Obesity and the Built Environment: Does the Density of Neighborhood Fast-Food Outlets Matter?
Open accessAbstract
Purpose.: Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Design.: Cross-sectional and multilevel design. Setting.: Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon. Subjects.: A total of 1221 residents (mean age, 65 years) recruited randomly from 120 neighborhoods (48% response rate). Measures.: A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass indices (BMI), frequency of visits to local fast food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity. Analyses.: Multilevel logistic regression analyses. Results.: Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI ≥ 30) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density: odds ratios for obesity, 95% confidence intervals (CI), were 1.878 (CI, 1.006–3.496) for weekly visits to local fast food restaurants; 1.792 (CI, 1.006–3.190) for not meeting physical activity recommendations; 1.212 (CI, 1.057–1.391) for low confidence in eating healthy food; and 8.057 (CI, 1.705–38.086) for non-Hispanic black residents. Conclusion.: Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults.
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In Portland, Oregon, adults who lived in neighborhoods with high density of fast-food restaurants and visited these restaurants regularly (at least once per week) had higher prevalence of obesity and weight gain over time.
“In Portland, Oregon, adults who lived in neighborhoods with a high density of fast-food restaurants and visited these restaurants regularly (at least once per week) had a higher prevalence of obesity309 and weight gain over time310”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [309]
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- Authors
- Li, F., Harmer, P., Cardinal, B. J., Bosworth, M., & Johnson-Shelton, D.
- Affiliations
- Oregon State University (US)
- Fuzhong Li, PhD; and Deb Johnson-Shelton, PhD, are with the Oregon Research Institute, Eugene, Oregon. Peter Harmer, PhD, MPH, is with the Department of Exercise Science, Willamette University, Salem, Oregon. Bradley J. Cardinal, PhD, is with the Department of Nutrition and Exercise Science, Oregon State University, Corvallis, Oregon. Mark Bosworth, MS, is with Metro Regional Services, Portland, Oregon
- Corresponding author
- Li, Fuzhong
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2009-01
- Volume
- 23
- Issue
- 3
- Pages
- 203-209
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- PMC
- PMC2730045
- OpenAlex
- W2157261925
- Cited by
- 234
- References
- 45
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 14 · 2021: 4 · 2020: 22 · 2019: 16 · 2018: 10 · 2017: 14 · 2016: 13 · 2015: 14 · 2014: 18 · 2013: 20 · 2012: 20
- FWCI
- 19.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Environmental Health Sciences (R01ES014252)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Transportation › Urban Transport and Accessibility
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- obesity, built environment, older adults, body mass index, physical activity, self-efficacy, fried food consumption, neighborhood characteristics, racial and ethnic disparities, psychosocial factors, Portland, Oregon
- MeSH terms
- Aged, Anthropometry, Cooking, Dietary Fats, Environment Design, Feeding Behavior, Female, Humans, Male, Middle Aged, Obesity, Oregon, Residence Characteristics, Restaurants, Socioeconomic Factors, Urban Health, Body Mass Index, Self Efficacy, Geographic Information Systems
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