Density Of Fast Food Outlets Research Articles

Built environment and childhood obesity.

Childhood obesity, an escalating global health challenge, is intricately linked to the built environment in which children live, learn, and play. This review and perspective examined the multifaceted relationship between the built environment and childhood obesity, offering insights into potential interventions for prevention. Factors such as urbanization, access to unhealthy food options, sedentary behaviors, and socioeconomic disparities are critical contributors to this complex epidemic. Built environment encompasses the human-modified spaces such as homes, schools, workplaces, and urban areas. These settings can influence children's physical activity levels, dietary habits, and overall health. The built environment can be modified to prevent childhood obesity by enhancing active transportation through the development of safe walking and cycling routes, creating accessible and inviting green spaces and play areas, and promoting healthy food environments by regulating fast-food outlet density. School design is another area for intervention, with a focus on integrating outdoor spaces and facilities that promote physical activity and healthy eating. Community engagement and education in reinforcing healthy behaviors is necessary, alongside the potential of technology and innovation in encouraging physical activity among children. Policy and legislative support are crucial for sustaining these efforts. In conclusion, addressing the built environment in the fight against childhood obesity requires the need for a comprehensive, multipronged approach that leverages the built environment as a tool for promoting healthier lifestyles among children, ultimately paving the way for a healthier, more active future generation.

Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys.

We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts. For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities. The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women. Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.

Population mobility data provides meaningful indicators of fast food intake and diet-related diseases in diverse populations

The characteristics of food environments people are exposed to, such as the density of fast food (FF) outlets, can impact their diet and risk for diet-related chronic disease. Previous studies examining the relationship between food environments and nutritional health have produced mixed findings, potentially due to the predominant focus on static food environments around people’s homes. As smartphone ownership increases, large-scale data on human mobility (i.e., smartphone geolocations) represents a promising resource for studying dynamic food environments that people have access to and visit as they move throughout their day. This study investigates whether mobility data provides meaningful indicators of diet, measured as FF intake, and diet-related disease, evaluating its usefulness for food environment research. Using a mobility dataset consisting of 14.5 million visits to geolocated food outlets in Los Angeles County (LAC) across a representative sample of 243,644 anonymous and opted-in adult smartphone users in LAC, we construct measures of visits to FF outlets aggregated over users living in neighborhood. We find that the aggregated measures strongly and significantly correspond to self-reported FF intake, obesity, and diabetes in a diverse, representative sample of 8,036 LAC adults included in a population health survey carried out by the LAC Department of Public Health. Visits to FF outlets were a better predictor of individuals’ obesity and diabetes than their self-reported FF intake, controlling for other known risks. These findings suggest mobility data represents a valid tool to study people’s use of dynamic food environments and links to diet and health.

8.A. Round table: An exploration of the EAT Lancet Commission on healthy diets for sustainable food systems

