• Am J Prev Med · Aug 2019

    Review

    Complex Systems Approaches to Diet: A Systematic Review.

    • Brent A Langellier, Usama Bilal, Felipe Montes, Jose D Meisel, CardosoLetícia de OliveiraLOOswaldo Cruz Foundation, Rio de Janeiro, Brazil., and Ross A Hammond.
    • Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania. Electronic address: bal95@drexel.edu.
    • Am J Prev Med. 2019 Aug 1; 57 (2): 273281273-281.

    ContextComplex systems approaches can help to elucidate mechanisms that shape population-level patterns in diet and inform policy approaches. This study reports results of a structured review of key design elements and methods used by existing complex systems models of diet.Evidence AcquisitionThe authors conducted systematic searches of the PubMed, Web of Science, and LILACS databases between May and September 2018 to identify peer-reviewed manuscripts that used agent-based models or system dynamics models to explore diet. Searches occurred between November 2017 and May 2018. The authors extracted relevant data regarding each study's diet and nutrition outcomes; use of data for parameterization, calibration, and validation; results; and generated insights. The literature search adhered to PRISMA guidelines.Evidence SynthesisTwenty-two agent-based model studies and five system dynamics model studies met the inclusion criteria. Mechanistic studies explored neighborhood- (e.g., residential segregation), interpersonal- (e.g., social influence) and individual-level (e.g., heuristics that guide food purchasing decisions) mechanisms that influence diet. Policy-oriented studies examined policies related to food pricing, the food environment, advertising, nutrition labels, and social norms. Most studies used empirical data to inform values of key parameters; studies varied in their approaches to calibration and validation.ConclusionsOpportunities remain to advance the state of the science of complex systems approaches to diet and nutrition. These include using models to better understand mechanisms driving population-level diet, increasing use of models for policy decision support, and leveraging the wide availability of epidemiologic and policy evaluation data to improve model validation.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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