Accessibility of fast food outlets is associated with fast food intake. A study in the Capital Region of Denmark
Section snippets
Background
Food environments are built environments described by the location of food outlets (FOs), and access to these environments is theorized to influence individual dietary patterns and, ultimately, risk of obesity and chronic diseases (Caspi et al., 2012). The accessibility of food is often defined by geographical measures from home to FOs. Specific measures hypothesized to be important contributors to eating patterns are proximity and density of different types of FOs (Boone-Heinonen et al., 2011b
The Danish Capital Region Health Survey
The present study is based on data from the Danish Capital Region Health Survey, a cross-sectional survey conducted in the 29 municipalities of the Capital Region of Denmark (Christensen et al., 2012, Hammer-Helmich et al., 2011). The survey was conducted from February to May 2010. A random sample of individuals was drawn from the Danish Civil Registration System (CRS). CRS identifies all inhabitants in Denmark by a unique 10-digit personal identification (CPR) number that allows record linkage
Characteristics of population
A total of 6203 participants (16.2%) reported consuming fast food at least once per week (Table 2). Frequent intake of fast food was highest among men, younger age groups, individuals of Danish origin, individuals with shorter education, and among those living in suburban municipalities. Frequent intake of fast food was lowest among the most affluent municipalities.
Accessibility of fast food outlets
Low FFO density and long distances to the nearest FFO were more prevalent in municipalities of higher SES (group 1) (Table 3). No
Discussion
We found an association between FFO access and fast food intake in the Capital Region of Denmark. Regardless of both individual and area characteristics, the likelihood of frequent fast food intake increased with increasing FFO density. Similarly, a resident's odds of frequent fast food intake decreased significantly with increasing distance to the nearest FFO (for distances up to 4 km). For distances greater than 4 km, the opposite association was found, although this applied only for car
Conclusion
This study presents results relevant for environmental influences on fast food intake in a Danish context, which differs in socioeconomic structures and urban form to the US and Australia. It is the first study based on validated FFO data to show that fast food accessibility measures are associated with weekly fast food intake in the Capital Region of Denmark. The association depended on both urbanicity and municipality SES. These results suggest that Danish health promotion strategies need to
Ethics
The research project was approved by the Danish Data Protection Agency according to the Danish Act on Processing of Personal Data. Approval from the Danish Health Research Ethics Committee System was not required according to Danish law, as the research project was purely based on data obtained from questionnaires and national registers. Written informed consent for publication based on the questionnaire data was provided by the participants when returning the questionnaires.
Declaration of conflicting interests
The authors declare that there are no conflicts of interest.
Acknowledgements
The authors thank the team behind the survey at the Research Centre for Prevention and Health. Furthermore, we thank all the participants who took part in the survey.
Funding
This project was funded by the Capital Region of Denmark.
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2020, Applied GeographyCitation Excerpt :The uncertainty in the spatial delineation of contextual units could have affected the associations between food accessibility and health-related behaviors (Black, Moon, & Baird, 2014; Kwan, 2012a, 2012b; Roux, 2007; Wilkins, Morris, Radley, & Griffiths, 2017). Most studies measured food accessibility in residential neighborhood (Feng, Glass, Curriero, Stewart, & Schwartz, 2010; Larson & Story, 2009; Walker, Keane, & Burke, 2010), either by an administrative boundary (e.g. census tract) (Apparicio, Cloutier, & Shearmur, 2007; Bower, Thorpe, Rohde, & Gaskin, 2014; Eckert & Vojnovic, 2017; Grow et al., 2010; Lamichhane et al., 2013; Lee & Lim, 2009; Li, Harmer, Cardinal, Bosworth, & Johnson-Shelton, 2009; Mooney et al., 2018; Moore & Diez Roux, 2006; Morland, Wing, & Roux, 2002; Pearce, Hiscock, Blakely, & Witten, 2008; Powell, Slater, Mirtcheva, Bao, & Chaloupka, 2007; Zenk et al., 2005), or by a home location buffer (Bernsdorf et al., 2017; Frank et al., 2009; Helbich, Schadenberg, Hagenauer, & Poelman, 2017; Jeffery, Baxter, McGuire, & Linde, 2006). A few studies compared healthy food accessibility among multiple delineations of residential neighborhoods (e.g. census tract and block group (Barnes et al., 2016); home location buffers with varying sizes (DuBreck et al., 2018; Burgoine, Alvanides, & Lake, 2013; Thornton, Pearce, Macdonald, Lamb, & Ellaway, 2012)) and found that different definitions of residential neighborhoods could affect the magnitude of food accessibility and its associations with health outcomes.
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2019, Health and PlaceCitation Excerpt :Stronger associations between the RFE and obesity-related outcomes have been found within more deprived neighbourhoods (Bernsdorf et al., 2017; Fiechtner et al., 2015; Thomsen et al., 2016). Differential associations have also been observed for people of differing income and education (Burgoine et al., 2016; Reitzel et al., 2014), ethnicity (Wong et al., 2017), age (Dwicaksono et al., 2017) and across urban/rural residences (Bernsdorf et al., 2017). Existing systematic reviews either do not account for potential divergent effects across measurement methods or population groups (Williams et al., 2014; Casey et al., 2014), or account only for a limited range of factors using simplistic groupings of studies; for example grouping diverse methods together (Cobb et al., 2015; Feng et al., 2010; Gamba et al., 2015; Caspi et al., 2012).
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Present address: Center for diabetes, Municipality of Copenhagen, Vesterbrogade 121, 3rd floor, 1620 Copenhagen V, Denmark.