Fast Food Outlets Research Articles

Supply chain resilience: the role of supplier development in the form of contract farming in fast-food outlets in Zimbabwe

PurposeThe study sought to determine the possibility of supplier development in the form of contract farming as a determinant of supply chain resilience in fast-food outlets. This is against the background of the restaurant having been designated as one of the industries that remained operational when the other industries were affected by the two-decade-long economic meltdown and more recently COVID-19 pandemic.Design/methodology/approachData were collected using questionnaires from the consenting restaurants with the most senior procurement personnel in target restaurants as the informants and analysed using analysis of moment structures (AMOS) software.FindingsThe results revealed that indeed supplier development in the form of contract farming leads to supply chain resilience as indicated by improved supply chain visibility, supply chain flexibility, and supply chain redundancy. Fast-food restaurant businesses that have not yet adopted supplier development in the form of contract farming are therefore encouraged to adopt it as a way of enhancing their resilience to traditional supply chain disruptions such as transport shortages, droughts, and more recently COVID-19 pandemic.Originality/valueIt is to the best knowledge of these researchers, that no studies have attempted to analyse the three drivers of supply chain resilience, namely supply chain redundancy, supply chain flexibility, and supply chain visibility in a single study and link them to a single antecedent.

Creating an ontology of environmental exposure that captures the main components of epidemiological research papers

BACKGROUND AND AIM Environmental exposure is a central concept of the health and behavioral sciences needed to study the influence of the environment on the health and behavior of people within a spatial context. While numerous studies measure some form of exposure, including the influence of air quality, noise, crime, the built environment, and fast food outlets in neighborhoods, we lack a common conceptual model of environmental exposure that captures its main components across all this variety. In this article we propose an ontology design pattern that can be used for this purpose. METHODS To develop the pattern, we encoded the content of six scientific articles that each study a different urban environmental health issue. The ontology pattern specifies causal relations between concepts including persons, activities, exposures, environments and health risks on a conceptual level. On this basis, central notions like environmental stressors and active and passive exposure could be defined in Description Logic (DL) and automatically inferred from the content of a paper. Concepts were linked with data models and modelling methods used in a study in RDF. To test our pattern, we ask competency questions about main study characteristics and translate them to SPARQL queries over RDF content. RESULTS Results summarize epidemiological approaches, exposure concepts, findings, modelling methods, and data used for research in a transparent manner. CONCLUSIONS This ontology systematically distinguishes different methodological approaches. This not only helps us better understand and articulate methodological differences (and thus variations and validity of methods) in past studies, but also shows us the potential to better link the content of the vast amount of scientific publications on this topic regarding methods and data in a clear and systematic way. KEYWORDS ontology, epidemiology, Python, RDF, health, GIS, computer science

The Contribution of Nutrients of Concern to the Diets of 18-to-30-Year-Old Australians from Food Prepared Outside Home Differs by Food Outlet Types: The MYMeals Cross-Sectional Study.

Young adults are frequent consumers of food prepared outside the home (FOH). In a cross-sectional survey, the MYMeals study, we showed FOH provided one-third of meals and snacks for young Australian adults, yet it contributed higher proportions of energy and nutrients of concern, such as saturated fat and sodium. This study aimed to determine the detailed proportional contribution of nutrients of concern from the nine food outlet types captured in the MYMeals study. Young adults residing in New South Wales (NSW), Australia, (n = 1001) used a validated smartphone app to report all types and amounts of food and beverages consumed for three consecutive days, as well as their preparation location. The proportions of daily energy, macronutrients, sodium, total sugars, and saturated fat were calculated for each of the nine following outlet types: bakeries or patisseries, coffee chains, cold-drink chains, fast-food chains, ice creamery or frozen yoghurt outlets, independent cafes or restaurants, pubs (hotels) and clubs, service stations or convenience stores, and others not fitting the above categories. Of all FOH outlet types, independent cafes or restaurants contributed the most energy (17.5%), sodium (20.0%) and saturated fat (17.8%) to the total diet, followed by fast-food chains (12.0% energy, 15.8% sodium, and 12.0% saturated fat) and other outlets, with smaller proportions. For males, the proportion of energy and nutrients contributed by fast-food outlets was higher than for females (14.8% versus 9.8% energy). Menu labelling at independent cafes and restaurants is recommended, comprising, in addition to the energy labels already in use in fast-food restaurants, the labelling of nutrients of concern. The feasibility of this recommendation warrants further exploration.

