food and beverage consumption for three days using the Eat and Track (EaT) app, and intakes were compared with three dietitian-administered 24-h recall interviews matched to the same days as the reference method. Wilcoxon signed-rank or t-tests, correlation coefficients and Bland–Altman plots assessed agreement between the two methods for energy and percentage energy from nutrients (%E). (3) Results: One hundred and eighty nine of 216 participants (54% females, 60% resided in higher socioeconomic areas, 49% university-educated) completed the study. There were significant differences in median energy intake between methods (p < 0.001), but the EaT app had acceptable agreement for most nutrient densities at the group level. Correlation coefficients ranged from r = 0.56 (%E fat) to 0.82 (%E sugars), and between 85% and 94% of participants were cross-classified into the same or adjacent quartiles. Bland–Altman plots showed wide limits of agreement but no obvious biases for nutrient densities except carbohydrate in males. (4) Conclusions: The EaT app can be used to assess group nutrient densities in a general population of 18-to-30-year olds.

Congruence of stage-of-change for fruit, vegetables and take-out foods with consumption

Purpose

Young adults frequently engage in sub-optimal dietary behaviours, such as inadequate intakes of fruits and vegetables and excessive consumption of take-out meals. Theory-based interventions are suggested to promote dietary change. The transtheoretical model is an example that stages an individual’s readiness to change behaviours as precontemplation, contemplation, preparation, action and maintenance, and includes a series of processes that help people move between stages. The purpose of this study is to investigate whether self-reported usual dietary intakes of fruits and vegetables and take-out foods differ by reported stage-of-change.

Design/methodology/approach

Cross-sectional data from 250 overweight young adults, aged 18-35 years, who enrolled in a lifestyle intervention to prevent weight gain are analysed. Participant’s stage-of-change for increasing fruit and vegetable intakes and reducing take-out foods is determined using staging algorithms. This is compared with self-reported dietary intakes over the past month using a food frequency questionnaire. Differences in intakes and variety by stage-of-change are compared for fruits, vegetables and take-out foods.

Findings

Take-out foods differed between stages (p < 0.0001), with lower weekly intakes in action (309 g) and maintenance (316 g) compared with preparation (573 g). Daily fruit intakes and variety scores varied by stage-of-change (p < 0.0001), being highest for action and maintenance (261 g and 263 g, respectively, and variety scores of 1 and 2) compared with precontemplation, contemplation and preparation (all = 100 g and 0 for variety). Daily vegetable consumption and variety scores differed by stage (p = 0.009 and p = 0.025, respectively) being highest for action/maintenance (204 g and 2 for variety) versus precontemplation and preparation (<110 g daily and Variety 1).

Practical implications

The finding of no differences in intakes between precontemplation, contemplation or preparation stages implies that the adoption of the dietary behaviours is not a continuum but a move from pre-action to actioning the target intakes. This means that for planning health promotion and dietary counselling, assigning people to the three different pre-action stages may be unnecessary.

Originality/value

This study is the first to examine the congruence of self-reported readiness to change behaviour with dietary intakes of take-out foods as well as variety of fruit and vegetables in overweight young adults.

Examining the Frequency and Contribution of Foods Eaten Away From Home in the Diets of 18- to 30-Year-Old Australians Using Smartphone Dietary Assessment (MYMeals): Protocol for a Cross-Sectional Study

Background

Young Australians aged between 18 and 30 years have experienced the largest increase in the body mass index and spend the largest proportion of their food budget on fast food and eating out. Frequent consumption of foods purchased and eaten away from home has been linked to poorer diet quality and weight gain. There has been no Australian research regarding quantities, type, or the frequency of consumption of food prepared outside the home by young adults and its impact on their energy and nutrient intakes.

Objectives

The objective of this study was to determine the relative contributions of different food outlets (eg, fast food chain, independent takeaway food store, coffee shop, etc) to the overall food and beverage intake of young adults; to assess the extent to which food and beverages consumed away from home contribute to young adults’ total energy and deleterious nutrient intakes; and to study social and physical environmental interactions with consumption patterns of young adults.

