Effect of fast-food environments on children's eating behaviour: A random effect within between analysis within the Generation R Study

Focussing on appetitive traits associated with obesity, this study aimed to estimate the association between the fast-food environment and satiety responsiveness, enjoyment of food and food responsiveness. We used data from the Generation R Study. We included 2008 children with repeated measurements at the age of 4-10 years old. Three eating behaviour subscales from the Child Eating Behaviour Questionnaire (CEBQ) were used as outcomes. Geographical Information System data were used to map individual-level exposure to fast-food outlets within 400 m from home. Random Effect Within Between (REWB) models were used to derive estimates. We tested for moderation of the associations with parental restriction at baseline using the parent-reported Child Feeding Questionnaire (CFQ). We did not find evidence of between-associations of fast-food exposure and eating behaviour subscales. Considering within-associations, an increase in absolute fast-food exposure was associated with a significant marginal increase in satiety responsiveness (β: 0.02 [95% confidence interval: 0.00-0.03]). No moderation by parental restriction was found. In environments with ubiquitous fast-food outlets, an increased exposure to fast-food outlets does not seem to have a substantial impact on eating behaviour. Further research is needed to better understand how fast-food exposure contributes to overweight.