Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?

Abstract

This review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multidimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions.

Keywords: Dietary inequalities; Food environment; Review.

Figure 1

Model of nutrition environments (Glanz et al. 2005)

Figure 2

Summary of findings relating density of healthier food stores to better dietary quality or higher fruit and vegetable intake. * Across 42 different exposure measures, 17 studies and 21 papers.

Figure 3

Summary of findings relating proximity of healthier food stores to better dietary quality/fruit and vegetable intake. * Across 11 different exposure measures, 16 studies and 18 papers.

Figure 4

Summary of findings relating density of less healthy food stores to poorer dietary outcome. * Across 10 different exposure measures for convenience stores, 7 studies and 7 papers. * Across 12 different exposure measures for fast food outlets, 8 studies and 9 papers. * 2 studies were not included in the convenience store calculation because different outcome measures were used. * 5 studies were not included in the fast food outlet calculation because different outcome measures were used.

Figure 5

Summary of findings relating density of less healthy stores to poorer dietary outcomes. * Across 5 different exposure measures for convenience stores, 7 studies and 7 papers. * Across 1 different exposure measures for fast food outlets, 4 studies and 5 papers. * 1 study was not included in the convenience store calculation because different outcome measures were used. * 1 study was not included in the fast food outlet calculation because different outcome measures were used.