Associations between neighbourhood fast-food environments and hypertension in Canadian adults.

ObjectivesHypertension is a leading cause of cardiovascular disease and premature death. Neighbourhoods characterized by a high proportion of fast-food outlets may contribute to hypertension in residents; however, limited research has explored these associations. The objectives of this study were to assess associations between neighbourhood fast-food environments, measured and self-reported hypertension.
 ApproachWe used data from 10,700 adults who participated in six cycles of the Canadian Health Measures Survey (CHMS). Measured hypertension was defined as having an average systolic blood pressure (BP) of ≥140, a diastolic BP ≥90 mm Hg or being on BP lowering medication. Participants were also asked if they had been diagnosed with high BP or if they take BP lowering medication (i.e., self-reported hypertension). We characterized the fast-food environment of each participant’s neighbourhood using the Canadian Food Environment Dataset (Can-FED). We considered the proportion of fast-food outlets relative to fast-food outlets and full-service restaurants as a continuous variable.
 ResultsThe mean proportion of fast-food outlets was 23.3% (SD 26.8%). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of measured hypertension in the full sample (OR=1.17, 95% CI 1.05 to 1.31) and in sex-specific models (women: OR=1.14, 95% CI 1.01 to 1.29; and men: OR=1.21, 95% CI 1.03 to 1.43). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of self-reported hypertension in the full sample (OR=1.13, 95% CI 1.02 to 1.24); however, associations were inconclusive in sex-specific models (women: OR=1.11, 95% CI 0.99 to 1.26; and men: OR=1.14, 95% CI 0.99 to 1.33).
 ConclusionBy linking neighbourhood food environment measures that were created from an administrative data source (the Statistics Canada Business Register) to individual-level data from the CHMS, we were able to demonstrate that reducing the proportion of fast-food outlets in neighbourhoods may reduce rates of hypertension and support individually targeted interventions.

The association between the presence of fast-food outlets and BMI: the role of neighbourhood socio-economic status, healthy food outlets, and dietary factors

BackgroundEvidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake.MethodsIn this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants’ residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value < 0.10 or improved model fit (∆AIC ≥ 2), we conducted stratified analyses. We used causal mediation methods to assess mediation.ResultsParticipants with one fast-food outlet within 1 km had a higher BMI than participants with no fast-food outlet within 1 km (B = 0.11, 95% CI: 0.01, 0.21). Effect sizes for at least two fast-food outlets were larger in low NSES areas (B = 0.29, 95% CI: 0.01, 0.57), and especially in low NSES areas where at least two healthy food outlets within 1 km were available (B = 0.75, 95% CI: 0.19, 1.31). Amount of fat intake, but not frequency of fast-food consumption, explained this association for 3.1%.ConclusionsParticipants living in low SES neighbourhoods with at least two fast-food outlets within 1 km of their residential address had a higher BMI than their peers with no fast-food outlets within 1 km. Among these participants, healthy food outlets did not buffer the potentially unhealthy impact of fast-food outlets. Amount of fat intake partly explained this association. This study highlights neighbourhood socio-economic inequalities regarding fast-food outlets and BMI.

Investigating the association between the socioeconomic environment of the service area and fast food visitation: A context-based crystal growth approach

Fast food consumption is one of the major causes of rising obesity rates. Fast food consumers are mostly residents located in the service area-the fast food outlet's surrounding area. Conventional buffer approaches may exhibit bias in measuring service areas by ignoring the local community's detailed spatial configuration and transportation preferences. This study uses fast food outlets and their visits provided by a mobile phone-based dataset named SafeGraph and applies a novel context-based crystal growth algorithm (CG) to delineate improved service areas of fast food outlets in Chicago. We also explore how socioeconomic variables in service areas by CG and buffer-based approaches are related to visits to fast food outlets. Results show that compared to conventional buffers, CG produces improved service areas as it excludes inaccessible barriers and adjusts the accessible areas by transportation preferences. Further, the model using service areas of public transport users by CG yields the best performance. Additionally, the rate of single-mother households and the number of other fast food outlets nearby are positively related to fast food visits in all models. Findings acknowledge the advantages of CG and help make policy interventions to reduce fast food consumption.

