title: The relationship between obesity and the prevalence of fast food restaurants: state-level analysis.
abstract: OBJECTIVE
  Obesity accounts for approximately 300,000 deaths a year in the United States, and prevalence rates have been increasing over the past decade. The nutrition environment may be contributing to this epidemic. This study examined the relationship between fast food restaurants and obesity on a state-wide basis.
  
  
  METHODS
  A one-time cross-sectional analysis of secondary data was used for this study.
  
  
  METHODS
  The setting for this study was the United States.
  
  
  METHODS
  State-level data were used as the unit of analysis. Alaska was excluded as an outlier, and the District of Columbia was added (N = 50).
  
  
  METHODS
  Measures included aggregate state-level means for square miles per fast food restaurant, population per fast food restaurant, population density, ethnicity, age, gender, physical inactivity, fruit and vegetable intake, and obesity rates. Data were obtained from the 2002 Behavioral Risk Factor and Surveillance Survey, the 2000 U.S. Census, and the 2002 U.S. Yellow Pages.
  
  
  RESULTS
  Multiple hierarchal regressions revealed that square miles per fast food restaurants and residents per restaurant accounted for 6% of the variance in state obesity rates after controlling for population density, ethnicity, age, gender, physical inactivity, and fruit and vegetable intake. The entire model explained 70% of the total variance in state obesity rates.
  
  
  CONCLUSIONS
  These results indicate a correlational relationship between both the number of residents per fast food restaurant and the square miles per fast food restaurants with state-level obesity prevalence. Limitations include the use of correlational aggregate data.
authors.affiliation: University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA. jmaddock@hawaii.edu
authors.forename: Jay
authors.initials: J
authors.lastname: Maddock
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011156:Population Density; D015995:Prevalence; D012044:Regression Analysis; D012147:Restaurants / Q000145:classification*; D014481:United States / Q000453:epidemiology; D014675:Vegetables