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Obesity (Silver Spring). 2015 Jul;23(7):1331-44. doi: 10.1002/oby.21118. Epub 2015 Jun 12.

The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
2
Welch Center for Epidemiology, Prevention and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
3
Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
4
Department of Surgery, Medicine and Social Sciences, Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Madrid, Spain.
5
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
6
Department of Family and Preventive Medicine, University of California San Diego School of Medicine, California, USA.

Abstract

OBJECTIVE:

To examine the relationship between local food environments and obesity and assess the quality of studies reviewed.

METHODS:

Systematic keyword searches identified studies from US and Canada that assessed the relationship of obesity to local food environments. We applied a quality metric based on design, exposure and outcome measurement, and analysis.

RESULTS:

We identified 71 studies representing 65 cohorts. Overall, study quality was low; 60 studies were cross-sectional. Associations between food outlet availability and obesity were predominantly null. Among non-null associations, we saw a trend toward inverse associations between supermarket availability and obesity (22 negative, 4 positive, 67 null) and direct associations between fast food and obesity (29 positive, 6 negative, 71 null) in adults. We saw direct associations between fast food availability and obesity in lower income children (12 positive, 7 null). Indices including multiple food outlets were most consistently associated with obesity in adults (18 expected, 1 not expected, 17 null). Limiting to higher quality studies did not affect results.

CONCLUSIONS:

Despite the large number of studies, we found limited evidence for associations between local food environments and obesity. The predominantly null associations should be interpreted cautiously due to the low quality of available studies.

PMID:
26096983
PMCID:
PMC4482774
DOI:
10.1002/oby.21118
[Indexed for MEDLINE]
Free PMC Article

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