Toward an eco-biopsychosocial framework for understanding food, nutrition, and health: The crucial role of food studies and food systems.

Abstract

Background: Engel's biopsychosocial model has long advanced our understanding of how biological, psychological, and social factors influence health and illness. However, its exclusion of ecological dimensions omits food studies and food systems from its analyses, thereby limiting the scope and efficacy of research, restricting communication, and preventing effective implementation of policy into practice. Aim: Using an expert-informed grounded theory approach, we propose developing an eco-biopsychosocial framework that includes the ecological context in which biological, psychological, and social factors operate. In this article, we report findings from expert interviews in which our objective was to explore the benefits, limitations, and opportunities associated with current biopsychosocial modeling. Methods: Using purposive sampling, we conducted interviews with leaders at community food organizations, healthcare professionals, researchers, and educators. Results: We analyzed interviews using naturalistic qualitative data analysis and identified themes related to the benefits of biopsychosocial framing and the strengths of current biopsychosocial frameworks. We also identified four thematic dimensions along which current models reveal significant deficits: (1) social inequities as systemic root causes of illness; (2) agency and ability as drivers of engagement in the food system; (3) traditional knowledge and historical connections to food and land as conveyors of agency; and (4) human-nature nonduality as a guide to patient and community care. Conclusion: Incorporating an eco-dimension into the model would integrate, more effectively, food studies into research, program design, and clinical practice. Future work will explore how this eco-biopsychosocial model can reduce current practical gaps in recognizing and responding to food system effects.