Food environment framework in low- and middle-income countries - An integrative review

Abstract

There are major gaps in our understanding of food environments (FE) in low-and middle-income countries (LMICs) witnessing differential and complex social and economic transition. The present integrative review was conducted to develop a conceptual framework of FE for LMICs using socio-ecological and access theory. The FE framework has four layers: public policy, community/neighborhood (including organizational e.g., markets, schools), household, and individual. Availability, accessibility, and affordability with built-in socio-cultural and contextual factors were the major domains in every layer. The following additional domains emerged: global influences, marketing and regulation, nutrition programs, time-constrained family members, and food behavior. Wet and informal markets are important components of FE. The next step is determining the model's resilience to accommodate and capture nuances across LMICs.