Discussion
obesity, muscle mass, Eating behaviour traits, eating and cognitive restraint, adiposity, eating
OBESITY, ADIPOSITY
In a sample of almost 5000 UK adults, we found that takeaway outlet exposure as well as emotional eating and uncontrolled eating were positively associated to both takeaway consumption and body fat percentage. We also found that cognitive restraint was negatively associated with takeaway consumption, but positively associated with body fat percentage. Eating behaviour traits partly moderated the association between takeaway outlet exposure and takeaway consumption and body fat percentage. Specifically, uncontrolled eating did not moderate the association between takeaway outlet exposure, and takeaway consumption and body fat percentage. Cognitive restraint moderated the association between takeaway outlet exposure and takeaway consumption, and emotional eating moderated the association between takeaway outlet exposure and body fat percentage. Namely, the association between takeaway outlet exposure and takeaway consumption was somewhat stronger for individuals with high cognitive restraint scores compared to lower cognitive restraint scores. Furthermore, the association between takeaway outlet exposure and body fat percentage was somewhat stronger for individuals with low emotional eating scores compared to higher emotional eating scores. However, these effects were small in all cases.While the evidence base with regards to the association between exposure to food outlets in residential neighbourhoods and dietary behaviours is generally mixed [We found some evidence of effect modification by cognitive restraint and emotional eating, but not uncontrolled eating. Furthermore, the moderating role of emotional eating and cognitive restraint on the association between takeaway outlet exposure, and takeaway consumption and adiposity was relatively small. As the evidence for interaction was not consistent across potential moderators and outcomes, and given the number of tests performed, it is possible that our findings are based on chance. The small moderating role of cognitive restraint and emotional eating is, however, not surprising as takeaway outlets are responsible for only a small amount of the variance in adiposity. Also, the direction of the effect modification is not surprising, which we explain in the following paragraphs.Cognitive restraint was negatively associated with reported takeaway consumption, but positively associated with body fat percentage. Given the positive association between takeaway consumption and body weight [In the current analysis, emotional eating was positively associated with both takeaway consumption and body fat percentage. Contrary to the aforementioned study [The current study results suggest that those exposed to the most takeaway outlets are at an increased risk of adiposity than those exposed to the least takeaway outlets. Thus, intervening on eating behaviour traits alone to improve health outcomes will not remove the negative influence the current obesogenic environment has on these health outcomes. The reverse is also true; intervening only on the food environment will not remove all individual differences in dietary behaviours and adiposity. As such, there is a need to implement integrated strategies addressing both individual and environmental influences on dietary behaviours. Multiple interventions at different levels of influence need to be implemented to reduce unhealthy dietary behaviours and obesity levels, including downstream approaches targeting individuals most at risk (e.g. mindfulness meditation for high emotional eaters [Our study has several strengths including having extensively measured diet, body weight, adiposity and the food environment. In particular, we used an objective imaging method to measure adiposity instead of BMI which is, among other things, unable to differentiate between fat mass and muscle mass [Besides longitudinal studies, further research is needed in different populations to confirm the current study results. This research may use other, more reliable or complementary, eating behaviour trait measurements such as the new version of the TFEQ (TFEQ-R21 [