Abstract
OBJECTIVES: Evidence shows that diet-related outcomes are influenced by the food environment. However, individuals with better cooking skills may be less dependent on what is available in their food environment. We examined whether the relation between the food environment around home and work and frequency of home cooking, diet quality and body mass index were modified by the level of cooking skills among Dutch adults. METHODS: Our study included 1782 Dutch adults aged 18–65 years, who participated in a cross-sectional survey. We measured the number of food retailers in a 1000m buffer around home and work and distinguished between counts of restaurants and food stores. These counts were summed and divided into quartiles. Participants reported their frequency of home cooking per week (≤ 5 days and 6–7 days) and completed a validated food frequency questionnaire, assessing adherence to the Dutch Healthy Diet score (0–150 points). Body mass index, based on reported length and weight, was categorized into < 25 kg/m(2) and ≥25 kg/m(2). Cooking skills score (1–5) was assessed using a validated questionnaire and added as interaction term to the linear and logistic regression models. We adjusted for age, sex, energy intake, education, income, household size, and urbanization. RESULTS: No significant effect modification was found between the food environment and cooking skills in relation to any of the outcomes (P-interaction >0.1). After adjustment for confounders, neither the count of restaurants or food stores was consistently associated with the frequency of home cooking. In adjusted models, participants having the most food stores around their home and work (>27 stores per 1000 square meter, quartile 4) had a 3.29 higher diet score (95%CI:0.20–6.39), compared to those in quartile 1. Furthermore, participants having the most food stores (>27/1000 square meter, quartile 4) and restaurants (>125/1000 square meter, quartile 4) had lower odds of being overweight, compared with those in quartile one: OR = 0.53 (95%CI:0.36–0.80) and OR = 0.63 (95%CI:0.42–0.94). CONCLUSIONS: Being exposed to many supermarkets and restaurants was associated with a better diet score and lower odds of being overweight, but not modified by the level of cooking skills. FUNDING SOURCES: The Eet & Leef study was funded by an NWO VENI grant on “Making the healthy choice easier–role of the local food environment”.