Changing the Food Environment for Obesity Prevention: Key Gaps and Future Directions
- 823 Downloads
The food environment has a great impact on the nutritional health of the population. Food environment interventions have become a popular strategy to address the obesity epidemic. However, there are still significant gaps in our understanding of the most effective strategies to modify the food environment to improve health. In this review, we examine key gaps in the food environment intervention literature, including the need for: developing appropriate formative research plans when addressing the food environment; methods for selecting intervention domains and components; incorporating food producers and distributors in intervention strategies; strengthening evaluation of environmental interventions; building the evidence base for food environment interventions in diverse settings; engaging policy makers in the process of modifying the food environment; and creating systems science models to examine the costs and benefits of a potential program or policy on the food environment prior to implementation. In addition, we outline the need for strategies for addressing these issues including conducting pilot interventions, developing additional methodologies, and embracing the use of simulation models.
KeywordsFood environment Obesity Food dessert Stores Intervention Nutrition Food access
The project described was supported by Grant Number U54HD070725 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD). The project is co-funded by the NICHD and the Office of Behavioral and Social Sciences Research (OBSSR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or OBSSR.
Compliance with Ethics Guidelines
Conflict of Interest
Elizabeth Anderson Steeves, Paula Andrea Martins, and Joel Gittelsohn declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 15.•Gittelsohn J, Lee-Kwan SH, Batorsky B. Community-based interventions in prepared-food sources: a systematic review. Prev Chronic Dis. 2013;10(8):E180. This is one of the first review papers of food environment interventions focusing on prepared food sources. Prepared food sources are not often the target of food environment interventions, despite the high percent of caloric intake consumed at this type of food source.PubMedCentralPubMedGoogle Scholar
- 21.Dodson JL, Hsiao Y-C, Kasat-Shors M et al. Formative research for a healthy diet intervention among inner-city adolescents: the importance of family, school and neighborhood environment. Ecol Food Nutr; 48(1):39–58.Google Scholar
- 23.Christiansen KMH, Qureshi F, Schaible A et al. Environmental factors that impact the eating behaviors of low-income African American adolescents in Baltimore City. J Nutr Educ Behav; 45(6):652–60.Google Scholar
- 24.Lee SH, Rowan MT, Powell LM et al. Characteristics of prepared food sources in low-income neighborhoods of Baltimore City. Ecol Food Nutr; 49(6):409–30.Google Scholar
- 27.Freimuth VS, Mettger W. Is there a hard-to-reach audience? Public Health Rep;105(3):232–8.Google Scholar
- 28.•Gittelsohn J, Laska MN, Karpyn A, et al. Lessons learned from small store programs to increase healthy food access. Am J Health Behav. 2014;38(2):307–15. The paper uses a case study approach to highlight the food environment work that have been conducted in four American cities: Minneapolis, MN; Philadelphia, PA; Baltimore, MD; and Burlington, NC. This article describes effective strategies and lessons learned across each of the cities.PubMedCrossRefGoogle Scholar
- 35.Beebe J. Rapid Assessment Process: An Introduction. Walnut Creek, CA: Rowman & Littlefield; 2001.Google Scholar
- 37.Community Economic Development Healthy Food Financing Initiative. [http://www.acf.hhs.gov/programs/ocs/resource/healthy-food-financing-initiative-0].
- 38.Ayala GX, Baquero B, Laraia BA et al. Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers’ intake of fruits and vegetables. Public Health Nutr. 2013:1–8.Google Scholar
- 45.Food Expenditures: Table 10 - Food Away from Home as a share of Food Expenditures. [http://www.ers.usda.gov/data-products/food-expenditures.aspx#.U2aqflyPRg0].
- 46.Stewart H, Blisard N, Jolliffe D. Let’s Eat Out: Americans Weigh Taste, Convenience, and Nutrition, District of Columbia: 2006.Google Scholar
- 54.Lee SH, Bleich S, Kim H, Gittelsohn J. Environmental intervention in carry-out restaurants increases sales of healthy menu items in a low-income urban setting. Am J Heal Promot. 2014 Jun 26. [Epub ahead of print].Google Scholar
- 60.U.S. Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity, Rockville, MD: 2001.Google Scholar
- 66.Baltimore Food Policy Initiative. [https://www.baltimorecity.gov/Government/AgenciesDepartments/Planning/BaltimoreFoodPolicyInitiative.aspx].
- 67.Giang T, Karpyn A, Laurison HB et al. Closing the grocery gap in underserved communities: the creation of the Pennsylvania Fresh Food Financing Initiative. J Public Health Manag Pract;14(3):272–9.Google Scholar
- 77.Vedovato G, Gittelsohn J, Trude A, et al. Community engagement process used to develop a food store intervention for a low-income Brazilian urban area. FASEB J. 2014;28:1019.Google Scholar
- 86.Gittelsohn J, Kumar MB. Preventing childhood obesity and diabetes: is it time to move out of the school? Pediatr. Diabetes. 2007;8 Suppl 9:55–69.Google Scholar