Issues in Measuring the Healthiness of Food Environments and Interpreting Relationships with Diet, Obesity and Related Health Outcomes
Purpose of Review
There is a broad consensus that policies to create healthier food environments are needed to address obesity. However, previous reviews of the relationships between the healthiness of food environments and diet/obesity-related outcomes have typically reported either mixed associations or none at all. This paper aimed to synthesise measurement and interpretation issues in this field, based on findings from previous reviews.
Key issues, drawn from 14 previous reviews in the last decade, included: (1) the use of measures of the food environments that are too narrow in scope; (2) inadequate measures of the way in which people are exposed to, and interact with, food environments; and (3) large heterogeneity in tools and methods used.
To evaluate the impact of food environments on diet and health, composite measures of the healthiness of food environments, informed by actual usage patterns, need to be developed and consistently applied.
KeywordsFood environments Obesity prevention Diet
GS is the recipient of an Australian Research Council Discovery Early Career Researcher Award (DE160100307) and a Heart Foundation Future Leader Fellowship from the National Heart Foundation of Australia. AJC is the recipient of an Australian Research Council Discovery Early Career Researcher Award (DE160100141). GS is a researcher within a NHMRC Centre for Research Excellence entitled Reducing Salt Intake Using Food Policy Interventions (APP1117300). GS and AJC are researchers within a NHMRC Centre of Research Excellence in Food Retail Environments for Health (APP1152968). GS and ER received funding related to this work from the Australian Government’s Medical Research Future Fund (MRFF) that provided funding to The Australian Prevention Partnership Centre under the Boosting Preventative Health Research Program. GS and AJC are academic partners on a healthy supermarket intervention trial that includes Australian local government and supermarket retail (IGA) collaborators.
GS and ER contributed equally to this paper. GS led the conceptual framing of the manuscript, data analysis and the writing of the manuscript. ER performed literature searches and data extraction, and contributed to data analysis and editing of the manuscript. AJC contributed to the data analysis and editing of the manuscript. All authors read and approved the final version of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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