Neha Gupta, Vaishali Deshmukh, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora. Food environment framework in low- and middle-income countries – An integrative review. Global Food Security. Volume 39. 2023. 100716. ISSN 2211-9124. https://doi.org/10.1016/j.gfs.2023.100716. (pay wall)
Relevant to:
Researchers from multidisciplinary domains, policy makers, program managers
Question:
The integrative review addressed the following objectives: (1) to develop a multi-level framework of Food Environments (FE) for low- and middle-income countries (LMICs) based on McLeroy socio ecological theory and Penchansky and Thomas’s theory of access; (2) to identify the factors operating at different levels of the FE framework; and (3) to understand the relationship between factors operating at different levels of FE framework and dietary behaviors in LMICs.
Bottom line for nutrition practice:
- Food environment embedded in the food systems is a key consideration in sustainability. This study finds that the food environments in LMICs are in a dynamic state and have context specific mix of traditional systems and emerging modern supply chain-based markets.
- The proposed socio-ecological model of the food environment in the context of LMICs should lay the foundation for an operational and analytical tool for surveillance, capturing dynamicity and its determinants.
Abstract:
- There are major gaps in our understanding of food environments (FE) in low-and middle-income countries (LMICs) witnessing differential and complex social and economic transition. The present integrative review was conducted to develop a conceptual framework of FE for LMICs using socio-ecological and access theory. The FE framework has four layers: public policy, community/neighborhood (including organizational e.g., markets, schools), household, and individual. Availability, accessibility, and affordability with built-in socio-cultural and contextual factors were the major domains in every layer. The following additional domains emerged: global influences, marketing and regulation, nutrition programs, time-constrained family members, and food behavior. Wet and informal markets are important components of FE. The next step is determining the model’s resilience to accommodate and capture nuances across LMICs.
Details of results:
- The integrative review included evidence from 28 studies about food environment in low and middle-income countries in the last two decades.
- The review used McLeroy’s socio-ecological model and Penchansky’s access theory as the basis for identifying the socio-economic and ecological factors operating at multiple levels in the LMIC food environment that influence dietary outcomes.
- The factors were operating at (i) policy, (ii) community, (iii) household, and (iv) individual levels under the availability, affordability, and accessibility domains at each level are interwoven among themselves
- The review identified that context and neighborhood characteristics characterise the food environment. In addition, the unorganized markets comprise of the major component of food environment
- The evidence synthesis identified the following additional domains at multiple levels: Nutrition programs and global influences (Policy level); marketing and regulations (policy and neighborhood level); and time constraint and food behavior (household level).
Of additional interest:
n/a
Conflict of interest/ Funding:
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
External relevant links:
n/a
Corresponding author:
Seema Puri, Department of Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, India, dr.seemapuri@gmail.com
Transparency | Diversity | Dynamism | Evidence-based |