title: Association between junk food consumption and fast-food outlet access near school among Quebec secondary-school children: findings from the Quebec Health Survey of High School Students (QHSHSS) 2010-11.
abstract: We investigated the association between junk food consumption at lunchtime (JCL) and fast-food outlet access near school among secondary-school children in Quebec.
  
  
  
  A geographic information system database was used to characterize the food environment around a sub-sample of 374 public schools in which 26 655 students were enrolled. The outcome variable was JCL during the previous week, dichotomized into low JCL (none or once) v. high JCL (twice or more). Access to fast-food outlets near school was assessed using an existing database of fast-food outlets in Quebec. Covariates included student (age, sex and self-rated perceived health), family (familial status and parental education) and school (urban/rural status and deprivation) variables. Hierarchical logistic regression models were employed for analyses using PROC GLIMMIX of SAS version 9.3.
  
  
  
  Province of Quebec, Canada.
  
  
  
  We used data from the Quebec Health Survey of High School Students (QHSHSS) 2010-11, a survey of secondary-school Quebec students.
  
  
  
  Exposure to two or more fast-food outlets within a radius of 750 m around schools was associated with a higher likelihood of excess JCL (OR=1·50; 95 % CI 1·28, 1·75), controlling for the characteristics of the students, their families and their schools.
  
  
  
  The food environment surrounding schools can constitute a target for interventions to improve food choices among secondary-school children living in the province of Quebec. Transforming environments around schools to promote healthy eating includes modifying zoning regulations that restrict access to fast-food outlets around schools.
authors.affiliation: 1INRS (National Institute for Scientific Research/Institut national de la recherche scientifique) - Institut Armand Frappier Research Center,531 Boul des Prairies,Building 12,Office 109,Laval,Quebec,Canada,H7V 1B7.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Cutumisu
authors.affiliation: 3Institute of Statistics of Quebec (Institut de la statistique du Québec),Montreal,Quebec,Canada.
authors.forename: Issouf
authors.initials: I
authors.lastname: Traoré
authors.affiliation: 2National Public Health Institute of Quebec (Institut national de santé publique du Québec),Montreal,Quebec,Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Paquette
authors.affiliation: 3Institute of Statistics of Quebec (Institut de la statistique du Québec),Montreal,Quebec,Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Cazale
authors.affiliation: 3Institute of Statistics of Quebec (Institut de la statistique du Québec),Montreal,Quebec,Canada.
authors.forename: Hélène
authors.initials: H
authors.lastname: Camirand
authors.affiliation: 2National Public Health Institute of Quebec (Institut national de santé publique du Québec),Montreal,Quebec,Canada.
authors.forename: Benoit
authors.initials: B
authors.lastname: Lalonde
authors.affiliation: 2National Public Health Institute of Quebec (Institut national de santé publique du Québec),Montreal,Quebec,Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Robitaille
mesh_terms: D000293:Adolescent; D002648:Child; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D004032:Diet; D057140:Fast Foods; D005260:Female; D005518:Food Preferences; D005522:Food Services; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D011792:Quebec; D012111:Residence Characteristics; D012574:Schools; D012959:Socioeconomic Factors; D013334:Students
keywords: Fast-food access; Geographic information systems; Junk food consumption; Secondary-school children