Drivers of change: dietary change, food and nutrition security and agricultural practices in peripheral communities in Pacific Island countries and territories: A scoping review protocol

Abstract

Pacific Island Countries and Territories (PICTs) are experiencing a Diet-Related Non-Communicable Disease (DR-NCD) health crisis(1). Increasing rates of DR-NCDs such as Type 2 diabetes and cardiovascular disease have been linked to dietary transitions and increasing food insecurity in the region(2). Anthropogenic climate change has also been identified as a significant threat to food security in PICTs(3). Additionally, the impacts of the COVID-19 Pandemic have been identified as both a contributor to food insecurity in the region and as an opportunity to transform PICT food systems and reduce rates of DR-NCDs(4). Yet, the drivers of dietary change, food security and agricultural practices in peripheral PICT communities are not well documented or understood. To determine how these drivers may change in the future and the impacts this may have on Pacific peoples, a deeper understanding of the historical and contemporary drivers of change is necessary. The aim of this scoping review was to collate existing information to improve this understanding, by mapping key factors evident in the literature that underpin the links between DR-NCDs and food security with a focus on women in PICT peripheral communities, to better clarify the challenges, working definitions and conceptual boundaries in the research area. The review maps where research has been conducted geographically and how the links between DR-NCDs and food security in PICTs have been investigated over time and identifies projections and suggestions for the future. The scoping review was conducted in accordance with a pre-defined protocol available online(5). A total of 476 peer-reviewed sources and 126 grey literature sources were identified by the initial search criteria. Two independent researchers completed title/abstract and full text screening using Covidence, and data extraction using a data extraction tool. The resulting data was quantified in table format, with common themes and ideas presented qualitatively. Sources spanned all sectors of PICT food systems with a heavy focus on production from fisheries and agriculture. Most PICTs were represented in the findings. Many drivers of change within food systems were identified, some of which included the impacts of anthropogenic climate change, the COVID-19 pandemic, and urbanisation. The drivers impacted all four pillars of food security, and many were directly or indirectly related to dietary and lifestyle changes associated with DR-NCD risk factors. This data is accompanied by an interpretation of results and a narrative summary. These results provide a useful platform to further explore the drivers of dietary change, food security, agricultural practices and DR-NCD’s in this region.