ENHANCING BUYER-SUPPLIER RELATIONSHIP IN THE HALAL FAST FOOD SECTOR IN MAURITIUS: THE ROLE OF TRUST

The aim of this paper is to investigate whether trust is present between Halal fast food outlets and their Halal certified suppliers, while assessing its influence on their relationship. Online questionnaires were distributed to a sample of Halal certified fast-food outlets and restaurants in Mauritius. Descriptive and correlation analyses were then carried out. The findings show that trust does exist between the two partners concerned. At the same time, trust is seen to have a positive relationship with all the variables within the buyer-supplier relationship, namely: commitment, communication, satisfaction and long-term orientation. Also, the overall results infer that Halal food certification principles are generally being respected by Halal certified suppliers, which explains the high trust levels between them and the Halal fast food outlets they supply. Concomitantly, Halal food certification in a way contributes to better buyer-supplier relationships due to strict Halal food security and handling practices which inspire trust and confidence. The study presents a unique case in a Small Island Developing State (SID) and is one of the pioneering research on the Halal food sector in Mauritius. Despite the contribution of this research to the literature both conceptually and empirically, the small sample size, affects to some extent the generality of the findings. For this reason, more qualitative research in the form of interviews and surveys with Halal Certifying Bodies (HCBs) need to be done to acquire deeper understanding on rampant issues such as Halal frauds, Halal logo tampering and consumer trust on the Halal food certification system.

The Nutritional Quality of Kids' Menus from Cafés and Restaurants: An Australian Cross-Sectional Study.

Australian families increasingly rely on eating foods from outside the home, which increases intake of energy-dense nutrient-poor foods. ‘Kids’ Menus’ are designed to appeal to families and typically lack healthy options. However, the nutritional quality of Kids’ Menus from cafes and full-service restaurants (as opposed to fast-food outlets) has not been investigated in Australia. The aim of this study was to evaluate the nutritional quality of Kids’ Menus in restaurants and cafés in metropolitan Perth, Western Australia. All 787 cafes and restaurants located within the East Metropolitan Health Service area were contacted and 33% had a separate Kids’ Menu. The validated Kids’ Menu Healthy Score (KIMEHS) was used to assess the nutritional quality of the Kids’ Menus. Almost all Kids’ Menus (99%) were rated ‘unhealthy’ using KIMEHS. The mean KIMEHS score for all restaurants and cafés was −8.5 (range −14.5 to +3.5) which was lower (i.e., more unhealthy) than the mean KIMEHS score for the top 10 most frequented chain fast-food outlets (mean −3.5, range −6.5 to +3). The findings highlight the need for additional supports to make improvements in the nutritional quality of Kids’ Menus. Local Government Public Health Plans provide an opportunity for policy interventions, using locally relevant tools to guide decision making.

Childhood obesity, is fast food exposure a factor?

Access to fast food has often been blamed for the rise in obesity which in turn has motivated policies to curb the spread of fast food. However, robust evidence in this area is scarce, particularly using data outside of the US. It is difficult to estimate a causal effect of fast food given spatial sorting and ever-present exposure. We investigate whether the residential access to fast food increased BMI of adolescents at a time when fast food restaurants started to open in the UK. The time period presents the study with large spatial and temporal differences in exposure as well as plausibly exogenous variation. We merge data on the location and timing of the first openings of all fast food outlets in the UK from 1968−1986, with data on objectively measured BMI from the 1970 British Cohort Survey. The relationship between adolescent BMI and the distance from the respondents’ homes and time since opening, is studied using OLS and Instrumental Variables regression. We find that fast food exposure had no effect on BMI. Extensive robustness checks do not change our conclusion.

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).

