PURPOSE OF REVIEW: There is a broad consensus that policies to create healthier food environments are needed to address obesity. However, previous reviews of the relationships between the healthiness of food environments and diet/obesity-related outcomes have typically reported either mixed associations or none at all. This paper aimed to synthesise measurement and interpretation issues in this field, based on findings from previous reviews.
RECENT FINDINGS: Key issues, drawn from 14 previous reviews in the last decade, included: (1) the use of measures of the food environments that are too narrow in scope; (2) inadequate measures of the way in which people are exposed to, and interact with, food environments; and (3) large heterogeneity in tools and methods used. To evaluate the impact of food environments on diet and health, composite measures of the healthiness of food environments, informed by actual usage patterns, need to be developed and consistently applied.
CONTEXT: Multiple studies have been conducted on correlates of dietary behavior in adults, but a clear overview is currently lacking.
OBJECTIVE: An umbrella review, or review-of-reviews, was conducted to summarize and synthesize the scientific evidence on correlates and determinants of dietary behavior in adults.
DATA SOURCES: Eligible systematic reviews were identified in four databases: PubMed, PsycINFO, The Cochrane Library, and Web of Science. Only reviews published between January 1990 and May 2014 were included.
STUDY SELECTION: Systematic reviews of observable food and dietary behavior that describe potential behavioral determinants of dietary behavior in adults were included. After independent selection of potentially relevant reviews by two authors, a total of 14 reviews were considered eligible.
DATA EXTRACTION: For data extraction, the importance of determinants, the strength of the evidence, and the methodological quality of the eligible reviews were evaluated. Multiple observers conducted the data extraction independently.
RESULTS: Social-cognitive determinants and environmental determinants (mainly the social-cultural environment) were included most often in the available reviews. Sedentary behavior and habit strength were consistently identified as important correlates of dietary behavior. Other correlates and potential determinants of dietary behavior, such as motivational regulation, shift work, and the political environment, have been studied in relatively few studies, but results are promising.
CONCLUSIONS: The multitude of studies conducted on correlates of dietary behavior provides mixed, but sometimes quite convincing, evidence. However, because of the generally weak research design of the studies covered in the available reviews, the evidence for true determinants is suggestive, at best.
There is a broad consensus that policies to create healthier food environments are needed to address obesity. However, previous reviews of the relationships between the healthiness of food environments and diet/obesity-related outcomes have typically reported either mixed associations or none at all. This paper aimed to synthesise measurement and interpretation issues in this field, based on findings from previous reviews.
RECENT FINDINGS:
Key issues, drawn from 14 previous reviews in the last decade, included: (1) the use of measures of the food environments that are too narrow in scope; (2) inadequate measures of the way in which people are exposed to, and interact with, food environments; and (3) large heterogeneity in tools and methods used. To evaluate the impact of food environments on diet and health, composite measures of the healthiness of food environments, informed by actual usage patterns, need to be developed and consistently applied.
