How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review.

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.

How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries.

Background: Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives: This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods: Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety. Results: The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food. Conclusions: Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.

Family Quality of Life: pet owners and veterinarians working together to reach the best outcomes.

Friction can occur between veterinarians and their clients when they are not aligned on the goals of care for a pet and what constitutes the best outcome of a case. Veterinarians frequently concentrate on providing the diagnostic and treatment protocol that is perceived to result in the best medical outcome for their patient. Pet owners frequently consider a myriad of factors relating to the pet as well as how different diagnostic and treatment recommendations will affect individual family members and the family as a whole in both concrete and subjective terms. This misalignment can lead to veterinarians experiencing moral distress and families feeling guilt and shame about their pet's care decisions. In this paper we examine the interdependencies of families and their pets and the factors that pet owners may consider in making care decisions. These factors, adapted from the concept of Family Quality of Life as used in the human health field, can be divided into three domains including pet-centric factors, family-centric factors, and external factors. By better understanding that there are a multitude of considerations that influence owners' care decisions and communicating with owners in a nonjudgmental manner, veterinarians can more holistically support families, decrease their own moral distress, and arrive at diagnostic and treatment plans that represent the overall best approach for the family and the patient.