School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
Curr Obes Rep. 2020 Sep;9(3):288-306. doi: 10.1007/s13679-020-00399-6.
Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study).
Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
本综述的目的是描述零售食品环境如何促进原住民人群的饮食相关健康和肥胖，并评估文献在整个研究过程中如何纳入原住民观点、方法和参与。结果包括饮食行为（购买、摄入量和饮食质量）和饮食相关健康结果（与体重相关的结果、非传染性疾病和整体健康或参与研究的原住民群体定义的健康）。
在 50 篇纳入的文章中（1996-2019 年），最大比例描述了加拿大的原住民社区（20 项研究，占 40%）、美国（16 项，占 32%）和澳大利亚（9 项，占 18%）。在明确关注的原住民人群的文章中（42 项研究，占 84%），最大比例（11 项研究，占 26%）发生在因纽特社区，其次是澳大利亚原住民和托雷斯海峡岛民社区（8 项研究，占 19%）。纳入的文献包括四种主要的研究设计：A 型，商店食品的饮食摄入量（14 项研究，占 28%），以及 B 型，商店食品环境（16 项，占 32%），占文章的最大比例；其余为 C 型，商店食品环境和饮食（7 项，占 14%）和 D 型，商店食品环境干预（13 项，占 26%）。在评估饮食或健康结果的研究中（36 项，占 72%），22 项（61%）评估了饮食摄入量；16 项（44%）销售/购买；8 项（22%）与体重相关的结果。与传统食品相比，商店食品往往为原住民人群的饮食提供了最大量的膳食能量，并增加了非传染性疾病的风险。多方面的干预措施似乎对饮食行为、食品购买和营养知识产生了积极影响；单独推广和营养教育的效果则更为复杂。在与原住民人群有较强互动的 9 项研究中，有 8 项研究具有中等或较高的方法学质量。有 18 项研究（36%）没有提到与原住民人群有任何互动。该文献证实了商店食品对原住民当代饮食总能量摄入的重要性，以及获取零售食品环境和传统食品的差距，以及新的饮食评估研究和零售食品环境干预策略有可能更好地与原住民的认知方式保持一致并赋予其优先权。
