Abstract
Research interest in the influence of environmental factors on nutrition and physical activity behaviors has surged internationally in recent years. This is evident from a rapidly expanding literature and facilitated by advances in methodological and analytical approaches to assessing multiple levels of influence on health behaviors. However, a number of conceptual challenges complicate research endeavours in this field. The purpose of this paper is to provide a 'state of the science' overview of evidence regarding environmental influences on nutrition and physical activity behaviors. We focus particularly on a number of key conceptual and methodological issues, including: a consideration of how the environment is defined; the selection and operationalization of environmental exposures; and the importance of integrating existing understanding of individual influences on behavior with the emerging data on the role of the environment. We draw on examples from the published literature including our own research studies to illustrate these issues. We conclude by proposing a research agenda to progress understanding of the influences of the environment on population nutrition and physical activity behaviors.
Highlights
Over the past decade there has been a growing recognition of the role of 'the environment' in influencing health and health behavior
The reemergence of social ecological theory [6,7] and its application to the study of nutrition and physical activity behaviors [8,9] provides a recent example of the shift in focus from individual-level influences on health to environmental influences
What do we mean by 'environment'? To paraphrase a leading international expert in the analysis of environmental effects on health, identifying "true" environmental differences requires identifying "true" environments [19]. While intuitively this seems like simple logic, in practice identifying 'true' environments that may exert influence on nutrition and physical activity behaviors may not be straightforward for a number of reasons
Summary
Over the past decade there has been a growing recognition of the role of 'the environment' in influencing health and health behavior. For nutrition and physical activity behaviors, the emergence of the obesity pandemic has brought this issue into sharp focus. Numerous reviews and reports by expert bodies throughout the world highlight the importance of 'environmental' factors on obesity and obesity-risk behaviors, and in terms of obesity prevention, there have been strong calls to focus on changing the environment [1,2,3]. The reemergence of social ecological theory [6,7] and its application to the study of nutrition and physical activity behaviors [8,9] provides a recent example of the shift in focus from individual-level (psycho-social) influences on health to environmental influences
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