To test the moderating role of the extent of fast-food restaurants in one's immediate environment in the association between mastery and metabolic risk. Higher sense of mastery (perceived control over one's circumstances) has been associated with better metabolic outcomes. Mastery may be instrumental in resisting unhealthful environmental food cues when these become ubiquitous, resulting in a greater health impact of mastery.
Blood samples were obtained from 344 individuals (50% men), aged 18 to 57 years (mean, 34.9 years), sampled from seven census tracts representing the spectrum of census tract-level socioeconomic status and language (French/English) in Montreal. Risk factors based on standards for high-density lipoprotein and total cholesterol, waist circumference, body mass index, triglycerides, and glycated hemoglobin were summed to obtain a cumulative metabolic risk score. Mastery was self-reported, using a validated scale. The proportion of restaurants classified as fast-food within 500 m of participants' residences was determined, using a geographic information system. Main and interactive effects were tested with Poisson regression, accounting for clustering of observations and participants' age, gender, education, and income.
Mastery interacted with fast-food exposure in relation to metabolic risk (p = .03). Higher mastery was significantly associated with lower metabolic risk for participants surrounded by a high proportion of fast food (relative risk, 0.80; 95% confidence interval, 0.76–0.84; p < .0001), but not for those living in areas with low proportion of fast-food restaurants (relative risk, 0.94; 95% confidence interval, 0.82–1.08; p = .37).
A positive relationship between mastery and lower metabolic risk was most apparent in environments with higher fast-food exposure.
SES = socioeconomic status; GIS = geographic information system; HDL-C = high-density lipoprotein cholesterol.
From the School of Health Sciences (C.P., M.D.), University of South Australia, Adelaide, Australia; Département de médecine sociale et préventive (C.P., L.G., Y.K., M.D.), Université de Montréal, Montréal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (C.P., L.G., Y.K., M.D.), Montréal, QC, Canada; Desautels Faculty of Management (L.D.), McGill University, Montréal, QC, Canada; and Direction de Santé Publique de Montréal (Y.K.), Montréal, QC, Canada.
Address correspondence and reprint requests to Catherine Paquet, PhD, School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia 5001, Australia. E-mail: firstname.lastname@example.org
Received for publication April 12, 2009; revision received November 19, 2009.
Data collection was provided in equal parts through the 1) Canada Research Chairs program and the Canada Foundation for Innovation (Grant 201252, MD); 2) Canadian Institutes of Health Research (Grant 200203 MOP 57805, LG); and 3) Fonds de la Recherche en Santé du Québec (FRSQ) (Team Grant 8394, LD). At the time of this research, C.P. was supported by a postdoctoral fellowship from the Fonds de la Recherche en Santé du Québec; M.D. was supported by a Canada Research Chair for Biopsychosocial Pathways in Population Health, awarded by the Canadian Institutes of Health Research; and Y.K. was supported by a postdoctoral fellowship from the Heart and Stroke Foundation of Canada. L.G. holds a Canadian Institutes for Health Research/Centre de Recherche en Prevention de l'Obésité Chair in Applied Public Health Chair on Neighborhoods, Lifestyle, and Healthy Body Weight. L.D. holds the James McGill Chair in Consumer and Lifestyle Psychology and Marketing. M.D. holds a Research Chair for Social Epidemiology at the University of South Australia.