Fast-food intake and perceived and objective measures of the local fast-food environment in adolescents

OBJECTIVE: We examined associations between fast-food intake and perceived and objective fast-food outlet exposure. DESIGN: 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. SUBJECTS: 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.