Methods

A cross-sectional study of 1008 young adults will be conducted. Individuals are eligible to participate if they: (1) are aged between 18 and 30 years; (2) reside in New South Wales, Australia; (3) own or have access to a smartphone; (4) are English-literate; and (5) consume at least one meal, snack, or drink purchased outside the home per week. An even spread of gender, age groups (18 to 24 years and 25 to 30 years), metropolitan or regional geographical areas, and high and low socioeconomic status areas will be included. Participants will record all food and drink consumed over 3 consecutive days, together with location purchased and consumed in our customized smartphone app named Eat and Track (EaT). Participants will then complete an extensive demographics questionnaire. Mean intakes of energy, nutrients, and food groups will be calculated along with the relative contribution of foods purchased and eaten away from home. A subsample of 19.84% (200/1008) of the participants will complete three 24-hour recall interviews to compare with the data collected using EaT. Data mining techniques such as clustering, decision trees, neural networks, and support vector machines will be used to build predictive models and identify important patterns.

Results

Recruitment is underway, and results will be available in 2018.

Conclusions

The contribution of foods prepared away from home, in terms of energy, nutrients, deleterious nutrients, and food groups to young people’s diets will be determined, as will the impact on meeting national recommendations. Foods and consumption behaviors that should be targeted in future health promotion efforts for young adults will be identified.

Determinants of takeaway and fast food consumption: a narrative review

Out-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.

A Meta-Analysis to Determine the Impact of Restaurant Menu Labeling on Calories and Nutrients (Ordered or Consumed) in U.S. Adults

A systematic review and meta-analysis determined the effect of restaurant menu labeling on calories and nutrients chosen in laboratory and away-from-home settings in U.S. adults. Cochrane-based criteria adherent, peer-reviewed study designs conducted and published in the English language from 1950 to 2014 were collected in 2015, analyzed in 2016, and used to evaluate the effect of nutrition labeling on calories and nutrients ordered or consumed. Before and after menu labeling outcomes were used to determine weighted mean differences in calories, saturated fat, total fat, carbohydrate, and sodium ordered/consumed which were pooled across studies using random effects modeling. Stratified analysis for laboratory and away-from-home settings were also completed. Menu labeling resulted in no significant change in reported calories ordered/consumed in studies with full criteria adherence, nor the 14 studies analyzed with ≤1 unmet criteria, nor for change in total ordered carbohydrate, fat, and saturated fat (three studies) or ordered or consumed sodium (four studies). A significant reduction of 115.2 calories ordered/consumed in laboratory settings was determined when analyses were stratified by study setting. Menu labeling away-from-home did not result in change in quantity or quality, specifically for carbohydrates, total fat, saturated fat, or sodium, of calories consumed among U.S. adults.

Higher densities of fast-food and full-service restaurants are not associated with obesity prevalence

Background: The obesity epidemic in the United States has been mirrored by an increase in calories consumed outside of the home and by expansions in the numbers of, and portion sizes at, both fast-food restaurants (FFRs) and full-service restaurants (FSRs), leading some to blame the epidemic on the restaurant industry. If this were indeed true, one would predict that greater per capita densities of FFRs and FSRs would lead to greater obesity prevalence.Objective: We evaluated the population-level association between both FSRs and FFRs and the prevalence of obesity and calculated the proportion of calories consumed in these establishments.Design: In this ecological cross-sectional study, we used county-level data (aggregate-level data) for obesity prevalence across the mainland United States in 2012 and matched these data to county-level per capita densities of FFRs and FSRs in the same year. Multiple linear regression was used to determine the relation between the prevalence of obesity and the densities of FFRs and FSRs after adjustment for confounding factors.Results: Contrary to expectations, obesity prevalence was highly significantly negatively related to the densities of both FFRs and FSRs (combined-effect R² = 0.195). This was principally because greater numbers of both FFRs and FSRs were located in areas in which individuals were on average wealthier and more educated. When we normalized for these factors (and additional socioeconomic variables), the associations between restaurant densities and obesity effectively disappeared (pooled R² = 0.008). Our calculations showed that the percentage of total calories consumed in FFRs and FSRs is a mean of only 15.9% of the total intake (maximum: 22.6%).Conclusions: Variations in the densities of FFRs and FSRs are not linked to the prevalence of obesity in the United States, and food consumed in these establishments is responsible for <20% of total energy intake. This finding has implications for policy decisions regarding how we aim to tackle the obesity epidemic.

