Abstract
Background: The global obesity pandemic and rates of nutrition-related noncommunicable diseases (NCDs) have increased worldwide, especially in the Latin American and Caribbean region. In an attempt to control this obesity epidemic, the Chilean government has established a comprehensive set of regulatory actions, including beverage taxation, warning labels on foods, and marketing restrictions to children. To improve the effectiveness of actions to prevent obesity, a better understanding of the food environment is needed. Objective: We developed and standardized photographic methods to assess and monitor packaged food and beverage products in supermarkets. Methods: A standardized protocol and food categorization system was used to guide photo collection and data management of photos taken between February and April 2015 in 11 supermarkets, consisting of 5 different supermarket chains, from high- (n = 6) and lower-middle (n = 5)-income neighborhoods in Santiago, Chile. Photos (n = ∼50,000) from nearly 10,000 unique food products from high- and lower-middle-income neighborhoods were used for this study. Results: We developed standardized methods to use photographs to assess and monitor the food environment. A food categorization scheme is essential to guiding the data collection process. Substantial time and human resources are required to assess packaged food and beverage products in supermarkets. Because the number of photos per food product is variable, the organization of the photographs according to the food categorization system, before data entry, is imperative for easy access during data entry and analysis. We identified the information necessary for a photographic registry, which, with the food categorization system, is critical to create unique identifiers that are linked to each food product and its photos. Conclusions: To adequately monitor food environments, standardized methods for food photo collection and management are essential. The information collected on food package photos to monitor food environments is important for guiding and evaluating actions in the context of the ongoing obesity and NCD epidemics.