Frequency of Eating Out at Both Fast-Food and Sit-Down Restaurants Was Associated With High Body Mass Index in Non-Large Metropolitan Communities in Midwest.

PURPOSE: We investigated the associations between frequency of eating at fast-food, fast-casual, all-you-can-eat, and sit-down restaurants and the body mass index (BMI) in non-large metro Wisconsin communities. To inform prevention efforts, we also analyzed the socioeconomic/environmental and nutrition attitudes/behavior variables that may drive the frequent eating away from home.

DESIGN: Cross-sectional analysis of an ancillary data set from the Survey of Health of Wisconsin collected between October 2012 and February 2013.

SETTING: Six Wisconsin counties: 1 classified as rural, 1 as large fringe metro, and 4 as small metro.

SUBJECTS: Adults ≥18 years (N = 1418).

MEASURES: Field staff measured height and weight and administered a survey on the frequency of eating away from home, and socioeconomic and nutritional behavior variables.

ANALYSIS: Multivariable regression.

RESULTS: The BMI of respondents averaged 29.4 kg/m2 (39% obese). Every 1-meal/week increase in fast-food and sit-down restaurant consumption was associated with an increase in BMI by 0.8 and 0.6 kg/m2 , respectively. Unavailability of healthy foods at shopping and eating venues and lack of cooking skills were both positively associated with consumption of fast-food and sit-down meals. Individuals who described their diet as healthy, who avoided high-fat foods, and who believed their diet was keeping their weight controlled did not visit these restaurants frequently.

CONCLUSION: Obesity prevention efforts in non-large metro Wisconsin communities should consider socioeconomic/environmental and nutritional attitudes/behavior of residents when designing restaurant-based or community education interventions.