Fast Food in Slow Towns: Does Rural Living Lead to Healthier Eating

September 27, 2012
Lebanon, NH

Ever wonder whether the presence of fast-food restaurants influence families' eating habits - especially families with adolescent children? What if they live in a small Vermont town with no pizza delivery, doughnut shop, or burger joint?

Researchers at Dartmouth-Hitchcock Norris Cotton Cancer are trying to learn more about the relationships between environment and dietary behaviors. In a study recently published in the  American Journal of Preventive Medicine, the research team examined how often adolescents and their parents who live in primarily rural areas ate at fast-food chain restaurants and what factors played a role in that decision.

"Our study illustrated that the impact of environment on a family's diet is complex," says Meghan Longacre, the lead author on the paper. Longacre is a member of the Cancer Control Program at Norris Cotton Cancer Center and research assistant professor with the Community Health Research Program at the Hood Center for Children and Families at the Geisel School of Medicine at Dartmouth.

Where Vermont  and New Hampshire families eat out

Through a series of phone surveys, the researchers found that more than half (52 percent) of the adolescents ages 12-18 and about one third (34 percent) of parents ate fast food in the past week. The team found that the number of fast food outlets in their residential town was one of the leading determinants of how often adolescents and their parents ate at these restaurants.

The study included 1,547 parent/adolescent pairs and covered 32 towns in Vermont and New Hampshire with varying numbers of fast-food restaurants, some with none and others with more than five.

"The most striking finding was that the influence of in-town fast-food restaurants was strongest among families with limited access to a family car," says Longacre. In households with few transportation options, adolescents were 69 percent more likely to eat fast food if they lived in a town with 5 or more fast food restaurants compared to no restaurants. In comparison, in households with many transportation options, adolescents in these same towns were 27 percent more likely to eat fast food.

Longacre, who's been part of this research team for eight years, explains that most of the research examining environmental influences on diet has been done in urban areas. "Our findings demonstrate that family resources are particularly important to consider when examining environmental influences in rural areas." The study didn't include local, non-chain restaurants, such as pizza shops, or convenience stores. "However, these venues offer similar types of food," says Longacre, "and may also be linked with a higher risk of obesity."

The research team was funded by the National Institute of Environmental Health Sciences to examine environmental influences on diet, physical activity, and obesity.

About Norris Cotton Cancer Center at Dartmouth-Hitchcock

Norris Cotton Cancer Center combines advanced cancer research at Dartmouth College and the Geisel School of Medicine at Dartmouth with patient-centered cancer care provided at Dartmouth-Hitchcock Medical Center, at Dartmouth-Hitchcock regional locations in Manchester, Nashua, and Keene, NH, and St. Johnsbury, VT, and at 12 partner hospitals throughout New Hampshire and Vermont. It is one of 41 centers nationwide to earn the National Cancer Institute's "Comprehensive Cancer Center" designation. Learn more about Norris Cotton Cancer Center research, programs, and clinical trials online at

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