Quick-Service Restaurant Density and Relation to Obesity and Disease Rates

Background/Objectives: Quick-service restaurants (QSRs), food establishments that focus on efficient “on-the-go” service, are prevalent in the USA and have seen significant growth in the past decade due to its convenience, inexpensiveness, and food palatability. Obesity and other chronic diseases can have multifactorial contributing factors, one of which being environmental factors, notably available food sources such as supermarkets and restaurants. However, it is unclear the relation between the presence of subcategories of QSRs and the prevalence of certain common comorbidities. This study aims to assess the relationship between QSR density and the prevalence of obesity, hypertension (HTN), and type 2 diabetes mellitus (DM). Subjects/Methods : A cross-sectional analysis was conducted using data on adults in the United States. State-level disease prevalence in 2022 was obtained from the Trust for America’s Health 2023 State of Obesity Report . Restaurant density data by state were obtained from online databases, restaurant websites, and the US Census Bureau. Total QSR density by state, along with subcategory densities of “Burger,” “Pizza,” “Breakfast/Dessert,” and individual chain restaurants, were analyzed. Linear regression models were created, and statistical significance was determined using correlation coefficient and sample size. Results : There was a significant positive correlation between overall QSR density and the rate of DM across the country ( P  = 0.007). QSR subset analysis revealed significant positive correlations between each QSR subcategory and obesity, HTN, and DM (all P  < 0.05), with the exception of DM with Subway ( P  = 0.100). Conclusions : These significant positive relationships between obesity rates and comorbidities with QSR prevalence may indicate an example of the influence of the surrounding environment on disease rates. These patterns may serve to promote future endeavors to change the restaurant industry in order to improve health outcomes.