Food security and taste preferences are important factors behind food choice in Malawian women. The prevalence of overweight and obesity in sub-Saharan Africa is rapidly increasing. In Malawi, overweight and obesity are now more common than underweight among women, and more common than wasting among children under five.Changes in diet have been implicated as a major cause of the overweight and obesity epidemic. However, few studies in sub-Saharan Africa have explored factors driving food choices.To address this gap, researchers from RTI International, the University of Malawi, Harvard University, and the University of Edinburgh conducted a longitudinal study of both the dry and rainy seasons in Malawi, enrolling households where the mother, the child, or both were overweight.Findings of this study are reported in the journal PLOS ONE.Predictors of preference Image Affordability and desirability are important factors in food choice. Food affordability and desirability as well as other factors, particularly child age, were the most consistent predictors of food consumption. Specifically, household food insecurity was associated with lower intake of grains, fruits, meat and eggs, oil, and snacks. Higher household food expenditures were associated with higher animal-source food consumption.Within the domain of desirability, maternal taste preferences predicted increased consumption of grains, legumes, nuts, vegetables, fish, and oil.Food accessibility was also a predictor for some food groups. Having to spend less time traveling to the market or shops, using some form of mechanised transport instead of walking there, and the mother, rather than someone else in the family, purchasing foods tended to be positively associated with intake of foods such as grains, vegetables, meat, eggs, oil, and sweets.As part of the same study, the researchers also conducted in-depth interviews with mothers after shadowing them during a typical trip to the market to buy food. Those interviews confirmed the importance of both cost and taste in driving food choice. Results were published in the journal Appetite earlier this year.We now need to test interventions that target specific drivers identified in this study and see if we are able to shift women and children towards healthier diets. Shifting taste and body size preferences among mothers will be key.Dr. Chrissie ThakwalakwaStudy lead author, University of Malawi’s Centre for Social ResearchChildren’s taste preferences and their influence on household food purchasing decisions also need to be considered in designing interventions. Mothers in our study bought unhealthy snack foods for their children, even when they had a limited budget.Dr Valerie FlaxStudy principal investigator, Researcher at RTI InternationalFood is only nutritious if it is eaten. As global nutrition shifts away from supplement-based approaches towards food-based approaches, much more research will be needed to understand consumer behaviours. It’s not just about whether food is affordable and accessible, it also has to be desirable.Dr. Lindsay JaacksStudy co-author, UKRI Future Leaders Fellow and Chancellor’s Fellow, University of EdinburghThis study was supported by the Drivers of Food Choice (DFC) Competitive Grants Programs, which is funded by the UK Government's Foreign, Commonwealth & Development Office and the Bill & Melinda Gates Foundation, and managed by the University of South Carolina, Arnold School of Public Health, US.Related linksDrivers of Food Choice ProgramsScientific publication in AppetiteScientific publication in PLOS ONEImage credit: Valerie Flax Publication date 13 Apr, 2022
