Does exposure to green or blue space impact dietary intake and food choices among adults? A Systematic Literature Review.

Abstract The health benefits of exposure to greenspace are well researched; however, causal pathways for improved health outcomes are complex, and evidence is minimal on potential moderating factors. This review aimed to assess the strength of the evidence and potential impact of exposure to green and blue spaces on dietary outcomes in adults. The inclusion criteria for the review were based on the PICO criteria. Five databases were searched: CINAHL, GreenFILE, AMED, Medline, and PubMed, accessed on 14th June 2021. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for quality assessment in all studies. Due to heterogeneity, narrative synthesis was conducted to evaluate the relationships between the included studies. Four observational studies which reported diet-related outcomes were included in the review, and participants within the studies ranged from 554 to > 350,000 participants. Other health outcomes, including physical activity and obesity, have also been reported. Socioeconomic status (SES) was identified as a significant determinant of dietary intake and food choice. Two studies found that dietary patterns were not correlated with exposure to greenspace. Due to the small number of articles retrieved and the paucity of evidence, the findings need to be interpreted with caution. Further research is required to elucidate the complex mechanisms involved. Research is also needed to determine which greenspace attributes impact dietary intake and food choices among adults. When developing public health interventions, the significant health benefits associated with different socioeconomic groups should be considered.