Community and Public Health Nutrition
Food systems are increasingly recognized as critical to advancing better nutrition, with the food environment as the nexus between food systems and dietary consumption. Developing a robust measurement framework of the market food environment is a research priority particularly for low and middle income countries (LMIC), where market food environments are rapidly shifting, accompanied by shifts in diet patterns and nutrition outcomes. The objective of this work was to identify existing metrics of the food environment and develop a measurement framework that can be used to assess the outcomes of nutrition-sensitive, market-focused interventions in LMIC.
We conducted a narrative review of the food environment literature using targeted searches of peer-reviewed articles, agency websites, and bibliographies to identify measures of the food environment in current or recent use. First, we extracted 182 unique measures from and compiled them into a list. Second, a pile-sorting exercise was conducted online by 5 nutrition experts, selected for their expertise in food environment, ethnographic, food choice, and/or nutritious value chain research. Participants were asked to sort the measures into piles that belonged together and create a label for each pile. An in-depth debriefing was conducted with each sorter to obtain the reasoning for their sorts. We then categorized the results into emergent groups based on the percentage agreement of the assignment of individual items into the piles.
Eight broad categories with at least 75% measure agreement emerged pertaining to both perceived and objective measures of the built/physical food environment. Etic measures included the availability of food stores, the availability and quality of foods within a store, food prices, and marketing. Emic (perception) measures included perceptions of access to food stores, perceptions of food availability and quality in stores, and affordability. Personal characteristics and values determining food choice also emerged; these are not measures of the food environment per se.
These results begin to outline a measurement framework for assessing the market food environment that can be adapted to LMIC. The next step will be to test the framework and evaluate its utility as a tool to further understanding around consumer food choices.
Funding Sources : GAIN