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The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries : a systematic review
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Westbury, Susannah, Ghosh, Iman, Jones, Helen M., Mensah, Daniel, Samuel, Folake, Irache, Ana, Azhar, Nida, Al-Khudairy, Lena, Iqbal, Romaina and Oyebode, Oyinlola (2021) The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries : a systematic review. BMJ Global Health, 6 (10). e006358.
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WRAP-influence-urban-food-environment-diet-health-low-income-countries-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (905Kb) | Preview |
Official URL: https://gh.bmj.com/content/6/10/e006358
Abstract
Introduction Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.Methods We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively.Results 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap.Conclusion ‘Zoning’ or ‘healthy food cart’ interventions to alter food availability may be appropriate in urban LMIC.PROSPERO registration number CRD42020207475.Data sharing not applicable as no datasets generated and/or analysed for this study.
| Item Type: | Journal Article | ||||||
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| Subjects: | H Social Sciences > HT Communities. Classes. Races R Medicine > RA Public aspects of medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Health planning -- Methodology -- Developing countries, Nutrition -- Developing countries, Diet -- Developing countries, Urban ecology (Sociology), Urban health -- Developing countries | ||||||
| Journal or Publication Title: | BMJ Global Health | ||||||
| Publisher: | BMJ Publishing Group | ||||||
| ISSN: | 2059-7908 | ||||||
| Official Date: | 11 October 2021 | ||||||
| Dates: |
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| Volume: | 6 | ||||||
| Number: | 10 | ||||||
| Article Number: | e006358 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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