What drives the fruit choice and fruit intake of women in different food environments in Kenya?
SUPERVISOR: Maria WURZINGER
PROJECT ASSIGNED TO: Barbara STADLMAYR
Fruit and vegetable intake is far below the recommended 400 g/day levels worldwide, particularly in low- and middle-income countries (LMICs), where over 80% consume lower amounts (Miller et al., 2016). This increases the risk of malnutrition and non-communicable diseases such as diabetes and cardiovascular disease (Global Burden of Disease Collaborators, 2017). Countries in sub-Saharan Africa, including Kenya, are in line with these low consumption rates, particularly for fruits with 62 g/capita/day (Frank et al., 2019). Among the barriers to fruit and vegetable intake in LMICs are low availability and access (Nijhuis and Brouwer, 2020). Moreover, what, when and why people choose to eat is influenced by a magnitude of factors, ranging from biological to social and cultural (Shepherd, 2005). Hence, it requires a broad understanding of how individuals are embedded in their environments (Story et al., 2008).
Research on food environments, described as the interface where people interact with the wider food system to acquire and consume foods is getting increasing attention in LMICs (Turner et al. 2020). Up to now, evidence about how people interact with the social and physical food environment to make food choices is, however, limited in Africa (Holdsworth and Landais, 2019).
The thesis aims to contribute to filling this knowledge gap. It aims to identify factors that impact fruit choice and consumption and assess how they vary among different food environments in Kenya. Given the key role of women in providing foods and being responsible for dietary choices within households, women are the main target group of the research (Inglis et al., 2005; Gissing et al., 2017).
Conceptual frameworks built on socio-ecological theory and suited to analyse food environments in low and middle-income countries as defined by Turner et al. 2018 and Downs et al. 2020 will be applied. A mixed-method approach, including surveys, focus group discussions and qualitative interviews will be conducted to characterize food environments, analyse how women perceive their environment and identify barriers and facilitators towards fruit choices and intake.
The doctoral project aims to contribute new insights to inform the design of interventions to increasee fruit consumption and stimulate a food environment conducive to better food choices. The project is embedded in the CGIAR Research Program on Forests, Trees and Agroforestry and will contribute to the Transformative Partnership Platform (TPP)-Nutri-scapes.
Downs, S.M., Ahmed, S., Fanzo, J., Herforth, A. (2020): Food environment typology: Advancing an expanded definition, framework, and methodological approach for improved characterization of wild, cultivated, and built food environments toward sustainable diets. Foods, 9 (4), 532.
Frank, S.M. et al. (2019): Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries. The Journal of Nutrition. 149 (7):1252–1259.
Gissing, S.C., Pradeilles, R., Osei-Kwasi, H.A., Cohen, E., Holdsworth, M. (2017): Drivers of dietary behaviours in women living in urban Africa: A systematic mapping review. Public Health Nutrition, 20 (12): 2104-2113.
Global Burden of Disease Collaborators (2017): Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390:1151–210.
Holdsworth, M., Landais, E. (2019): Urban food environments in Africa: Implications for policy and research. Proceedings of the Nutrition Society, 78 (4): 513-525.
Inglis, I., Ball, K., Crawford, D. (2005): Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration. Appetite, 45 (3): 334-343.
Nijhuis, A., Brouwer, I.D. (2020): Fruits and Vegetables Consumption in Low-and Middle-Income Countries. A comprehensive review of fruits and vegetables intake and determinants using a food systems approach. Division of Human Nutrition and Health, Wageningen University & Research Wageningen, The Netherlands.
Shepherd R. (2005): Influences on food choice and dietary behaviour. Forum Nutr. (57):36– 43.
Story et al. (2007): Creating Healthy Food and Eating Environments: Policy and Enviornmental Approaches: Annu. Rev. Public. Health 2008.
Turner, C., Aggarwal, A., Walls, H., Herforth, A., Drewnowski, A., Coates, J., Kalamatianou, S., Kadiyala, S. (2018): Concepts and critical perspectives for food environment research: A global framework with implications for action in low- and middle-income countries. Global Food Security(18): 93-101.
Turner, C., Kalamatianou, S., Drewnowski, A., Kulkarni, B., Kinra, S., Kadiyala, S. (2020): Food Environment Research in Low- and Middle-Income Countries: A Systematic Scoping Review. Advances in Nutrition, 11 (2): 387-397.