Understanding drivers of food choice in low- and middle-income countries: A systematic mapping study

Karanja, Alice; Ickowitz, Amy; Stadlmayr, Barbara; McMullin, Stepha

doi:10.1016/j.gfs.2022.100615

Cited by 54 publications

(30 citation statements)

References 107 publications

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“…A study of athletes’ opinions of the food provided during a major competition has shown that the availability of appropriate food is driven by cultural acceptance, and this may impact food choice [ 46 ]. The relationship between the food environment and individual food choices of athletes across different countries, regions and sociocultural contexts would be of value as this has been identified as an area for further research in general populations [ 47 ]. The interplay between physiological function (for example; appetite, gut function, brain regulation), psychological factors, food beliefs, knowledge and skills, and the food environment relevant to athletes needs further investigation.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Food Choice in Athletes: A Systematic Scoping Review

2022

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Background The individual determinants of food choice have been extensively investigated in the general population, but there have been limited studies in athletes. A better understanding of the food making decisions can help to target interventions that lead to optimal intake for athletes’ health and performance. A scoping review will provide an understanding of the sports and settings that have been investigated, the methods and approaches to assessing food choice, as well as the factors influencing food choice. Objective The objective of this review was to map the available evidence on the multi-faceted determinants of food choice in athletes and describe key influences impacting their choices. Eligibility criteria. Athletes 16 years and over from any country who engage in physical activity with the intent to be competitive. Studies were included if they reported the multi-faceted determinants of food choice as either a primary or secondary outcome. All study designs were considered. Sources of Evidence. This review followed the PRISMA extension for Scoping Reviews. Eleven databases including PubMed, Web of Science (Clarivate Analytics), SPORTDiscus (EBSCO), PsycNET (APA), Health Collection (Informit), CINAHL (EBSCO), the Cochrane Library, ProQuest Dissertations and Theses Global, Trove (National Library of Australia), JBI (Ovid), and Google scholar were searched between September–November 2020 and updated in March 2021. Charting of Data Search results were screened with selected studies extracted into a summary table established a priori by the authors. Study quality was assessed using standardised reporting tools for qualitative and quantitative research designs. The scope and quality of evidence was summarised and reported. Results A total of 15 studies were included. Qualitative research included one research thesis and six primary research studies using both focus groups and semi-structured interviews. Quantitative research included one research thesis and seven primary research studies with cross-sectional design using different validated and non-validated survey instruments. No longitudinal or intervention studies were found. The majority of studies have been published since 2018 and conducted across multiple countries with either mixed cohorts of athletes or focused on predominately endurance or team sports. The quality of reporting was variable, particularly for qualitative research. Outcomes suggested that performance and health were relevant to athlete food choice, with varying impact of competition season, the level of experience, the culture of the sport, the cultural background or nationality of the athlete, athlete sex and the food environment. Conclusion More research is needed on the multi-faceted determinants of food choice in different cohorts of athletes, particularly females. Future research could explore the relationship between food choice, nutrition knowledge and diet quality or the change in food choice across the phase of the seasons and through injury and illness. Use of validated measurement tools and robust reporting will enable critical interpretation of the study methods and outcomes for use in practice. Registration OSF Registries: Open-ended registration 25th Sept 2020 https://doi.org/10.17605/OSF.IO/4PX2A

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Section: Discussionmentioning

confidence: 99%

Determinants of Food Choice in Athletes: A Systematic Scoping Review

2022

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“…These interviews with PLHIV and caregivers allowed us to identify the family as a third domain connecting the external and personal domains. A systemic mapping on low-to-middle-income countries food choices explained the sociocultural factors, sensory appeal, health and nutrition perceptions, and socio-demographic factors prevalent in this peri-urban setting [ 37 ]. We acknowledge the food environment's structures while being attentive to culture, tradition, and individual agency, we identify decision-making nodes related to food choice.…”

