title: A cross sectional study investigating the association between exposure to food outlets and childhood obesity in Leeds, UK.
abstract: BACKGROUND
  Current UK policy in relation to the influence of the 'food environment' on childhood obesity appears to be driven largely on assumptions or speculations because empirical evidence is lacking and findings from studies are inconsistent. The aim of this study was to investigate the number of food outlets and the proximity of food outlets in the same sample of children, without solely focusing on fast food.
  
  
  METHODS
  Cross sectional study over 3 years (n = 13,291 data aggregated). Body mass index (BMI) was calculated for each participant, overweight and obesity were defined as having a BMI >85(th) (sBMI 1.04) and 95(th) (sBMI 1.64) percentiles respectively (UK90 growth charts). Home and school neighbourhoods were defined as circular buffers with a 2 km Euclidean radius, centred on these locations. Commuting routes were calculated using the shortest straight line distance, with a 2 km buffer to capture varying routes. Data on food outlet locations was sourced from Leeds City Council covering the study area and mapped against postcode. Food outlets were categorised into three groups, supermarkets, takeaway and retail. Proximity to the nearest food outlet in the home and school environmental domain was also investigated. Age, gender, ethnicity and deprivation (IDACI) were included as covariates in all models.
  
  
  RESULTS
  There is no evidence of an association between the number of food outlets and childhood obesity in any of these environments; Home Q4 vs. Q1 OR = 1.11 (95% CI = 0.95-1.30); School Q4 vs. Q1 OR = 1.00 (95% CI 0.87 - 1.16); commute Q4 vs. Q1 OR = 0.1.00 (95% CI 0.83 - 1.20). Similarly there is no evidence of an association between the proximity to the nearest food outlet and childhood obesity in the home (OR = 0.77 [95% CI = 0.61 - 0.98]) or the school (OR = 1.01 [95% CI 0.84 - 1.23]) environment.
  
  
  CONCLUSIONS
  This study provides little support for the notion that exposure to food outlets in the home, school and commuting neighbourhoods increase the risk of obesity in children. It seems that the evidence is not well placed to support Governmental interventions/recommendations currently being proposed and that policy makers should approach policies designed to limit food outlets with caution.
authors.affiliation: Institute for Sport, Physical Activity and Leisure, Leeds Metropolitan University, Fairfax Hall, Headingley Campus, Leeds, LS6 3QS, UK. C.Griffiths@leedsmet.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Griffiths
authors.affiliation: The Office of the Director of Public Health Technorth, 9 Harrogate Road, Chapel Allerton, LS7 3NB, UK. anna.frearson@leeds.gov.uk.
authors.forename: Anna
authors.initials: A
authors.lastname: Frearson
authors.affiliation: The Office of the Director of Public Health, NHS Leeds/Leeds City Council, 2nd Floor West - Civic Hall, Leeds, LS1 1UR, UK. Adam.Taylor@leeds.gov.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Taylor
authors.affiliation: Institute for Sport, Physical Activity and Leisure, Leeds Metropolitan University, Fairfax Hall, Headingley Campus, Leeds, LS6 3QS, UK. Dunacan.Radley@leedsmet.ac.uk.
authors.forename: Duncan
authors.initials: D
authors.lastname: Radley
authors.affiliation: Institute for Sport, Physical Activity and Leisure, Leeds Metropolitan University, Fairfax Hall, Headingley Campus, Leeds, LS6 3QS, UK. C.Cooke@leedsmet.ac.uk.
authors.forename: Carlton
authors.initials: C
authors.lastname: Cooke
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D057140:Fast Foods; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D018673:Nutrition Policy; D063766:Pediatric Obesity / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012147:Restaurants / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology