The UK food environment: a systematic review of domains, methodologies and outcomes

Understanding food environments is crucial for developing policies and interventions to enhance the healthfulness and sustainability of UK diets. We systematically reviewed published scientific research to answer two research questions. First, what types and domains of the food environment have been assessed in the UK using what methodologies? Domains included availability, affordability, promotion, product characteristics/quality, convenience, and sustainability. Second, what outcomes have been assessed in relation to food environments? Outcomes were classified as descriptive (describing the food environment), dietary intake, and health. Articles published between January 2000 and December 2024 were identified by searching seven databases: CAB Abstracts, CINAHL, EMBASE, Global Health, PubMed, Scopus, and Web of Science. A total of 31,457 articles were identified, 3,418 full texts were reviewed, and 286 articles were included. Another 26 articles were included after screening the references of articles identified in the database search. Thus, data were extracted from a total of 312 articles. The most common domain studied was availability (n=100, 32%), followed by product characteristics/quality (n=94, 30%) and promotion (n=33, 10%). There was a paucity of research on the domains of sustainability (n=19, 6%) and affordability (n=16, 5%), with no articles on the domain of convenience. Only 49 articles (16%) evaluated more than one domain. Most articles were descriptive (n=206, 66%); 64 (20%) evaluated the association of the food environment with dietary intake and 42 (13%) evaluated the association with health, nearly all with obesity.Though several recent government initiatives aim to improve the healthfulness of food environments in the UK, more research is needed to understand how different domains of the food environment interact to influence dietary intakes and overall health.