Frontiers in Nutrition · Oct 31, 2026
Mobility-Derived Fast-Food Visitation and Obesity Among Adults: Evidence from the Houston Methodist Cardiovascular Disease Learning Health System Registry
By Sarayu Chandra Mouli, Samuel Yousefzai, Pedro Rafael Vieira De Oliveira Salerno et al.
Background Neighborhood food environments may contribute to obesity risk, but traditional measures of restaurant density or proximity do not capture population behavior. Mobility-derived visitation data may better characterize real-world engagement with food environments. We evaluated the association between neighborhood fast-food visitation patterns and obesity in a large metropolitan health system. Methods We conducted a cross-sectional study of adults aged ≥18 years in the Houston Methodist Cardiovascular Disease Learning Health System Registry. Patients were linked by residential census tract to Advan Research mobility data. Fast-food visitation share was defined as the proportion of food-related visits attributable to fast-food establishments. Obesity was defined as body mass index ≥30 kg/m² using the first available measurement. Multilevel logistic regression with census-tract random intercepts estimated odds ratios (ORs) across visitation-share quartiles, sequentially adjusting for demographics, neighborhood Social Vulnerability Index, and smoking. Tract-level correlations were examined using EHR-derived obesity proportion and CDC PLACES obesity prevalence. Results Among 1,033,824 adults, obesity prevalence increased from 33.7% in the lowest quartile of neighborhood fast-food visitation share to 44.4% in the highest (p < 0.001). Compared with those residing in neighborhoods within the lowest quartile, participants residing in neighborhoods within the highest quartile had greater odds of obesity in the unadjusted multilevel model (OR, 1.42; 95% CI, 1.32–1.53) and after full adjustment (OR, 1.40; 95% CI, 1.32–1.49). Fast-food visitation share was positively correlated with EHR-derived obesity proportion (r = 0.28) and CDC PLACES obesity prevalence (r = 0.17; both p < 0.001). Conclusions Greater neighborhood fast-food visitation share was associated with higher obesity proportion and odds of obesity. Mobility-derived visitation measures may complement traditional proximity-based food-environment metrics and inform obesity prevention efforts.