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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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Stadlmayr B, Trübswasser U, McMullin S, Karanja A, Wurzinger M, Hundscheid L, Riefler P, Lemke S, Brouwer ID, Sommer I. Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review. Front Nutr 2023; 10:1113013. [PMID: 37113298 PMCID: PMC10126510 DOI: 10.3389/fnut.2023.1113013] [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: 11/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.
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Affiliation(s)
- Barbara Stadlmayr
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- World Agroforestry (ICRAF), Nairobi, Kenya
| | - Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | | | | - Maria Wurzinger
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Laura Hundscheid
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Petra Riefler
- Institute for Marketing and Innovation, Department of Economics and Social Science, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Stefanie Lemke
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- Center for Agroecology, Water and Resilience, Coventry University, Coventry, United Kingdom
| | - Inge D. Brouwer
- Division of Human Nutrition and Health/CGIAR Initiative Sustainable Healthy Diets (SHiFT), Wageningen University, Wageningen, Netherlands
| | - Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education, Krems, Austria
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Bissett M, Gray CM, Abdulla S, Bunn C, Crampin AC, Dillip A, Gill JMR, Kaare HC, Kalima S, Kambalu E, Lwanda J, Makoye HF, Mtema O, Perry M, Strachan Z, Todd H, Mtenga SM. "I see salt everywhere": A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000927. [PMID: 36962765 PMCID: PMC10022006 DOI: 10.1371/journal.pgph.0000927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/22/2022] [Indexed: 12/28/2022]
Abstract
The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants' experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants' beliefs about NCDs and their impact (e.g., "… it spreads all over your body and kills you-snake's poison is similar to diabetes poison"), while the focus groups provided more basic accounts (e.g., "diabetes is a fast killer"). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma.
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Affiliation(s)
- Maria Bissett
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Sharifa Abdulla
- Fine and Performing Arts Department, University of Malawi, Zomba, Malawi
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Amelia C. Crampin
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Angel Dillip
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Jason M. R. Gill
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Heri C. Kaare
- Taasisi ya Sanaa na Utamaduni Bagamoyo (TaSUBa), Bagamoyo, United Republic of Tanzania
| | | | | | - John Lwanda
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Herbert F. Makoye
- Taasisi ya Sanaa na Utamaduni Bagamoyo (TaSUBa), Bagamoyo, United Republic of Tanzania
| | | | - Mia Perry
- School of Education, University of Glasgow, Glasgow, United Kingdom
| | - Zoë Strachan
- School of Critical Studies, University of Glasgow, Glasgow, United Kingdom
| | - Helen Todd
- Art and Global Health Centre Africa, Zomba, Malawi
| | - Sally M. Mtenga
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
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Ndambo MK, Nyondo-Mipando AL, Thakwalakwa C. Eating behaviors, attitudes, and beliefs that contribute to overweight and obesity among women in Lilongwe City, Malawi: a qualitative study. BMC Womens Health 2022; 22:216. [PMID: 35681137 PMCID: PMC9185864 DOI: 10.1186/s12905-022-01811-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is increasingly a public health concern in low- and middle-income countries, including Malawi where 36% of women have body mass index in overweight/obese categories in urban areas. Eating behaviors, attitudes, and beliefs are associated with body size, but have not been studied in-depth in sub-Saharan African countries. This study therefore, explored eating behaviors, attitudes, and beliefs of women in Lilongwe, Malawi.
Methods This was a descriptive ancillary qualitative study utilising in-depth interviews with 27 women (13 in normal weight range and 14 in overweight/obesity ranges) puporsively selected in Lilongwe City, Malawi from October to November 2017. The concept of data saturation guided data collection, and it was reached with the 27 interviewed participants when there was no new information coming from the participants. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were analysed manually using thematic content analysis. Results Majority of participants perceived overweight as an indication of good health such that with food affordability, women deliberately gain weight to demonstrate their good health. Most normal weight respondents said they ate less food than they wanted to because of financial constraints. Most women in overweight/obese ranges in our sample reported that they eat large portions and eat frequently due to the desire to portray a good image of their marital life since there is a societal expectation that when a woman is married, her weight should increase to show that the marriage is successful. The perceived contributors to weight gain include eating behaviors, feelings about weight gain, and gender roles and social expectations to gain weight. Conclusion Beliefs and attitudes related to eating behaviors may have contributed to women being in overweight range and should be considered in designing obesity prevention interventions targeting women in Malawi. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01811-0.
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Affiliation(s)
- Myness Kasanda Ndambo
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi.
| | - Alinane Linda Nyondo-Mipando
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi
| | - Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
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Cáceres P, Juretić N, Segovia L, Rivera C. Exploration of Taste and Preferences for Primary Flavors, Flavor Combinations, Aromatic Flavors and Ethnic Flavors: An Approach to the Acceptability of Culinary Diversity in Chile. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2022. [DOI: 10.1080/15428052.2022.2057886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paola Cáceres
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Nevenka Juretić
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Luna Segovia
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Constanza Rivera
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
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Understanding drivers of food choice in low- and middle-income countries: A systematic mapping study. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100615] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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de Bruyn J, Wesana J, Bunting SW, Thilsted SH, Cohen PJ. Fish Acquisition and Consumption in the African Great Lakes Region through a Food Environment Lens: A Scoping Review. Nutrients 2021; 13:2408. [PMID: 34371918 PMCID: PMC8308864 DOI: 10.3390/nu13072408] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/04/2021] [Accepted: 07/08/2021] [Indexed: 12/15/2022] Open
Abstract
Effective actions for the fishery and aquaculture sectors to contribute toward improving nutrition rely on an understanding of the factors influencing fish intake, particularly amongst vulnerable populations. This scoping review synthesises evidence from 33 studies in the African Great Lakes Region to examine the influence of food environments on fish acquisition and consumption. We identified only two studies that explicitly applied a food environment framework and none that linked policy conditions with the contribution of fish to diets. Economic access to fish was represented in the largest number of included studies (21 studies), followed by preferences, acceptability and desirability of fish (17 studies) and availability and physical access (14 studies). Positive perceptions of taste and low cost, relative to other animal-source foods, were drivers of fish purchases in many settings; however, limited physical and economic access were frequently identified as preventing optimal intake. In lakeside communities, fish were increasingly directed toward external markets which reduced the availability and affordability of fish for local households. Few studies considered intra-household variations in fish access according to age, gender or physiological status, which represents an important knowledge gap. There is also scope for future research on seasonal influences on fish access and the design and rigorous evaluation of programmes and policies that address one or more constraints of availability, cost, convenience and preferences.
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Affiliation(s)
- Julia de Bruyn
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
- Melbourne Sustainable Society Institute, University of Melbourne, Parkville, VIC 3010, Australia
| | - Joshua Wesana
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
| | - Stuart W. Bunting
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
| | - Shakuntala H. Thilsted
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas 11960, Penang, Malaysia; (S.H.T.); (P.J.C.)
| | - Philippa J. Cohen
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas 11960, Penang, Malaysia; (S.H.T.); (P.J.C.)
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