Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India

Abstract

BackgroundThe food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India.MethodsData are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs). Geographic information system data were available for 131 CEBs (n = 5264) from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m2.ResultsThe most common full service and fast food restaurants were Indian savory restaurants (57.2%) and Indian sweet shops (25.8%). Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p < 0.05). In unadjusted logistic regression models, participants in the highest versus lowest tertile of full service and fast food restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval), 1.44 (1.24, 1.67). After adjustment for age, household income, and education, the effect was attenuated: 1.08 (0.92, 1.26). Results were consistent with further adjustment for tobacco and alcohol use, moderate physical activity, and owning a bicycle or motorized vehicle.ConclusionsMost full service and fast food restaurants were Indian, suggesting that the nutrition transition in this megacity may be better characterized by the large number of unhealthy Indian food outlets rather than the Western food outlets. Full service and fast food restaurant density in the residence area of adults in Delhi, India, was associated with poor dietary intake. It was also positively associated with overweight/obesity, but this was largely explained by socioeconomic status. Further research is needed exploring these associations prospectively and in other LMICs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4598-8) contains supplementary material, which is available to authorized users.

Model Of Analysis Of Restaurant Services’ Regional Market In Context Of Intercultural Communication

“…All these institutions are not elite and are designed for middle-income people. Therefore, it is impossible to single out the part of consumers that provide a greater volume of sales [18][19][20].…”

Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil?

“…These types of foods are sources of energy, solid fats, added sugars, and sodium, and may be associated with unhealthy weight gain. Restaurants that sell these types of foods may contribute to the settings of the so-called obesogenic environment 35,36 . A study on the association between fast food consumption and diet quality in more than 5,000 individuals in the United States, found that fast food consumption and neighborhood fast food exposure were associated with a poorer diet (e.g., fats and oils, high-fat and processed meats, fried potatoes, savory snacks, and sweets) 37 .…”

“…Moreover, Cad. Saúde Pública 2020; 36(2):e00048619 another study on a population in India, has demonstrated that residing in areas closer to fast food restaurants was associated with decreased consumption of meat, fish, eggs, fruits 35 , and other lowenergy, nutrient-dense food sources.…”

Excesso de peso, consumo de frutas e hortaliças por adolescentes e ambiente alimentar local em São Paulo

“…Fast-foods podem ser definidos como "alimentos processados facilmente preparados em restaurantes como uma refeição rápida ou para serem levados" (Oxford University Press, 2010). Esse tipo de alimento costuma apresentar alta densidade energética, sendo rico em gordura, carboidratos refinados, colesterol, cujo consumo é associado ao aumento de peso, propiciando a configuração dos denominados ambientes obesogênicos (Patel et al, 2018;Duffrey et al, 2007). Em estudo da associação entre consumo de fast-foods e dieta realizado por Moore e colaboradores (2009) com mais de 5 mil indivíduos americanos, observou-se que o aumento da exposição a restaurantes de fast-foods elevava o risco de consumo de fast-foods perto de casa, além de contribuir para pior qualidade da dieta.…”

“…Em estudo da associação entre consumo de fast-foods e dieta realizado por Moore e colaboradores (2009) com mais de 5 mil indivíduos americanos, observou-se que o aumento da exposição a restaurantes de fast-foods elevava o risco de consumo de fast-foods perto de casa, além de contribuir para pior qualidade da dieta. Indivíduos com maior densidade de restaurantes, tanto de fast-foods quanto de outros tipos de alimentos, apresentaram maior consumo de grãos refinados e menor consumo de carnes, peixes, ovos e frutas em estudo transversal de base populacional realizado em Delhi (Patel et al, 2018).…”