How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review

Abstract

How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review Emma Kenney 1,* , Krystal K Rampalli 1 , Sharraf Samin 1 , Edward A Frongillo 1 , Ligia I Reyes 1,2 , Shiva Bhandari 1 , Morgan Boncyk 1,3 , Stella Nordhagen 4 , Helen Walls 5 , Sigrid Wertheim-Heck 6 , Amy Ickowitz 7 , Solveig A Cunningham 8 , Ramya Ambikapathi 3,9 , Beatrice Ekesa 10, Mirriam Matita 11, Christine E Blake 1 1 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; 2 Division of Nutritional Science, College of Human Ecology, Cornell University, Ithaca, NY, United States; 3 Department of Public Health, Purdue University, West Lafayette, IN, United States; 4 Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland; 5 Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom; 6 Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands; 7 Center for International Forestry Research-World Agroforestry Center, Beit Zayit, Israel; 8 Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States; 9 Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States; 10 Alliance of Bioversity International and CIAT, Kampala, Uganda; 11 Extension Department, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi 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 re lationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the devel opment of policies, programs, and other actions to promote sustainable healthy diets and planetary health. Keywords: livelihood, food choice, scoping review, production, acquisition, preparation, distribution, consumption, occupation, locality, time, income, social relations