Economic preferences and fast food consumption in US adults: Insights from behavioral economics

OBJECTIVE

To examine the relationship between economic time preferences and frequency of fast food and full-service restaurant consumption among U.S. adults.

METHODS

Participants included 5871U.S. adults who responded to a survey conducted in 2011 pertaining to the lifestyle behaviors of families and the social context of these behaviors. The primary independent variable was a measure of time preferences, an intertemporal choice assessing delay discounting. This was elicited via responses to preferences for an immediate dollar amount or a larger sum in 30 (30-day time horizon) or 60days (60-day time horizon). Outcomes were the frequency of fast food and full-service restaurant consumption. Ordered logistic regression was performed to examine the relationship between time preferences and food consumption while adjusting for covariates (e.g. socio-demographics).

RESULTS

Multivariable analysis revealed that higher future time preferences were significantly related to less frequent fast food intake for both the 30- and 60-day time horizon variables (P for linear trend <0.05; both). Notably, participants with the highest future time preference were significantly less likely to consume fast food than those with very low future time preferences (30-day: OR=0.74, 95%CI: 0.62-0.89; and 60-day: OR=0.86, 95%CI: 0.74-1.00). In comparison, higher future time preferences were not significantly associated with full-service restaurant intake (30-day: p for linear trend=0.73; 60-day: p for linear trend=0.83).

CONCLUSIONS

Higher future time preferences were related to a lower frequency of fast food consumption. Utilizing concepts from behavioral economics (e.g. pre-commitment contracts) to facilitate more healthful eating is warranted using experimental studies.

Comparative validity and repeatability of a single question, a twenty-eight-item FFQ and estimated food records to assess takeaway meal intake

A single question (SQ) and a twenty-eight-item FFQ to measure takeaway meal intake were compared with two 7-d estimated food records (EFR; reference method). Test methods were completed after the reference period and repeated 6-8 d later for repeatability. The SQ asked about intake of high-SFA takeaway meals. FFQ items included low- and high-SFA meals. Test methods were compared with EFR for sensitivity, specificity, and positive and negative predictive values, using a goal of ≤1 high-SFA weekly takeaway meals. Bland-Altman analyses were used to check agreement between measurement approaches, the κ coefficient was used to summarise the observed level of agreement, and Spearman's correlation was used to assess the degree to which instruments ranked individuals. Young adults were recruited from two universities, and 109 participants (61 % female) completed the study. The mean age was 24·4 (sd 4·9) years, and the mean BMI was 23·5 (sd 3·7) kg/m2. The SQ and the FFQ had a sensitivity of 97 and 83 % and a specificity of 46 and 92 %, respectively. Both methods exhibited moderate correlation for measuring total and high-SFA takeaway meal intakes (r s ranging from 0·64 to 0·80). Neither instrument could measure precise, absolute intake at the group or individual level. Test methods ranged from fair (κ w =0·24) to moderate agreement (κ w =0·59). The repeatability for all was acceptable. The FFQ identified excessive high-SFA takeaway meal intake and measured individuals' category for total and high-SFA takeaway intakes. Both methods are suitable for ranking individuals for total or high-SFA takeaway meal intakes.

The impact of a new McDonald's restaurant on eating behaviours and perceptions of local residents: A natural experiment using repeated cross-sectional data

Neighbourhood food environments are posited as an important determinant of eating behaviours; however causality is difficult to establish based on existing studies. Using a natural experiment study design (incorporating repeated cross-sectional data), we tested whether the development of a new McDonald's restaurant increased the frequency of consumption of McDonald's products amongst local residents in the suburbs of Tecoma (site of a new McDonald's restaurant development) and Monbulk (control site) in Victoria, Australia. Across both sites, the reported frequency of McDonald's consumption did not change during the follow-up surveys. In the context explored, the development of a new McDonald's restaurant has not resulted in an increased consumption of McDonald's products.

