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Issues in Measuring the Healthiness of Food Environments and Interpreting Relationships with Diet, Obesity and Related Health Outcomes

  • Etiology of Obesity (T Gill, Section Editor)
  • Published:
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Abstract

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.

Recent Findings

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.

Summary

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.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, et al. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev. 2013;14(S1):1–12.

    Article  PubMed  Google Scholar 

  2. Swinburn B, Sacks G, Hall K, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.

    Article  PubMed  Google Scholar 

  3. World Health Organization. Global action plan for the prevention and control of non-communicable diseases 2013–2020 Geneva: WHO; 2013 [cited March 2019]. Available from: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1&ua=1.

  4. World Health Organization. Global strategy on diet, physical activity and health Geneva: WHO; 2004 [cited March 2019]. Available from: http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf.

  5. Hall KD. Did the food environment cause the obesity epidemic? Obesity (Silver Spring, Md). 2018;26(1):11–3.

    Article  Google Scholar 

  6. World Health Organization. Report of the commission on ending childhood obesity Geneva: WHO; 2016 [cited March 2019]. Available from: http://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf?sequence=1&isAllowed=y.

  7. Cobb LK, Appel LJ, Franco M, Jones-Smith JC, Nur A, Anderson CAM. The relationship of the local food environment with obesity: a systematic review of methods, study quality, and results. Obesity. 2015;23(7):1331–44.

    Article  PubMed  Google Scholar 

  8. Gamba RJ, Schuchter J, Rutt C, Seto EYW. Measuring the food environment and its effects on obesity in the United States: a systematic review of methods and results. J Community Health. 2015;40(3):464–75.

    Article  PubMed  Google Scholar 

  9. Gustafson A, Hankins S, Jilcott S. Measures of the consumer food store environment: a systematic review of the evidence 2000-2011. J Community Health. 2012;37(4):897–911.

    Article  PubMed  Google Scholar 

  10. •• Rodgers A, Woodward A, Swinburn B, Dietz WH. Prevalence trends tell us what did not precipitate the US obesity epidemic. Lancet Public Health. 2018;3(4):e162–e3 Indicates role of food environment as driver of obesity epidemic.

    Article  PubMed  Google Scholar 

  11. Vandevijvere S, Chow CC, Hall KD, Umali E, Swinburn BA. Increased food energy supply as a major driver of the obesity epidemic: a global analysis. Bull World Health Organ. 2015;93(7):446–56.

    Article  PubMed  PubMed Central  Google Scholar 

  12. McKinnon RA, Reedy J, Handy SL, Rodgers AB. Measuring the food and physical activity environments: shaping the research agenda. Am J Prev Med. 2009;36(4, Supplement):S81–S5.

    Article  PubMed  Google Scholar 

  13. Caspi CE, Sorensen G, Subramanian SV, Kawachi I. The local food environment and diet: a systematic review. Health Place. 2012;18(5):1172–87.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Engler-Stringer R, Le H, Gerrard A, Muhajarine N. The community and consumer food environment and children’s diet: a systematic review. BMC Public Health. 2014;29(May):14.

    Google Scholar 

  15. Feng J, Glass TA, Curriero FC, Stewart WF, Schwartz BS. The built environment and obesity: a systematic review of the epidemiologic evidence. Health Place. 2010;16(2):175–90.

    Article  PubMed  Google Scholar 

  16. Fleischhacker SE, Evenson KR, Rodriguez DA, Ammerman AS. A systematic review of fast food access studies. Obes Rev. 2011;12(5):e460–e71.

    Article  CAS  PubMed  Google Scholar 

  17. Giskes K, Fv L, Avendano-Pabon M, Brug J. A systematic review of environmental factors and obesogenic dietary intakes among adults: are we getting closer to understanding obesogenic environments? Obes Rev. 2011;12(5):e95–e106.

    Article  CAS  PubMed  Google Scholar 

  18. Holsten JE. Obesity and the community food environment: a systematic review. Public Health Nutr. 2009;12(3):397–405.

    PubMed  Google Scholar 

  19. Williams J, Scarborough P, Matthews A, Cowburn G, Foster C, Roberts N, et al. A systematic review of the influence of the retail food environment around schools on obesity-related outcomes. Obes Rev. 2014;15(5):359–74.

    Article  CAS  PubMed  Google Scholar 

  20. Kelly B, Flood VM, Yeatman H. Measuring local food environments: an overview of available methods and measures. Health Place. 2011;17(6):1284–93.

    Article  PubMed  Google Scholar 

  21. Kirkpatrick SI, Reedy J, Butler EN, Dodd KW, Subar AF, Thompson FE, et al. Dietary assessment in food environment research: a systematic review. Am J Prev Med. 2014;46(1):94–102.

    Article  PubMed  PubMed Central  Google Scholar 

  22. • Lytle LA, Sokol RL. Measures of the food environment: a systematic review of the field, 2007–2015. Health Place. 2017;44:18–34 A comprehenisve systematic review of the methods employed to measure the food environment.

    Article  PubMed  Google Scholar 

  23. McKinnon RA, Reedy J, Morrissette MA, Lytle LA, Yaroch AL. Measures of the food environment: a compilation of the literature, 1990–2007. Am J Prev Med. 2009;36(4, Supplement):S124–S33.

