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van Erpecum CPL, van Zon SKR, Bültmann U, Smidt N. Effects of changes in residential fast-food outlet exposure on Body Mass Index change: longitudinal evidence from 92,211 Lifelines participants. Int J Behav Nutr Phys Act 2024; 21:31. [PMID: 38486265 PMCID: PMC10941418 DOI: 10.1186/s12966-024-01577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Evidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline. METHODS We used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p < 0.10. RESULTS Participants who had an increase in the number of fast-food outlets within 1 km had a greater BMI increase (B(95% CI): 0.003 (0.001,0.006)). Decreases in fast-food outlet exposure were not associated with BMI change (B(95% CI): 0.001 (-0.001,0.004)). No clear moderation pattern by age or fast-food outlet exposure at baseline was found. CONCLUSIONS Increases in residential fast-food outlet exposure are associated with BMI gain, whereas decreases in fast-food outlet exposure are not associated with BMI loss. Effect sizes of increases in fast-food outlet exposure on BMI change were small at individual level. However, a longer follow-up period may have been needed to fully capture the impact of increases in fast-food outlet exposure on BMI change. Furthermore, these effect sizes could still be important at population level considering the rapid rise of fast-food outlets across society. Future studies should investigate the mechanisms and changes in consumer behaviours underlying associations between changes in fast-food outlet exposure and BMI change.
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Affiliation(s)
- Carel-Peter L van Erpecum
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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Ahrens W, Brenner H, Flechtner-Mors M, Harrington JM, Hebestreit A, Kamphuis CBM, Kelly L, Laxy M, Luszczynska A, Mazzocchi M, Murrin C, Poelman MP, Steenhuis I, Roos G, Steinacker JM, van Lenthe F, Zeeb H, Zukowska J, Lakerveld J, Woods CB. Dietary behaviour and physical activity policies in Europe: learnings from the Policy Evaluation Network (PEN). Eur J Public Health 2022; 32:iv114-iv125. [PMID: 36444106 PMCID: PMC9706119 DOI: 10.1093/eurpub/ckac148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The European Policy Evaluation Network (PEN), initiated in autumn 2018, aimed at advancing the evidence base for public policies impacting dietary behaviour, physical activity and sedentary behaviours in Europe. This is needed because non-communicable diseases-the leading cause of global mortality-are substantially caused by physical inactivity and unhealthy dietary behaviours, which in turn are driven by upstream factors that have not yet been addressed effectively by prevention approaches. Thus, successful policy interventions are required that target entire populations and tackle the 'causes of the causes'. To advance our knowledge on the effective implementation of policies and their impact in terms of improving health behaviours, PEN focused on five research tasks: (i) Adaptation and implementation of a Food Environment Policy Index (Food-EPI) and development of a Physical Activity Environment Policy Index (PA-EPI); (ii) Mapping of health-related indicators needed for policy evaluation and facilitating a harmonized pan-European approach for surveillance to assess the impact of policy interventions; (iii) Refining quantitative methods to evaluate the impact of public policies; (iv) Identifying key barriers and facilitators of implementation of policies; and (v) Advance understanding the equity impact of the development, implementation and evaluation of policies aimed at promoting physical activity and a healthy diet. Finally, and in order to provide concrete evidence for policymaking, existing exemplary policies, namely sugar-sweetened beverages taxation, active transport policies and school policies on nutrition and physical activity were assessed in consideration of these five tasks. At the end of the PEN project's formal runtime, considerable advancements have been made. Here, we present an overview of the most important learnings and outputs.
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Affiliation(s)
- Wolfgang Ahrens
- Correspondence: Wolfgang Ahrens, Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Achterstrasse 30, 28359 Bremen, Germany, Tel: +49 421 218 56822, e-mail:
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marion Flechtner-Mors
- Division of Sports and Rehabilitation Medicine, Department of Medicine, University Hospital Ulm, Ulm, Germany
| | - Janas M Harrington
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Michael Laxy
- Technical University of Munich, Professorship of Public Health and Prevention, Munich, Germany
| | | | - Mario Mazzocchi
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
| | - Ingrid Steenhuis
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute De Boelelaan 1085, VU University Amsterdam, Amsterdam, The Netherlands
| | - Gun Roos
- Consumption Research Norway, Oslo Metropolitan University, Oslo, Norway
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Medicine, University Hospital Ulm, Ulm, Germany
| | - Frank van Lenthe
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Human Geography and Public Health, Utrecht University, Utrecht, The Netherlands
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany,Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
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Romaniuk P, Kaczmarek K, Brukało K, Grochowska-Niedworok E, Łobczowska K, Banik A, Luszczynska A, Poelman M, Harrington JM, Vandevijvere S. The Healthy Food Environment Policy Index in Poland: Implementation Gaps and Actions for Improvement. Foods 2022; 11:foods11111648. [PMID: 35681398 PMCID: PMC9180244 DOI: 10.3390/foods11111648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Poland is facing the growing problem of overweight and obesity in the population, which makes it necessary to conduct a thorough assessment of the existing food environment policies. The aims of the study were: (1) to depict the strength of healthy food environment policies in Poland and identify implementation policies and infrastructure support gaps; (2) to identify and prioritise improvement policies, taking into account their importance, achievability and equity. Methods: We used the Healthy Food Environment Policy Index (Food-EPI). An experts’ panel rated Polish policies and infrastructure compared to international best practices and developed a list of recommended improvement actions addressing both components. Results: eight of the twenty-two policy and four of the twenty-two infrastructure indicators achieved the “no/very weak policy” result. Another four policy and five infrastructure indicators were considered “weak”. Another seven and eight indicators, respectively, were assessed as “moderate”. Among the identified actions, the highest priority was given to a food labelling system and training for persons involved in nutrition in schools. Conclusions: The Polish healthy food environment has been assessed as very weak or weak in most aspects. The infrastructure was assessed as slightly better compared to the policies domain, with more indicators receiving the “moderate” score.
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Affiliation(s)
- Piotr Romaniuk
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
| | - Krzysztof Kaczmarek
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
- Correspondence:
| | - Katarzyna Brukało
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
| | - Elżbieta Grochowska-Niedworok
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Jordana Street 19, 41-808 Zabrze, Poland;
| | - Karolina Łobczowska
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
| | - Anna Banik
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
| | - Aleksandra Luszczynska
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
- Lyda Hill Institute for Human Resilience, University of Colorado at Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80918, USA
| | - Maartje Poelman
- Consumption and Healthy Lifestyles, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, The Netherlands;
| | - Janas M. Harrington
- School of Public Health, University College Cork, T12 XF62 Cork City, Ireland;
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1142, New Zealand;
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