Food environments and markets: B
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Intro animation:

Food environments and markets studies at ANH2020


Session recording:

ANH2020: Food environments and markets B


Speakers and presentations:

  • Session chair: Selena Ahmed, Montana State University
  • Akua Tandoh, University of Ghana
    @akuatd @UnivofGh
    Unhealthy food and beverage practices in everyday life in Ghanaian cities
    Presentation | Slides
  • Jocelyn Marie Boiteau,  Cornell University
    Perspectives on quantity and quality food loss of perishable vegetables: food loss estimates across tomato supply chain actors in south India
    Presentation | Slides
  • Savannah Froese, Purdue University
    Market food diversity and access drive household food purchase patterns and diets in Rural Tanzania: The EFFECTS study
    Presentation | Slides
  • Stella Nordhagen, Global Alliance for Improved Nutrition
    @StellaNordhagen @GAINalliance
    Artisanal mining in rural Africa: Blurring the line between urban, non-agricultural and rural, agricultural food environments
    Presentation | Slides


Unhealthy food and beverage practices in everyday life in Ghanaian cities

Michelle Holdsworth1,2

Rebecca Pradeilles2

Francis Zotor3

Mark Green4

Akua Tandoh5

Senam Klomegah3

Hibbah Osei-Kwasi2

Nicolas Bricas6

Paula Griffiths7

Amos Laar5

1NUTRIPASS, French National Research Institute for Sustainable Development- IRD

2University of Sheffield

3University of Health and Allied Sciences

4University of Liverpool

5University of Ghana

6French Agricultural Research Centre for International Development (CIRAD)

7Loughborough University


Urbanisation in Ghana is occurring at a rapid pace. This paradigm raises the concern of changing food environments and the accompanying transitioning of people’s dietary practices. Presently, there is little evidence on the driving role of urban environments on dietary practices in African cities. This requires an exploration of how habits related to food consumption are structured and organised in social practices, such as when unhealthy food and beverages are eaten, how quickly, where and with whom. Hence, this study investigated how unhealthy food and/or beverages are embedded in everyday life in Ghanaian cities.


Our study was sited in two Ghanaian cities- Accra (capital city) and Ho (provincial capital). We targeted deprived neighbourhoods in these cities and recruited participants with a quota sampling method (including occupation and economic status). We recruited 301 female and male adolescents/adults. All recruited participants were at least 13 years old and above. Qualitative in-depth 24-hour recalls were conducted via face-to-face interviews with all study participants. We collected data on all food and drink consumed inside/outside the home in the previous 24-hour period. The time of day of the food event (‘periodicity’); how long a food event lasts (‘tempo’); who participants eat with and where (‘synchronization’) were recorded. Scores were calculated to indicate the healthiness of foods based on energy and nutrient density. To answer the question of how unhealthy food and beverages are embedded in everyday life, we analysed how ‘tempo’, ‘periodicity’ and ‘synchronization’ are associated with the healthiness of foods consumed.


The dominant meal pattern was structured around 3 main meals a day with few snacks in between. Most study participants consumed unhealthy foods. However consumption of traditional foods that are nutrient rich but energy-dense persisted, with 89.4% of the sample consuming these. Low socio-economic groups were more likely to consume unhealthy foods and individuals who ate more frequently were less likely to eat unhealthy foods. The duration of most food episodes was quick (40.1% at <10 mins; 47.0% at 10-29 mins; 12.9% ≥30 minutes). Shorter food episodes were more likely to include greater intake of unhealthy foods, sweet foods or sugar sweetened beverages, in contrast with longer food episodes, which contained more traditional foods that were nutrient rich but also energy dense and often fried. Families and the home environment were very important in meal synchronization. 82% of meals were consumed at home- especially the evening meal which tended to be energy dense. Consumption of fried foods and sugar sweetened beverages were higher with friends, with whom breakfast was also often eaten. Eating alone was quite common (39% of the sample population).


