CHAPTER FIVE

Food Environments

Improving Their Healthfulness

Gabriela Fretes, Quinn Marshall, and Jef L. Leroy

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Food environments warrant attention to better understand how they affect diets and to develop policy actions that promote sustainable healthy diets

OVERVIEW

  • Food environments in low- and middle-income countries (LMICs) are undergoing dramatic changes. Their important role warrants attention from researchers to better understand how they are impacting diets, and from decision-makers to develop policies and actions for food environments that promote sustainable healthy diets for all.
  • Ultra-processed foods are now ubiquitous and heavily consumed in both urban and rural areas. These cater to increasing demand for convenience from busy consumers and are heavily marketed, especially to children and adolescents.
  • Fruits, vegetables, and other nutrient-dense fresh foods are often available from informal vendors in LMICs, but food safety remains a serious challenge, and availability is subject to high postharvest losses, deterioration in quality, and seasonal fluctuations.
  • Online grocery and food delivery services are changing how consumers engage with food environments, while social media is opening up new avenues for marketing and advertising of (primarily unhealthy) foods that are difficult to monitor and regulate.

A variety of policies and actions can improve food environments to promote sustainable healthy diets:

  • Mandatory front-of-package labeling systems and taxes have reduced consumption of unhealthy foods and beverages in LMICs, particularly in the Americas, and could be expanded to other regions.
  • Restrictions on marketing of unhealthy products, especially to children and adolescents, hold promise for reducing consumption of ultra-processed foods but require further evaluation.
  • To address new threats created by the digital food environment, valid metrics for monitoring and research are urgently needed to assess the impact on dietary habits and to inform effective, enforceable regulation of marketing.
  • Policies and actions designed to promote access to healthy foods, including fresh produce and animal-source foods, require further research in LMICs. Studies examining subsidies for healthy foods and retail-level interventions such as product placement have been limited to high-income countries, and those for retail-level interventions are still inconclusive.

Browse Chapters

Chapter One

Advancing Nutrition

Chapter Two

Diets and Nutrition

Chapter Three

Demand-Side Approaches

Chapter Four

Diet Affordability

Chapter Five

Food Environments

Chapter Six

Plant-Source Foods

Chapter Seven

Animal-Source Foods

Chapter Eight

Improved Governance

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Chapter One: Advancing Nutrition: Food System Policies and Actions for Healthy Diets​

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Chapter Two: Diets and Nutrition: The Potential of a Food Systems Approach

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Chapter Three: Demand-Side Approaches: Supporting Healthier Food Choices

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Chapter Four: Diet Affordability: Understanding the High Cost of Healthy Diets​

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Chapter Five: Food Environments: Improving their Healthfulness

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Chapter Six: Plant-Source Foods: Leveraging Crops for Nutrition and Healthy Diets

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Chapter Seven: Animal-Source Foods: Their Role in Sustainable Healthy Diets​

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Chapter Eight: Improved Governance: Creating Supportive Environments for Diet and Nutrition Policies​

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