Obesity and food away from home: What drives the socioeconomic gradient in excess body weight?

Rising obesity rates are one of the most challenging public health issues in many emerging economies. To what extent food away from home (FAFH) and its nutritional components are behind this rise is not yet well understood. To address the issue, this paper combines a representative restaurant survey that includes detailed information on the diet quality of the most widely consumed meals and their nutritional components from 1605 restaurants and a representative household survey with anthropometric measures of adult women living in 40 neighborhoods in the Lima Metropolitan Area. One important advantage of the dataset is the fact that nutrition professionals observed the preparation of the meals and that they were subject to a detailed laboratory analysis. Exploiting this data, we examine the differences in nutritional quality of FAFH among 40 neighborhoods of various socioeconomic groups and explore whether these differences can explain part of the observed socioeconomic gradient in excess body weight. The findings indicate that less healthy food in restaurants located in the food environment of the households is significantly associated with higher rates of obesity and overweight. In particular, the high supply and intake of sodium potentially drives higher excess body weight. The study also finds that up to 15 percent of the socioeconomic gradient in obesity is attributable to the restaurant food quality in the food environment of the households.