Abstract Sustainable food systems are those that are healthy, sustainable, and equitable, while also addressing environmental challenges. The 2019 EAT-Lancet Commission on Healthy Diets for Sustainable Food Systems provides comprehensive recommendations for transforming the global food system to address malnutrition, reduce the use of antibiotics in animal agriculture, environmental degradation and climate change. However, the implementation of the EAT-Lancet recommendations has been slow and uneven across different regions and sectors. Holistic approaches to achieve food system sustainability are needed, emphasising the interconnectedness of different systems and the need for multidisciplinary approaches. One Health, Health Impact Assessment (HIA), and mandatory food fortification are all approaches that can contribute to the implementation of EAT-Lancet recommendations. The One Health approach recognizes that human health, animal health, and environmental sustainability are interconnected and that collaboration across sectors is necessary to address complex health challenges. By considering the health of animals and the environment in addition to human health, the One Health approach can inform the development of sustainable food systems that promote health for all. Health Impact Assessment (HIA) is a structured process that evaluates the potential health impacts of policies, programs, and projects. HIAs can be used to identify and address potential health risks associated with food systems and help to promote policies and interventions that support healthy and sustainable food systems. Mandatory food fortification is a strategy that involves adding essential vitamins and minerals to food products to address nutrient deficiencies. Mandatory fortification can be used to ensure that essential nutrients are present in the food supply, which can have significant impacts on public health, when consumed passively. The objective of this round table session is to show how multisectoral approaches can be used to achieve better human and planetary health and promote more sustainable and healthy food systems. This session will bring together experts from different disciplines to explore how holistic approaches can promote healthy and sustainable food systems. There will be three short presentations followed by a round table discussion in which the audience is invited to interact with the discussants. First, the One Health approach of AMR will be discussed outlining the need for a binding international legal framework. Second, a presentation on Health Impact Assessment, planning and public health in relation to the food environment in the UK will be conducted. Finally, the case for a mandatory approach of folic acid supplementation in Ireland with strict regulation, monitoring and oversight with penalties for non-compliance by the food industry is presented. Panellists will share lessons learnt from the Netherlands, the UK, Ireland and Bulgaria and the case for EU-wide approaches will be made. Key messages • Holistic approaches to achieve food system sustainability are needed, emphasising the interconnectedness of different systems and the need for multidisciplinary approaches from local to transnational. • There is a clear role for binding international legal frameworks to tackle challenges related to the food system, such as AMR, fast food outlet density and folic acid fortification. Speakers/Panelists Thom Geertsema Groningen Center Health Law, Faculty of Law, University of Groningen, Groningen, Netherlands Ben Cave Ben Cave Associates Ltd, Leeds, UK Mary Rose Sweeney Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland Desislava Vankova Medical University of Varna, Varna, Bulgaria Nikhil Gokani University of Essex, Colchester, UK

Can mindful eating buffer against the influence of neighbourhood fast food exposure on unhealthy food intake?

A food-abundant environment is associated with unhealthy food intake, but not everyone is affected to the same degree. Mindful eating, which is eating with attention and awareness, has been associated with less external eating and less food cravings, and could act as a protective factor against influences from the food environment. The current study aimed to investigate whether the association between exposure to fast-food around the home and unhealthy food intake was moderated by mindful eating. The study was conducted in 1086 Dutch adults of 55 years and older of the Longitudinal Aging Study Amsterdam study. The mindful eating domains (Mindful Eating Behavior Scale) were tested as moderating variables in the linear regression models with absolute and relative density of fast-food outlets in the neighbourhood (400, 800 and 1600m) as independent variables and unhealthy food intake (snacks (g/d)) and saturated fat as a percentage of total energy intake (en%)) as dependent variable. Bootstrapping with 5000 samples using the pick-a-point approach showed that after adjustments, only two out of 48 interactions terms were statistically significant: Eating with Awareness (EwA) and Eating without Distraction (EwD) moderated the positive association between the relative density of fast-food outlets and saturated fat (en%) respectively in a buffer of 800m (interaction EwA: B=-0.84, 95% CI [-1.46; -0.22]) and in a buffer of 1600m (interaction EwD: B=-0.82, 95% CI [-1.61; -0.04]). The results of the current study indicate that mindful eating cannot buffer against the influence of the fast-food abundant environment on unhealthy food intake. Future research is needed to confirm these findings, for example in younger populations.

The analysis of the main contributing factors for the increasing trend of Diabetes Type 2, diabetes morbidity and mortality trends in England, 2017-2022.

