Exploring the relationship between the food environment, food poverty, insecurity and obesity: A mixed-method systematic review

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INTRODUCTION: There is continued concern about the obesity epidemic. Studies have shown food environments and food poverty/insecurity may increase overweight and obesity¹. Evidence suggests the association between these variables is inconsistent. A systematic review was carried out to explore the relationship between food environments, food poverty/insecurity and weight status.

METHODS: Thirteen electronic and three grey literature databases were searched. The search was restricted to articles published from 1992 onwards. Objectives, inclusion/exclusion criteria and methods of analysis are documented in the protocol (PROSPERO [CRD42019124339]).

RESULTS: Twenty‐six studies met the inclusion criteria, including 20 cross sectional, two mixed methods and four qualitative studies. Twenty‐one were based in USA, four in Canada and one in the UK, and this included 27 504 individuals. Half of the studies were published post 2015 and the remaining were published between 2002 and 2014. The study population in 61.5% of papers were adults and the remainder related to children or both children and their carers (38.5%). Preliminary results suggest a significant positive association between food insecurity and BMI. Food‐insecure (FI) households were also reported as having a poorer food environment compared to food‐secure (FS) households. Food‐secure families were more likely to report consuming healthier foods such as fruits and vegetables, whereas those from FI households were more likely to consume energy dense, less healthy alternatives. Food‐insecure women perceived significantly lower neighbourhood availability and affordability of fresh produce compared with FS women. Youths from FI households had a higher BMI, ate more fast food, engaged in fewer family meals and were more likely to skip breakfast compared with those who were FS. Qualitative evidence revealed a reliance on energy‐dense, nutrient‐poor foods due to their affordability, accessibility and extended shelf life. Participants questioned the quality of items received from food banks and some attributed this to their weight gain.

CONCLUSION: The results show a link between the food environment, food security status and obesity. Therefore, policy efforts are needed to remediate obesity and food insecurity as both are associated with negative health consequences. These efforts should also focus on affordability and availability of neighbourhood fresh produce as well as considering the food environment in mediating the relationship between food‐insecurity and BMI in low‐income families. The role of food banks has the potential to influence users' health and body weight, increasing the nutritional quality of food provided by food banks is also essential.


Kral T, Chittams J, & Moore RH (2017). Journal for specialists in pediatric nursing: JSPN, 22(2), doi: 10.1111/jspn.12177
Original languageEnglish
Publication statusPublished - 29 Aug 2020
EventEuropean and International Congress on Obesity 2020 -
Duration: 1 Sept 20204 Sept 2020


ConferenceEuropean and International Congress on Obesity 2020
Abbreviated titleECOICO 2020
Internet address


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