Restaurants in the Neighborhood, Eating Away from Home and BMI in China

BACKGROUND To investigate the association between environmental risk factors, eating away from home, and increasing BMI of Chinese adults. METHODS Participants were selected from the recent four waves (2004, 2006, 2009, and 2011) of the China Health and Nutrition Survey (CHNS). 10633 participants, including 5084 men and 5549 women, were used in the analysis. 24-h dietary recall data for three consecutive days with information on the time and place of consumption were collected. Nearby restaurants were measured by the number of fast food outlets, indoor restaurants, and food stands in the neighborhood. Random effects multivariable regression was used to assess associations between these variables. RESULTS People living in neighborhoods with large numbers of indoor restaurants are more likely to eat away from home (p<0.05). Higher frequency of eating away from home is positively associated with BMI, but this effect is only significant for men (p<0.05). Moreover, while eating dinner or breakfast away from home contributes to BMI increase for men (p<0.05), no such association is found for lunch. CONCLUSION Eating dinner and breakfast away from home is positively associated with BMI for Chinese men. Labeling energy and portion size for the dishes served in indoor restaurants is recommended in China.