Background and aim: Diabetes Type 2 is a non-communicable disease which is characterized by chronic hyperglycaemia and disruption of metabolism. A poor management of diabetes leads to serious cardiovascular and neural complications. The prevalence of Diabetes Type 2 is increasing globally; in the United Kingdom, the number of people living with a diabetes increased by more than 100,000 from 2018 to 20191. In 2019, 3,9 million people had diagnosis of diabetes, and predictions are that this number will increase to 5,3 million in 2025. The aim of this research is to examine the main contributing factors and their influence on the prevalence of Diabetes Type 2 among people aged 17+ in England based on the routine epidemiological data for 2017-2022 years. Additionally, this research will analyze trends for hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality statistics. Methods: The Pearson’s and the Spearman’s correlation analyses are used to investigate possible associations, their strength, monotonicity and direction between the prevalence of diabetes, deprivation, low physical activity, obesity and density of fast food outlets. Stratified random sampling of 153 England counties & unitary authorities (the division of 2017) are used for the statistical analysis. A comparative analysis is used to analyze trends for hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality statistics. Descriptive statistics and quantitative analysis of secondary routine numerical data collected by the National Health Service Digital, the National Health Survey and the Office for Health Improvement & Disparities is used. Findings: The analysis revealed positive correlations between the prevalence of diabetes and indicators of deprivation, obesity, low physical activity. In general, diabetes, obesity and physically inactive adults are more prevalent in counties with higher deprivation score. The strong positive correlation was found between density of fast food outlets and deprivation; the analysis of mean values indicated a positive linear relationships between obesity, diabetes indicators and density of fast food outlets. The comparative analysis revealed an upward trend for both, hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality. Conclusion: In conclusion, analysis based on 80 counties & unitary authorities of England indicated that the main contributing factors for the increasing trend of Diabetes Type 2 can be the increasing prevalence of overweight and obese adults, low physical activity and deprivation. Additionally, the analysis demonstrated that the availability and abundance of fast food outlets, especially in more deprived deciles of England are closely associated with obesity and indirectly with the prevalence of Diabetes Type 2. Additionally, an increasing trend in the prevalence of Diabetes Type 2 is accompanied by a similar growth of hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality.

Would you like fries with that? Investigating fast-food outlet availability near schools in Perth, Western Australia.

Locating fast-food outlets near schools is a potential public health risk to schoolchildren, given the easy access and repeated exposure to energy-dense, nutrient-poor foods they provide. Fast-food outlet availability near schools has not been previously investigated in Perth, Western Australia. This study aimed to quantify fast-food outlet availability near Perth schools and determine whether differences in area-level disadvantage and school type exist. Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth Primary (n=454), Secondary (n=107) and K-12 (n=94) schools were assigned an area-level disadvantage decile ranking based on the Australian Bureau of Statistics Socio-Economic Index for Areas (SEIFA). Regression models assessed whether fast-food outlet availability within 400 m, 800 m and 1km of schools differed by school type (ie, Primary/Secondary/K-12) or SEIFA. Secondary schools were significantly more likely than Primary and K-12 schools to have a higher presence and density of fast-food outlets and the "Top 4" fast-food outlet chains (McDonalds, Hungry Jacks, KFC and Red Rooster) nearby. Schools located in low socio-economic status (SES) areas had a significantly higher density of fast-food outlets within 400 m, and "Top 4" fast-food outlet chains within 400 m and 1km, than schools located in high SES area. Perth schools are surrounded by fast-food outlets with densities significantly higher around secondary schools and schools located in lower SES areas. SO WHAT?: Policies and regulations aimed at reducing fast-food outlets near schools is an essential strategy to improve dietary intakes and reduce obesity in schoolchildren.

Changes in retail food environments around schools over 12 years in Flanders, Belgium

Abstract Background Food environments influence food preferences, in particular among children. Besides their homes, children spend most of their time in and around the school. This study mapped changes in retail food environments around primary and secondary schools in Flanders between 2008 and 2020. In addition, associations between those indicators and children's weight status were assessed. Methods The food environment near primary and secondary schools was mapped using three spatial indicators: 1) The density of different types of food retailers within 1000m road distance from the school entrance, 2) the percentage of schools with at least one food retailer of a certain type within 1000m road distance from the entrance, and 3) the median walking distance from the school entrance to the nearest food retailer of a certain type. Associations between the density of convenience stores, as well as fast food outlets around the schools and the weight status of the schools’ children were assessed using generalized linear models adjusted for level of urbanization, socio-economic status of children at school level and sex. Results Food environments near schools in Flanders were found to be unhealthy, with a significant increase in fast-food outlets and convenience stores between 2008 and 2020. Food environments near schools with a higher proportion of children from a poor socio-economic background were found more unhealthy than those near schools with a lower proportion of such children, regardless of the urbanization level. A significant positive association was found between the density of fast food outlets as well as convenience stores around primary schools and the weight status of children aged <6 years and 6-12 years. Conclusions Food environments around schools in Flanders became more unhealthy over time and were associated with children's weight status. The government therefor has the responsibility to create healthy food environments near schools to protect children's health. Key messages • The food environment near schools became more unhealthy between 2008 and 2020. • The food environment near schools was associated with younger children's weight status.

