Are sit-down restaurant, fast food and café usage independently associated with diet and obesity?

Abstract

Background Frequency of eating away-from-home has been associated with reduced intakes of healthy nutrients and foods and increased body weight. However, examining independent links between the use of different retail locations, overall diet quality and measured obesity status are needed. Methods A cross-sectional analysis of repeated cross-sectional data for 2083 adults from the UK National Diet and Nutrition Survey. Using 4-day unweighed food diaries participants recorded foods, drinks and eating location. Height and weight were objectively measured. Exposures were the proportion of energy intake (kJ) away-from-home and within three retail locations. Outcomes were accordance with the Dietary Approaches to Stop Hypertension (DASH) diet and obesity status (BMI > =30kg/m2). Logistic regressions were used to estimate associations between eating location exposures, DASH accordance and obesity. Results Overall the highest proportion of eating away-from-home was associated with decreased odds of DASH accordance (0.45 [0.31, 0.67]) and increased odds of obesity (1.48 [1.10, 1.99]). After controlling for demographics, socioeconomic factors and respective retail and non-retail locations, use of fast food outlets was significantly associated with decreased odds of DASH accordance (0.48 [0.33, 0.69]) and increased odds of obesity (1.30 [1.01, 1.69]). After socioeconomic adjustment use of sit-down restaurants or cafés was not significantly associated with DASH accordance or obesity. Conclusions Eating away-from-home was associated with decreased diet quality and increased obesity. However, away-from-home eating locations were not homogeneous in their independent associations. When developing population health interventions to reduce retail usage it may be important to focus on specific food outlet types and the drivers of individual usage within a broader social and economic context.