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Kenney E, Rampalli KK, Samin S, Frongillo EA, Reyes LI, Bhandari S, Boncyk M, Nordhagen S, Walls H, Wertheim-Heck S, Ickowitz A, Cunningham SA, Ambikapathi R, Ekesa B, Matita M, Blake CE. How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review. Adv Nutr 2024; 15:100203. [PMID: 38462217 PMCID: PMC11007434 DOI: 10.1016/j.advnut.2024.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024] Open
Abstract
Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.
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Affiliation(s)
- Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Krystal K Rampalli
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Ligia I Reyes
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Division of Nutritional Science, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Morgan Boncyk
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Department of Public Health, Purdue University, West Lafayette, IN, United States
| | - Stella Nordhagen
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | - Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands
| | - Amy Ickowitz
- Center for International Forestry Research-World Agroforestry Center, Beit Zayit, Israel
| | - Solveig A Cunningham
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, United States; Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States
| | - Beatrice Ekesa
- Alliance of Bioversity International and CIAT, Kampala, Uganda
| | - Mirriam Matita
- Extension Department, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Mallinson PA, Lieber J, Kinra S, Debbarma A, Walls HL, Bhogadi S, Addanki S, Pande R, Kurpad AV, Kannuri NK, Aggarwal S, Kulkarni B, Finkelstein EA, Deo S. Evaluating novel methods of enhancing the impact of financial incentives on household nutrition in developing nations - authors' reply. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 24:100399. [PMID: 38756154 PMCID: PMC11096676 DOI: 10.1016/j.lansea.2024.100399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/23/2024] [Indexed: 05/18/2024]
Affiliation(s)
| | - Judith Lieber
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sanjay Kinra
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Arindam Debbarma
- Indian School of Business, Hyderabad, 500111, India
- University of Minnesota, Minneapolis, MN, 55455, USA
| | - Helen L. Walls
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Santhi Bhogadi
- Indian Institute of Public Health, Hyderabad, 500033, India
| | | | - Richa Pande
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 50007, India
| | | | | | | | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 50007, India
| | | | - Sarang Deo
- Indian School of Business, Hyderabad, 500111, India
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Downs S, Manohar S, Staromiejska W, Keo C, Say S, Chhinh N, Fanzo J, Sok S. Centering context when characterizing food environments: the potential of participatory mapping to inform food environment research. Front Nutr 2024; 11:1324102. [PMID: 38450238 PMCID: PMC10914972 DOI: 10.3389/fnut.2024.1324102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.g., across a given day or across seasons). We provide a case study example of the application of PM and the lessons learned from it in Cambodia. By conceptualizing food environments in a more comprehensive way, from the perspective of the people living within a given community, we will be able to measure food environments in a way that more closely aligns with people's lived experiences.
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Affiliation(s)
- Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Swetha Manohar
- Global Food Ethics Policy Program, School of Advanced International Studies, Washington, DC, United States
- Nutrition, Diets and Health Unit, International Food Policy Research Institute, Washington, DC, United States
| | - Wiktoria Staromiejska
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Chanvuthy Keo
- Faculty of Social Science and Humanities, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Sophea Say
- Department of Tourism, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Nyda Chhinh
- Department of Economic Development, Faculty of Development Studies, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Jessica Fanzo
- Columbia’s Climate School, Columbia University, New York, NY, United States
| | - Serey Sok
- Research Office, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
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Hasan AMR, Smith G, Selim MA, Khatun F, Mahmood SS, Reidpath DD, Rasheed S. Qualitative exploration of the impact of COVID-19 on the food environment of urban informal settlements of Dhaka, Bangladesh. BMJ Open 2023; 13:e067652. [PMID: 37527892 PMCID: PMC10394537 DOI: 10.1136/bmjopen-2022-067652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Our study explored the impact of the COVID-19 pandemic on the food environment from the perspective of the urban poor and food vendors. DESIGN This was a qualitative study conducted during September 2020 and February 2021. SETTING The study was carried out in two purposively selected informal settlements of Dhaka City, Bangladesh. PARTICIPANTS We conducted 21 in-depth interviews with residents of informal settlements and 10 key informant interviews with food vendors and food aid workers. RESULT The availability of staple foods was not disrupted during the pandemic but some perishables foods became more expensive due to supply chain disruptions and increased transportation costs. Limited market hours affected market access and mobility restrictions adversely affected local vendors. Cart vendors selling perishables incurred business losses they could ill afford. Demand for food reduced as employment disruption lead to reduced purchasing power and, therefore, reduction of quantity, quality and desirability of foods purchased. Respondents reported skipping meals and going hungry. The aid received was considered inadequate to meet needs. CONCLUSION The food environment of the urban poor was disrupted from both supply and demand sides and the organisational response (both government and non-government) was severely inadequate. The social safety net needs to be extended and redesigned to ensure food security and health for the urban working poor in the future.