No new fast-food outlets allowed! Evaluating the effect of planning policy on the local food environment in the North East of England

The environment in which we live impacts on our health. The food available to us in our environment is likely to influence what we eat and subsequently our weight. The use of planning policy can be one way for both local and national government to help shape a healthy environment. In England there are three main types of planning policy used to promote a healthy food environment: 1) restricting new fast-food outlets near schools; 2) restricting new fast-food outlets if the density of existing outlets has surpassed a certain threshold of all retail outlets, 3) restricting new fast-food outlets if childhood obesity rates are above a certain threshold. In 2015, Gateshead council, a local authority in the North East of England implemented all three types of guidance. We utilise a longitudinal administrative dataset, the Food Standards Agency Food Hygiene Rating Scheme Data, covering the period 2012–2019 on all premises selling or preparing food in Great Britain. To analyse the impact of employing all three types of planning guidance on the density, proportion, and number of fast-food outlets in Gateshead, we employ a propensity score matching difference-in-difference approach. We match small geographical areas in Gateshead (lower super output areas) to other local authorities in the North East with similar demographic characteristics that did not implement planning guidance. Results show a reduction in density of fast-food outlets by 12.45 per 100,000 of the population and a 13.88% decrease in the proportion of fast-food outlets in Gateshead compared to other similar local authorities in the North East. There was a marginally significant reduction in the number of restaurants which became insignificant after controlling for population density. These results suggest that a multi-pronged planning approach significantly changed the proportion and density of fast-food outlets in the food environment in the short term (4 years).

The Food Environment Around Primary Schools in a Diverse Urban Area in the Netherlands: Linking Fast-Food Density and Proximity to Neighbourhood Disadvantage and Childhood Overweight Prevalence.

In the Netherlands, the neighbourhood food environment has received little attention in initiatives to combat overweight/obesity. This study maps the food environment around primary schools in The Hague, The Netherlands, and examines associations between neighbourhood disadvantage, the school food environment and childhood overweight using Geographic Information Systems (GIS). Linear regression analyses were performed to test the association between schools' disadvantage scores (proxy for neighbourhood disadvantage) and relative fast-food density within 400 m and 1000 m and fast-food proximity. Univariable and multivariable linear regression analyses were used to test the association between the school food environment and overweight prevalence among children in the respective sub-district in which the schools is found. Multivariable analyses were adjusted for the schools' disadvantage scores. Results show that fast-food outlets were available around most primary schools. Schools in disadvantaged neighbourhoods were closer to and surrounded by a higher number of fast-food restaurants, grillrooms and kebab shops. On the sub-district level, the density of such fast-food outlets was associated with overweight prevalence among children. These findings highlight the importance of national and local policies to improve the food environment, particularly in disadvantaged neighbourhoods.

Does fast-food outlet density differ by area-level disadvantage in metropolitan Perth, Western Australia?