Fast food restaurant locations according to socioeconomic disadvantage, urban-regional locality, and schools within Victoria, Australia

Features of the built environment provide opportunities to engage in both healthy and unhealthy behaviours. Access to a high number of fast food restaurants may encourage greater consumption of fast food products. The distribution of fast food restaurants at a state-level has not previously been reported in Australia. Using the location of 537 fast food restaurants from four major chains (McDonald׳s, KFC, Hungry Jacks, and Red Rooster), this study examined fast food restaurant locations across the state of Victoria relative to area-level disadvantage, urban-regional locality (classified as Major Cities, Inner Regional, or Outer Regional), and around schools. Findings revealed greater locational access to fast food restaurants in more socioeconomically disadvantaged areas (compared to areas with lower levels of disadvantage), nearby to secondary schools (compared to primary schools), and nearby to primary and secondary schools within the most disadvantaged areas of the major city region (compared to primary and secondary schools in areas with lower levels of disadvantage). Adjusted models showed no significant difference in location according to urban-regional locality. Knowledge of the distribution of fast food restaurants in Australia will assist local authorities to target potential policy mechanisms, such as planning regulations, where they are most needed.

Nutrition Promotion to Prevent Obesity in Young Adults

Young adulthood is a vulnerable period for weight gain and the health consequences of becoming obese during this life-stage of serious concern. Some unhealthy dietary habits are typical of young adults in many developed nations encountering the obesity epidemic. These include high sugar-sweetened beverage consumption, lower vegetable intake and greater consumption of foods prepared outside the home including fast foods. Each of these dietary behaviours may place young adults at increased risk for overweight and obesity. Evidence suggests many young adults with unhealthy nutrition behaviours are not considering nor preparing to make changes. To improve their nutrition and health as they progress through the lifecycle requires approaches specifically targeted to this age group. Strategies and programs should include both individual level and population approaches. The evidence base for prevention of weight gain and halting overweight and obesity in young adulthood is currently small with few studies of high quality. Studies modifying food environments in colleges and universities are also of limited quality, but sufficiently promising to conduct further research employing better, more sophisticated, study designs and additionally to include health outcome measures. More research into programs tailored to the needs of young adults is warranted with several studies already underway.

The association of socio-demographic status, lifestyle factors and dietary patterns with total urinary phthalates in Australian men

OBJECTIVE

To investigate the associations between socio-demographic status, lifestyle factors, dietary patterns and urinary total phthalate concentration in a cohort of South Australian men.

METHOD

We randomly selected 1527 males aged 39 to 84 from wave two of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. Total phthalate concentration was examined in fasting morning urine samples. Socio-demographic and lifestyle factors were assessed by questionnaire. Food intake was assessed by food frequency questionnaire (FFQ). Dietary patterns were constructed using factor analysis.

RESULTS

Total phthalates were detected in 99.6% of the urine samples. The overall geometric mean (95% CI) of total phthalate concentration was 112.4 (107.5-117.5) ng/mL. The least square geometric means (LSGMs) of total phthalate concentration were significantly higher among people who were obese (127.8 ng/mL), consuming less than two serves fruit per day (125.7 ng/mL) and drinking more than one can (375mL) of carbonated soft drink per day (131.9 ng/mL). Two dietary patterns were identified: a prudent dietary pattern and a western dietary pattern. Both the western dietary pattern (p = 0.002) and multiple lifestyle risk factors including smoking, obesity, insufficient physical activity and the highest quartile of the western dietary pattern (p<0.001), were positively associated with total phthalate levels. There was no significant relationship between total phthalate concentration and socio-demographic status.

CONCLUSION

Phthalate exposure is ubiquitous and positively associated with lifestyle risk factors in urban dwelling Australian men.

Characteristics of fast-food/takeaway-food and restaurant/café-food consumers among New Zealand adults

OBJECTIVE

To investigate: (i) the percentage of the New Zealand (NZ) population reporting fast food/takeaway food and restaurant/café food per day; (ii) examine demographic factors associated with their use; (iii) quantify their contribution to energy intake; and (iv) describe the specific types of foods reported from both sources.

DESIGN

Twenty-four hour diet recalls from the cross-sectional 2008/09 NZ Adult Nutrition Survey were used to identify fast-food and restaurant-food consumers.

SETTING

NZ households.

SUBJECTS

Adults aged 15 years and older (n 4721).

RESULTS

Overall 28 % reported consuming at least one fast food and 14 % a restaurant food within the 24 h diet recall. Fast-food consumption was not associated with level of education or an area-based measure of socio-economic status, but a higher education was positively associated with restaurant-food consumption. Individual factors such as ethnicity, household size, age, sex and marital status were found to be important influences on the use of fast food and restaurant food. Fast-food consumption was more prevalent among participants living in urban areas, young adults (19-30 years) and Māori compared with NZ European and Others. The most frequently reported fast foods were bread-based dishes, potatoes (including fries) and non-alcoholic beverages.

