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Article: Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants

TitleAre exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants
Authors
Issue Date2018
PublisherElsevier: Creative Commons. The Journal's web site is located at https://www.thelancet.com/journals/lanplh
Citation
The Lancet Planetary Health, 2018, v. 2, p. e438-e450 How to Cite?
AbstractBackground Rapid urbanisation and associated socioeconomic transformations have modified current lifestyles, shifting dietary preferences towards ready-to-eat, calorie-dense food of poor nutritional quality. The effect of ready-to-eat food environments that sell food for instant consumption on the risk of type 2 diabetes has received scant attention. We therefore aimed to examine the association between exposure to ready-to-eat food environments and type 2 diabetes in a large and diverse population sample. Methods We conducted a cross-sectional study of adult male and female participants from the baseline phase of the UK Biobank cohort. Participants in this cohort were aged 37–73 years and resided in one of 21 cities in the UK. Ready-to-eat food environments, which we determined from a modelled and linked built environment database, were objectively measured within 1-km catchment areas of the residential streets of participants and were expressed as metrics of density and proximity to the participants' homes. We used logistic regression models to examine the associations between exposure to ready-to-eat food environments and the odds of type 2 diabetes, adjusting for individual covariates such as physical activity. As sensitivity analyses, we investigated the associations between the street distance to the nearest ready-to-eat food outlet and type 2 diabetes. We also tested post hoc for effect modification by sex, income, body-mass index, and location of the UK Biobank collection centre. Findings Of 502 635 UK Biobank participants enrolled between March 13, 2006, and Oct 1, 2010, the sample analysed included 347 551 (69·1%) participants. The density of ready-to-eat food environments within a 1-km catchment area was associated with higher odds of type 2 diabetes for participants in the groups with highest exposure to restaurants and cafeterias (odss ratio 1·129, 95% CI 1·05–1·21; p=0·0007) and a composite measure of ready-to-eat outlet density (1·112, 1·02–1·21; p=0·0134) compared with those with no exposure. Exposure to hot and cold takeaways was only significantly associated with higher odds of type 2 diabetes at the second highest exposure category that we examined (1·076, 1·01–1·14; p=0·0171), representing a density of 0·75–2·15 units per km2. A protective effect with distance decay was observed: participants in the highest quintile of street distance to nearest ready-to-eat food outlet reported lower odds of type 2 diabetes than those in the lowest quintile (0·842, 0·78–0·91; p<0·0001 for restaurants and cafeterias; and 0·913, 0·85–0·98; p=0·0173 for hot and cold takeaways). These effects were most pronounced in overweight participants (p=0·0329), but there was no evidence of interaction by sex, income, or UK Biobank collection centre. Interpretation Access to ready-to-eat food environments was positively associated with type 2 diabetes. Top-down policies aimed at minimising unhealthy food access could potentially reduce unhealthy consumption and risks of chronic diseases. Further long-term studies are needed to effectively guide such interventions.
Persistent Identifierhttp://hdl.handle.net/10722/265065
ISSN
2023 Impact Factor: 24.1
2023 SCImago Journal Rankings: 5.057
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSarkar, C-
dc.contributor.authorWebster, CJ-
dc.contributor.authorGallacher, J-
dc.date.accessioned2018-11-20T01:59:29Z-
dc.date.available2018-11-20T01:59:29Z-
dc.date.issued2018-
dc.identifier.citationThe Lancet Planetary Health, 2018, v. 2, p. e438-e450-
dc.identifier.issn2542-5196-
dc.identifier.urihttp://hdl.handle.net/10722/265065-
dc.description.abstractBackground Rapid urbanisation and associated socioeconomic transformations have modified current lifestyles, shifting dietary preferences towards ready-to-eat, calorie-dense food of poor nutritional quality. The effect of ready-to-eat food environments that sell food for instant consumption on the risk of type 2 diabetes has received scant attention. We therefore aimed to examine the association between exposure to ready-to-eat food environments and type 2 diabetes in a large and diverse population sample. Methods We conducted a cross-sectional study of adult male and female participants from the baseline phase of the UK Biobank cohort. Participants in this cohort were aged 37–73 years and resided in one of 21 cities in the UK. Ready-to-eat food environments, which we determined from a modelled and linked built environment database, were objectively measured within 1-km catchment areas of the residential streets of participants and were expressed as metrics of density and proximity to the participants' homes. We used logistic regression models to examine the associations between exposure to ready-to-eat food environments and the odds of type 2 diabetes, adjusting for individual covariates such as physical activity. As sensitivity analyses, we investigated the associations between the street distance to the nearest ready-to-eat food outlet and type 2 diabetes. We also tested post hoc for effect modification by sex, income, body-mass index, and location of the UK Biobank collection centre. Findings Of 502 635 UK Biobank participants enrolled between March 13, 2006, and Oct 1, 2010, the sample analysed included 347 551 (69·1%) participants. The density of ready-to-eat food environments within a 1-km catchment area was associated with higher odds of type 2 diabetes for participants in the groups with highest exposure to restaurants and cafeterias (odss ratio 1·129, 95% CI 1·05–1·21; p=0·0007) and a composite measure of ready-to-eat outlet density (1·112, 1·02–1·21; p=0·0134) compared with those with no exposure. Exposure to hot and cold takeaways was only significantly associated with higher odds of type 2 diabetes at the second highest exposure category that we examined (1·076, 1·01–1·14; p=0·0171), representing a density of 0·75–2·15 units per km2. A protective effect with distance decay was observed: participants in the highest quintile of street distance to nearest ready-to-eat food outlet reported lower odds of type 2 diabetes than those in the lowest quintile (0·842, 0·78–0·91; p<0·0001 for restaurants and cafeterias; and 0·913, 0·85–0·98; p=0·0173 for hot and cold takeaways). These effects were most pronounced in overweight participants (p=0·0329), but there was no evidence of interaction by sex, income, or UK Biobank collection centre. Interpretation Access to ready-to-eat food environments was positively associated with type 2 diabetes. Top-down policies aimed at minimising unhealthy food access could potentially reduce unhealthy consumption and risks of chronic diseases. Further long-term studies are needed to effectively guide such interventions.-
dc.languageeng-
dc.publisherElsevier: Creative Commons. The Journal's web site is located at https://www.thelancet.com/journals/lanplh-
dc.relation.ispartofThe Lancet Planetary Health-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleAre exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants-
dc.typeArticle-
dc.identifier.emailSarkar, C: csarkar@hku.hk-
dc.identifier.emailWebster, CJ: cwebster@hku.hk-
dc.identifier.authoritySarkar, C=rp01980-
dc.identifier.authorityWebster, CJ=rp01747-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/S2542-5196(18)30208-0-
dc.identifier.scopuseid_2-s2.0-85054889400-
dc.identifier.hkuros295880-
dc.identifier.volume2-
dc.identifier.spagee438-
dc.identifier.epagee450-
dc.identifier.isiWOS:000525874800009-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl2542-5196-

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