ArticleThe international journal of behavioral nutrition and physical activity2020
The use and misuse of ratio and proportion exposure measures in food environment research.
Article in The international journal of behavioral nutrition and physical activity, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- Identifying co-occurring neighbourhood environmental patterns and their association with health behaviours in a Dutch urban population at high cardiometabolic risk.BMC public health · 2026Article
- Neighbourhood out-of-home food environment, menu healthiness, and their associations with meal purchasing and diet quality: a multiverse analysis.Nutrition journal · 2025Article
- Defining household exposure to the food environment: A comparison of measures based on residential area and activity space.PloS one · 2025Article
- Measuring associations between the food environment and dietary habits: comparing the proportion and density of food outlets.BMC public health · 2024Article
- Intake of Snacks and Sweets in a National Study of Built and Social Environments: the REasons for Geographic And Racial Differences in Stroke Study.The Journal of nutrition · 2024Article
- What North American retail food environment indices miss in Guatemala: Cultural considerations for the study of place and health.Applied geography (Sevenoaks, England) · 2024Article
- BMI and the Food Retail Environment in Melbourne, Australia: Associations and Temporal Trends.Nutrients · 2023Article
- Assessing the association between food environment and dietary inflammation by community type: a cross-sectional REGARDS study.International journal of health geographics · 2023Article
- What counts? Adding nuance to retail food environment measurement tools in a Canadian context.Public health nutrition · 2023Article
- Who uses what food retailers? A cluster analysis of food retail usage in the Netherlands.Health & place · 2023Article
- Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement.The open public health journal · 2023Article
- The Weight of Place: Built Environment Correlates of Obesity and Diabetes.Endocrine reviews · 2022Review
- The association between the presence of fast-food outlets and BMI: the role of neighbourhood socio-economic status, healthy food outlets, and dietary factors.BMC public health · 2022Article
- Social Determinants of Cardiovascular Disease.Circulation research · 2022Review
- Neighbourhood food typologies, fast food outlet visitation and snack food purchasing among adolescents in Melbourne, Australia.Public health nutrition · 2022Article
- An Indicator Measuring the Influence of the Online Public Food Environment: An Analytical Framework and Case Study.Frontiers in nutrition · 2022Article
- The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study.International journal of environmental research and public health · 2021Article
- The effect of the food environment on fresh produce served in family child care homes.Nutrition and health · 2021Article
- Comparing competing geospatial measures to capture the relationship between the neighborhood food environment and diet.Annals of epidemiology · 2021Article
- Seeing the food swamp for the weeds: Moving beyond food retail mix in evaluating young people's food environments.SSM - population health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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 BODY: In 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.