The home environment and families are key to maintaining healthy diets. Eating with friends was associated with unhealthy eating practices. Low socio-economic groups were more likely to consume unhealthy foods. This association may be explained by the effects that poverty has on limiting frequency of food consumption to more filling energy dense foods. The association between poverty and consumption of unhealthy foods may also be mediated by the low cost of some unhealthy foods. Therefore, fiscal policies that subsidise healthy foods and tax unhealthy foods may promote public health goals.


Perspectives on quantity and quality food loss of perishable vegetables: food loss estimates across tomato supply chain actors in south India

Jocelyn Marie Boiteau1

Prabhu Pingali1

1Cornell University


Globally, two billion people are food insecure, living without regular access to safe, nutritious and sufficient food (1). Food supply is a function of food production, imports, exports and losses. There is insufficient availability of fruits and vegetables in the global food system to meet the dietary needs of all people (2–4). Food loss (FL) in lower-income regions primarily occurs between production to retail stages (5). Fruits and vegetables are among the more perishable food groups and are more at risk of FL. Understanding the nature, stages and extent of FL is critical to designing FL prevention interventions.


We conducted an observational study in Chittoor and Hyderabad districts to estimate quantity and quality FL of fresh tomatoes from farm to retail. Tomatoes were selected because they are highly perishable (6), and are an important vegetable, globally (7). India is the world’s second largest tomato producer (8). In Andhra Pradesh and Telangana, tomato wholesale markets and urban vegetable markets are the major channels through which tomatoes are traded. Chittoor district, Andhra Pradesh is a major tomato producing region and Madanapalle tomato wholesale market is one of the largest tomato markets in Asia. Hyderabad, Telangana is a major metropolis where vegetable markets import tomatoes from surrounding wholesale markets, including Madanapalle. Survey data collection in Chittoor began in February 2019, and in Hyderabad in April 2019. We attempt to measure FL across the supply chain using same-day recalls from farmers, from harvest to markets, and wholesale traders who win auctions from participant farmers. We surveyed urban vegetable traders and retailers to measure FL at the urban market level. In this paper we attempt to answer the question: What is the extent of quantity and quality FL and at what stage does loss occur along tomato supply chains from farm to retail?


Farmers report the greatest quantity loss at post-harvest before tomatoes leave the farmgate, on average losing 8.7% (s.d. 11.9%) of total harvest (n=109 harvests). Farmers at the Madanapalle wholesale market report losing an average 1.5% (s.d. 4.8%) of total harvest at the market before auction (n=185 harvests). Farmers report the greatest quality loss at time of harvest, on average 24.4% (s.d. 54.0%) of total harvest damaged (n=161 harvests), compared with 0.9% (s.d. 3.5%) of total harvest damaged during post-harvest activities (n=109 harvests). Farmers most often report color, size and pest damage as important quality attributes. Tomato traders report an average quantity loss of 23.8% (s.d. 39.7%, n=21 auctions), and an average quality loss of 1.18% (s.d. 7.1%, n=16 auctions) of purchased tomatoes prior to transporting from the market. Tomato traders most often report firmness, shine, size, and color as important quality attributes. More stringent grading standards at the wholesale market level compared to the farm level may explain the higher levels of quantity loss at the market level. In Hyderabad, all vegetable traders report 0% (s.d. 0%) loss during trading activities (n=126 visits). Retailers report losing 2.6% (s.d. 18.1%) of tomatoes they had available to sell that day (n=249 visits).


Preliminary analysis of an ongoing survey across a tomato supply chain from farm to retail shows that all supply chain actors, with the exception of vegetable traders, report quantity FL. This loss was highest at the wholesale market. Farmers reported greater quality FL than tomato traders. Using same-day recalls, this study adds new insights into the stages and extent of FL along tomato supply chains in south India. Quantity and quality FL estimates within and between supply chain actors are essential to streamlining vegetable supply chains. Determining appropriate measurement methodologies will inform FL reduction interventions designed to improve food security.


