the centre for diet and activity research (cedar) is focussed on:
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Associations between neighbourhood takeaway food outlet exposure, takeaway food consumption and body weight Thomas Burgoine IPH Away Day 25 th April 2014, University Arms Hotel. About CEDAR. The Centre for Diet and Activity Research (CEDAR) is focussed on: - PowerPoint PPT PresentationTRANSCRIPT
Associations between neighbourhood takeaway food outlet exposure, takeaway food consumption and body weight
Thomas BurgoineIPH Away Day25th April 2014, University Arms Hotel
• The Centre for Diet and Activity Research (CEDAR) is focussed on:• studying the determinants of dietary and PA
behaviours• developing and evaluating public health
interventions• helping shape public health practice and policy.
• The Centre is one of five Centres of Excellence in Public health Research funded through the UKCRC.
• Find out more: http://www.cedar.iph.cam.ac.uk/
About CEDAR
Introduction
• UK obesity levels have reached ‘epidemic’ proportions• 29% increase in expenditure on foods consumed out of
the home in the last 10 years• Meals consumed outside of the home are less healthy:
more energy dense, more saturated fat, more salt; bigger portions
• Takeaway consumption associated with weight gain over time
• Neighbourhood access to takeaway food outlets may play an important role in determining diet and health
Sources: Food – an analysis of the issues, 2008 Food matters – towards a strategy for the 21st century, 2008
Centre for Diet and Activity Research
Takeaways, Increased policy recognition
Food Environment effect on
diet/weight
Morland and Evenson 2009
Mehta and Chang 2008
Chou et al 2004
Maddock et al 2004
Boone-Heinonen et al 2011
Davis and Carpenter 2009
Currie et al 2009
Powell et al 2007
Bodor et al 2007
Moore et al 2008
Zenk et al 2005
Laraia et al 2004
Wrigley et al 2003
Rose and Richards 2004
No or unexpected food environment
effect on diet/weight
Simmons et al 2005
Spence et al 2009
Jeffery et al 2006
Mobley et al 2006
Rundle et al 2009
Sturm and Datar 2005
Crawford et al 2008
Burdette and Whitaker 2004
Boone-Heinonen et al 2011
Morland et al 2002
Edmonds et al 2001
Cummins et al 2005
Burgoine et al 2009
Burgoine et al 2011
BMI outcomeDiet outcome
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Evidence?
Centre for Diet and Activity Research
Associations between exposure to takeaway food outlets, takeaway food consumption, and body weight in Cambridgeshire, UK: population based, cross sectional study
Institute of Public Health
Burgoine, T., Forouhi, N.G., Griffin, S.J., Wareham, N. and Monsivais, P. (2014) BMJ 348 (7950)
The Fenland Study sample
5442 adults
Aged 29-62Weight (measured BMI)
food consumption)Diet (takeaway
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Study design
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WORK HOME
JOURNEY
Participants exposed to:• 32 takeaway outlets on average• up to as many as 165 outlets• majority of outlets at work.
Takeaway Exposure - Consumption
** p<0.001; * p<0.05. a Q1, least exposed – Q4, most exposed. β co-efficients represent change in takeaway type food consumption (g) per quartile of takeaway food outlet exposure. All models control for age, sex, education (individual-level socio-economic status), daily
energy intake (kcal), car ownership and supermarket availability. Commuting and combined models also adjust for journey length. Error bars represent 95% confidence intervals.
3.0g
5.7g
(least exposed) (most exposed)
40g/week
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Takeaway Exposure – Body Mass Index
** p<0.001; * p<0.05. a Q1, least exposed – Q4, most exposed. β co-efficients represent estimated BMI (kg/m2) per quartile of takeaway food outlet exposure. All models control for age, sex, education (individual-level socio-economic status), smoking status, car ownership
and supermarket availability. Commuting and combined models also adjust for journey length. Error bars represent 95% confidence intervals.
1.21kg/m2
(least exposed) (most exposed)
Conclusions
• Neighbourhood takeaway food environments matter.• Limiting the number of takeaway food outlet encountered on a
daily basis may be one way of positively influencing diets and body weight
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Takeaway food
accessBMI and takeawayfood consumption
Socio-economic status (education)
Hypothetical models
Source: adapted from Ford & Dzewaltowski (2008) Nutrition Reviews 66(4)
Unhealthy food exposure Unhealthy food exposure
Low SES
High SES
Low SES
High SES
Unh
ealth
y fo
od c
onsu
mpt
ion
Unh
ealth
y fo
od c
onsu
mpt
ion
…with evidence of an interaction?
“Deprivation amplification”
Exposure by Education - Consumption
Means, 95% CIs adjusted for age, sex, household income, energy intake, car access, weighted journey distance, supermarket availability.
Adapted from Burgoine et al In Preparation
Exposure by Education – Body Mass Index
Means, 95% CIs adjusted for age, sex, smoking status, household income, car access, weighted journey distance, physical activity energy expenditure, supermarket availability.
Adapted from Burgoine et al In Preparation
Conclusions
• Less educated individuals, living in ‘unhealthy’ neighbourhoods, face a particular challenge (deprivation amplification)
• Neighbourhood takeaway food environments matter, across all education groups.
• Results indicate that the association between takeaway exposure and takeaway consumption varies according to level of education
• Environmental interventions may to some extent reduce socio-economic patterning of diet.
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ACKNOWLEDGEMENTS
Thank you to Pablo Monsivais, Nita Forouhi, Simon Griffin, Nick Wareham, Soren Brage.
This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence.
Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, and Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
Centre for Diet and Activity Research