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Affiliation(s)
- A M Rumayan Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mohammad Abdus Selim
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fatema Khatun
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Kinra S, Mallinson PA, Debbarma A, Walls HL, Lieber J, Bhogadi S, Addanki S, Pande R, Kurpad AV, Kannuri NK, Aggarwal S, Kulkarni B, Finkelstein EA, Deo S. Impact of a financial incentive scheme on purchase of fruits and vegetables from unorganised retailers in rural India: a cluster-randomised controlled trial. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 12:100140. [PMID: 37384059 PMCID: PMC10305860 DOI: 10.1016/j.lansea.2022.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/28/2022] [Accepted: 12/22/2022] [Indexed: 06/30/2023]
Abstract
Background Inadequate intake of fruits and vegetables is prevalent in rural areas of India, where around 65% of the population reside. Financial incentives have been shown to increase the purchase of fruits and vegetables in urban supermarkets, but their feasibility and effectiveness with unorganised retailers in rural India is unclear. Methods A cluster-randomised controlled trial of a financial incentive scheme involving ∼20% cashback on purchase of fruits and vegetables from local retailers was conducted in six villages (3535 households). All households in three intervention villages were invited to participate in the scheme which ran for three months (February-April 2021), while no intervention was offered in control villages. Self-reported (pre-intervention and post-intervention) data on purchase of fruits and vegetables were collected from a random sub-sample of households in control and intervention villages. Findings A total of 1109 households (88% of those invited) provided data. After the intervention, the weekly quantity of self-reported fruits and vegetables purchased were (i) 18.6 kg (intervention) and 14.2 kg (control), baseline-adjusted mean difference 4 kg (95% CI: -6.4 to 14.4) from any retailer (primary outcome); and (ii) 13.1 kg (intervention) and 7.1 kg (control), baseline-adjusted mean difference 7.4 kg (95% CI: 3.8-10.9) from local retailers participating in the scheme (secondary outcome). There was no evidence of differential effects of the intervention by household food security or by socioeconomic position, and no unintended adverse consequences were noted. Interpretation Financial incentive schemes are feasible in unorganised food retail environments. Effectiveness in improving diet quality of the household likely hinges on the percentage of retailers willing to participate in such a scheme. Funding This research has been funded by the Drivers of Food Choice (DFC) Competitive Grants Program, which is funded by the UK Government's Department for International Development and the Bill & Melinda Gates Foundation, and managed by the University of South Carolina, Arnold School of Public Health, USA; however, the views expressed do not necessarily reflect the UK Government's official policies.
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Affiliation(s)
- Sanjay Kinra
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | - Arindam Debbarma
- Indian School of Business, Hyderabad, 500111, India
- University of Minnesota, Minneapolis, MN, 55455, USA
| | - Helen L. Walls
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Judith Lieber
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Santhi Bhogadi
- Indian Institute of Public Health, Hyderabad, 500033, India
| | | | - Richa Pande
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 50007, India
| | | | | | | | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 50007, India
| | | | - Sarang Deo
- Indian School of Business, Hyderabad, 500111, India
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Isanovic S, Constantinides SV, Frongillo EA, Bhandari S, Samin S, Kenney E, Wertheim-Heck S, Nordhagen S, Holdsworth M, Dominguez-Salas P, Ambikapathi R, Laar A, Patil CL, Kulkarni B, Bukachi SA, Ngutu M, Blake CE. How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries. Curr Dev Nutr 2023; 7:100015. [PMID: 37181131 PMCID: PMC10100931 DOI: 10.1016/j.cdnut.2022.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/30/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety. Results The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food. Conclusions Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.