Exploring the environmental determinants of food choice among Haudenosaunee female youth

BackgroundResearch on Indigenous food literacy within Canada has been focused on northern and remote communities despite the fact there are considerable and unique barriers to food access, availability, and utilization in southern Indigenous communities. Food insecurity is also a prevalent issue among Indigenous Peoples living in these more populous regions. Study objectives included investigating the determinants of food choice among youth, along with perceived opportunities that would improve food environments individually and at the community level.MethodsThis community-based study used Photovoice to explore the perceptions and experiences of traditional foods and the determinants of food choice among youth in the community of Six Nations of the Grand River. Participants took photos of their local food environments, including where foods were acquired, consumed, prepared, or shared, and participated in semi-structured interviews to share the stories behind these images. Thematic analysis was used to identify patterns in participants’ photos and interview content.ResultsEnvironmental factors were found to influence participants’ traditional and everyday food choices. Built, social, economic and ecological environments were described by the youth as distinct yet inter-related determinants that converge to influence individual food choice. Built environments had a notable impact on food choice, most notably at home and in school settings. Home and family were found to be facilitators of meal consistency and healthy food choices across participants. The social environment including participants’ relationships with their peers and community friends was often a barrier to healthy food choices. Eating at fast food outlets was a common social activity. The economic environment included cost deterrents associated with food choices and regular meals. The ecological environment was less of an influence and impacted the seasonal consumption of traditional and other locally harvested foods.ConclusionsOverall, the study findings have generated important knowledge regarding food environments and literacy and serves as a unique example of how to explore the traditional and everyday food experiences of Indigenous youth. Recommendations will inform the development of new as well as existing initiatives and resources to enhance the holistic wellbeing of youth and the broader community.

Consumption Frequency and Purchase Locations of Foods Prepared Outside the Home in Australia: 2018 International Food Policy Study

BackgroundFoods prepared outside the home (e.g., fast-food chains, restaurants) represent increasing proportions of diets worldwide, and have been associated with higher energy intakes and BMIs. To improve the healthiness of population diets, it is important to understand patterns of consumption of these foods, and whether related policy measures are effective. ObjectivesThis study aimed to identify the frequency and sources of consumption of foods prepared outside the home in Australia, and to understand the impact of nutrition information in restaurants on related food choices. MethodsData were from a web-based survey (the International Food Policy Study) completed in 2018 by Australian adults aged ≥18 years (n = 4103). The number of meals prepared outside the home, their purchase locations, and the extent to which nutrition information was noticed and influenced purchasing decisions were each analyzed by sociodemographic characteristics and BMI, with linear models also adjusted for sex, age group, education, ethnicity, and BMI. ResultsAn average of 2.73 (95% CI, 2.61–2.86) meals per week were prepared outside the home, with higher frequencies among men, younger ages, and more highly educated participants. A wide variety of sources for these foods was observed, with fast-food outlets being most common. Around one-quarter of all foods prepared outside the home were delivered. A small percentage (14.9%; 95% CI, 13.3%–16.7%) of participants reported noticing nutrition information, but among those who did, around half reported that it influenced their behavior. ConclusionsFoods prepared outside the home are commonly purchased in Australia, particularly by young adults, from a variety of outlet types. While current menu energy labeling regulations may provide some population health benefit, a broader policy focus on foods prepared outside the home is needed as part of efforts to improve population diets.

Plant-based Food in the Hospitality Industry: An Exploratory Case Study of Leading Fast Food Outlets

Plant-based food is one of the growing sectors within the food industry, and fast food companies may have an important role to play in driving both the trialling, and the consumption, of plant-based foods. This exploratory paper outlines the growth of plant-based foods, explores how the leading fast food companies are incorporating plant-based foods into their menus, and offers some wider reflections on the fast food companies’ approach to plant-based food. The findings reveal that the leading fast food companies within the UK were promoting their plant-based menu items at both the corporate and outlet level. That said, the fast food companies made little, or no, attempt to associate the introduction of plant-based menu items with a healthier diet, and the author suggested that substantially increasing their plant-based menus could provide a challenge to the fast food companies’ traditional business models. More generally, the paper concluded that in the medium-term future, the fast food companies are likely to play a limited, rather than a leading, role in driving plant-based consumption across society, and in contributing to a more sustainable future. Keywords: plant-based foods, fast food companies, menus, healthy diets, sustainable futures

