Neighbourhood Out-of-Home Food Environment, Menu Healthiness, and Their Associations with Meal Purchasing and Diet Quality: A Multiverse Analysis

The article explores how various characteristics of the neighborhood out-of-home (OOH) food environment influence meal purchasing and diet quality in Great Britain. Through a multiverse analysis—testing 162 analytical combinations—the study evaluates proximity to OOH outlets, number of outlets, and healthiness of menus. It finds that the number of food outlets is consistently linked to higher frequency of meal purchases, but not necessarily to poor diet quality. Menu healthiness was weakly associated with diet outcomes. These findings suggest that simple metrics like proximity or outlet count may not fully capture food environment influence, and policies should consider more nuanced factors when addressing food choice behaviors.