Abstract
ABSTRACT Food systems in many countries are experiencing a shift from traditional foods toward processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack foods while an increased consumption of fruit and vegetables is not evident. It identifies cash availability is the main driver of increased rice, meat and snack food consumption. The second driver is the 2015 Nepal earthquake, which accelerated the transition from homegrown food to purchased food as people got habituated to eating more meat and snack foods while reconstruction tripled local wages and changed the food environment. This shows how humanitarian assistance in the wake of extreme shocks can unintentionally contribute to unhealthy eating habits. An integrated school and home garden intervention appears to contribute to healthier diets.
Highlights
Of the world’s 7.5 billion people, approximately 3 billion have low quality diets—either consuming insufficient amounts of healthy foods, consuming excessive amounts of unhealthy foods, or doing both at the same time (Global Panel 2016)
The district was severely affected by the Nepal earthquake of 25 April 2015 and its largest aftershock on 12 May 2015, which had its epicenter at the district border
We reviewed the interview notes and discussed the data extensively and through this process identified a large number of drivers of food choice using an inductive approach
Summary
Of the world’s 7.5 billion people, approximately 3 billion have low quality diets—either consuming insufficient amounts of healthy foods, consuming excessive amounts of unhealthy foods, or doing both at the same time (Global Panel 2016). Vegetables are one category of healthy food that tends to be under-consumed (Willett et al 2019, Afshin et al 2019, Pushpamma, Kalpalathika, and Rajyalakshmi 1984) and not necessarily increasing with growth in average income (Global Panel 2016). It is not wellunderstood why this is the case. It is understood that changes in food consumption patterns are complex, reflecting changes in availability and affordability and changes in tastes, lifestyles, convenience, nutritional awareness and policies (Blake et al 2021, Constantinides et al 2021, Kearney 2010, Traill et al 2014, Turner et al 2018, Finzer et al 2013)
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