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Affiliation(s)
- Sejla Isanovic
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shilpa V. Constantinides
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, the Netherlands
| | | | - Michelle Holdsworth
- Montpellier Interdisciplinary Center on Sustainable Agri-food Systems, University of Montpellier, French Agricultural Research Centre for International Development, International Center for Advanced Mediterranean Agronomic Studies, Mediterranean Agronomic Institute of Montpellier, French National Institute for Agricultural Research, Institut Agro, French National Research Institute for Sustainable Development, Montpellier, France
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, USA
- Department of Global Development, Cornell University, Ithaca, NY, USA
| | - Amos Laar
- University of Ghana, Department of Population, Family and Reproductive Health, School of Public Health, Accra, Ghana
| | - Crystal L. Patil
- Department of Human Development Nursing Science, University of Illinois–Chicago, Chicago, IL, USA
| | - Bharati Kulkarni
- Division of Reproductive Biology, Maternal and Child Health and Nutrition, Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Christine E. Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Ghosh M, Singh AK. Potential of engineered nanostructured biopolymer based coatings for perishable fruits with Coronavirus safety perspectives. PROGRESS IN ORGANIC COATINGS 2022; 163:106632. [PMID: 34931104 PMCID: PMC8674086 DOI: 10.1016/j.porgcoat.2021.106632] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 05/25/2023]
Abstract
Fresh fruits are prioritized needs in order to fulfill the required health benefits for human beings. However, some essential fruits are highly perishable with very short shelf-life during storage because of microbial growth and infections. Thus improvement of fruits shelf-life is a serious concern for their proper utlization without generation of huge amount of fruit-waste. Among various methods employed in extension of fruits shelf-life, design and fabrication of edible nanocoatings with antimicrobial activities have attracted considerable interest because of their enormous potential, novel functions, eco-friendly nature and good durability. In recent years, scientific communities have payed increased attention in the development of advanced antimicrobial edible coatings to prolong the postharvest shelf-life of fruits using hydrocolloids. In this review, we attempted to highlight the technical breakthrough and recent advancements in development of edible fruit coating by the application of various types of agro-industrial residues and different active nanomaterials incorporated into the coatings and their effects on shelf-life of perishable fruits. Improvements in highly desired functions such as antioxidant/antimicrobial activities and mechanical properties of edible coating to significantly control the gases (O2/CO2) permeation by the incorporation of nanoscale natural materials as well as metal nanoparticles are reviewed and discussed. In addition, by compiling recent knowledge, advantages of coatings on fruits for nutritional security during COVID-19 pandemic are also summarized along with the scientific challenges and insights for future developments in fabrication of engineered nanocoatings.
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Affiliation(s)
- Moushumi Ghosh
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004, India
| | - Arun Kumar Singh
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004, India
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Chaudhry M, Jaacks LM, Bansal M, Mahajan P, Singh A, Khandelwal S. A Direct Assessment of the External Domain of Food Environments in the National Capital Region of India. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.726819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Data on food environments in India and other low- and middle-income countries are scarce. The objective of this study was to assess the four dimensions of the external domain of food environments (availability, price, vendor and product properties, and marketing) in food establishments in the National Capital Region of India. The assessment focused on fruits, vegetables, and ultra-processed foods. The 60 food establishments surveyed were categorized as stores, restaurants, or mobile food vendors. Only 13.3% of food establishments sold fruits and vegetables. Stores were more likely to sell vegetables than mobile food vendors (14.8 vs. 6.2%, respectively) and sold a greater variety of both fruits and vegetables as compared to mobile food vendors [mean (SD) of 8.6 (3.2) fruits and 18.6 (9.2) vegetables available at stores vs. 5.5 (5.7) fruits and 25 vegetables available at the one mobile food vendor who sold vegetables]. However, these healthy food items were more expensive at stores. The availability (100% of stores, 12.5% of mobile food vendors, and 12.5% of restaurants) and variety (156 types) of ultra-processed foods across food establishments were higher than fruits and vegetables. A greater percentage of food establishments displayed advertisements for ultra-processed foods as compared to unprocessed or minimally processed foods such as fruits and vegetables. The National Capital Region of India has an unhealthy food environment. Regulations that limit the availability of ultra-processed foods and improve the availability and affordability of fruits and vegetables are needed to reverse the rising tide of chronic non-communicable diseases in this setting.
