A systematic review employing the GeoFERN framework to examine methods, reporting quality and associations between the Retail Food Environment and obesity

This systematic review quantifies methods used to measure the ‘retail food environment’ (RFE), appraises the quality of methodological reporting, and examines associations with obesity, accounting for differences in methods. Only spatial measures of the RFE, such as food outlet proximity were included. Across the 113 included studies, methods for measuring the RFE were extremely diverse, yet reporting of methods was poor (average reporting quality score: 58.6%). Null associations dominated across all measurement methods, comprising 76.0% of 1937 associations in total. Outcomes varied across measurement methods (e.g. narrow definitions of ‘supermarket’: 20.7% negative associations vs 1.7% positive; broad definitions of ‘supermarket’: 9.0% negative associations vs 10.4% positive). Researchers should report methods more clearly, and should articulate findings in the context of the measurement methods employed.