School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
School of Sport, Exercise and Health Sciences, Loughborough University, Sheffield, LE11 3TU, UK.
Nutr J. 2020 Nov 25;19(1):127. doi: 10.1186/s12937-020-00634-9.
Healthy and sustainable dietary practices offer a possible solution to competing tensions between health and environmental sustainability, particularly as global food systems transition. To encourage such dietary practices, it is imperative to understand existing dietary practices and factors influencing these dietary practices. The aim of this study was to identify multi-level factors in lived rural and urban Ugandan food environments that influence existing dietary practices among women of reproductive age (WRA).
A mixed methods study was conducted. Multiple correspondence analysis followed by hierarchical cluster analysis were performed on dietary data collected among a sample (n = 73) of Ugandan WRA in Kampala (urban) and Wakiso (rural) districts to elicit dietary clusters. Dietary clusters, which were labelled as dietary typologies based on environmental impact and nutrition transition considerations, were reflective of dietary practices. Following this, a smaller sample of WRA (n = 18) participated in a Photovoice exercise and in-depth interviews to identify factors in their social, physical, socio-cultural and macro-level environments influencing their enactment of the identified dietary typologies, and therefore dietary practices.
Four dietary typologies emerged: 'urban, low-impact, early-stage transitioners', 'urban, medium-impact, mid-stage transitioners', 'rural, low-impact, early-stage transitioners' and 'rural, low-impact, traditionalists'. Although experienced somewhat differently, the physical environment (access, availability and cost), social networks (parents, other family members and friends) and socio-cultural environment (dietary norms) were cross-cutting influences among both urban and rural dietary typologies. Seasonality (macro-environment) directly influenced consumption of healthier and lower environmental impact, plant-based foods among the two rural dietary typology participants, while seasonality and transportation intersected to influence consumption of healthier and lower environmental impact, plant-based foods among participants in the two urban dietary typologies.
Participants displayed a range of dietary typologies, and therefore dietary practices. Family provides an avenue through which interventions aimed at encouraging healthier and lower environmental impact dietary practices can be targeted. Home gardens, urban farming and improved transportation could address challenges in availability and access to healthier, lower environmental impact plant-based foods among urban WRA.
健康和可持续的饮食实践为解决健康和环境可持续性之间的竞争紧张关系提供了一种可能的解决方案，尤其是在全球粮食系统转型时期。为了鼓励这种饮食实践，了解现有的饮食实践以及影响这些饮食实践的因素是至关重要的。本研究的目的是确定在乌干达农村和城市生活食品环境中影响育龄妇女（WRA）现有饮食实践的多层次因素。
本研究采用混合方法进行。对坎帕拉（城市）和瓦基索（农村）地区的乌干达 WRA 样本（n=73）的饮食数据进行多元对应分析，然后进行层次聚类分析，以得出饮食聚类。基于环境影响和营养转型的考虑，根据饮食聚类标签为饮食类型学，反映了饮食实践。在此基础上，较小的 WRA 样本（n=18）参与了摄影发声活动和深入访谈，以确定影响他们实施确定的饮食类型学（因此影响饮食实践）的社会、物理、社会文化和宏观环境因素。
四种饮食类型学出现：“城市、低影响、早期转型者”、“城市、中影响、中期转型者”、“农村、低影响、早期转型者”和“农村、低影响、传统主义者”。尽管体验方式略有不同，但物理环境（获取、可用性和成本）、社会网络（父母、其他家庭成员和朋友）和社会文化环境（饮食规范）是城市和农村饮食类型学的交叉影响因素。季节性（宏观环境）直接影响着两个农村饮食类型学参与者食用更健康和环境影响较低的植物性食物，而季节性和交通则相互作用，影响着两个城市饮食类型学参与者食用更健康和环境影响较低的植物性食物。
参与者表现出多种饮食类型学，因此也表现出多种饮食实践。家庭提供了一个可以针对鼓励更健康和环境影响较低的饮食实践的干预措施的途径。家庭菜园、城市农业和改善交通可以解决城市 WRA 获取和获得更健康、环境影响较低的植物性食物的挑战。