Socio-economic spatial patterning of fast-food outlets can result in disparities in the availability and access of food across geographic areas, contributing to health inequalities. This study investigated whether area-level socio-economic disparities exist in fast-food availability across the Perth metropolitan region of Western Australia. Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth suburbs (n=328) were allocated a decile ranking based on the Australian Bureau of Statistics Socio-Economic Index for Areas with decile 1 indicating relatively greater disadvantage and decile 10 indicating a relative lack of disadvantage. Zero-inflated negative binomial regression models, adjusted for suburb area and population density, were used to investigate the association between area-level disadvantage decile and availability of fast-food outlets. A socio-economic gradient was identified; for every unit increase in disadvantage decile (ie a reduction in relative disadvantage), the count of fast-food outlets decreased by 6% (P<.01), and the count of the "top ranking" fast-food chains (ie McDonalds, KFC, Hungry Jacks and Red Rooster) decreased by 10% (P<.001). Consistent with evidence internationally and from within Australia, socio-economic spatial patterning of fast-food outlet availability was shown to exist in Perth, with greater fast-food availability in areas with more relative socio-economic disadvantage. SO WHAT?: To address health inequities associated with fast-food consumption, policy and practice changes are needed that manage fast-food outlet proliferation in areas of greater socio-economic disadvantage.

Is Food Outlet Accessibility a Significant Factor of Fruit and Vegetable Intake? Evidence from a Cross-Sectional Province-Wide Study in Quebec, Canada

Unhealthy eating habits can compromise one’s health and generate significant individual, social, and health services costs. The adoption of healthy eating habits depends on individual and environmental determinants related to the characteristics of the physical, economic, political, and socio-cultural environments. The objective of this cross-sectional study was to assess the effect of the physical environment, more precisely the effect of food outlet accessibility, on diet. A subsample of the CARTaGENE survey, composed of 7783 adults aged 40 to 70 years old residing in four cities in Quebec (Canada), was used. Measures of proximity as well as absolute and relative measures of the density of retail food outlets, fast-food outlets, and convenience stores near participants’ residences were used to analyze fruit and vegetable (F&amp;V) intake. Univariate logistic regression showed that the minimal recommended portions of F&amp;V intake (5 or more portions) were significantly associated with all seven measures of the retail food environment (OR between 0.76 and 1.27). However, these relations were mostly non-significant when confounding variables were considered in the analysis except and counterintuitively for proximity to the nearest convenience store and density of convenience stores. Variables most significantly correlated to F&amp;V intake were individual-level confounding variables of sex, income, and education. These results show that more research is needed to understand factors explaining F&amp;V intake in this population.

Associations between the fast-food environment and diabetes prevalence in the Netherlands: a cross-sectional study

Diabetes is a major health concern and is influenced by lifestyle, which can be affected by the neighbourhood environment. Specifically, a fast-food environment can influence eating behaviours and thus diabetes prevalence. Therefore, our aim was to assess the relationship between fast-food environment and diabetes prevalence for urban and rural environments in the Netherlands, using multiple indicators and buffer sizes. In this cross-sectional study, data on a nationwide sample of adults older than 19 years in the Netherlands were taken from the 2012 Dutch national health survey (from Public Health Monitor), in which participants were surveyed on topics related to health and lifestyle behaviour. Fast-food outlet exposures were determined within street-network buffers of 100 m, 400 m, 1000 m, and 1500 m around residential addresses. For each of these buffers, three indicators were calculated: presence (yes or no) of fast-food outlets, fast-food outlet density, and ratio. Logistic regression analyses were carried out to assess associations of these indicators with diabetes, adjusting for potential confounders and stratifying into urban and rural areas. 387 195 adults were surveyed, 284 793 of whom were included in the study. 22 951 (8%) reported having diabetes. Fast-food outlet exposures were positively associated with diabetes prevalence. We did not observe large differences between urban and rural areas. The effect estimates were small for all indicators. For example, in the 400 m buffer in the urban environment, the odds ratio (OR) for having diabetes among people with a fast-food outlet present compared with those without, was 1·006 (95% CI 1·003-1·009) using the presence indicator. The presence indicator showed higher effect estimates and the most consistent results across buffer sizes (ranging from OR 1·005 [95% CI 1·000-1·010] with the 1000 m buffer to 1·016 [1·005-1·028] with the 1500 m buffer in urban areas and from 1·002 [0·998-1·005] with the 1500 m buffer to 1·009 [1·006-1·018] with the 100 m buffer in rural areas) compared with the density and ratio indicators. The results confirm the evidence that the fast-food outlet environment is a diabetes risk factor. All data included were at the individual level and the variability was ensured by the spatial distribution and number of participants. In this study, we only accounted for residential exposure because we were unable to account for exposure outside the residential environment. The findings of this study encourage local governments to consider the potential adverse effects of fast-food exposures and aim at minimising unhealthy food access. Global Geo Health Data Centre, Utrecht University, Netherlands.

