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. 2015 Jul;23(7):1331-44.
doi: 10.1002/oby.21118. Epub 2015 Jun 12.

The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results

Laura K Cobb  1   2 , Lawrence J Appel  1   2   3 , Manuel Franco  1   4 , Jessica C Jones-Smith  5 , Alana Nur  1 , Cheryl A M Anderson  1   6
Affiliations

The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results

Laura K Cobb et al. Obesity (Silver Spring). 2015 Jul.

Erratum in

Abstract

Objective: To examine the relationship between local food environments and obesity and assess the quality of studies reviewed.

Methods: Systematic keyword searches identified studies from US and Canada that assessed the relationship of obesity to local food environments. We applied a quality metric based on design, exposure and outcome measurement, and analysis.

Results: We identified 71 studies representing 65 cohorts. Overall, study quality was low; 60 studies were cross-sectional. Associations between food outlet availability and obesity were predominantly null. Among non-null associations, we saw a trend toward inverse associations between supermarket availability and obesity (22 negative, 4 positive, 67 null) and direct associations between fast food and obesity (29 positive, 6 negative, 71 null) in adults. We saw direct associations between fast food availability and obesity in lower income children (12 positive, 7 null). Indices including multiple food outlets were most consistently associated with obesity in adults (18 expected, 1 not expected, 17 null). Limiting to higher quality studies did not affect results.

Conclusions: Despite the large number of studies, we found limited evidence for associations between local food environments and obesity. The predominantly null associations should be interpreted cautiously due to the low quality of available studies.

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Figures

Figure 1
Figure 1. Associations with obesity by type of exposure measurement: Supermarkets and fast food restaurant availability
Figure 1a: Supermarkets in adults: Results from 18 studiesa Figure 1b: Supermarkets in children: Results from 11 studiesa Figure 1c: Fast food in adults: Results from 25 studiesa Figure 1d: Fast food in children: Results from 19 studiesa aStudies using the same cohort, year, and exposure data set have been combined
Figure 1
Figure 1. Associations with obesity by type of exposure measurement: Supermarkets and fast food restaurant availability
Figure 1a: Supermarkets in adults: Results from 18 studiesa Figure 1b: Supermarkets in children: Results from 11 studiesa Figure 1c: Fast food in adults: Results from 25 studiesa Figure 1d: Fast food in children: Results from 19 studiesa aStudies using the same cohort, year, and exposure data set have been combined
Figure 1
Figure 1. Associations with obesity by type of exposure measurement: Supermarkets and fast food restaurant availability
Figure 1a: Supermarkets in adults: Results from 18 studiesa Figure 1b: Supermarkets in children: Results from 11 studiesa Figure 1c: Fast food in adults: Results from 25 studiesa Figure 1d: Fast food in children: Results from 19 studiesa aStudies using the same cohort, year, and exposure data set have been combined
Figure 1
Figure 1. Associations with obesity by type of exposure measurement: Supermarkets and fast food restaurant availability
Figure 1a: Supermarkets in adults: Results from 18 studiesa Figure 1b: Supermarkets in children: Results from 11 studiesa Figure 1c: Fast food in adults: Results from 25 studiesa Figure 1d: Fast food in children: Results from 19 studiesa aStudies using the same cohort, year, and exposure data set have been combined
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References

Appendix 2: Included studies

    1. Block JP, Christakis NA, O'Malley AJ, Subramanian SV. Proximity to food establishments and body mass index in the Framingham Heart Study Offspring cohort over 30 years. Am J Epidemiol. 2011;174:1108–1114. - PMC - PubMed
    1. Gibson DM. The neighborhood food environment and adult weight status: Estimates from longitudinal data. Am J Public Health. 2011;101:71–78. - PMC - PubMed
    1. Kapinos KA, Yakusheva O, Eisenberg D. Obesogenic environmental influences on young adults: Evidence from college dormitory assignments. Economics and Human Biology. 2013 - PubMed
    1. Li F, Harmer P, Cardinal BJ, Bosworth M, Johnson-Shelton D, Moore JM, et al. Built environment and 1-year change in weight and waist circumference in middle-aged and older adults: Portland Neighborhood Environment and Health study. Am J Epidemiol. 2009;169:401–408. - PMC - PubMed
    1. Powell LM, Han E. Adult obesity and the price and availability of food in the United States. Am J Agric Econ. 2011;93:378–384.

References

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    1. Poti JM, Popkin BM. Trends in energy intake among US children by eating location and food source, 1977-2006. J Am Diet Assoc. 2011;111:1156–1164. - PMC - PubMed

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