Neighbourhood retail food outlet access, diet and body mass index in Canada: a systematic review.

Abstract:

INTRODUCTION:There is growing interest in the role of food environments in suboptimal diet and overweight and obesity. This review assesses the evidence for the link between the retail food environment, diet quality and body mass index (BMI) in the Canadian population. METHODS:We conducted a systematic keyword search in two bibliometric databases. We tabulated proportions of conclusive associations for each outcome and exposure of interest. Absolute and relative measures of exposure to the food environment were compared and theoretical framing of the associations noted. We assessed two key methodological issues identified a priori-measurement of BMI, and validation of the underlying retail food environment data. RESULTS:Seventeen studies were included in the review. There was little evidence of a food environment-diet quality relationship and modest evidence of a food environment-BMI relationship. Relative measures of the food environment were more often associated with an outcome in the expected direction than absolute measures, but many results were inconclusive. Most studies adopted ecological theoretical frameworks but methodologies were similar regardless of stated theoretical approaches. Self-reported BMI was common and there was no "gold standard" database of food outlets nor a consensus on best ways to validate the data. CONCLUSION:There was limited evidence of a relationship between the food environment and diet quality, but stronger evidence of a relationship between the food environment and BMI for Canadians. Studies with broad geographic scope that adopt innovative methods to measure diet and health outcomes and use relative measures of the food environment derived in geographic information systems are warranted. Consensus on a gold standard food environment database and approaches to its validation would also advance the field. INTRODUCTION:On s’intéresse de plus en plus au rôle de l’environnement alimentaire dans l’alimentation sous-optimale, le surpoids et l’obésité. Cette revue analyse les données probantes sur le lien entre l’environnement de la vente alimentaire au détail, la qualité de l’alimentation et l’indice de masse corporelle (IMC) au sein de la population canadienne. MÉTHODOLOGIE:Nous avons réalisé une recherche systématique par mot-clé dans deux bases de données bibliométriques. Nous avons calculé les proportions d’associations concluantes pour chaque résultat et exposition d’intérêt. Nous avons comparé les mesures absolues et relatives de l’exposition à l’environnement alimentaire et consigné le cadre théorique des associations. Nous avons examiné deux enjeux méthodologiques importants relevés a priori : la mesure de l’IMC et la validation des données sous-jacentes sur l’environnement de la vente alimentaire au détail. RÉSULTATS:Dix-sept études ont été incluses dans cette revue. Nous avons relevé peu de preuves d’un lien entre l’environnement alimentaire et la qualité de l’alimentation, mais quelques preuves d’un lien entre l’environnement alimentaire et l’IMC. Les mesures relatives de l’environnement alimentaire étaient plus souvent associées à un résultat attendu que les mesures absolues, mais de nombreux résultats n’étaient pas concluants. La plupart des études ont adopté des cadres théoriques globaux, les méthodologies demeurant néanmoins semblables quelles que soient les approches théoriques choisies. L’IMC autodéclaré était une mesure courante et nous n’avons repéré ni base de données « de référence » sur les points de vente d’aliments ni consensus sur les meilleures façons de valider les données. CONCLUSION:Si peu de données probantes étayaient un lien entre l’environnement alimentaire et la qualité de l’alimentation, les preuves d’un lien entre l’environnement alimentaire et l’IMC dans la population canadienne se sont révélées plus solides. Il faudrait disposer d’études à grande portée géographique faisant appel à de nouvelles méthodes pour mesurer les résultats en matière d’alimentation et de santé et recourir à des mesures relatives de l’environnement alimentaire dérivées des systèmes d’information géographique. Il serait également utile d’établir un consensus sur ce qu’est une base de données de référence sur l’environnement alimentaire et sur la méthodologie associée à sa validation. :Seventeen studies that investigated the food environment and its relationship to diet quality or body mass index in Canada met inclusion criteria for systematic review. There was little evidence of a relationship between the neighbourhood food environment and diet, possibly due to error and bias in diet quality measurement. There was modest evidence of a relationship between the neighbourhood food environment and body mass index. Relative measures perform better than absolute measures of food environment exposure. There is no consensus on a “gold standard” food outlet database nor on approaches to field validation of these databases. :Dix-sept études portant sur l’envi-ronnement alimentaire et son lien avec la qualité de l’alimentation ou l’indice de masse corporelle au Canada satisfaisaient aux critères d’inclusion de la revue systématique. On a relevé peu de preuves d’un lien entre l’environnement alimentaire de proximité et l’alimentation, possiblement en raison d’erreurs et de biais dans la mesure de la qualité alimentaire. On a relevé quelques preuves d’un lien entre l’environnement alimentaire de proximité et l’indice de masse corporelle. Les mesures relatives de l’exposition à l’environnement alimentaire donnent de meilleurs résultats que les mesures absolues. Il n’y a pas de consensus sur ce qu’est une base de données « de référence » sur les points de vente d’aliments ni sur les méthodes de validation d’une base de données de ce type sur le terrain.

authors

Stevenson AC,Brazeau AS,Dasgupta K,Ross NA

doi

10.24095/hpcdp.39.10.01

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

261-280

issue

10

issn

2368-738X

journal_volume

39

pub_type

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