Senior Research Fellow, Department of Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, India.
Former Professor, Department of Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, India.
Indian J Public Health. 2024 Jan 1;68(1):95-105. doi: 10.4103/ijph.ijph_436_23. Epub 2024 Apr 4.
Worldwide, 7 million mortalities and 187.7 million morbidities have been associated with dietary risks. Poor diets emerge because of an obesogenic environment. However, clear evidence indicating an association between food environment and noncommunicable diseases (NCDs) is inconclusive. The present review was conducted to study the associations between the availability/accessibility of healthy/unhealthy foods and the risk of NCDs among adults of the age group above 18. Studies published between 2012 and 2022 were reterived using three databases - PubMed, Google Scholar, and Science Direct. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), (2018) guidelines and based on the selection criteria, 3034 studies were retrieved, of which 64 were included in this review. Maximum studies were conducted in high-income countries and adopted a cross-sectional study design. Overall, the results of the review illustrate mixed findings. Compared to healthy food, direct associations between obesity and the availability/accessibility of unhealthy foods were reported (n = 12). In case of diabetes, supermarket availability was more likely to be protective (4 positive) compared to negative association with unhealthy food stores (3 associations in 11 studies). For cardiovascular diseases, an increased number of cases with fast-food outlets (n = 6) outnumbered positive associations with healthy food (n = 3). Studies concerning multiple NCDs reported direct association with unhealthy food outlets (n = 5) while inconclusive associations with healthy food. Despite a large number of studies, a weak, inconclusive relationship between food environment and NCDs was found. The use of standardized tools and longitudinal and interventional studies are warranted to rationalize the execution of the policies related to the food environment.
全球范围内，饮食风险导致 700 万人死亡和 1.877 亿例发病。不良饮食源于致肥胖环境。然而，食物环境与非传染性疾病（NCDs）之间关联的确切证据尚无定论。本综述旨在研究健康/不健康食品的可得性/可及性与 18 岁以上成年人 NCDs 风险之间的关联。使用三个数据库 - PubMed、Google Scholar 和 Science Direct 检索了 2012 年至 2022 年期间发表的研究。根据系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）（2018 年）指南，并根据选择标准，共检索到 3034 项研究，其中 64 项研究纳入了本综述。大多数研究在高收入国家进行，并采用了横断面研究设计。总体而言，综述结果表明存在混合结果。与健康食品相比，肥胖与不健康食品的可得性/可及性之间存在直接关联（n = 12）。在糖尿病方面，与不健康食品商店（11 项研究中有 3 项关联）相比，超市的供应更有可能具有保护作用（4 项阳性）。对于心血管疾病，快餐店的病例数增加（n = 6）多于与健康食品的阳性关联（n = 3）。关于多种 NCDs 的研究报告与不健康食品店有直接关联（n = 5），而与健康食品的关联不确定。尽管有大量研究，但食物环境与 NCDs 之间的关系微弱且不确定。需要使用标准化工具和纵向及干预性研究来合理执行与食物环境相关的政策。
