PROTOCOL: Impact of the food environment on diet‐related health outcomes in school‐age children and adolescents in low‐ and middle‐income countries: a systematic review

Abstract

Background The problem, condition or issue Current estimates indicate that some form of malnutrition (undernutrition, overweight or obesity, and poor dietary habits) affects one in three people worldwide (International Food Policy Research Institute, 2016), and the 2016 Global Burden of Disease study has placed poor dietary habits as one of the leading risk factors for mortality globally (Collaborators GBDRF, 2017). The food system According to the Food and Agriculture Organization (FAO) High Level Panel of Global Food and Nutrition Security, the food system is defined as ‘a system that embraces all the elements (environment, people, inputs, processes, infrastructure, institutions, markets and trade) and activities that relate to the production, processing, distribution and marketing, preparation and consumption of food and the outputs of these activities, including socio-economic and environmental outcomes' (High Level Panel of Experts, 2017). Importantly, this group identified three food system typologies (i.e. traditional, mixed and modern), based on distinct inputs (natural resources, human capital, physical capital, agriculture and food technology), outputs (food purchasing patterns, diet, health and environmental sustainability) and processes (food production, supply chains and the food environment) Table 1. See PDF] Within traditional (or rural) food systems, there is a greater proportion of informal food markets (i.e. wet markets, mobile street vendors), compared to formal food outlets, as food is produced locally by rural smallholder farmers, is minimally processed and dependent on seasons. [...]there is minimal food promotion through advertising, limited food quality control and increase food affordability as a significant portion of monthly household expenditure is allocated to food.