Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Proximity of supermarkets is positively associated with diet quality index for pregnancy.
OBJECTIVES To investigate the association between distance to the closest supermarket and a composite measure of diet , the diet quality index for pregnancy ( DQI-P ) was constructed . METHODS Data from the Pregnancy , Infection and Nutrition ( PIN ) cohort , a prospect i ve study of determinants of preterm birth , were analyzed . Food frequency question naires were used to construct DQI-P which includes : servings of grains , vegetables , fruits , folate , iron and calcium intake , percentage of calories from fat , and meal pattern score . Street address of residence , supermarkets , grocery and convenience stores were geocoded . Participants with complete food frequency and address data were included ( n = 918 ) .  Multinomial logistic regression was used to estimate the conditional association of food outlets on diet quality , controlling for confounders and using a robust variance estimator to account for clustering of neighborhood characteristics . RESULTS Women living greater than 4 miles from a supermarket were more than twice the odds ( adjusted odds ratio = 2.16 ; 95 % confidence interval = 1.2 , 4.0 ) of falling into the lowest compared to highest DQI-P tertile compared to women living within 2 miles of a supermarket , after controlling for individual characteristics , other food retail outlets . CONCLUSION These findings suggest that proximity of food retail outlets influences the diet quality of pregnant women
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .