Energy balance
High density of unhealthy food outlets (food swamps) is a stronger predictor of adult obesity rates than lack of access to healthy food (food deserts), with the effect being significantly underestimated by standard observational methods.
To reduce obesity, local governments should prioritize zoning laws that restrict the density of fast food and junk food outlets, rather than just trying to bring in grocery stores. This is especially important in low-income areas with high inequality and limited transportation options.
Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates.
Why this rating
Uses instrumental variables (IV) to correct for endogeneity, providing stronger causal inference than typical observational studies, though it remains cross-sectional.
Source
Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States
Kristen Cooksey Stowers et al. · International Journal of Environmental Research and Public Health · 2017
DOI 10.3390/ijerph14111366
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