title: Fast-food intake and perceived and objective measures of the local fast-food environment in adolescents.
abstract: OBJECTIVE
  We examined associations between fast-food intake and perceived and objective fast-food outlet exposure.
  
  
  METHODS
  Information from the Health Behaviours in School-aged Children Study was linked to fast-food outlets in seventy-five school neighbourhoods. We used multivariate multilevel logistic regression analyses to examine associations between at least weekly fast-food intake and perceived and objective fast-food outlet measures.
  
  
  METHODS
  Data represent 4642 adolescents (aged 11-15 years) in Denmark.
  
  
  RESULTS
  Boys reporting two or more fast-food outlets had 34% higher odds consuming fast food at least weekly. We detected higher odds of at least weekly fast-food intake among 15-year-old 9th graders (ORall=1.74; 95% CI 1.40, 2.18; ORboys=2.20; 95% CI 1.66, 2.91; ORgirls=1.41; 95% CI 1.03, 1.92), Danish speakers (ORall=2.32; 95% CI 1.68, 3.19; ORboys=2.58; 95% CI 1.69, 3.93; ORgirls=2.37; 95% CI 1.46, 3.84) and those travelling 15 min or less to school (ORall=1.21; 95% CI 1.00, 1.46; ORgirls=1.44; 95% CI 1.08, 1.93) compared with 11-year-old 5th graders, non-Danish speakers and those with longer travel times. Boys from middle- (OR=1.28; 95% CI 1.00, 1.65) and girls from low-income families (OR=1.46; 95% CI 1.05, 2.04) had higher odds of at least weekly fast-food intake compared with those from high-income backgrounds. Girls attending schools with canteens (OR=1.47; 95% CI 1.00, 2.15) had higher odds of at least weekly fast-food intake than girls at schools without canteens.
  
  
  CONCLUSIONS
  The present study demonstrates that perceived food outlets may impact fast-food intake in boys while proximity impacts intake in girls. Public health planning could target food environments that emphasize a better understanding of how adolescents use local resources.
authors.affiliation: 1Global Nutrition and Health, Metropolitan University College,Pustervig 8,1126 Copenhagen K,Denmark.
authors.forename: Chalida
authors.initials: C
authors.lastname: Svastisalee
authors.affiliation: 2National Institute of Public Health,University of Southern Denmark,Copenhagen,Denmark.
authors.forename: Trine
authors.initials: T
authors.lastname: Pagh Pedersen
authors.affiliation: 3Institute of Sports Science and Biomechanics,University of Southern Denmark,Odense,Denmark.
authors.forename: Jasper
authors.identifier: http://orcid.org/0000-0002-6558-7610
authors.initials: J
authors.lastname: Schipperijn
authors.affiliation: 2National Institute of Public Health,University of Southern Denmark,Copenhagen,Denmark.
authors.forename: Sanne Ellegaard
authors.initials: SE
authors.lastname: Jørgensen
authors.affiliation: 2National Institute of Public Health,University of Southern Denmark,Copenhagen,Denmark.
authors.forename: Bjørn E
authors.initials: BE
authors.lastname: Holstein
authors.affiliation: 2National Institute of Public Health,University of Southern Denmark,Copenhagen,Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Krølner
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003718:Denmark; D057140:Fast Foods; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D055361:Multilevel Analysis; D012111:Residence Characteristics; D012574:Schools; D012959:Socioeconomic Factors
keywords: Adolescents; Built environment; Fast-food intake; Measures; Schools