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Constantinides SV, Turner C, Frongillo EA, Bhandari S, Reyes LI, Blake CE. Using a global food environment framework to understand relationships with food choice in diverse low- and middle-income countries. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riediger N, Dhalla A, Cooper M, Bombak A, Sreeramaiah H. A qualitative analysis of the perceived socio-cultural contexts and health concerns of sugar-sweetened beverages among adults studying or working at a post-secondary institution in Dharwad, India. BMC Public Health 2021; 21:1016. [PMID: 34051790 PMCID: PMC8164752 DOI: 10.1186/s12889-021-11033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We sought to explore the perceptions of the socio-cultural contexts and health concerns of consuming sugar-sweetened beverages (SSB) among Indian adults working or studying at a post-secondary institution in Karnataka, India. METHODS We completed a qualitative study, including 24 semi-structured interviews between 2017 and 2018 at the University of Agricultural Sciences, Dharwad, Karnataka, India. Data were analyzed using thematic content analysis. RESULTS One over-arching theme emerged, westernization and changing perceptions of food, sugar, and health. Participants discussed SSB and associated health concerns in the broad context of westernization and overall economic development in India. Three sub-themes regarding the health perceptions of consuming SSB were: healthy drinks are clean and natural; hydration and energy; and moderation and body weight. Hygienically-prepared beverages were a consistent concern among participants. Juices and beverages, such as tea or coffee, sweetened with jaggery were viewed positively due to their naturalness and lack of processed sugar. Participants perceived SSB as providing hydration and energy, particularly in hot weather. Lastly, if consumed in moderation, SSB were thought to have no direct adverse health consequences. Though some participants noted excessive, 'addictive' consumption would contribute to weight gain and diabetes. CONCLUSION Perceived health concerns of SSB reflect dominant health issues in India, namely, food insecurity, food safety, and increasingly, diabetes. Policymakers tend to prioritize acute challenges over long-term concerns. As such, the capacity of any policy to address chronic nutritional concerns related to SSB are likely to be muted in the absence of improvements to food safety and security.
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Affiliation(s)
- Natalie Riediger
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada.
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Anika Dhalla
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Maureen Cooper
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, NB, Canada
| | - Hemalatha Sreeramaiah
- Food Science and Technology Department, University of Agricultural Sciences Dharwad, Dharwad, India
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Wu YH, Moore S, McRae C, Dubé L. Tracing the Single and Combined Contributions of Home-Grown Supply and Health Literacy on Fruit and Vegetable Consumption: An Empirical Exploration in Rural India. Front Public Health 2021; 9:591439. [PMID: 34095042 PMCID: PMC8175893 DOI: 10.3389/fpubh.2021.591439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 01/19/2023] Open
Abstract
Low fruit and vegetable consumption (FVC) remains a global health challenge. Fostering subsistence agriculture through the production and home-grown consumption (HGC) of fruits and vegetables are seen as potential strategies for improving overall FVC, in particular, for developing countries like India. In addition, educational strategies targeting FVC health literacy are also used. Little evidence has documented a connection between these two strategies. We examine the single and combined influence of HGC and health literacy with regard to benefits from fruits and vegetable consumption. Data were collected from 427 rural households in the state of Odisha, India. Three outcomes were examined: FVC, as well as fruit and vegetables separately. Linear and Poisson regression were used to examine the association among home-grown consumption (HGC), FVC health literacy, and the FVC outcomes. Findings show that HGC, but not FVC health literacy, was directly associated with FVC (β = 0.65, SE = 0.10, p = 0.008) and vegetable consumption (β = 0.57, SE = 0.11, p = 0.02). However, both HGC (β = 0.58, SE = 0.05, p < 0.01) and FVC health literacy (β = -0.07, SE = 0.02, p = 0.001) were associated with fruit consumption. In addition, HGC effect is concentrated among participants who reported low FVC health literacy, especially on overall FVC and vegetables alone. Results are discussed in relation to the beneficial role played by HGC in those particularly vulnerable households who perceived little FVC health literacy. Our results provide insights on novel improved FVC consumption across all population segments. Future research should explore the complex interplay between agricultural policies and educational programs in the design of interventions promoting fruit and vegetable production and consumption.
