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 multi-dimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions.

Is in utero exposure to maternal socioeconomic disadvantage related to offspring ovarian reserve in adulthood?

“…1 Offspring ovarian reserve markers across categories of maternal neighborhood-level SES (education, poverty), adjusted for covariates and early childhood environments, suggesting particular exposures during these sensitive periods may shape trajectories of ovarian aging. Exposures related to maternal nutritional stress and maternal smoking, which are also significantly correlated with lower SES [76][77][78], are strong candidates for inclusion in future research to address whether maternal neighborhood-level SES in the current study may be marking behavioral, anthropometric, or other health-related characteristics of the mother.…”

Improving Diet in Low-Income Neighborhoods: Leveraging the Food Environment for Change

“…49 Among 31 articles using measures of density (e.g., presence or number of food outlets within a specified area), 20 of the studies identified at least one significant positive association between density and diet in the expected direction (e.g., greater density of green grocers is associated with better dietary quality). Thirteen of 24 articles reviewed had no significant association between proximity (distance from the participant's home to the food outlet) and diet.…”

“…49 Eleven studies examined 38 possible relationships between in-store availability of foods and dietary quality and found only 9 associations in the expected direction as well as 2 in the unexpected direction. Price yielded an even more complicated story -28 outcomes were examined and 12 demonstrated no relationships with price, five showed relationships in the expected direction, and 11 reported relationships in the unexpected direction (that better diets were associated with healthy foods being more expensive).…”

“…25 These communities are often referred to as "food deserts" and a growing body of research has studied the relationship between living in a food desert and negative health outcomes such as obesity and poor diet. 49,50,72 The HHFI encourages the growth of food venues by supporting the construction of new food outlets (e.g., supermarkets and farmer's markets) as well as the renovation/expansion of existing food stores to include more healthy foods through grants, zoning changes, and monetary incentives (e.g., tax breaks, matching funds).…”

“…49,71,72 Although the food environment extend broadly to settings including schools, workplaces, and early child care centers, 26 most commonly, researchers have used residence-based measures of the food environment that look at distance (e.g., miles to the nearest supermarket) and density (e.g., number of supermarkets within a 1-mile radius) of stores in the geographic area where people live. A few have looked at storelevel measures, such as in-store product availability and relative price of foods, however it is rare for studies to examine both simultaneously.…”