    Article  PubMed  Google Scholar 

  24. Smith M, Stanley J, Signal L, Barr M, Chambers T, Balina A, et al. Children’s healthy and unhealthy beverage availability, purchase and consumption: a wearable camera study. Appetite. 2019;133:240–51.

    Article  PubMed  Google Scholar 

  25. • Clary C, Cummins S, Shareck M. Enduring challenges in estimating the effect of the food environment on obesity. Am J Clin Nutr. 2017;106(2):445–6 Provides a brief summary of challenges in estimating the effect of the food environment on obesity.

    Article  CAS  PubMed  Google Scholar 

  26. Lewis DJ, Flint E, Smith NR, Cummins S, Kestens Y, Clary C. The local food environment and fruit and vegetable intake: a geographically weighted regression approach in the ORiEL study. Am J Epidemiol. 2016;184(11):837–46.

    Article  PubMed  PubMed Central  Google Scholar 

  27. • Vandevijvere S, Mackay S, D’Souza E, Swinburn B. How healthy are New Zealand food environments? A comprehensive assessment 2014–2017. Auckland, New Zealand: 2018. Comprehensive and novel approach to assessing food environments in New Zealand.

  28. Moayyed H, Kelly B, Feng X, Flood V. Is living near healthier food stores associated with better food intake in regional Australia? Int J Environ Res Public Health. 2017;14(8):884.

    Article  PubMed Central  Google Scholar 

  29. Dunford EK, Neal B. FoodSwitch and use of crowdsourcing to inform nutrient databases. J Food Compos Anal. 2017;64:13–7.

    Article  Google Scholar 

  30. Vandevijvere S, Williams R, Tawfiq E, Swinburn B. A food environments feedback system (FoodBack) for empowering citizens and change agents to create healthier community food places. Health Promot Int 2017;1–14.

  31. • Vandevijvere S, Waterlander W, Molloy J, Nattrass H, Swinburn B. Towards healthier supermarkets: a national study of in-store food availability, prominence and promotions in New Zealand. Eur J Clin Nutr. 2018;72:971–8 Application of a comprehensive, validated tool for assessing in-store food environments.

    Article  PubMed  Google Scholar 

  32. World Health Organization. WHO Regional Office for Europe Nutrient Profile Model Geneva: WHO; 2015 [cited January 2019]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0005/270716/Nutrient-children_web-new.pdf?ua=1.

  33. World Health Organization. WHO nutrient profile model for the Western Pacific Region: a tool to protect children from food marketing Geneva: World Health Organization; 2016 [cited January 2019]. Available from: http://iris.wpro.who.int/bitstream/handle/10665.1/13525/9789290617853-eng.pdf.

  34. Pan American Health Organization. Pan American health organization nutrient profile model Washington, D.C: Pan American health organization; 2016 [cited January 2019]. Available from: http://iris.paho.org/xmlui/bitstream/handle/123456789/18621/9789275118733_eng.pdf?sequence=9&isAllowed=y.

  35. Australian Government. Health star rating system Canberra 2014 [cited January 2019]. Available from: http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/Applying-to-your-products.

  36. Bandy L, Adhikari V, Jebb S, Rayner M. The use of commercial food purchase data for public health nutrition research: a systematic review. PLoS One. 2019;14(1):e0210192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho A. Acculturation and obesity among migrant populations in high income countries – a systematic review. BMC Public Health. 2013;13:458.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Leatherdale ST. Natural experiment methodology for research: a review of how different methods can support real-world research. Int J Soc Res Methodol. 2019;22(1):19–35.

    Article  Google Scholar 

  39. Mayne SL, Auchincloss AH, Michael YL. Impact of policy and built environment changes on obesity-related outcomes: a systematic review of naturally occurring experiments. Obes Rev. 2015;16(5):362–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: a review of food deserts literature. Health Place. 2010;16(5):876–84.

    Article  PubMed  Google Scholar 

  41. Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966–2007. Prev Chronic Dis. 2009;6(3):A105.

    PubMed  PubMed Central  Google Scholar 

  42. INFORMAS. INFORMAS: benchmarking food environments [cited March 2019]. Available from: https://www.informas.org/.

  43. Charlton EL, Kähkönen LA, Sacks G, Cameron AJ. Supermarkets and unhealthy food marketing: an international comparison of the content of supermarket catalogues/circulars. Prev Med. 2015;81:168–73.

    Article  PubMed  Google Scholar 

  44. Thornton LE, Cameron AJ, McNaughton SA, Waterlander WE, Sodergren M, Svastisalee C, et al. Does the availability of snack foods in supermarkets vary internationally? Int J Behav Nutr Phys Act. 2013;10(1):56.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

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.

Contribution Statement

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.

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Authors and Affiliations

  1. Global Obesity Centre, Melbourne Burwood Campus, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia

    Gary Sacks, Ella Robinson & Adrian J. Cameron

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  1. Gary Sacks
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Correspondence to Gary Sacks.

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Sacks, G., Robinson, E. & Cameron, A.J. Issues in Measuring the Healthiness of Food Environments and Interpreting Relationships with Diet, Obesity and Related Health Outcomes. Curr Obes Rep 8, 98–111 (2019). https://doi.org/10.1007/s13679-019-00342-4

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