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Market Food Diversity and Access Drive Household Food Purchase Patterns and Diets in Rural Tanzania: The EFFECTS Study

Savannah Froese1

Ramya Ambikapathi1,2

Dominic Mosha3

Cristiana Edwards1

Morgan Boncyk1,2

Lauren Galvin4

Elfrida Kumalija4

Frank Mapendo3

Roman Evarist4

Isaac Lyatuu3

Mary Pat Kieffer4

Mary Mwanyika-Sando3

Joshua Jeong5

Aisha Yousafzai5

George Praygod6

Nilupa S. Gunaratna2

1Department of Nutrition Science, Purdue University, USA

2Department of Public Health, Purdue University, USA

3African Academy of Public Health, Tanzania

4Project Concern International 5Harvard T.H. Chan School of Public Health, USA

6National Institute for Medical Research, Tanzania


Literature indicates that food purchases from markets are a major source of food availability and diversity among rural households in Sub-Saharan Africa. Although diversity of farm production plays a role, it is associated with only a small shift in dietary diversity. To address the larger factors that drive dietary diversity, this study explores the role of the market food environment and market accessibility on food purchasing patterns of households in Mara, Tanzania.


This paper draws from the baseline evaluation of the Engaging Fathers for Effective Child Nutrition and Development (EFFECTS) Project ( Identifier: NCT03759821) in Mara, Tanzania, which occurred December 2018-February 2019 and a subset in May 2019. Participants provided informed consent per IRBs at Harvard University, Project Concern International, and the National Institute of Medical Research, Tanzania. Households (n=960) were randomly sampled from 80 villages. Household food purchase diversity and expenditures were measured. Father, mother, and child (0-24 months) consumption was measured through a food consumption questionnaire that queried 1-day and 7-day consumption of 96 food items. Markets were assessed for availability, prices, and sources of 69 food and beverage items over the last 12 months. Market food diversity (MFD) and dietary diversity for men and women were scored based on consumption of ten food groups as described by the Minimum Dietary Diversity for Women (MDD-W). Child dietary diversity was scored based on 7 food groups6. We examined associations between market food diversity, household food purchase patterns and expenditure, and consumption of food groups among men, women, and children aged 6-24 months. Statistical analyses were adjusted for clustering at the village level.


Excluding a small fish (used as relish), we found intra-household differences in dietary diversity, as 31% of men and 20% of women achieved minimum dietary diversity (MDD) and 19% of children 6-24 months achieved MDD. Over 70% of markets sold all ten food groups year-round, with little seasonal variation in availability. Every market sold candy, soda, biscuits, and chapatis. Less diverse markets were more likely to source their food locally and demonstrated greater seasonal price variation. Ninety-eight percent of households reported purchasing food in the previous month. On average, households purchased 3 food groups per month; fish (85%), fruits and vegetables (85%), and sweets (82%) were the most commonly purchased food groups. Severely food insecure households spent a higher percentage of their total food expenditure on staples and less on produce, organ meat, and dairy. As household purchasing power increased, the diversity of households’ food purchases also increased. Households living close (within 30 minutes, p=0.005) to a highly diverse market (10 food groups year-round, p=0.004) purchased 0.7 food groups more per month, after adjusting for parents' age and household size, wealth, and purchasing power.


Describing market food diversity and household food purchase patterns is important to understand the food environment and household food choices in rural Sub-Saharan Africa. In the Mara Region of Tanzania, markets were highly diverse throughout the year, but diets were still poor. However, household food purchase diversity significantly increased by both household proximity to market and by the diversity of foods in the market. Understanding market characteristics and household constraints to market accessibility can enable future tailoring of interventions to improve dietary quality of men, women, and children.


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Headey, D., Hirvonen, K., Hoddinott, J. & Stifel, D. Rural Food Markets and Child Nutrition. American Journal of Agricultural Economics 101, 1311–1327 (2019).

