摘要：Introduction: There is growing interest in the role of food environments in suboptimal
diet and overweight and obesity. This review assesses the evidence for the link between
the retail food environment, diet quality and body mass index (BMI) in the Canadian
population.
Methods: We conducted a systematic keyword search in two bibliometric databases.
We tabulated proportions of conclusive associations for each outcome and exposure of
interest. Absolute and relative measures of exposure to the food environment were
compared and theoretical framing of the associations noted. We assessed two key
methodological issues identified a priori—measurement of BMI, and validation of the
underlying retail food environment data.
Results: Seventeen studies were included in the review. There was little evidence of a
food environment–diet quality relationship and modest evidence of a food environment–BMI
relationship. Relative measures of the food environment were more often
associated with an outcome in the expected direction than absolute measures, but many
results were inconclusive. Most studies adopted ecological theoretical frameworks but
methodologies were similar regardless of stated theoretical approaches. Self-reported
BMI was common and there was no “gold standard” database of food outlets nor a
consensus on best ways to validate the data.
Conclusion: There was limited evidence of a relationship between the food environment
and diet quality, but stronger evidence of a relationship between the food environment
and BMI for Canadians. Studies with broad geographic scope that adopt innovative
methods to measure diet and health outcomes and use relative measures of the food
environment derived in geographic information systems are warranted. Consensus on a
gold standard food environment database and approaches to its validation would also
advance the field.