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Affiliation(s)
- Yun-Hsuan Wu
- Department of Public Health, China Medical University, Taichung, Taiwan
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Spencer Moore
- Health and Society Group, Wageningen University and Research, Wageningen, Netherlands
| | - Cameron McRae
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
| | - Laurette Dubé
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
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My NH, Demont M, Verbeke W. Inclusiveness of consumer access to food safety: Evidence from certified rice in Vietnam. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100491] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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13
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Custodio MC, Ynion J, Samaddar A, Cuevas RP, Mohanty SK, Ray (Chakravarti) A, Demont M. Unraveling heterogeneity of consumers' food choice: Implications for nutrition interventions in eastern India. GLOBAL FOOD SECURITY 2021; 28:100497. [PMID: 33738189 PMCID: PMC7937786 DOI: 10.1016/j.gfs.2021.100497] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 01/13/2023]
Abstract
Understanding heterogeneity of consumers' food choice is critical in formulating tailored nutrition interventions. To illustrate this, we survey urban and rural consumers from low- and middle-income households in eastern India to unravel five sources of heterogeneity (5 Ws) in gastronomic systems that affect diets: (i) socioeconomic characteristics of the target population (who); (ii) food environments (where); (iii) eating occasions (when); (iv) consumed dishes (what); and (v) ingredient attributes and consumer attitudes towards food (why). Diets in eastern India are predominantly starch-based featuring infrequent intake of fruits and vegetables. Accounting for heterogeneity in gastronomic systems can help policy makers and nutritionists develop more targeted nutrition interventions, which can aid in the development of planetary health diets in various contexts around the world.
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Affiliation(s)
| | - Jhoanne Ynion
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | - Arindam Samaddar
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | - Rosa Paula Cuevas
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | - Suva Kanta Mohanty
- Kalinga Institute of Industrial Technology, KIIT School of Management, Bhubaneswar, India
- Institute of Rural Management Anand (IRMA), Anand, Gujrat, India
| | | | - Matty Demont
- International Rice Research Institute, Los Baños, Laguna, Philippines
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14
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Walls H, Cook S, Matzopoulos R, London L. Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework. BMJ Glob Health 2020; 5:e001958. [PMID: 32377401 PMCID: PMC7199708 DOI: 10.1136/bmjgh-2019-001958] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 11/12/2022] Open
Abstract
Alcohol-related harm has gained increased attention in high-income countries (HICs) in recent years which, alongside government regulation, has effected a reduction in alcohol consumption. The alcohol industry has turned its attention to low-income and middle-income country (LMIC) markets as a new source of growth and profit, prompting increased consumption in LMICS. Alcohol use in LMICs is also increasing. There is a need to understand particularly in LMICs the impact of industry strategy in shaping local contexts of alcohol use. We draw on conceptualisations from food systems research, and research on the commercial determinants of health, to develop a new approach for framing alcohol research and discuss implications for alcohol research, particularly in LMICs, focusing on South Africa as an illustrative example. We propose a conceptualisation of the ‘alcohol environment’ as the system of alcohol provision, acquisition and consumption—including, critically, industry advertising and marketing—along with the political, economic and regulatory context of the alcohol industry that mediates people’s alcohol drinking patterns and behaviours. While each country and region is different in terms of its context of alcohol use, we contrast several broadly distinct features of alcohol environments in LMICs and HICs. Improving understanding of the full spectrum of influences on drinking behaviour, particularly in LMICs, is vital to inform the design of interventions and policies to facilitate healthier environments and reduce the harms associated with alcohol consumption. Our framework for undertaking alcohol research may be used to structure mixed methods empirical research examining the role of the alcohol environment particularly in LMICs.
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Affiliation(s)
- Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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