Ambikapathi, R. et al. Market food diversity mitigates the effect of environment on women’s dietary diversity in the Agriculture to Nutrition (ATONU) study, Ethiopia. Public Health Nutr. 22, 2110–2119 (2019).

Minimum Dietary Diversity for Women (MDD-W) | Food and Nutrition Technical Assistance III Project (FANTA).

World Health Organization (WHO). Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. (World Health Organization (WHO), 2008).

Artisanal mining in rural Africa: Blurring the line between urban, non-agricultural and rural, agricultural food environments

Stella Nordhagen1

Peter Winch2

Rolf Klemm2,3

Mohammed Lamine Fofana3

Alpha Oumar Barry4

Sadio Diallo4

Ronald Stokes-Walters2

Laetitia Zhang2

1Global Alliance for Improved Nutrition

2Johns Hopkins Bloomberg School of Public Health

3Helen Keller International

4Université Julius Nyerere Kankan


Artisanal and small-scale mining (ASM) supports millions of people in low-income countries, primarily in rural communities with high levels of poverty and malnutrition. Understanding food choice in such areas is essential for equitably reducing malnutrition. However, there has been little study of the food environments that shape food choices within ASM and other resource-extraction communities. Such focused study is important, as their non-agricultural rural characteristics depart from the "cash-income urban" and "agricultural rural" dichotomy that pervades existing food environment literature. We help fill this gap through a case study examining external and personal food environments of ASM communities in Guinea.


Data were collected as part of a multi-phase study within the Drivers of Food Choice project in Kankan region, northeastern Guinea—the country’s main ASM region. Data collection included market surveys (n=4), a cross-sectional household survey (n=613), mining site observations (n=10), food preparation observations (n=25), and in-depth structured interviews with mothers of young children, single miners, and food vendors (n=112). Data were collected in three waves across 18 study sites, stratified by type of settlement (i.e., established village vs. temporary camp). Data collection was undertaken by local interviewers in the local language Malinké. Quantitative data were analyzed using Stata SE15; this involved primarily descriptive analysis by subgroup and statistical testing for associations between variables. Interview data were analyzed using a deductive coding scheme in ATLAS.ti software.


The external food environment in the sites revealed widespread availability of processed and prepared food, including commercially produced drinks and snacks such as energy drinks and candy. There is lower availability and higher prices for more nutritious non-staple foods, and access to options for purchasing non-prepared foods (e.g., supermarkets and daily open-air markets) is limited. Remote mining camps have the lowest availability and highest prices for most foods. Examining the personal food environment revealed that mining households are largely dependent on cash incomes but constrained in their food choices by considerable variability in daily income—which depends on finding gold. Given limited time for food acquisition and preparation, and the time pressure associated with their livelihoods, mining households place a premium on convenience and rapidly accessible food. Women, in particular, have limited time for procuring and preparing food for their families. Food safety and hygiene are also key concerns. Food vendors respond to these needs by making ready-to-eat food available at a range of price points, offering credit, and attempting to signal their products’ safety. The resulting food environment reflects the intersection of the constraints and opportunities of the setting and how consumers and vendors respond to them.


In examining the characteristics of the studied food environments, it is clear that this rural setting has many characteristics typically associated with urban areas. Given this, we argue for bringing greater nuance and complexity to food environment research, with more focus on diverse rural settings covering both agricultural and non-agricultural livelihoods. The results also make it clear that food environments are dynamic and partly shaped by their actors (producers and consumers)—but that the ability to reshape them also has limits, leading to several policy and programmatic suggestions to support nutritious food choices and improve diets in ASM communities.


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Turner, Christopher, Sofia Kalamatianou, Adam Drewnowski, Bharati Kulkarni, Sanjay Kinra, and Suneetha Kadiyala. 2019. “Food Environment Research in Low- and Middle-Income Countries: A Systematic Scoping Review.” Advances in Nutrition.

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