What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK.

Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4-6; 10-12 and 16-18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.

Leveraging the Potential of Sorghum as a Healthy Food and Resilient Crop in the South African Food System.

An erosion of indigenous and traditional foods in the Global South has dramatically changed the global food system in the last 50 years. Reinvigorating these crops and the agro-biodiversity that they represent could provide benefits for healthier and more sustainable food systems. In South Africa, it has been proposed that studying indigenous plants more extensively and focussing on innovation to include them as mainstream foods on people's plates could improve food and nutrition security. With this background, this paper aims to contribute to addressing this challenge by researching sorghum (Sorghum bicolor) to identify the opportunities for innovating around sorghum as a healthy food and resilient crop. The paper traces sorghum through various encounters across the South African food system. The results point at clear areas where policy interventions could bolster the sorghum value chain. These include zero-rating VAT on sorghum products, investing more extensively in research and marketing across diverse stakeholders, raising awareness about the health benefits of sorghum and using public procurement as a way of instigating a market for novel sorghum products. The outcomes of a successful sorghum innovation programme could improve smallholder farmers' livelihoods, make a healthy food more accessible to South Africans and develop a local market for innovative products that utilize a crop that is resilient to projected climatic changes.

'Hampers' as an effective strategy to shift towards sustainable diets in South African low-income communities.

Transitioning towards sustainable diets is imperative to avoid the worst effects of climate change, environmental degradation, and malnutrition. In South Africa, households most vulnerable to food insecurity employ various strategies to access food. These include purchasing hampers; a combination of staple foods sold in bulk at a discounted price, which are cake wheat flour, super maize meal, white sugar, cooking oil, and white parboiled rice. We explore the barriers and opportunities for hampers to advance sustainable diets in the context of Cape Town. Our findings show hampers contain energy-dense, nutrient-poor foods. Furthermore, we find that brand loyalty plays an important role in households' purchase of hampers. We conclude there is potential to leverage hampers to become a sustainable strategy through which people can access healthier food by working with retailers to offer nutritious and sustainably produced alternatives. Such change would require challenging retailers' and consumers' understanding of what 'necessities' are.

Connecting food systems for co-benefits: how can food systems combine diet-related health with environmental and economic policy goals?

This policy brief was prepared in support of the Austrian EU Presidency to explore how food systems can combine diet-related health with environmental and economic policy goals. It builds on considerable earlier work by analysing the connections between different policy goals and between policy goals and food systems. Through this process, the authors identify three core aspects of food systems functioning which would need to connect (economic benefits for farmers and businesses derived from the production and delivery of nutritious food using sustainable methods) in order to produce co-benefits.

How to engage across sectors: lessons from agriculture and nutrition in the Brazilian School Feeding Program

ABSTRACT OBJECTIVE To provide insights for nutrition and public health practitioners on how to engage with other sectors to achieve public health goals. Specifically, this study provides lessons from the example of integrating family farming and a nutrition into a legal framework in Brazil on how to successfully shift other sectors toward nutrition goals. METHODS The study analyzed policy processes that led to a Brazilian law linking family farming with the National School Feeding Program. Main actors involved with the development of the law were interviewed and their narratives were analyzed using a well-established theoretical framework. RESULTS The study provides five key lessons for promoting intersectorality. First, nutrition and health practitioners can afford to embrace bold ideas when working with other sectors. Second, they should engage with more powerful sectors (or subsectors) and position nutrition goals as providing solutions that meet the interests of these sector. Third is the need to focus on a common goal - which may not be explicitly nutrition-related - as the focus of the intersectoral action. Fourth, philosophical, political, and governance spaces are needed to bring together different sectors. Fifth, evidence on the success of the intersectoral approach increases the acceptance of the process. CONCLUSIONS This study on policy processes shows how a convergence of factors enabled a link between family farming and school feeding in Brazil. It highlights that there are strategies to engage other sectors toward nutrition goals which provides benefits for all sectors involved.

Implications of the Central America-Dominican Republic-Free Trade Agreement for the nutrition transition in Central America / Implicaciones del Tratado de Libre Comercio entre Centroamérica y República Dominicana sobre la transición alimentaria en Centroamérica

OBJECTIVES: To identify potential impacts of the Central America-Dominican Republic-Free Trade Agreement (CAFTA-DR) on food consumption patterns associated with the nutrition transition, obesity, and diet-related chronic diseases. METHODS: Examination of CAFTA-DR agreement to identify measures that have the potential to affect food availability and retail prices. RESULTS: CAFTA-DR includes agreements on tariffs, tariff-rate quotas (TRQs), and sanitary and phytosanitary regulations with direct implications for the availability and prices of various foods. Agreements on investment, services, and intellectual property rights (IPR) are also relevant because they create a business climate more conducive to long-term investment by the transnational food industry. Trade liberalization under CAFTA-DR is likely to increase availability and lower relative prices of two food groups associated with the nutrition transition: meat and processed foods. These outcomes are expected to occur as the direct result of increased imports from the United States and increased production by U.S. companies based in Central America, and the indirect result of increased domestic meat production (due to increased availability of cheaper animal feed) and increased production of processed foods by domestic companies (due to a more competitive market environment). CONCLUSIONS: CAFTA-DR is likely to further the nutrition transition in Central America by increasing the consumption of meat; highly processed foods; and new, non-traditional foods. The public health community should be more aware of the implications of trade agreements for dietary health. Governments and related stakeholders should assess the coherence between changes fostered by specific trade agreements with national policies on diet and nutrition.

OBJETIVOS: Identificar el posible impacto del Tratado de Libre Comercio entre Centroamérica y República Dominicana (TLCCA-RD) sobre el patrón de consumo de alimentos relacionados con la transición alimentaria, la obesidad y las enfermedades crónicas asociadas con la alimentación. MÉTODOS: Se examinó el TLCCA-RD para identificar las medidas que podrían afectar a la disponibilidad de alimentos y los precios al consumidor. RESULTADOS: El TLCCA-RD contiene acuerdos sobre tarifas, cuotas arancelarias y regulaciones sanitarias y fitosanitarias con implicaciones directas sobre la disponibilidad y los precios de varios alimentos. Los acuerdos sobre inversión, servicios y derechos de propiedad intelectual son también importantes debido a que crean un ambiente de negocios más favorable a inversiones a largo plazo de empresas transnacionales de la industria alimentaria. La liberalización del comercio por el TLCCA-RD podría incrementar la disponibilidad y reducir los precios relativos de dos grupos de alimentos asociados con la transición alimentaria: las carnes y los alimentos procesados. Esto podría ser resultado directo del aumento en las importaciones desde los Estados Unidos de América y de la producción de las compañías estadounidenses basadas en Centroamérica, y resultado indirecto del aumento en la producción local de carne (por la mayor disponibilidad de alimentos más baratos para animales) y el aumento en la producción de alimentos procesados por compañías locales (debido a un ambiente comercial más competitivo). CONCLUSIONES: El TLCCA-RD podría reforzar la transición alimentaria en Centroamérica al elevar el consumo de carne, alimentos muy procesados y alimentos nuevos no tradicionales. La comunidad de salud pública debe estar más atenta a las implicaciones de los acuerdos comerciales sobre la salud alimentaria. Los Gobiernos y las entidades relacionadas con el tema deben evaluar la coherencia entre los cambios propiciados por los acuerdos comerciales específicos y las políticas alimentarias y dietéticas nacionales