The association between fast-food consumption and job-related factors among Russian adults

Time constraints contribute to individuals’ dietary choices along with incomes, prices, and preferences. As fast food is prepared and served quickly, it is often preferred to other food options, especially when individuals are under time pressure. This paper focuses on a set of job-related characteristics that could potentially contribute to fast-food consumption choice, and controls for standard socio-demographic, economic, and lifestyle factors. This study uses data from a quantitative household survey on health behavior and medicine of Russian adults conducted in 2017 (n = 4006). The study applies simple probit, ordered probit, and zero-inflated ordered probit models to examine how job-related characteristics are connected to the probability and frequency of fast-food consumption among Russian adults. The results shows that employment is positively associated with both probability and frequency of fast-food consumption. However, for working adults, the decisions to eat fast food, and how frequently it is eaten, are affected by different factors. For example, working part time decreases the probability of fast-food consumption; having more than one job increases the frequency of its intake for fast-food consumers; having canteens with hot meals at work decreases the frequency of fast-food intake. Although job-related factors are significant in all models, marginal effects show that living in large cities, especially Moscow and Saint Petersburg, plays a larger role in the probability and frequency of fast-food consumption because access to various fast-food outlets increases in relation to the size of the settlement.

Fast food and obesity: risks to children and adolescents?

In the modern world, fast food is becoming part of the food culture; herewith, children and teenagers are no exception. A fairly busy lifestyle and lack of time contribute to an increasingly frequent appeal to fast food outlets. Given the national health policies of many countries, including those aimed at keeping up and supporting healthy lifestyles among children and adolescents, the researchers are increasingly focusing on the dependence of obesity on the younger generation’s fascination with fast food. In the proposed review, the authors have analyzed the published data represented in the studies at various levels and regarding a few problems. They are: the establishment of the relationship between a systematic intake of fast food and obesity among children and adolescents; the influence of the distance of fast food outlets from educational institutions on the occurrence and development of metabolic pathologies. Taking into consideration the relationship between fast food consumption by children and adolescents, parents and schools should strictly control their intake of unhealthy foods that leads to the weight gain and obesity-related diseases. Stopping marketing of junk food targeted at kids with eye-catching advertising personalities and gifts, could be one of the ways of childhood’s nutrition revitalizing.

Employee Intention to Leave a Job: A Case of Fast Food Restaurants in Malaysia

The purpose of this study is to investigate the factors influencing intention to leave among employees at fast food restaurants. It examines two issues; workplace stress and organizational commitment. A quantitative survey of 132 employees working in the fast food restaurants from three different states was conducted. The reliability statistics of the data was preferable, ranging from .71 to .91 for all variables. Using Pearson correlation analysis, it was found that there was a positive relationship between workplace stress and intention to leave (r=.265). Interestingly, the statistic showed that there was a positive relationship between organizational commitment and intention to leave (r=.294). The results contributed to a contradicting finding in investigating intention to leave among employees, indicating although the commitment was high, the potential to leave the job is considerately high. It might relate to the nature of job of fast food outlets that requires work shift, and the employees might seek towards “nine-to-five” jobs. Retaining employees could be challenging and managers should play an important role to deliver the information about career enhancement in fast food industry with improved levels of salary and employment.

Non-alcoholic beverage and fast-food consumption, among first- and fourth-year nursing students in Madrid

Sugar-sweetened beverages and fast-food consumption have been associated with non-communicable diseases. Objective. Was to analyze consumption of non-alcoholic beverage and fast-food consumption among first- and fourth-year nursing students. Materials and methods. A questionnaire-based survey was conducted among first-and fourth-year nursing students in Madrid, Spain. Anthropometric data (weight and height) and demographic data were collected, as were data on consumption of specific foods and beverages. Results. The survey was completed by 436 students. Mean (SD) age was 22.0 (6.8) years, 84.1 % of were women.26.2 % of the students were underweight; 6.3 % were overweight. Consumption of sugar-sweetened beverages and diet drinks was moderate. Slightly more than three-quarters of the students (75.5 %) purchased fast food in the previous month. Burger bars were the most frequently visited fast-food outlet (77.2 %). A direct relationship was observed between BMI and fast-food consumption (rho = 0.099; p = 0.042) and between BMI and consumption of diet cola or carbonated drinks (rho = 0.120; p = 0.013). Conclusion. We provide new epidemiological data from a specific university population that could be useful to promote more studies that help design appropriate strategies to increase a healthy lifestyle.

