Grappling With Complex Food Systems to Reduce Obesity: A US Public Health Challenge

Abstract

Despite 2 decades of effort by the public health community to combat obesity, obesity rates in the United States continue to rise. This lack of progress raises fundamental questions about the adequacy of our current approaches. Although the causes of population-wide obesity are multifactorial, attention to food systems as potential drivers of obesity has been prominent. However, the relationships between broader food systems and obesity are not always well understood. Our efforts to address obesity can be advanced and improved by the use of systems approaches that consider outcomes of the interconnected global food system, including undernutrition, climate change, the environmental sustainability of agriculture, and other social and economic concerns. By implementing innovative local and state programs, taking new approaches to overcome political obstacles to effect policy, and reconceptualizing research needs, we can improve obesity prevention efforts that target the food systems, maximize positive outcomes, and minimize adverse consequences. We recommend strengthening innovative local policies and programs, particularly those that involve community members in identifying problems and potential solutions and that embrace a broad set of goals beyond making eating patterns healthier. We also recommend undertaking interdisciplinary research projects that go beyond testing targeted interventions in specific populations and aim to build an understanding of the broader social, political, and economic context.

COVID‐19 and maternal and child food and nutrition insecurity: a complex syndemic

“…We urge donors to fund research that focuses on food and nutrition implications of pandemics and answers emerging implementation science questions around effective delivery of equitable social protection programmes and policies in these "unusual" circumstances. Research recommendations for moving forward include how to: (1) adapt and continue school feeding and other food assistance programmes to continue the provision of meals to quarantined families with children, adolescents,pregnant and lactating women; (2) develop equitable effective rapid response systems to prevent or mitigate food insecurity based on complex adaptive systems frameworks (Barnhill et al, 2018; Paina & Peters, 2012) that address the food, nutrition, health care, and social protection systems, and the multiple complex interrelationship among them; paying special attention to households with children, adolescents, pregnant and lactating women; and (3) monitor and use surveillance systems to effectively identify and target provision of healthy and nutritious foods to families that are the most socio‐economically vulnerable, such as young children,adolescents, pregnant and lactating women. It is our hope that addressing these questions will protect the food and nutrition security as well as the health, and wellbeing of children and youth,pregnant and lactating women, and their families (Nurturing Care for Early Childhood Development, 2020) in the complex syndemics world in which we now live.…”

Methods and Risks of Bias in Natural Experiments in Obesity: Opportunities for the Future Informed by a Systematic Review

“…Researchers can look for additional training and resources on these study designs and methods by seeking interdisciplinary collaborators , searching for NIH‐funded workshops , short courses and online courses , and using the resources listed in Tables and .…”

A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions

“…Given the complexity, dynamics, and reciprocal processes of the Retail Food Environment and Customer Interaction Model, we also suggest a need for more sophisticated research methods and transdisciplinary partnerships. Two recommended research approaches are systems science and multilevel, multicomponent (MLMC) interventions [ 134 , 135 , 136 ]. Systems science involves methodological approaches, often computational models, that aim to understand the impacts produced from complex interrelated mechanisms and relationships among multiple factors [ 134 , 135 ].…”

“…Two recommended research approaches are systems science and multilevel, multicomponent (MLMC) interventions [ 134 , 135 , 136 ]. Systems science involves methodological approaches, often computational models, that aim to understand the impacts produced from complex interrelated mechanisms and relationships among multiple factors [ 134 , 135 ]. Except for a few exceptions [ 137 , 138 , 139 , 140 ], relatively little work has studied the RFE using such methods, and incorporating these approaches could help to not only identify solutions that improve multiple outcomes but identify those to avoid to circumvent unexpected consequences.…”