CONCLUSIONS

Given the high reported consumption of fast food by young adults, health promotion initiatives both to improve the nutritional quality of fast-food menus and to encourage healthier food choices would likely make a large impact on the overall diet quality of this group.

Fast-food consumers in Singapore: demographic profile, diet quality and weight status

OBJECTIVE

To determine the demographic profile of fast-food consumers among adult Singapore residents and ascertain whether fast-food consumption frequency is associated with diet quality and weight status.

DESIGN

A nationally representative cross-sectional survey including an FFQ and anthropometric measures. Participants were grouped based on their fast-food consumption frequency as non-consumer, occasional consumer or regular consumer, with regular defined as at least once per week.

SETTING

Individuals living in the community in Singapore.

SUBJECTS

Singapore residents (n 1627) aged 18-69 years of Chinese, Malay and Indian ethnicity.

RESULTS

Proportions of regular fast-food consumers were higher in younger age groups, higher income groups and middle education level groups. Mean daily energy intake was positively associated with fast-food consumption frequency (non-consumers 9636 kJ (2303 kcal); occasional consumers 11 159 kJ (2667 kcal); regular consumers 13 100 kJ (3131 kcal); P for trend < 0·001). Fast-food consumers were more likely to exceed the RDA for energy, fat and saturated fat, and less likely to meet wholegrain and fruit recommendations. Both regular consumers (OR = 1·24; 95 % CI 1·03, 1·51) and occasional consumers (OR = 1·52; 95 % CI 1·32, 1·77) were more likely to have a waist:hip ratio indicating abdominal obesity. Occasional consumers were more likely to have a BMI ≥ 23·0 kg/m2 (OR = 1·19; 95 % CI 1·04, 1·37), whereas regular consumers were less likely (OR = 0·76; 95 % CI 0·64, 0·91) to have an 'at-risk' BMI.

CONCLUSIONS

Fast-food consumption is most prevalent in young adults, high income and middle education level groups. Frequent fast-food consumption in Singapore is associated with unfavourable dietary and nutrient profiles and abdominal obesity.

What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study

This study assessed whether the inclusion of kilojoule labelling alone or accompanied by further nutrition information on menus led adults to select less energy-dense fast food meals. A between-subjects experimental design was used with online menu boards systematically varied to test the following labelling conditions: none (control); kilojoule; kilojoule+percent daily intake; kilojoule+traffic light; and kilojoule+traffic light+percent daily intake. Respondents were 1294 adults aged 18-49 in Victoria, Australia who had purchased fast food in the last month and were randomly assigned to conditions. Respondents in the no labelling condition selected meals with the highest mean energy content and those viewing the kilojoule and kilojoule+traffic light information selected meals with a significantly lower mean energy content, that constituted a reduction of around 500kJ (120kcal). Respondents most commonly reported using the traffic light labels in making their selections. These findings provide support for the policy of disclosure of energy content on menus at restaurant chains. Given the magnitude of the reduction in energy density reported, and the prevalence of fast food consumption, this policy initiative has the potential to yield health benefits at the population level.

Optimising women's diets. An examination of factors that promote healthy eating and reduce the likelihood of unhealthy eating

The majority of nutrition promotion research that has examined the determinants of unhealthy or healthy dietary behaviours has focused on factors that promote consumption of these foods, rather than factors that may both promote healthy eating and buffer or protect consumption of unhealthy foods. The purpose of this paper is to identify factors that both promote healthy eating and also reduce the likelihood of eating unhealthily amongst women. A community sample of 1013 Australian women participated in a cross-sectional self-report survey that assessed factors associated with diet and obesity. Multiple logistic regressions were used to examine the associations between a range of individual, social and environmental factors and aspects of both healthy and unhealthy eating, whilst controlling for key covariates. Results indicated that women with high self efficacy for healthy eating, taste preferences for fruit and vegetables, family support for healthy eating and the absence of perceived barriers to healthy eating (time and cost) were more likely to consume components of a healthy diet and less likely to consume components of a unhealthy diet. Optimal benefits in overall diet quality amongst women may be achieved by targeting factors associated with both healthy and unhealthy eating in nutrition promotion efforts.