Food environment and diabetes mellitus in South Asia: A geospatial analysis of health outcome data.

BackgroundThe global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people’s diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the role they may play in the context of low- and middle-income countries (LMICs). We examined the associations of food environments on T2DM among adults and its heterogeneity by income and sex.Methods and findingsWe linked individual health outcome data of 12,167 individuals from a network of health surveillance sites (the South Asia Biobank) to the density and proximity of food outlets geolocated around their homes from environment mapping survey data collected between 2018 and 2020 in Bangladesh and Sri Lanka. Density was defined as share of food outlets within 300 m from study participant’s home, and proximity was defined as having at least 1 outlet within 100 m from home. The outcome variables include fasting blood glucose level, high blood glucose, and self-reported diagnosed diabetes. Control variables included demographics, socioeconomic status (SES), health status, healthcare utilization, and physical activities. Data were analyzed in ArcMap 10.3 and STATA 15.1. A higher share of fast-food restaurants (FFR) was associated with a 9.21 mg/dl blood glucose increase (95% CI: 0.17, 18.24; p < 0.05). Having at least 1 FFR in the proximity was associated with 2.14 mg/dl blood glucose increase (CI: 0.55, 3.72; p < 0.01). A 1% increase in the share of FFR near an individual’s home was associated with 8% increase in the probability of being clinically diagnosed as a diabetic (average marginal effects (AMEs): 0.08; CI: 0.02, 0.14; p < 0.05). Having at least 1 FFR near home was associated with 16% (odds ratio [OR]: 1.16; CI: 1.01, 1.33; p < 0.05) and 19% (OR: 1.19; CI: 1.03, 1.38; p < 0.05) increases in the odds of higher blood glucose levels and diagnosed diabetes, respectively. The positive association between FFR density and blood glucose level was stronger among women than men, but the association between FFR proximity and blood glucose level was stronger among men as well as among those with higher incomes. One of the study’s key limitations is that we measured exposure to food environments around residency geolocation; however, participants may source their meals elsewhere.ConclusionsOur results suggest that the exposure to fast-food outlets may have a detrimental impact on the risk of T2DM, especially among females and higher-income earners. Policies should target changes in the food environments to promote better diets and prevent T2DM.

Shaping Pathways to Child Health: A Systematic Review of Street-Scale Interventions in City Streets.

Street-level built environment factors, for example, walking infrastructure, building density, availability of public transport, and proliferation of fast-food outlets can impact on health by influencing our ability to engage in healthy behaviour. Unhealthy environments are often clustered in deprived areas, thus interventions to improve the built environments may improve health and reduce inequalities. The aim of this review was to identify whether street-level built environment interventions can improve children’s health in high income countries. A secondary aim was to describe key built environment elements targeted in interventions and research gaps. A systematic review of published literature was conducted by a multi-disciplinary team. Ten intervention papers were included. Physical activity or play was the only health outcome assessed. Most interventions described temporary changes including closure of streets to traffic (N = 6), which were mainly located in deprived neighbourhoods, or the addition of technology to ‘gamify’ active travel to school (N = 2). Two studies reported permanent changes to street design. There was limited evidence that closing streets to traffic was associated with increases in activity or play and inconclusive evidence with changes to street design and using technology to gamify active travel. Our ability to draw conclusions was hampered by inadequate study designs. Description of interventions was poor. Rigorous evaluation of built environment interventions remains challenging. We recommend a multi-disciplinary approach to evaluation, explicit reporting of built environment indicators targeted in interventions and offer solutions to others working in this area.

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.