title: Is the number of fast-food outlets in the neighbourhood related to screen-detected type 2 diabetes mellitus and associated risk factors?
abstract: OBJECTIVE
  We investigated whether a higher number of fast-food outlets in an individual's home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Three UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes.
  
  
  METHODS
  In total 10 461 participants (mean age 59 years; 53% male; 21% non-White ethnicity).
  
  
  RESULTS
  There was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (P<0.001) and in socially deprived areas (P<0.001). After adjustment (social deprivation, urban/rural, ethnicity, age, sex), more fast-food outlets was associated with significantly increased odds for diabetes (OR=1.02; 95% CI 1.00, 1.04) and obesity (OR=1.02; 95% CI 1.00, 1.03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes.
  
  
  CONCLUSIONS
  These results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Patrice
authors.initials: P
authors.lastname: Carter
authors.affiliation: 2University of Leicester,Department of Geography,Leicester,UK.
authors.forename: Alexis
authors.initials: A
authors.lastname: Comber
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Edwardson
authors.affiliation: 3University of Leicester,Department of Health Sciences and Leicester Diabetes Centre,Leicester General Hospital,Leicester,UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Hill
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: David
authors.initials: D
authors.lastname: Webb
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Yates
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: 1University of Leicester,Diabetes Research Centre and Leicester Diabetes Centre,Leicester General Hospital,Gwendolen Road,Leicester LE5 4PW,UK.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D057140:Fast Foods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Fast food; Obesity; Takeaway; Type 2 diabetes mellitus