Healthier Food Access Limits Obesity Burden Among Those With Socioeconomic Disadvantages

Policies that allow for healthier food access may improve public health and reduce obesity.

Healthier food access can improve population health and reduce obesity among individuals of lower socioeconomic position, according to research published in Obesity Reviews. While the report found that persons of higher socioeconomic positioning were equally likely to make healthier food choice when presented with them, it highlights the disparity in the availability of healthy foods among the former.

“More socioeconomically deprived communities have increased access and availability of the types of outlets that sell foods higher in energy, and access to these types of outlets has been associated with a higher prevalence of overweight and obesity,” the researchers explain. “In line with this, nutritional quality of diet is also socioeconomically patterned, with lower socioeconomic position (SEP) associated with less nutritious dietary patterns.”

Researchers performed a systematic review and meta-analysis including 13 experimental studies that examined nutritional choices in participants who were given the option of consuming healthier vs less healthy foods and drinks. Although the criteria for healthy foods varied across studies, they were frequently defined as lower-energy foods with less caloric intake.

Overall, the investigators included 40 interventions comparing increased healthier food access with conditions involving lower availability conditions — 20 involved individuals of higher socioeconomic status compared with 20 involving persons of lower socioeconomic status. The primary outcome measure was the percentage of individuals choosing healthier foods, while secondary outcomes included the total energy selected or consumed by participants or the amount of food purchased (proxy for amount eaten).

Regardless of socioeconomic status, an increased odds of choosing healthier foods was a main effect of healthier food access (odds ratio [OR], 5.00; 95% CI, 3.27-7.67; P <.001). Similar effects were noted among individuals of lower socioeconomic positioning (OR, 4.90; 95% CI, 3.00-8.00; P < .001). Doubling healthier food access increased the odds of healthier food choices (OR, 2.00), the report shows.

Given the need to encourage healthier diets for all, policies that increase the availability of healthier food have potential as equitable strategies to reduce obesity and improve population health.

Secondary analysis revealed lower caloric selection when selecting from menus with healthier food access (-122.19 kcal; 95% CI, 78.06-180.71) for the cohort. This caloric reduction was 109.90 kcal (95% CI, 73.33, 146.48; P < .001) among individuals with lower socioeconomic positioning compared with 131.24 kcal (95% CI, 75.79-186.69; P < .001) in individuals with a higher socioeconomic status.

Study limitations include the use of education level to determine socioeconomic positioning.

“Increasing the proportion of healthier foods (relative to less healthy foods) increases the likelihood of choosing healthier food options and reduces energy content of food selections to a similar degree among higher and lower [socioeconomically positioned] individuals,” according to the study authors. “Given the need to encourage healthier diets for all, policies that increase the availability of healthier food have potential as equitable strategies to reduce obesity and improve population health…”


Langfield T, Marty L, Inns M, Jones A, Robinson E. Healthier diets for all? A systematic review and meta-analysis examining socioeconomic equity of the effect of increasing availability of healthier foods on food choice and energy intake. Obes Rev. Published online March 28, 2023. doi:10.1111/obr.13565