Fast food and take-away food consumption are associated with different lifestyle characteristics

BACKGROUND

One of the most prominent characteristics of fast food and take-away food is that it is convenient, meaning that it saves time, it reduces the required effort for food provisioning and culinary skills are transferred. Studies that investigate the unique effect of these factors on dietary behaviours are lacking. Therefore, the present study aimed to examine the associations of time, effort, time spent cooking and cooking skills with fast food and take-away food consumption.

METHODS

Between May and June 2009, a random postal survey was sent out to 2323 Swiss households. The response rate was 44% (n = 1017). Spearman rank correlations and logistic regression analysis were used to determine the multiple relationships of fast food and take-away food intake with gender, age, educational level, income, mental effort, physical effort, working status, cooking skills and time spent cooking.

RESULTS

Fast food consumption was found to be associated with gender (males) [odds ratio (OR) = 1.61, P < 0.05], age (40-59 years) (OR = 0.41, P < 0.001), age (≥60 years) (OR = 0.13, P < 0.001), time spent cooking (OR = 0.99; P < 0.01) and cooking skills (OR = 0.81, P < 0.05). Take-away food consumption was found to be associated with gender (males) (OR = 1.86, P < 0.01), age (40-59 years) (OR = 0.58, P < 0.01), age (≥60 years) (OR = 0.28, P < 0.001), income (OR = 1.11, P <0.01), education (middle) (OR = 0.65, P < 0.05) and mental effort (OR = 1.25, P < 0.05).

CONCLUSIONS

Take-away and fast food consumption are behaviours that share the same demographic determinants of age and gender, although they are influenced by different life style determinants. It is very likely that motivations related to time, effort and cooking are of increasing importance for food decisions in our society.

Purchase rates and energy content of nutritionally promoted and traditional fast foods purchased at lunchtime in Australia – a pilot study

Objective

Nutritionally promoted foods are now available at fast-food establishments. Little is known about their popularity, who is purchasing them, or their impact on dietary intake. Our study aimed to determine: how often nutritionally promoted fast foods were purchased; the demographic characteristics of people purchasing these foods; and if purchasing these foods resulted in reduced energy, and increased vegetable, content of lunches compared with those who purchased traditional fast foods.

Design

A survey collecting lunchtime fast-food purchases and demographic details was administered over two months. Nutritionally promoted products included the McDonalds’ ‘Heart Foundation Tick Approved’ range and Subway's ‘Six grams of fat or less’ range. Energy and vegetable contents were estimated using information from fast-food companies’ websites. Differences in demographics, energy and vegetable contents between individuals purchasing nutritionally promoted and traditional lunches were assessed using χ2 and t tests.

Setting

Queensland, Australia.

Subjects

Lunchtime diners aged over 16 years at Subway and McDonalds.

Results

Surveys were collected from 927 respondents (58 % male, median age 25 (range 16–84) years; 73 % response rate). Only 3 % (n 24/910) of respondents who ordered a main option had purchased a nutritionally promoted item. Purchasers of nutritionally promoted foods were ∼13 years older, predominantly female (79 %), and more often reported involvement in a health-related profession (29 % v. 11 %) than purchasers of traditional foods (P < 0·05). Purchasers of nutritionally promoted foods ordered 1·5 fewer megajoules and 0·6 more vegetable servings than purchasers of traditional foods (P < 0·05).

Conclusions

Nutritionally promoted fast foods may reduce lunchtime energy content, however these foods were infrequently chosen.

Socio-economic differences in takeaway food consumption among adults

Objective

To examine socio-economic differences in the frequency and types of takeaway foods consumed.

Design

A cross-sectional postal survey.

Setting

Participants were asked about their usual consumption of overall takeaway food (<4 times/month or ≥4 times/month) and of twenty-two specific takeaway food items (<1 time/month or ≥1 time/month); these latter foods were grouped into ‘healthy’ and ‘less healthy’ choices. Socio-economic position was measured on the basis of educational level and equivalised household income, and differences in takeaway food consumption were assessed by calculating prevalence ratios using log binomial regression.

Subjects

Adults aged 25–64 years from Brisbane, Australia, were randomly selected from the electoral roll (n903; 63·7 % response rate).

