title: Diet in the Digital Food Environment: Food Ordering Impacts and Wellbeing in Urban Chinese
Creators: name: Zou, Yuanyi
Publisher: name: University of Liverpool Repository
Year: 2026

description: As China's megacities approach the culmination of their urbanization trajectory, the ascent of online-to-offline (O2O) take-out food consumption is profoundly reshaping the lifestyle patterns and dietary practices of urban dwellers. This trend is concurrently engendering a multifaceted urban foodscape wherein the traditional food environment converges with the burgeoning digital food environment. Particularly accentuated in the aftermath of the COVID-19 pandemic, urban residents have increasingly leaned on convenient online ordering and delivery modalities, minimizing or eliminating physical interactions.
While extensive research has elucidated the associations between general dietary behaviors and heightened risks to physical health, including overweight and obesity, as well as adverse mental well-being outcomes, scant attention has been directed towards discerning the specific health ramifications of O2O take-out food. Moreover, there remains a dearth of understanding regarding how the urban food environment, especially the nascent digital food environment, influences O2O take-out food consumption behaviors.
This study endeavors to address existing research lacunae by pursuing several key objectives. Firstly, it seeks to comprehensively delineate the diverse array of characteristics underpinning O2O take-out food consumption behaviors among Chinese urban residents. Secondly, it aims to scrutinize the ramifications of take-out food consumption on the rates of overweight and obesity and the manifestation of adverse subjective well-being among urban denizens. Thirdly, the study endeavors to elucidate and substantiate potential mediating mechanisms inherent within this nexus. Fourthly, it endeavors to scrutinize the influence exerted by distinct types of urban food environments on O2O take-out food consumption behaviors.
The survey of this research adopted a cross-sectional design and recruited participants from the metropolitan areas of Shanghai and Suzhou through an online structured survey questionnaire. A total of 716 valid respondents were included in the study cohort. Data for each variable primarily relied on self-reported information. For instance, participants' weight status was determined using the Body Mass Index (BMI) calculated from self-reported height and weight. Subjective well-being was assessed using the Personal Well-being Index-Adults (PWI-A), while various aspects of O2O take-out food consumption behavior were measured using a self-established five-level Likert scale. Evaluation of the urban food environment was primarily based on participants' subjective perceptions. In terms of data analysis, a range of techniques was employed, including linear regression models, binary logistic regression models, hierarchical regression models, and Bootstrap sampling tests. Additionally, Cronbach's alpha and Exploratory Factor Analysis (EFA) were utilized to assess the reliability and validity of the dietary-related questions to O2O take-out food consumption.
Regarding the study findings, several notable outcomes emerged. Firstly, the findings revealed a positive correlation between frequent O2O take-out consumption and heightened risks of overweight and obesity. Specifically, a predilection for and frequent indulgence in Western-style fast-food positively contributed to the likelihood of being overweight and obese. Conversely, while an initial association between a preference for Chinese-style fast-food and reduced risks of overweight and obesity was observed, this association attenuated when accounting for non-O2O take-out food consumption behaviors.
Secondly, multiple instances indicated a negative association between the frequency of weekly take-out food consumption and subjective well-being, alongside a positive correlation between a preference for ordering vegetables and fruits and subjective well-being. Notably, irrespective of weight status and physical activity levels, respondents' inclination towards Western-style fast food take-out exerted a detrimental effect on subjective well-being.
Thirdly, traditional urban environmental factors, particularly the presence of diverse food outlets, exhibited a consistent and noteworthy influence on O2O take-out food consumption behaviors. Specifically, the availability of supermarkets vending fresh food demonstrated a recurrent negative correlation with the frequency or inclination to order various types of take-outs. Similarly, the availability of vegetable markets or stores was associated with a decreased propensity to opt for Chinese fast-food take-outs. Conversely, an increase in the presence of traditional restaurants correlated with a diminished preference for ordering Western fast-food take-outs. Moreover, easier accessibility to fast-food outlets tended to heighten the preference for ordering Western or Chinese fast-food take-outs, respectively. Contrarily, digital food environment factors showcased limited impacts on O2O take-out food consumption behaviors.