Section: Discussionmentioning

confidence: 99%

Exploring drivers of food choice among PLHIV and their families in a peri-urban Dar es Salaam, Tanzania

et al. 2022

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Background A nutritious diet is critical to minimizing disease progression of human immunodeficiency virus (HIV) and maximizing treatment efficacy. In low resource settings, meeting the food preference needs of people living with the HIV (PLHIV) can be achieved with a supportive food environment when HIV status is disclosed. However, less is known about family-level strategies related to building a supportive food environment. The Diet, Environment, and Choices of positive living (DECIDE), a mixed-methods observational study conducted in peri-urban Dar es Salaam, Tanzania, explored food preferences as influenced by the personal, family, and external food domains. Methods We completed a qualitative analysis of data generated from 40 interviews (n = 20 PLHIV and n = 20 family members) aimed at exploring the dynamics of food choice for using a family perspective. We expanded on Turner’s food environment framework and drew on Giddens’ structuration theory to guide our data collection and analysis. Interviews were audio recorded, transcribed, translated from Kiswahili to English, coded, and organized into themes. Results We found PLHIV personal food preferences were influenced by organoleptic properties, medications, disease stage, and gender norms. Family members were knowledgeable about the importance of nutritious food for HIV treatment and prioritized these needs to avoid HIV-related stigma and fulfill family obligations. With high prices of nutritious foods (animal source foods, fruits), family members strategized to secure preferred foods for the PLHIV by, 1) forgoing their own food preferences; 2) reallocating food within the household; 3)making food substitutions; and 4) leveraging external networks. These strategies were increasingly employed as the disease progressed. Conclusion The use of this expanded framework that included a family perspective on PLHIV food choice illuminated the various households decision-making dynamics that took place in this low resource community. Family members of PLHIV tried to buffer the limitations imposed by the external food environment, especially as the disease progressed. In the context of HIV status disclosure, integrating a family perspective into HIV nutrition interventions and programs has the potential to influence health outcomes and slow disease progression.

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“…Finally, due to the modification in study design, this study was limited to a few indicators related to physical access of food and food promotion. There is recognition in the literature that economic and social access, for example one’s position in society (e.g., gender, class) and other forms of food marketing (e.g., social media) dramatically affects consumer behaviour and food choice, which further reinforces access and availability of food within the food environment (i.e., positive feedback loop) [ 44 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Characterizing Retail Food Environments in Peri-Urban Pakistan during the COVID-19 Pandemic

Carducci

Wasan

Shakeel

et al. 2022

IJERPH

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(1) Background: To date, there are limited data in low- and middle-income countries (LMICs) that collect, monitor, and evaluate food environments in standardized ways. The development of a pilot survey tool, tailored to LMICs and focused on retail food environments, is necessary for improving public health nutrition. (2) Methods: A novel survey tool was developed and piloted in a sample of village retail food environments (n = 224) in Matiari, Pakistan between October 2020 to April 2021. Villages were randomly selected, and food outlets were surveyed within a 500-m radius from each village center. Descriptive statistics (counts and percentages) were used to describe the characteristics of food outlets and the availability of food. To test whether there was a difference in characteristics or in the mean of number of healthy, unhealthy, and total food items available by village size, a χ2 test or one-way ANOVA was conducted, respectively. (3) Results: In total, 1484 food outlets were surveyed for food accessibility, availability, and promotion across small (n = 54), medium (n = 112), and large villages (n = 58). In small and medium-sized villages, mobile food vendors were the predominant food outlet type (47.8% and 45.1%, respectively), whereas in large villages, corner stores (36%) were more prominent. The mean number of total food items (p < 0.006) and unhealthy food items (p < 0.001) available in food outlets differed by village size. The proportion of food outlets with available fruits, meat and poultry, water, and sugar-sweetened beverages also differed by village size (p < 0.001). (4) Conclusions: This study informs the global evidence gap in the current understanding of food environments in various ethnically diverse and dynamic LMICs, and the developed methodology will be useful to other LMICs for measuring and monitoring the food environment, especially among vulnerable population groups. This work complements current national and provincial survey efforts in Pakistan.

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Understanding drivers of food choice in low- and middle-income countries: A systematic mapping study

Cited by 54 publications

References 107 publications

Determinants of Food Choice in Athletes: A Systematic Scoping Review

Determinants of Food Choice in Athletes: A Systematic Scoping Review

Exploring drivers of food choice among PLHIV and their families in a peri-urban Dar es Salaam, Tanzania

Characterizing Retail Food Environments in Peri-Urban Pakistan during the COVID-19 Pandemic

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