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Associations Between Fast-Food Consumption and Body Mass Index: A Cross-Sectional Study in Adult Twins

  • Hannah Cohen-Cline (a1), Richard Lau (a2), Anne V. Moudon (a3), Eric Turkheimer (a4) and Glen E. Duncan (a1) (a2)...


Obesity is a substantial health problem in the United States, and is associated with many chronic diseases. Previous studies have linked poor dietary habits to obesity. This cross-sectional study aimed to identify the association between body mass index (BMI) and fast-food consumption among 669 same-sex adult twin pairs residing in the Puget Sound region around Seattle, Washington. We calculated twin-pair correlations for BMI and fast-food consumption. We next regressed BMI on fast-food consumption using generalized estimating equations (GEE), and finally estimated the within-pair difference in BMI associated with a difference in fast-food consumption, which controls for all potential genetic and environment characteristics shared between twins within a pair. Twin-pair correlations for fast-food consumption were similar for identical (monozygotic; MZ) and fraternal (dizygotic; DZ) twins, but were substantially higher in MZ than DZ twins for BMI. In the unadjusted GEE model, greater fast-food consumption was associated with larger BMI. For twin pairs overall, and for MZ twins, there was no association between within-pair differences in fast-food consumption and BMI in any model. In contrast, there was a significant association between within-pair differences in fast-food consumption and BMI among DZ twins, suggesting that genetic factors play a role in the observed association. Thus, although variance in fast-food consumption itself is largely driven by environmental factors, the overall association between this specific eating behavior and BMI is largely due to genetic factors.

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Corresponding author

address for correspondence: Hannah Cohen-Cline, University of Washington, Department of Epidemiology, 1959 NE Pacific Street, Health Sciences Building F-250, PO Box 357236, Seattle, WA 98195-7236, USA. E-mail:


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