The association between fast-food outlet proximity and density and Body Mass Index: Findings from 147,027 Lifelines Cohort Study participants

Unhealthy food environments may contribute to an elevated Body Mass Index (BMI), which is a chronic disease risk factor. We examined the association between residential fast-food outlet exposure, in terms of proximity and density, and BMI in the Dutch adult general population. Additionally, we investigated to what extent this association was modified by urbanisation level. In this cross-sectional study, we linked residential addresses of baseline adult Lifelines Cohort participants (n = 147,027) to fast-food outlet locations using geo-coding. We computed residential fast-food outlet proximity, and density within 500 m, 1, 3, and 5 km. We used stratified (urban versus rural areas) multilevel linear regression models, adjusting for age, sex, partner status, education, employment, neighbourhood deprivation, and address density. The mean BMI of participants was 26.1 (SD 4.3) kg/m2. Participants had a mean (SD) age of 44.9 (13.0), 57.3% was female, and 67.0% lived in a rural area. Having two or more (urban areas) or five or more (rural areas) fast-food outlets within 1 km was associated with a higher BMI (B = 0.32, 95% confidence interval (CI): 0.03, 0.62; B = 0.23, 95% CI: 0.10, 0.36, respectively). Participants in urban and rural areas with a fast-food outlet within <250 m had a higher BMI (B = 0.30, 95% CI: 0.03, 0.57; B = 0.20, 95% CI: 0.09, 0.31, respectively). In rural areas, participants also had a higher BMI when having at least one fast-food outlet within 500 m (B = 0.10, 95% CI: 0.02, 0.18). In conclusion, fast-food outlet exposure within 1 km from the residential address was associated with BMI in urban and rural areas. Also, fast-food outlet exposure within 500 m was associated with BMI in rural areas, but not in urban areas. In the future, natural experiments should investigate changes in the fast-food environment over time.

The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study.

The aim of our study is to utilise longitudinal data to explore if the association between the retail fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n = 13,469) and 6 (ages 14/15; 2014/15; n = 11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations and test for observed confounding. A small positive association was initially detected between fast food outlets and overweight (e.g., at age 11/12, Odds Ratio (OR) = 1.0006, 95% Confidence Intervals (CI) = 1.0002–1.0009). Following adjusting for the confounding role of neighbourhood deprivation, this association was non-significant. Individuals who resided in the most deprived neighbourhoods had higher odds of overweight than individuals in the least deprived neighbourhoods (e.g., at age 11/12 OR = 1.95, 95% CIs = 1.64–2.32). Neighbourhood deprivation was also positively associated to the density of fast food outlets (at age 11/12 Incidence Rate Ratio = 3.03, 95% CIs = 2.80–3.28).

Diet and Cardiovascular Health

Diet and Cardiovascular Health

Association between food-outlet availability near secondary schools and junk-food purchasing among Australian adolescents

ObjectivesWe sought to investigate the association between food-outlet availability near Australian secondary schools and frequency of Australian students’ discretionary food purchases. MethodsSecondary-school students in Perth (Western Australia) reported the frequency of their discretionary food purchases from food outlets near their school (17 schools, n = 2389 students grades 7–12, ages 12–17 y). Food-outlet availability was sourced from local governments, then geocoded. A mixed-effects model was used in analyses. ResultsAlmost half of students (45%) purchased discretionary foods from food outlets near their secondary school at least weekly. Only the density of top-ranking fast-food chain outlets near secondary schools was associated with a significant increase in the frequency of discretionary food purchases. ConclusionsAvailability of major fast-food chains near Australian secondary schools appears to be a key driver of Australian students’ discretionary food purchasing. Restricting these outlets near schools may help reduce adolescents’ discretionary food intake.