Results

Compared with their more educated counterparts, the least educated were more regular consumers of overall takeaway food and fruit or vegetable juice and less regular consumers of sushi. For the ‘less healthy’ items, the least educated more regularly consumed potato chips, savoury pies, fried chicken and non-diet soft drinks; however, the least educated were less likely to consume curry. Household income was not associated with overall takeaway consumption. The lowest-income group was a more regular consumer of fruit or vegetable juice compared with the highest-income group. Among the ‘less healthy’ items, the lowest-income group was a more regular consumer of fried fish, ice cream and milk shakes, whereas curry was consumed less regularly.

Conclusions

The frequency and types of takeaway foods consumed by socio-economically disadvantaged groups may contribute to inequalities in overweight or obesity and to chronic disease.

Determinants of fast-food consumption. An application of the Theory of Planned Behaviour

This study applied and extended the Theory of Planned Behaviour (TPB; Ajzen, 1988) in an examination of the variables influencing fast-food consumption in an Australian sample. Four hundred and four participants responded to items measuring TPB constructs and retrospective and prospective measures of fast-food consumption. Additional independent variables included: Consideration of Future Consequences (Strathman, Gleicher, Boninger, & Edwards, 1994), Fear of Negative Evaluation (Leary, 1983), and Self-Identification as a Healthy Eater Scale (Armitage & Conner, 1999a). Structural Equation Modeling (SEM) was used to examine predictors of consumption. SEM indicated that the TPB successfully predicted fast-food consumption. Factor analyses assisted in the definition of constructs that underlay attitudes towards fast foods. These constructs were included in an 'extended' TPB model which then provided a richer source of information regarding the nature of the variables influencing fast-food consumption. Findings suggest that fast-food consumption is influenced by specific referent groups as well as a general demand for meals that are tasty, satisfying, and convenient. These factors reflect immediate needs and appear to override concerns about longer-term health risks associated with fast food. Results are discussed in the context of possible applications.

A systematic review of environmental factors and obesogenic dietary intakes among adults: are we getting closer to understanding obesogenic environments?

This study examined whether physical, social, cultural and economical environmental factors are associated with obesogenic dietary behaviours and overweight/obesity among adults. Literature searches of databases (i.e. PubMed, CSA Illumina, Web of Science, PsychInfo) identified studies examining environmental factors and the consumption of energy, fat, fibre, fruit, vegetables, sugar-sweetened drinks, meal patterns and weight status. Twenty-eight studies were in-scope, the majority (n= 16) were conducted in the USA. Weight status was consistently associated with the food environment; greater accessibility to supermarkets or less access to takeaway outlets were associated with a lower BMI or prevalence of overweight/obesity. However, obesogenic dietary behaviours did not mirror these associations; mixed associations were found between the environment and obesogenic dietary behaviours. Living in a socioeconomically-deprived area was the only environmental factor consistently associated with a number of obesogenic dietary behaviours. Associations between the environment and weight status are more consistent than that seen between the environment and dietary behaviours. The environment may play an important role in the development of overweight/obesity, however the dietary mechanisms that contribute to this remain unclear and the physical activity environment may also play an important role in weight gain, overweight and obesity.

Who is eating where? Findings from the SocioEconomic Status and Activity in Women (SESAW) study

OBJECTIVE

Foods prepared outside of the home have been linked to less-than-ideal nutrient profiles for health. We examine whether the locations where meals are prepared and consumed are associated with socio-economic predictors among women.

DESIGN

A cross-sectional study using self-reported data. We examined multiple locations where meals are prepared and consumed: (i) at home; (ii) fast food eaten at home; (iii) fast food eaten at the restaurant; (iv) total fast food; (v) non-fast-food restaurant meals eaten at home; (vi) non-fast-food restaurant meals eaten at the restaurant; and (vii) all non-fast-food restaurant meals. Multilevel logistic regression was used to determine whether frequent consumption of meals from these sources varied by level of education, occupation, household income and area-level disadvantage.

SETTING

Metropolitan Melbourne, Australia.

SUBJECTS

A total of 1328 women from forty-five neighbourhoods randomly sampled for the SocioEconomic Status and Activity in Women study.

