The influence of the food environment on overweight and obesity in young children: a systematic review

Abstract

Background and objectiveThe increasing prevalence of childhood obesity has led to interest in its prevention, particularly through school-based and family-based interventions in the early years. Most evidence reviews, to date, have focused on individual behaviour change rather than the ‘obesogenic environment’.ObjectiveThis paper reviews the evidence on the influence of the food environment on overweight and obesity in children up to 8 years.Data sourcesElectronic databases (including MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), DARE, CINAHL and Psycho-Info) and reference lists of original studies and reviews were searched for all papers published up to 31 August 2011.Study selectionStudy designs included were either population-based intervention studies or a longitudinal study. Studies were included if the majority of the children studied were under 9 years, if they related to diet and if they focused on prevention rather than treatment in clinical settings.Data extractionData included in the tables were characteristics of participants, aim, and key outcome results. Quality assessment of the selected studies was carried out to identify potential bias and an evidence ranking exercise carried out to prioritise areas for future public health interventions.Data synthesisThirty-five studies (twenty-five intervention studies and ten longitudinal studies) were selected for the review. There was moderately strong evidence to support interventions on food promotion, large portion sizes and sugar-sweetened soft drinks.ConclusionsReducing food promotion to young children, increasing the availability of smaller portions and providing alternatives to sugar-sweetened soft drinks should be considered in obesity prevention programmes aimed at younger children. These environment-level interventions would support individual and family-level behaviour change.

Sugar-Sweetened Beverages and Obesity among Children and Adolescents: A Review of Systematic Literature Reviews

“…Heterogeneity in dietary measurement tools used and lack of homogeneity regarding SSB definition between studies were also reported. Other limitations inherent to study designs mentioned in reviews [30][31][32]35 were related to small sample sizes, short follow-ups, and convenience samples. Whether or not measurement limitations were mentioned did not influence reviews' conclusions.…”

“…Five reviews 14,18,27,28,31 did not state their source of funding, six 26,29,30,[32][33][34] were publicly funded, and two 25,35 were funded by the industry. Conflict of interest was not reported in six reviews, 18,25,28,29,31,34 authors of five reviews 26,27,30,32,35 reported not having any conflict of interest, and authors of two reviews 14,33 reported having conflict of interest (Table 1).…”

“…The list of studies within each review is presented in Supplementary Tables 3-5 (see online supplementary material at http://www.liebertpub .com). All reviews concluding that there was a direct association between SSB intake and weight gain, overweight, and obesity in children and adolescents included longitudinal studies, eight included intervention studies, 18,26,27,[29][30][31][32]34 and four included cross-sectional studies as well. 26,29,31,34 Among the four reviews that did not find a direct association between SSB intake and weight gain, overweight, and obesity in children and adolescents, all included intervention studies, 14,25,33,35 two further included longitudinal studies, 25,35 and one also included cross-sectional studies 25 ( Table 1).…”

Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review

“…100 Neighborhood Food Outlets Many food outlets readily accessible to children have poor dietary choices (e.g., fast-food restaurants, convenience stores, small food stores) with high fat, large portion sizes, and sugary drink options. [111][112][113] Research shows that children who have easy access to poor quality food outlets tend to have a higher BMI and the potential to become overweight/obese when compared to children who do not have easy access to these food outlet types. 107 In addition, the built environment plays a critical role in how adolescents perceive distances and safety to these various food outlets.…”

“…Studies show that these types of stores, when in close proximity to neighborhoods or schools, increased the likelihood of purchases made at these food outlet types. 107,[111][112][113][114] Sanchez et al 111 indicated that minorities, specifically in neighborhoods that are predominantly Hispanic and African American, have a higher prevalence of obesity related to neighborhood food choices, and that 1/3 of all U.S. public middle and high schools have at least one fast food or convenience store within walking distance. In 2011, Leung et al 114 suggested that residents with more produce vendors or farmers markets nearby had a lower risk of being overweight/ obese.…”