Neighborhood influences on overweight and obesity

The fast-food environment may influence the development of overweight, which is a key risk factor for non-communicable diseases. Due to mixed evidence and a United States focus of the research base, the effect of the fast-food environment in the Netherlands is unclear. Therefore, this study aims to investigate the association between neighborhood fast-food outlet exposure and overweight in the Dutch adult general population. Furthermore, we will examine whether this association is mediated by daily caloric intake.
Baseline Lifelines adult cohort study participant addresses will be linked to LISA (employer register) data of 2012, containing fast-food outlet locations. In this way, individualized fast-food density and proximity measures will be calculated and subsequently linked to measures of overweight. Multilevel analysis will be conducted to examine the association between neighbourhood fast-food measures and overweight. We will adjust for relevant sociodemographic and neighbourhood factors. We will perform mediation analysis to investigate the mediating role of daily caloric intake within this association. Finally, we will run several sensitivity analyses to assess the robustness of results.