title: Eating at fast-food restaurants is associated with dietary intake, demographic, psychosocial and behavioural factors among African Americans in North Carolina.
abstract: OBJECTIVE
  To examine associations of the frequency of eating at fast-food restaurants with demographic, behavioural and psychosocial factors and dietary intake in African American adults.
  
  
  METHODS
  Self-reported data from a population-based cross-sectional survey of 658 African Americans, aged 20-70 years, in North Carolina. An 11-page questionnaire assessed eating at fast-food restaurants, demographic, behavioural and diet-related psychosocial factors, and dietary intake (fruit, vegetable, total fat and saturated fat intakes, and fat-related dietary behaviours).
  
  
  RESULTS
  The participants were aged 43.9+/-11.6 years (mean+/-standard deviation), 41% were male, 37% were college graduates and 75% were overweight or obese. Seventy-six per cent reported eating at fast-food restaurants during the previous 3 months: 4% usually, 22% often and 50% sometimes. Frequency of eating at fast-food restaurants was positively associated with total fat and saturated fat intakes and fat-related dietary behaviours (P<0.0001) and inversely associated with vegetable intake (P<0.05). For example, mean daily fat intake was 39.0 g for usually/often respondents and 28.3 g for those reporting rare/never eating at fast-food restaurants. Participants who reported usual/often eating at fast-food restaurants were younger, never married, obese, physically inactive and multivitamin non-users (all P<0.01). Frequency of eating at fast-food restaurants was positively associated with fair/poor self-rated health, weak belief in a diet-cancer relationship, low self-efficacy for healthy eating, weight dissatisfaction, and perceived difficulties of preparing healthy meals and ordering healthy foods in restaurants (all P<0.05). Frequency of eating at fast-food restaurants did not differ significantly by sex, education, smoking, ability to purchase healthy foods or knowledge of the Food Guide Pyramid.
  
  
  CONCLUSIONS
  Eating at fast-food restaurants is associated with higher fat and lower vegetable intakes in African Americans. Interventions to reduce fast-food consumption and obesity in African Americans should consider demographic and behavioural characteristics and address attitudes about diet-disease relationships and convenience barriers to healthy eating.
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. jessie.satia@amgen.com
authors.forename: Jessie A
authors.initials: JA
authors.lastname: Satia
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Galanko
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage*; D005260:Female; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D052756:Nutritional Sciences / Q000193:education; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D012147:Restaurants; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D004041:Dietary Fats