Local food availability, diet and obesity: Development and empirical testing of a complex theory
type: CreativeWork
description: Individuals with poor quality diets face an increased risk of developing a range of chronic diseases. Aspects of the local food environment, including food availability, have been linked to less healthy diets and increased body weight in adults. However, there is limited theory development to guide the synthesis of empirical studies or the design and evaluation of intervention strategies. Therefore, this dissertation sought to 1) develop a theory of change for unpacking the association between local food availability, diet quality and weight status through identifying hypothesized pathways of influence; and 2) test identified mechanisms using nationally representative data for adults across the United Kingdom and England. Firstly, a systematic review and realist synthesis were used to generate a novel theory of change for food availability, diet and obesity. This involved integration of tacit knowledge from an expert panel with evidence from a range of published food availability interventions. The resulting theory suggested that the influence of food availability on diet and weight status involves a complex set of pathways. Including the importance of understanding the link between the adoption of, and exposure to, different types of food outlets and the alignment of these factors with the preferences and needs of people of varying socioeconomic position (SEP). Thus, use of different away-from-home food outlets (i.e. fast food, restaurant and café) were examined in adults from the National Diet and Nutrition Survey showing that only use of fast food outlets (but not restaurants or cafés) was associated with poor diet quality and obesity, after accounting for SEP. Next, given the potential importance of exposure to the density of food outlets in their use, the same types of away-from-home food outlets were examined in a cross-sectional spatial study of adults from the first wave of the UK Household Longitudinal Study (UKHLS). This analysis showed that again, regardl…
abstract: Individuals with poor quality diets face an increased risk of developing a range of chronic diseases. Aspects of the local food environment, including food availability, have been linked to less healthy diets and increased body weight in adults. However, there is limited theory development to guide the synthesis of empirical studies or the design and evaluation of intervention strategies. Therefore, this dissertation sought to 1) develop a theory of change for unpacking the association between local food availability, diet quality and weight status through identifying hypothesized pathways of influence; and 2) test identified mechanisms using nationally representative data for adults across the United Kingdom and England. Firstly, a systematic review and realist synthesis were used to generate a novel theory of change for food availability, diet and obesity. This involved integration of tacit knowledge from an expert panel with evidence from a range of published food availability interventions. The resulting theory suggested that the influence of food availability on diet and weight status involves a complex set of pathways. Including the importance of understanding the link between the adoption of, and exposure to, different types of food outlets and the alignment of these factors with the preferences and needs of people of varying socioeconomic position (SEP). Thus, use of different away-from-home food outlets (i.e. fast food, restaurant and café) were examined in adults from the National Diet and Nutrition Survey showing that only use of fast food outlets (but not restaurants or cafés) was associated with poor diet quality and obesity, after accounting for SEP. Next, given the potential importance of exposure to the density of food outlets in their use, the same types of away-from-home food outlets were examined in a cross-sectional spatial study of adults from the first wave of the UK Household Longitudinal Study (UKHLS). This analysis showed that again, regardl…
author: Penney, TL
language: en
keywords: dietary public health, complex systems, food choice, food availability, obesity
license: https://www.repository.cam.ac.uk/bitstreams/018d3ccc-3351-40a2-b3b9-6e897742c2ee/download
license: https://www.rioxx.net/licenses/all-rights-reserved/
date published: 2017-04-29
date modified: 2026-07-24T01:33:23Z
provider: Cambridge University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Cambridge

PropertyValue
property ID: DOI
value: 10.17863/CAM.12764