We examined associations between fast-food intake and perceived and objective fast-food outlet exposure.

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.

Data represent 4642 adolescents (aged 11–15 years) in Denmark.

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.

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.