Background Amid rising childhood obesity, local governments in England are introducing planning policies to restrict opening of new takeaways near schools. Extending the focus beyond outlets targeted by these policies, we analyse relationships between different types of food outlets near schools, food purchases, and the intake of foods high in fat, sugar or salt (HFSS) during school time by adolescents aged 17–18 years. Methods The Diet and Eating Behaviours across Early Adulthood Transitions (DEBEAT) study collected data from students in the final year of school (Year 13) between September 2023 and April 2024 in England, the United Kingdom. Diet data were collected using three online 24-h dietary recalls, with school and personal data reported by questionnaire. Exposures were counts of seven food outlet types within 400m buffers around school boundaries. Multilevel logistic regression analysed associations between exposure to each type of food outlet and two binary outcomes: 1) purchase of food from a food outlet as opposed to food obtained from elsewhere (e.g., home and school), and 2) eating occasions which had >50% of energy intake from HFSS foods, as opposed to those of ≤50% energy intake from HFSS foods, during school hours. Analyses were adjusted for exposure to other food outlet types, school characteristics, individual sociodemographic and health-related covariates. Results Our analyses included 1245 individuals who attended 222 schools and reported data across 3074 eating occasions within school hours. Of these eating occasions, 20% included food purchased from a food outlet, and 55% contained >50% energy from HFSS foods. Of the 222 schools, two thirds had at least one takeaway in the surrounding area, 55% a supermarket, and 30% a chain fast-food outlet. Only exposure to supermarkets was associated with greater odds of purchasing food from a food outlet: OR 1.61 (95% CI: 1.07, 2.42) for exposure to 1–2 supermarkets, compared to no supermarkets. Weak evidence suggested that greater exposure to either chain fast-food outlets (OR 1.40, 95% CI 0.90, 2.18 for exposure to ≥3 fast-food outlets) or takeaways (OR 1.13, 95% CI 0.73, 1.76 for exposure to >5 takeaways) was associated with increased odds of HFSS food intake. Conclusions Greater supermarket exposure near schools was associated with a higher probability of food outlet use during school time, but not with a higher likelihood of a high-HFSS eating occasion. Takeaway-focused planning policies do not fully address the range of outlets used by older adolescents for school-time food purchasing, particularly supermarkets.
Urban density is a central concern in urban design and public health, yet evidence on its relationships with health is dispersed across disciplines. This study used bibliometric methods to map the global research landscape on urban density and health, and to identify publication trends, themes, key contributors, and research priorities. A search of the Web of Science Core Collection in May 2025 combined terms for density, health, and urban context. English-language articles and reviews were screened, cleaned, and analysed. Performance analysis and science mapping techniques, including co-authorship, co-citation, and keyword co-occurrence, were conducted using VOSviewer. The dataset comprised 1,670 publications published between 1965 and 2025, with marked growth after 2019. Research output was concentrated in high-income countries, particularly the Global North, with no African country among the most productive contributors. Frequently co-cited sources showed a multidisciplinary field spanning public health, urban design, and physical activity research. Keyword analysis identified nine clusters. Built environment, walkability, and physical activity formed the core. Green space and metabolic health appeared as a distinct but less prominent cluster. These findings show that density-health research has been organised mainly around built environment and movement-related pathways. Psychosocial, environmental exposure, and equity-related pathways remain less integrated. For urban health practice, the findings identify evidence gaps that are relevant to policy and planning. These patterns indicate a need for broader geographical coverage, stronger attention to non-mobility and psychosocial pathways, clearer and more comparable density measures, and deeper cross-disciplinary integration to generate evidence that can better inform healthy densification policies.
