The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases

* Corresponding author: Email [email protected]

Food environments are the collective physical, economic and policy conditions that influence people’s food and beverage choices and nutritional status⁽¹⁾. They work as a bridge between the macro food system – food supply chains, processing, wholesale and logistics⁽²⁾ – and people’s dietary choices. The International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS) has provided a comprehensive framework to study the food environment, operationalizing it into seven distinct dimensions: food retail, provision, labelling, marketing/promotion, prices, composition, and trade and investment (Fig. 1)⁽¹⁾. These dimensions independently influence dietary behaviours, body weight and related health outcomes^(3–9) and are amenable to intervention through health promotion policies. Examples of policies that modify the food environment include effective food labelling systems, regulation on the type and number of food outlets around schools, regulation of advertising of unhealthy foods to children, taxation of sugar-sweetened beverages (SSB) and reformulation of food products⁽¹⁰⁾.

Fig. 1

Conceptual food environment framework adapted from INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support) for the current systematic review of food environments relevant to obesity and related chronic diseases in Latin America^{(1,18,20,67,125)}

[Figure omitted. See PDF]

The Latin American region is comprised of thirty-three countries, home to 650 million people. Most Latin American countries are well underway in the nutrition transition⁽¹¹⁾ and face a large public health burden due to obesity and related chronic diseases⁽¹²⁾. There is a growing body of literature on the food environment arising from Latin American countries which has not been summarized to date.

The objective of the current systematic review was to summarize the scientific literature on the food environment in Latin America. We focused on the following INFORMAS dimensions of the food environment: food retail, food provision, food labelling, food marketing, food price and food composition (Fig. 1). The INFORMAS framework is a fairly new framework (2013) and only in recent years have studies adopted it for monitoring the food environment^(13,14). This framework is useful to examine and characterize the peer-reviewed literature on the food environment in Latin America because dimensions are clearly defined and strongly relate to policy options to prevent obesity and...