Association between access to full-service restaurants and childhood obesity.


Jia P(1)(2)(3), Yang H(4), Cao X(4), Yuan C(3)(5), Xiao Q(3)(6), Yang S(3)(7), Wang Y(4).
Author information:
(1)Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.
(2)Faculty of Geo-Information Science and Earth Observation, University of Twente, Enschede, The Netherlands.
(3)International Institute of Spatial Lifecourse Epidemiology
(ISLE), Hong Kong, China.
(4)Department of Health Service Management, School of Public Health, Tianjin Medical University, Tianjin, China.
(5)The Children's Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
(6)Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
(7)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.


The lack of access to full-service restaurants (FSRs) is generally thought to be a risk factor for childhood obesity, as it could discourage healthful eating-out behaviours while increasing the exposure to unhealthful food venues as "compensatory" options. However, the association between FSR access and childhood obesity has not been comprehensively reviewed previously. A literature search was conducted on PubMed and Web of Science for articles published before 1 January 2019 that examined the association between FSR access and weight-related behaviours and outcomes among children and adolescents. Eighteen studies conducted in three countries were identified, published from 2006 to 2018 with a median sample size of 2352 (ranging from 323 to 529 367). Findings were mixed among these 18 studies that reported on the association between access to FSRs and weight-related outcomes. Our meta-analyses showed that there were no significant associations of FSR access with the level of body mass index (BMI) and the BMI z-score among children. Also, there was no apparent evidence on the association between FSR access and the risk of overweight/obesity. Our results need to be interpreted with caution, considering the menu quality of FSRs and heterogeneity of eligible studies in this meta-analysis. Well-designed epidemiologic studies are warranted to further elaborate on the potential association between FSR access and children's weight status.