Food environments are directly linked to diets and health outcomes such as overweight, obesity, and noncommunicable diseases. The digitalization of food environments is becoming a central issue in public health, yet little is known about this emerging field. We performed a systematic scoping review to map the research on the digital food environment and investigate how the eight dimensions of the food environment, according to an established framework (availability, prices, vendor and product properties, marketing and regulation, accessibility, affordability, convenience, and desirability), might be shifting in the context of a digital society. We searched MEDLINE, EMBASE, Scopus, and Web of Science for studies published between 2000 and 2019, using search terms covering digital technology and food environment, which yielded 13,580 unique records. Our analysis of 357 studies shows that digitalization is taking place in all dimensions of the food environment, and enabling the emergence of new forms of buying and selling food, such as online grocery shopping and online food delivery, which may be changing availability of foods and affecting the physical distance to shops and time allocated for shopping. Systematic reviews identified indicated that digital food marketing and social media can influence food choices, preferences and consumption. Our findings suggest that digital and physical food environments are interconnected and influencing one another, but the impact of the digital on health and nutrition is yet unclear.

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Background Marketing of unhealthy foods and beverages is recognized as a contributing factor to the global increase in overweight and obesity, particularly among children. Such marketing negatively affects children’s dietary preferences, food choices, purchasing requests, and consumption patterns. Given that little is known about food marketing in Africa, including in Uganda, monitoring children’s exposure to food marketing is essential to generate evidence on the problem and develop meaningful policy responses. The aim of this study was to describe the food and beverage marketing environment surrounding schools in urban and peri-urban areas of Kampala city. Methods Outdoor advertising around 25 randomly sampled primary and secondary schools within a radius of 250 m of each school was mapped. Information on size, setting, type, and position of the advertisements and the healthiness of the foods and beverages promoted was collected using the INFORMAS Outdoor Advertising Protocol. The occurrence of advertising was described using frequencies, median, and density per 100m2. Results A total of 1034 branded advertisements were identified around the schools. Of these, 86% featured unhealthy products, 7% healthy products, and 7% miscellaneous products. The most advertised products were sugar-sweetened beverages and alcoholic beverages (51 and 23%, respectively). Schools in the urban area were surrounded by more unhealthy ads than those in the peri-urban areas (median of 45 vs 24 advertisements). Conclusion The widespread extent of unhealthy food and beverage advertisements around primary and secondary schools highlights the need for food marketing regulation in Uganda, in line with the World Health Organization’s recommendations, to ensure that young people are protected from unhealthy food marketing.

Socioeconomic inequalities in diets need to be tackled to improve population diets and prevent obesity and diet-related non-communicable diseases. The potential of food environment policies to reduce such inequalities has to date however not been appraised. The objective of this umbrella review was to assess the impact of food environment policies on socioeconomic inequalities in diets and to identify knowledge gaps in the existing literature, using the Healthy Food Environment Policy Index as a conceptual framework. The policies considered in the umbrella review are within six domains: 1) food composition 2) food labelling 3) food promotion 4) food provision 5) food retail 6) food pricing. A systematic search for systematic literature reviews on the effect of food environment policies on dietary-related outcomes across socioeconomic groups and published in English between 2004 and 2019 was conducted. Sixteen systematic literature reviews encompassing 159 primary studies were included, covering food composition (n = 2), food labelling (n = 3), food provision (n = 2), food prices (n = 13) and food in retail (n = 4). Quality assessment using the “Assessing the Methodological Quality of Systematic Reviews” quality rating scale showed that review quality was mainly low or critically low. Results suggest that food taxation may reduce socioeconomic inequalities in diets. For all other policy areas, the evidence base was poor. Current research largely fails to provide good quality evidence on impacts of food environment policies on socioeconomic inequalities in diets. Research to fill this knowledge gap is urgently needed.

Background Obesity prevalence in Norway has increased over the past decades despite political objectives and strategies for obesity prevention. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. Governments play a critical role to form such environments. The aim of the study was to assess the efforts of the Norwegian Government towards creating healthier food environments and suggest actions using the Healthy Food Environment Policy Index (Food-EPI) methodology. Methods Evidence of policy implementation was assembled and verified by government stakeholders for 45 good practice indicators across 12 policy and infrastructure support domains. Independent public health nutrition experts from academia and civil society (n = 34) assessed the level of implementation of each indicator compared with international best practices, using an online tool. Results Most indicators were rated at “medium” level of implementation (51%). An almost equal number of indicators were rated at “high” and “low” level of implementation (21% and 28%, respectively). None of the indicators were rated as “very low, if any” level of implementation. More indicators under the infrastructure domain were rated at “high” or “medium” as compared with the policy domain. The expert panel developed a list of priority actions that should be implemented to improve the food environment, including actions regarded as most effective in decreasing social inequalities in diet. The top priority action was that the Government should to a larger extent use price and taxes to change food consumption. Conclusions The Food-EPI framework and process can be used to identify gaps in national policy implementation and to develop recommendations for strengthened policy action supported by a coalition of public health experts.