The community food environment and its association with diet, health or weight status in Australia: A systematic review with recommendations for future research

Alexia Bivoltsis; Hayley Christian; Gina L Ambrosini; Paula Hooper; Claire E Pulker; Lukar Thornton; Gina S A Trapp

doi:10.1002/hpja.679

The community food environment and its association with diet, health or weight status in Australia: A systematic review with recommendations for future research

Health Promot J Austr. 2023 Apr;34(2):328-365. doi: 10.1002/hpja.679. Epub 2022 Dec 12.

Authors

Alexia Bivoltsis¹, Hayley Christian^{2

3}, Gina L Ambrosini⁴, Paula Hooper⁵, Claire E Pulker^{6

7}, Lukar Thornton⁸, Gina S A Trapp^{1

3}

Affiliations

¹ Telethon Kids Institute, Nedlands, Western Australia, Australia.
² Telethon Kids Institute, The University of Western Australia, Perth, Australia.
³ School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia.
⁴ Public and Aboriginal Health Division, Western Australian Department of Health, East Perth, Western Australia, Australia.
⁵ The Australian Urban Design Research Centre (AUDRC), School of Design, The University of Western Australia, Nedlands, Western Australia, Australia.
⁶ School of Population Health, Curtin University, Bentley, Western Australia, Australia.
⁷ Community & Population Health, East Metropolitan Health Service, Perth, Western Australia, Australia.
⁸ Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium.

PMID: 36433658
DOI: 10.1002/hpja.679

Abstract

Issue addressed: This study systematically reviewed Australian literature to determine if an association exists between geospatial exposure to food outlets and diet, health or weight status. Recommendations for future research are provided.

Methods: A systematic literature search was conducted in December 2021 using CINAHL Plus, PubMed and Web of Science databases. Data were extracted, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using an eight-item checklist. A descriptive synthesis of study characteristics and findings was carried out, stratified via study outcomes.

Results: Of the 36 included articles, the majority were from Victoria (n = 19), involving adult participants (n = 30) and cross-sectional in design (n = 27). Overall, associations were mainly null (nonsignificant) for diet (80%), weight status (75%) and health outcomes (90%). Significant findings were mixed with no positive trend with study quality.

Conclusions: Six recommendations are suggested to address current knowledge gaps and limitations in the Australian evidence base: (1) Conduct research on different populations; (2) Employ robust study designs that can test the impact of change over time; (3) Improve the accuracy of food outlet data sources; (4) Improve food outlet geospatial exposure measures; (5) Improve measurement of outcome variables; and (6) Incorporate theoretical models into study design and data analysis. SO WHAT?: Improving the quality and consistency of research will be critical to informing locally relevant policy. Despite the present limitations in the evidence base, it is reasonable to assume that decisions to purchase and consume food are driven by availability and access. Thus, policy and planning aimed at improving the overall "healthiness" of the community food environment by increasing access to healthy food outlets is warranted to ensure that healthy options are easier choice for all.

Keywords: Australia; diet; fast food; food environment; obesity; review; supermarket.

Publication types

Systematic Review
Review

MeSH terms

Adult
Cross-Sectional Studies
Diet*
Environment
Humans
Social Environment*
Victoria