The use and misuse of ratio and proportion exposure measures in food environment research

International Journal of Behavioral Nutrition and Physical Activity

Lukar E. Thornton¹  Simon R. White²  Karen E. Lamb³ 

[1] Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia;Medical Research Council (MRC) Biostatistics Unit, University of Cambridge, Cambridge, UK;Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia;

关键词: Food environment;    Built environment;    Neighbourhood;    Dietary behaviours;    Obesity;   

DOI  :  10.1186/s12966-020-01019-1

来源: Springer

【 摘 要 】

BackgroundThe food stores within residential environments are increasingly investigated as a possible mechanism driving food behaviours and health outcomes. Whilst increased emphasis is being placed on the type of study designs used and how we measure the outcomes, surprisingly little attention gets diverted to the measures of the food environment beyond calls for standardised approaches for food store coding and geographic scales of exposure. Food environments are a challenging concept to measure and model and the use of ratio and proportion measures are becoming more common in food environment research. Whilst these are seemingly an advance on single store type indicators, such as simply counting the number of supermarkets or fast food restaurants present, they have several limitations that do not appear to have been fully considered.Main bodyIn this article we report on five issues related to the use of ratio and proportion food environment measures: 1) binary categorisation of food stores; 2) whether they truly reflect a more or less healthy food environment; 3) issues with these measures not reflecting the quantity of food stores; 4) difficulties when no stores are present; and 5) complications in statistical treatment and interpretation of ratio and proportion measures. Each of these issues are underappreciated in the literature to date and highlight that ratio and proportion measures need to be treated with caution.ConclusionCalls for the broader adoption of relative food environment measures may be misguided. Whilst we should continue to search for better ways to represent the complexity of food environments, ratio and proportion measures are unlikely to be the answer.

【 授权许可】

CC BY