RESULTS

Those with higher educational qualifications or who were not in the workforce (compared with those in professional employment) were more likely to report frequent consumption of meals prepared and consumed at home. High individual- and area-level socio-economic characteristics were associated with a lower likelihood of frequent consumption of fast food and a higher likelihood of frequent consumption of meals from non-fast-food sources. The strength and significance of relationships varied by place of consumption.

CONCLUSIONS

The source of meal preparation and consumption varied by socio-economic predictors. This has implications for policy makers who need to continue to campaign to make healthy alternatives available in out-of-home food sources.

The geography of Fast Food outlets: a review

The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

Takeaway food consumption and its associations with diet quality and abdominal obesity: a cross-sectional study of young adults

BACKGROUND

Few studies have investigated the associations of takeaway food consumption with overall diet quality and abdominal obesity. Young adults are high consumers of takeaway food so we aimed to examine these associations in a national study of young Australian adults.

METHODS

A national sample of 1,277 men and 1,585 women aged 26-36 completed a self-administered questionnaire on demographic and lifestyle factors, a 127 item food frequency questionnaire, usual daily frequency of fruit and vegetable consumption and usual weekly frequency of takeaway food consumption. Dietary intake was compared with the dietary recommendations from the Australian Guide to Healthy Eating. Waist circumference was measured for 1,065 men and 1,129 women. Moderate abdominal obesity was defined as >/= 94 cm for men and >/= 80 cm for women. Prevalence ratios (PR) were calculated using log binomial regression. Takeaway food consumption was dichotomised, with once a week or less as the reference group.

RESULTS

Consumption of takeaway food twice a week or more was reported by more men (37.9%) than women (17.7%, P < 0.001). Compared with those eating takeaway once a week or less, men eating takeaway twice a week or more were significantly more likely to be single, younger, current smokers and spend more time watching TV and sitting, whereas women were more likely to be in the workforce and spend more time watching TV and sitting. Participants eating takeaway food at least twice a week were less likely (P < 0.05) to meet the dietary recommendation for vegetables, fruit, dairy, extra foods, breads and cereals (men only), lean meat and alternatives (women only) and overall met significantly fewer dietary recommendations (P < 0.001). After adjusting for confounding variables (age, leisure time physical activity, TV viewing and employment status), consuming takeaway food twice a week or more was associated with a 31% higher prevalence of moderate abdominal obesity in men (PR: 1.31; 95% CI: 1.07, 1.61) and a 25% higher prevalence in women (PR: 1.25; 95% CI: 1.04, 1.50).

CONCLUSION

Eating takeaway food twice a week or more was associated with poorer diet quality and a higher prevalence of moderate abdominal obesity in young men and women.

Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

Background

While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003.

Methods

The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant.

Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics.

Results

Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors.

Conclusion

Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.

Why eat at fast-food restaurants: reported reasons among frequent consumers

A convenience sample of adolescents and adults who regularly eat at fast-food restaurants were recruited to participate in an experimental trial to examine the effect of nutrition labeling on meal choices. As part of this study, participants were asked to indicate how strongly they agreed or disagreed with 11 statements to assess reasons for eating at fast-food restaurants. Logistic regression was conducted to examine whether responses differed by demographic factors. The most frequently reported reasons for eating at fast-food restaurants were: fast food is quick (92%), restaurants are easy to get to (80%), and food tastes good (69%). The least frequently reported reasons were: eating fast food is a way of socializing with family and friends (33%), restaurants have nutritious foods to offer (21%), and restaurants are fun and entertaining (12%). Some differences were found with respect to the demographic factors examined. It appears that in order to reduce fast-food consumption, food and nutrition professionals need to identify alternative quick and convenient food sources. As motivation for eating at fast-food restaurants appears to differ somewhat by age, sex, education, employment status, and household size, tailored interventions could be considered.

Beliefs about fast food in Australia: a qualitative analysis

The consumption of energy-dense fast foods has been implicated as a causal factor in the development of obesity. The development of strategies to modify food choice behaviour requires an understanding of the behaviour and the driving factors. This study examined the rationale behind decisions to either choose or avoid fast foods. Drawing partly on the Theory of Planned Behaviour (Ajzen, (1988)), a qualitative design was employed to examine the beliefs and perceptions associated with fast-food consumption within an Australian sample. Findings provided an indication that positive affective reactions to fast food, convenience, and self-serving cognitions may override cognitive analyses of the longer-term health risks associated with frequent fast-food consumption.