Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021

Abstract

Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.

Keywords: Food composition; Food environments, Monitoring, Research methodologies and measures, Food marketing, Food labelling; Food prices; Food provision; Food retail; Food trade and investment.

Fig. 1

Flow diagram for study selection process

Fig. 2

Number of articles assessing the food environment in Canada published by year for each domain and overall. *2021 data represent only half a year

Fig. 3

Number of articles accounting for equity in the assessment of food environments, by factor and domain in which equity aspects were considered. Notes: Socioeconomic status included factors related to income such as annual household income, the percentage of residents in a household living below the low-income cut-off, and socioeconomic status more generally (when no definition was provided). Examples of ethnicity-related factors included cultural or racial group, period of arrival in Canada, immigration and aboriginal status. Family status included factors related to parenthood status, number of children, marital status and household size. Geographic location included factors related to rural or urban location, population density or centres and remoteness. Examples of dwelling-related factors included homes needing major/minor repair, average dwelling value, home ownership, and residential instability. Transportation included factors related to car ownership and use of transit