Objective food environments and health outcomes

Area of Science:

• Public Health
• Nutritional Epidemiology
• Environmental Health

Background:

• Pathways linking food environments to diet-related health outcomes remain unclear.
• Identifying these pathways is crucial for developing effective public health strategies.
• Understanding the role of resident perceptions is a key area of investigation.

Purpose of the Study:

• To investigate if resident perceptions mediate the association between objective food environment measures and individual diet quality and weight status.
• To differentiate between direct and indirect effects of the food environment on health outcomes.

Main Methods:

• Objective food environment data (Nutrition Environment Measure Survey in Stores and Restaurants, fruit/vegetable shelf space, Retail Food Environment Index) were collected in Waterloo Region.
• Household surveys assessed residents' perceptions of the food environment (n=2223).
• Diet quality and weight status (weight, height, waist circumference) were self-reported (n=4102), with diet records from a subsample (n=1170).

Main Results:

• Resident perceptions did not mediate the relationship between objective food environment measures and diet-related outcomes.
• Objectively measured food environment factors, specifically food access and relative food affordability, had a direct effect on outcomes.
• Resident perceptions of the food environment were generally not associated with diet quality or weight status.

Conclusions:

• In this study setting, interventions targeting residents' perceptions of the food environment may be less effective than those directly improving food access and affordability.
• Directly modifying the food environment is likely a more impactful strategy for improving population diet quality and weight status.
• Future research should focus on direct environmental interventions.