Fast Food Access and Family Habits

When a town has no traffic lights, pizza delivery or drive-through windows... Does rural living lead to healthier eating?

Focus article photo

Ever wonder whether the presence of a fast-food restaurant influences family eating habits—especially families with adolescent children? Consider this question in a rural setting. Does that make a difference? What should doctors and public health officials know to help their patients and their communities?

Researchers at Dartmouth-Hitchcock Norris Cotton Cancer are trying to learn more about the relationships between environment and dietary behaviors. In a study published in the June 2012 issue of 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.

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.

What matters most? Access to wheels or a drive-through window?

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.

Fast food: urban versus rural

Longacre, who's been part of this research team for 8 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.

September 24, 2012