Creating healthy food and eating environments: policy and environmental approaches

Food and eating environments likely contribute to the increasing epidemic of obesity and chronic diseases, over and above individual factors such as knowledge, skills, and motivation. Environmental and policy interventions may be among the most effective strategies for creating population-wide improvements in eating. This review describes an ecological framework for conceptualizing the many food environments and conditions that influence food choices, with an emphasis on current knowledge regarding the home, child care, school, work site, retail store, and restaurant settings. Important issues of disparities in food access for low-income and minority groups and macrolevel issues are also reviewed. The status of measurement and evaluation of nutrition environments and the need for action to improve health are highlighted.