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Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants
Carel‐Peter L. van Erpecum, Sander K. R. van Zon, Ute Bültmann, Nynke Smidt. European Journal of Public Health, 2019-11-01
Topic: Risk, prevention and care in population studies
Abstract Background Elevated Body Mass Index (BMI) is a key risk factor for numerous non-communicable diseases, such as cardiovascular diseases, cancer, diabetes type II and dementia. Previous studies showed associations between fast-food outlet exposure and BMI, but contained methodological shortcomings. Particularly within the Netherlands, evidence is scarce. We aimed to examine the association between fast-food outlet exposure and BMI among the Dutch adult general population, and whether this association was mediated by daily caloric intake. Methods Cross-sectionally linking baseline adult data (N = 124,286) from the Lifelines cohort to fast-food outlet location (LISA: employer register) data, we regressed fast-food outlet density (within distances of 500 metre(m), and 1, 3, and 5 kilometre (km)) and fast-food outlet proximity around participants’ residential address on BMI. We used multilevel regression and multilevel mediation models, adjusting for age, sex, partner status, education, employment, neighbourhood deprivation and neighbourhood address density. We stratified analyses for urban and rural areas, as these involve different living environments and study populations. Results More than half (56%) of participants was overweight (BMI ≥ 25.0). The average BMI in urban and rural areas was 25.9 (SD 4.4) and 26.3 (SD 4.3), respectively. In rural areas, having at least three fast-food outlets within 500 m was associated with higher BMI (B = 0.17, 95% confidence interval (CI): 0.06, 0.28). In urban areas, having at least five fast-food outlets within 1 km was associated with higher BMI (B = 0.42, 95% CI: 0.20, 0.63). Having the nearest fast-food outlet within 100m was associated with higher BMI (B = 0.43, 95% CI: 0.19, 0.67). The associations were partly explained by daily caloric intake. Conclusions Fast-food outlet exposure may be an important environmental determinant of BMI. Policy-makers should consider intervening upon the fast-food environment. Key messages Fast-food outlets within 500 metres in rural areas and 1 kilometre in urban areas may play a fundamental role in the rise of BMI. Targeting fast-food outlets may be key to reduce BMI on a population level.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
van Erpecum, C. L., van Zon, S. K. R., Bültmann, U., & Smidt, N. (2019). Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants. European Journal of Public Health. https://doi.org/10.1093/eurpub/ckz185.062
Vancouver
van Erpecum CL, van Zon SKR, Bültmann U, Smidt N. Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants. European Journal of Public Health. 2019. doi:10.1093/eurpub/ckz185.062.
BibTeX
@article{vanerpecum2019-bdeaf137,
author = {van Erpecum, Carel‐Peter L. and van Zon, Sander K. R. and Bültmann, Ute and Smidt, Nynke},
title = {{Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants}},
journal = {European Journal of Public Health},
year = {2019},
doi = {10.1093/eurpub/ckz185.062},
url = {https://doi.org/10.1093/eurpub/ckz185.062}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results More than half (56%) of participants was overweight (BMI ≥ 25.0).
- In rural areas, having at least three fast-food outlets within 500 m was associated with higher BMI (B = 0.17, 95% confidence interval (CI): 0.06, 0.28).
- In urban areas, having at least five fast-food outlets within 1 km was associated with higher BMI (B = 0.42, 95% CI: 0.20, 0.63).
- Having the nearest fast-food outlet within 100m was associated with higher BMI (B = 0.43, 95% CI: 0.19, 0.67).
Why it matters
In this cross-sectional study of 124,286 Dutch adults, more fast-food outlets near home were associated with higher body mass index in both rural and urban areas. Elevated BMI is described as a risk factor for several conditions including dementia, but this study did not measure dementia, so it cannot show an effect on Alzheimer's disease.
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Study details
- Participants124,286
- Evidence strengthModerate
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (European Journal of Public Health) |
| Journal's citation record | 1 / 4 | European Journal of Public Health: journal h-index 147 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 124,286 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.1 citations a year over 9 year(s) since 2019 |
| Impact for its field and year | 1 / 6 | Cited 0.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Nynke Smidt: h-index 43 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Groningen: institution h-index 1,383 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1093/eurpub/ckz185.062
- Original source →
- Free full text: European Journal of Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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