Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study

Version 1 : Received: 22 September 2021 / Approved: 24 September 2021 / Online: 24 September 2021 (12:51:26 CEST)

How to cite: Green, M.; Hobbs, M.; Ding, D.; Widener, M.; Murray, J.; Reece, L.; Singleton, A. The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study. Preprints 2021, 2021090434 (doi: 10.20944/preprints202109.0434.v1). Green, M.; Hobbs, M.; Ding, D.; Widener, M.; Murray, J.; Reece, L.; Singleton, A. The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study. Preprints 2021, 2021090434 (doi: 10.20944/preprints202109.0434.v1).

Abstract

The aim of our study is to utilise longitudinal and representative national data to explore the extent that the association between the fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Longitudinal data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n=13,469) and 6 (ages 14/15; 2014/15; n=11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations at both ages and explicitly test for confounding. While we found some evidence for an association between the number of fast food outlets and overweight, any associations disappeared following accounting for the confounding nature of neighbourhood deprivation. Neighbourhood deprivation was consistently associated to overweight, with adolescents who resided in deprived areas more likely to be overweight. Results were largely consistent depending on different methodological decisions. Our findings suggest that policy efforts should prioritise focusing on tackling the social determinants of excess body mass which will be more effective than interventions aimed at the built environment.

Keywords

fast food; neighbourhood; deprivation; overweight; obesity; adolesence; confounding

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