Density of Fast Food Outlets around Educational Facilities in Riyadh, Saudi Arabia: Geospatial Analysis.

Background: Childhood obesity remains a public health issue globally. The latest estimate from the World Health Organization showed that over 340 million children and adolescents aged 5–19 were overweight or obese in 2016. Objective: Our study aimed to assess the density of fast food outlets around educational facilities in Riyadh, Saudi Arabia. Methods: We employed geospatial and quantitative analyses using data on fast food outlets (from surveys conducted between November 2019 and May 2020) and educational facilities in Riyadh city. Data analyses conducted using ArcMap 10.6 and Stata 15 compared the density within 500 m and 500–1000 m from the facilities. Results: We found a high density of fast food outlets around educational facilities. Nearly 80% of fast food were within twelve-minute walking or five-minute driving distances from schools, and nearly 70% of all educational facilities had at least one fast food outlet within the buffer. We also found the densities were high within both the areas closer and the areas farther away from educational facilities. In addition, the density was significantly higher around private schools compared to government schools, and the density around girls-only schools and both-gender schools was higher than that around boys-only schools. Conclusion: There is a high density of fast food outlets around educational facilities in Saudi Arabia. Effective policies are needed to help reduce potential exposure to fast food among young people in Saudi Arabia and other countries with similar settings.

Does the neighbourhood food environment contribute to ethnic differences in diet quality? Results from the HELIUS study in Amsterdam, the Netherlands.

The aim of the current study was to establish whether the neighbourhood food environment, characterised by the healthiness of food outlets, the diversity of food outlets and fast-food outlet density within a 500 m or 1000 m street network buffer around the home address, contributed to ethnic differences in diet quality. Cross-sectional cohort study. Amsterdam, the Netherlands. Data on adult participants of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan descent (n total 4728) in the HELIUS study were analysed. The neighbourhood food environment of ethnic minority groups living in Amsterdam is less supportive of a healthy diet and of less diversity than that of participants of Dutch origin. For example, participants of Turkish, Moroccan and South-Asian Surinamese descent reside in a neighbourhood with a significantly higher fast-food outlet density (≤1000 m) than participants of Dutch descent. However, we found no evidence that neighbourhood food environment characteristics directly contributed to ethnic differences in diet quality. Although ethnic minority groups lived in less healthy food environments than participants of ethnic Dutch origin, this did not contribute to ethnic differences in diet quality. Future research should investigate other direct or indirect consequences of residing in less supportive food environments and gain a better understanding of how different ethnic groups make use of their neighbourhood food environment.

Impact of fast-food outlet density on incidence of myocardial infarction in the Hunter region.

There is an established association between fast-food consumption and metabolic diseases. Some studies also suggest that calorie-dense food promotes a proinflammatory response, which is itself linked with myocardial infarction (MI). Whether increased fast-food availability is a risk factor for MI remains unknown. To investigate the role of fast-food outlet density (FFD) as a novel environmental risk factor for MI in the Hunter region, New South Wales (NSW). We conducted a retrospective cohort study using a database of all MI events between 1996 and 2013, extracted from the Hunter Cardiac and Stroke Outcomes unit. FFD was calculated for each local government area (LGA) of the Hunter region, allowing for a comparative analysis. Stratification by fast-food outlet data and LGA resulted in a total of 3070 cases. Weighted linear regression was used to investigate the role of FFD on incidence of MI in regional and rural Australia. FFD was positively correlated with rates of MI, remaining consistent in both single and multivariate predictor models adjusting for age, obesity, hyperlipidaemia, hypertension, smoking status, diabetes and socioeconomic status (P < 0.001). An increase of one fast-food outlet corresponded with four additional cases of MI per 100 000 people per year (4.07, 95% confidence interval, 3.86-4.28). FFD was positively associated with incidence of MI in both rural and metropolitan areas of NSW. This relationship remained consistent after multivariate adjustment for standard cardiovascular risk factors, highlighting the importance of an individual's food environment as a potential contributor towards their health.