Is density of neighbourhood restaurants associated with BMI in rural Chinese adults? A longitudinal study from the China Health and Nutrition Survey

Abstract

ObjectivesThe neighbourhood availability of restaurants has been linked to the weight status. However, little is known regarding the relation between access to restaurant and obesity among the Chinese population. This study aims to explore the relationship between neighbourhood restaurant density and body mass index (BMI) in rural China.DesignA longitudinal study using data from the China Health and Nutrition Survey (CHNS) was conducted. Participants aged 18 and older from the 2004, 2006, 2009 and 2011 CHNS were recruited Separate sex-stratified random intercept-slope growth models of repeated BMI observations were estimated in the study.SettingThe data were derived from rural communities in nine provinces in China.ParticipantsThere were 11 835 male and 12 561 female person-years assessed in this study.OutcomesThe primary outcome of this study was weight status. It is defined as a BMI value, a continuous variable which is calculated by dividing weight (kg) by the square of height (m2).ResultsThe study indicated that among men an increase of one indoor restaurant in the neighbourhood was associated with a 0.01 kg/m2 increase in BMI, and an increase of one fixed outdoor food stall was associated with a 0.01 kg/m2 decrease in BMI, whereas among women, an increase of one indoor restaurant in the neighbourhood was associated with a 0.005 kg/m2 increase in BMI, and an increase of one fast-food restaurant and one fixed outdoor food stall was associated with a 0.02 and 0.004 kg/m2 decline in BMI, respectively.ConclusionsThe density of neighbourhood restaurants was found to be significantly related to BMI in rural China. The results indicated that providing healthy food choices and developing related public health policies are necessary to tackle obesity among rural Chinese adults.

Social and Physical Determinants of Obesity in Adults

“…Individual level variables were also taken into consideration. It was seen that married adults had lower body mass index compared to unmarried adults and also participants who were physically active had lower body mass index compared to those who were not [16].…”

“…Moreover, another study was conducted to examine the relationship between body mass index and neighbourhood density restaurants in rural Chinese adults [16]. It was a longitudinal study, and the data was collected from the China Health and Nutrition Survey.…”

“…Future research should take this into account. Also, it should examine the effect of these neighbourhood restaurants on eating behaviours and individual dietary intake [16].…”

A Review of the Growth of the Fast Food Industry in China and Its Potential Impact on Obesity

“…The changes have exacerbated the shifts from traditional eating patterns to more modern including Westernized eating patterns featuring high-energy density, high-fat, and low fiber diets [5,6]. The number of people who eat out more frequently due to rapid income growth [7] increased by 40.20% from 2000 (14.70%) to 2008 (20.61%) [8]. Increased Western influences in China include more available FF choices.…”

Changing the Food Environment for Obesity Prevention: Key Gaps and Future Directions

“…While the majority of intervention trials to impact the food environment have taken place in the US and Europe, there is growing evidence that food environments are related to obesity and chronic disease rates in non-Western countries, including work in South Korea [68], Brazil [69], China [70] and others. Yet very little intervention work has taken place in these settings, with some exceptions.…”