The Extent, Range, and Nature of Quantitative Nutrition Research Engaging with Intersectional Inequalities: A Systematic Scoping Review

IF 8 1区 医学 Q1 NUTRITION & DIETETICS
Emily Fivian , Helen Harris-Fry , Claudia Offner , Michele Zaman , Bhavani Shankar , Elizabeth Allen , Suneetha Kadiyala
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引用次数: 0

Abstract

Addressing malnutrition for all requires understanding inequalities in nutrition outcomes and how they intersect. Intersectionality is increasingly used as a theoretical tool for understanding how social characteristics intersect to shape inequalities in health outcomes. However, little is known about the extent, range, and nature of quantitative nutrition research engaging with intersectional inequalities. This systematic scoping review aimed to address this gap. Between 15 May 2021 and 15 May 2022, we searched 8 databases. Studies eligible for inclusion used any quantitative research methodology and aimed to investigate how social characteristics intersect to influence nutrition outcomes. In total, 55 studies were included, with 85% published since 2015. Studies spanned populations in 14 countries but were concentrated in the United States (n = 35) and India (n = 7), with just 1 in a low-income country (Mozambique). Race or ethnicity and gender were most commonly intersected (n = 20), and body mass index and overweight and/or obesity were the most common outcomes. No studies investigated indicators of infant and young child feeding or micronutrient status. Study designs were mostly cross-sectional (80%); no mixed-method or interventional research was identified. Regression with interaction terms was the most prevalent method (n = 26); 2 of 15 studies using nonlinear models took extra steps to assess interaction on the additive scale, as recommended for understanding intersectionality and assessing public health impacts. Nine studies investigated mechanisms that may explain why intersectional inequalities in nutrition outcomes exist, but intervention-relevant interpretations were mostly limited. We conclude that quantitative nutrition research engaging with intersectionality is gaining traction but is mostly limited to the United States and India. Future research must consider the intersectionality of a wider spectrum of public health nutrition challenges across diverse settings and use more robust and mixed-method research to identify specific interventions for addressing intersectional inequalities in nutrition outcomes. Data systems in nutrition must improve to facilitate this.

This review was registered in PROSPERO as CRD42021253339.

涉及交叉不平等的定量营养研究的程度、范围和性质:系统性范围审查。
要解决所有人的营养不良问题,就必须了解营养结果的不平等以及它们是如何相互交织的。交叉性越来越多地被用作一种理论工具,用于理解社会特征如何相互交织,从而形成健康结果的不平等。然而,人们对涉及交叉性不平等的定量营养研究的程度、范围和性质知之甚少。本系统性范围界定综述旨在填补这一空白。在 2021 年 5 月 15 日至 2022 年 5 月 15 日期间,我们检索了 8 个数据库。符合纳入条件的研究使用了任何定量研究方法,旨在调查社会特征如何交叉影响营养结果。共纳入 55 项研究,其中 85% 的研究发表于 2015 年之后。研究涉及 14 个国家的人口,但主要集中在美国(35 项)和印度(7 项),只有一项研究涉及低收入国家(莫桑比克)。种族或民族与性别的交叉最为常见(20 项),体重指数和超重和/或肥胖是最常见的结果。没有研究调查了婴幼儿喂养或微量营养素状况的指标。研究设计大多为横断面研究(80%);没有发现混合方法或干预性研究。带有交互项的回归是最普遍的方法(n=26);在 15 项使用非线性模型的研究中,有两项研究采取了额外的步骤来评估加法尺度上的交互作用,这是理解交叉性和评估公共健康影响所建议的。九项研究调查了可能解释营养结果中存在交叉不平等的机制,但与干预相关的解释大多有限。我们得出的结论是,涉及交叉性的定量营养研究正获得越来越多的关注,但大多局限于美国和印度。未来的研究必须考虑不同环境中更广泛的公共卫生营养挑战的交叉性,并使用更强大的混合方法研究来确定具体的干预措施,以解决营养结果的交叉不平等问题。必须改进营养数据系统,以促进这项工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Nutrition
Advances in Nutrition 医学-营养学
CiteScore
17.40
自引率
2.20%
发文量
117
审稿时长
56 days
期刊介绍: Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.
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