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American Journal of Epidemiology Advance Access originally published online on May 8, 2009
American Journal of Epidemiology 2009 170(1):29-36; doi:10.1093/aje/kwp090
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Fast-Food Consumption, Diet Quality, and Neighborhood Exposure to Fast Food

The Multi-Ethnic Study of Atherosclerosis

Latetia V. Moore, Ana V. Diez Roux, Jennifer A. Nettleton, David R. Jacobs and Manuel Franco

Correspondence to Dr. Latetia V. Moore, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS K-46, Atlanta, GA 30341 (e-mail: lvmoore{at}cdc.gov).

Received for publication February 3, 2009. Accepted for publication March 16, 2009.

The authors examined associations among fast-food consumption, diet, and neighborhood fast-food exposure by using 2000–2002 Multi-Ethnic Study of Atherosclerosis data. US participants (n = 5,633; aged 45–84 years) reported usual fast-food consumption (never, <1 time/week, or ≥1 times/week) and consumption near home (yes/no). Healthy diet was defined as scoring in the top quintile of the Alternate Healthy Eating Index or bottom quintile of a Western-type dietary pattern. Neighborhood fast-food exposure was measured by densities of fast-food outlets, participant report, and informant report. Separate logistic regression models were used to examine associations of fast-food consumption and diet; fast-food exposure and consumption near home; and fast-food exposure and diet adjusted for site, age, sex, race/ethnicity, education, and income. Those never eating fast food had a 2–3-times higher odds of having a healthy diet versus those eating fast food ≥1 times/week, depending on the dietary measure. For every standard deviation increase in fast-food exposure, the odds of consuming fast food near home increased 11%–61% and the odds of a healthy diet decreased 3%–17%, depending on the model. Results show that fast-food consumption and neighborhood fast-food exposure are associated with poorer diet. Interventions that reduce exposure to fast food and/or promote individual behavior change may be helpful.

diet; food; residence characteristics

Abbreviations: AHEI, Alternate Healthy Eating Index; aOR, adjusted odds ratio; CI, confidence interval; FPM, fats and processed meats dietary pattern; MESA, Multi-Ethnic Study of Atherosclerosis


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