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      Correlates of English local government use of the planning system to regulate hot food takeaway outlets: a cross-sectional analysis

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          Abstract

          Background

          Greater neighbourhood takeaway food outlet access has been associated with increased takeaway food consumption and higher body weight. National planning guidelines in England suggest that urban planning could promote healthier food environments through takeaway food outlet regulation, for example by restricting the proliferation of outlets near schools. It is unknown how geographically widespread this approach is, or local characteristics associated with its use. We aimed to address these knowledge gaps.

          Methods

          We used data from a complete review of planning policy documents adopted by local government areas in England ( n = 325), which contained policies for the purpose of takeaway food outlet regulation. This review classified local government area planning policies as having a health (diet or obesity) or non-health focus. We explored geographical clustering of similar planning policies using spatial statistics. We used multinomial logistic regression models to investigate whether the odds of planning policy adoption varied according to local characteristics, for example the proportion of children with excess weight or the current number of takeaway food outlets.

          Results

          We observed clusters of local government areas with similar adopted planning policies in the North East, North West, and Greater London regions of England. In unadjusted logistic regression models, compared to local government areas with the lowest, those with highest proportion of 10–11 year olds with excess weight (OR: 25.31; 95% CI: 6.74, 94.96), and takeaway food outlet number (OR: 54.00; 95% CI: 6.17, 472.41), were more likely to have a health-focused planning policy, than none. In models adjusted for deprivation, relationships for excess weight metrics were attenuated. Compared to local government areas with the lowest, those with the highest takeaway food outlet number remained more likely to have a health-focused planning policy, than none (OR: 16.98; 95% CI: 1.44, 199.04). When local government areas were under Labour political control, predominantly urban, and when they had more geographically proximal and statistically similar areas in the same planning policy status category, they were also more likely to have health-focused planning policies.

          Conclusions

          Planning policies for the purpose of takeaway food outlet regulation with a health focus were more likely in areas with greater numbers of takeaway food outlets and higher proportions of children with excess weight. Other characteristics including Labour political control, greater deprivation and urbanisation, were associated with planning policy adoption, as were the actions of similar and nearby local government areas. Further research should engage with local policymakers to explore the drivers underpinning use of this approach.

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          Most cited references19

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            The built environment and obesity: a systematic review of the epidemiologic evidence.

            We completed a systematic search of the epidemiologic literature on built environment and obesity and identified 63 relevant papers, which were then evaluated for the quality of between-study evidence. We were able to classify studies into one of two primary approaches for defining place and corresponding geographic areas of influence: those based on contextual effects derived from shared pre-determined administrative units and those based on individually unique geographic buffers. The 22 contextual papers evaluated 80 relations, 38 of which did not achieve statistical significance. The 15 buffer papers evaluated 40 relations, 24 of which did not achieve statistical significance. There was very little between-study similarity in methods in both types of approaches, which prevented estimation of pooled effects. The great heterogeneity across studies limits what can be learned from this body of evidence. Copyright 2009 Elsevier Ltd. All rights reserved.
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              Persistent effect at 30-month post intervention of a community-based randomized trial of KM2H 2 in reducing stroke and heart attack among senior hypertensive patients

              Background The effect of the Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) program at 6-month post intervention has been assessed.  The purpose of this study is to evaluate the KM2H2 program at 30-month post intervention. Methods A total of 450 senior hypertensive patients from 12 community health centers were randomized by center to either receive KM2H2 plus standard care (6 centers, n = 232) or standard care only (6 centers, n = 218). Data for outcome measures at 30-month post intervention were analyzed. New cases of stroke and heart attack were verified with medical records; levels of physical activity were assessed using self-reported questionnaire. In addition to comparative analysis, adjusted incidence rate and program effects were determined using mixed effects modeling method. Results At the 30-month follow-up, the adjusted incidence rate [95% CI] of stroke was 11.81% [5.90, 17.72] for patients in the intervention group and 19.78% [14.07, 25.50] (p = 0.03) for the control group. The adjusted incidence rate of heart attack was 3.34% [1.91, 8.58] and 6.68% [1.64, 11.73] for the intervention and control groups (p = 0.16), respectively; the proportion and the duration of engaging in regular physical activity were significantly greater for the intervention group than the control group. The reductions in blood pressure between the intervention and the control was not statistically significant. Conclusions The KM2H2 program showed a persistent effect up to 30 months post intervention in enhancing physical activity and reducing the risk of cardio-cerebrovascular events, particularly stroke. These findings demonstrate the persistent effect of the KM2H2 and suggest the need for a full-scale evaluation of the intervention program for practical use. Trial registration ISRCTN Register ISRCTN12608966. Registered 03 March 2015. Retrospectively registered.
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                Author and article information

                Contributors
                Matthew.Keeble@mrc-epid.cam.ac.uk
                jma79@medschl.cam.ac.uk
                Martin.White@mrc-epid.cam.ac.uk
                carolyn.summerbell@durham.ac.uk
                Steven.Cummins@lshtm.ac.uk
                tb464@medschl.cam.ac.uk
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                9 December 2019
                9 December 2019
                2019
                : 16
                : 127
                Affiliations
                [1 ]ISNI 0000000121885934, GRID grid.5335.0, UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, , University of Cambridge, School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, ; Cambridge, CB2 0QQ England
                [2 ]ISNI 0000 0000 8700 0572, GRID grid.8250.f, Fuse: the centre for translational research in public health, Department of Sport and Exercise Sciences, , Durham University, ; 32 Old Elvet, Durham, DH1 3HN England
                [3 ]ISNI 0000 0004 0425 469X, GRID grid.8991.9, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, , London School of Hygiene and Tropical Medicine, ; 15-17 Tavistock Place, London, WC1H 9SH England
                Author information
                http://orcid.org/0000-0002-1512-7421
                Article
                884
                10.1186/s12966-019-0884-4
                6902532
                31818307
                56e3fa7f-e9be-4d06-8dff-891ab26f8c1f
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 April 2019
                : 13 November 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100012349, School for Public Health Research;
                Award ID: PD-SPH-2015-10025
                Funded by: Economic and Social Research Council
                Award ID: ES/G007462/1
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 087636/Z/08/Z
                Funded by: Cancer Research UK
                Award ID: ES/G007462/1
                Funded by: Medical Research Council
                Award ID: ES/G007462/1
                Funded by: FundRef http://dx.doi.org/10.13039/501100000274, British Heart Foundation;
                Award ID: ES/G007462/1
                Funded by: National Institute for Health Research
                Award ID: ES/G007462/1
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Nutrition & Dietetics
                takeaway food outlet,fast food,food environment,urban planning,local government,diet,geography,england

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