title: Fast-food outlets and grocery stores near school and adolescents' eating habits and overweight in Finland.
abstract: BACKGROUND
  Environmental factors may affect adolescents' eating habits and thereby body weight. However, the contribution of school neighbourhood environment is poorly understood. This study examined the association between proximity of a fast-food outlet or grocery store to school and adolescents' eating habits and overweight.
  
  
  METHODS
  Participants were 23 182 adolescents (mean age 15 years) who responded to a classroom survey in 181 lower secondary schools in Finland (2008-09). School location was linked to data on distance from school to the nearest fast-food outlet or grocery store (≤100 m, 101-500 m, >500 m) using global positioning system-coordinate databases. Outcomes were irregular eating habits (skipping breakfast, skipping free school lunch, skipping free school-provided snacks and not having family dinners), the accumulation of these habits and overweight, including obesity (body mass index ≥ 25 kg/m(2)).
  
  
  RESULTS
  Thirteen percentage of the participants were overweight. Having a fast-food outlet or grocery store near school was associated with skipping often breakfast and free school lunch, and the accumulation of irregular eating habits. The proximity of a fast-food outlet or grocery store was associated with a 1.25-fold (95% confidence interval 1.03-1.52) risk of overweight among adolescent with a low socioeconomic status but not among those with higher socioeconomic status. This association was partly (12%) explained by the accumulation of irregular eating habits.
  
  
  CONCLUSIONS
  Among adolescents from low socioeconomic background, the presence of fast-food retailers near schools is associated with accumulation of irregular eating habits and greater overweight. These findings suggest that obesogenic school neighbourhoods may contribute to social inequalities in overweight.
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland marianna.virtanen@ttl.fi.
authors: Marianna
authors: M
authors: Virtanen
authors: 2 Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland.
authors: Hanne
authors: H
authors: Kivimäki
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Jenni
authors: J
authors: Ervasti
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Tuula
authors: T
authors: Oksanen
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Jaana
authors: J
authors: Pentti
authors: 3 Department of Social Research, University of Helsinki, Helsinki, Finland 4 University of Social Sciences and Humanities, Faculty in Wroclaw, Wroclaw, Poland 5 UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, UK.
authors: Anne
authors: A
authors: Kouvonen
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Jaana I
authors: JI
authors: Halonen
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland 6 Department of Epidemiology and Public Health, University College London, London, UK.
authors: Mika
authors: M
authors: Kivimäki
authors: 1 Finnish Institute of Occupational Health, Helsinki, Finland 7 Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
authors: Jussi
authors: J
authors: Vahtera
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D057140:Fast Foods / Q000706:statistics & numerical data*; D005247:Feeding Behavior; D005260:Female; D005387:Finland / Q000453:epidemiology; D005523:Food Supply / Q000706:statistics & numerical data*; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors