Drivers of Food Choice in the Context of Overweight Among Women and Children in Malawi
Abstract
The prevalence of overweight is rapidly increasing in Malawi and throughout sub-Saharan Africa (SSA), but little is known about food choices and the factors driving them in SSA households. We propose to conduct a mixed methods study to identify and explain predictors of dietary intake and food choice among Malawian mother-child dyads (n=240) containing an overweight mother, child (6 months-5 years), or both. Dyads will be equally divided by urban/rural location and will be followed longitudinally during the rainy and dry seasons. In each season, we will use questionnaires to collect data on dietary intake and factors related to food choice, including food preferences, household food insecurity, female autonomy, body size perceptions, household composition, food expenditures, and socioeconomic status. During both seasons, one-quarter of the dyads will also participate in a structured observation of a market trip to document types, quantities, location, and cost of food purchases and an in-depth interview to explore factors driving food choice. The project will be a collaboration between RTI International, University of Malawi, and Harvard University. We will coordinate regularly with key stakeholders, build local capacity to conduct obesity-related research, and findings will be used to develop obesity prevention interventions.
Lead Institution
- RTI International
Collaborating Institutions
- University of Malawi, College of Medicine
- Harvard University
Principal Investigator(s)
- Valerie Flax, PhD, International Nutrition Research Advisor, RTI: Food, Nutrition, and Obesity Policy Research Program
- Chrissie Thakwalakwa, PhD, Scientific Administrator and Research Nutritionist, University of Malawi, College of Medicine
Co-Investigator(s)
- Lindsey Jaacks, PhD, Assistant Professor, Department of Global Health and Population, Harvard University
-
John Phuka, MBBS, PhD, Dean of the School of Public Health and Family Medicine Senior Lecturer Public Health, University of Malawi
Journal Publications
- Flax VL, Thakwalakwa C, Schnefke CH, Phuka JC, Jaacks LM. (2021). “Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition.” Appetite, 156, 104855.
- Bliznashka L, Danaei G, Fink G, Flax VL, Thakwalakwa C, Jaacks LM. (2020). “Cross-country comparison of dietary patterns and overweight and obesity among adult women in urban Sub-Saharan Africa.” Public Health Nutrition, 1-11.
- Flax VL, Thakwalakwa C, Phuka JC, Jaacks LM. (2020). “Body size perceptions, body size preferences, and food choice among mothers and their children in Malawi.” Maternal & Child Nutrition.
- Thakwalakwa C, Flax VL, Phuka JC, Garcia H, Jaacks LM. (2020). “Drivers of food consumption among overweight mother-child dyads in Malawi.” PLoS ONE 15(12): e0243721.
Posters & Presentations
- “Drivers of food choice in overweight and normal weight mother-child dyads in Malawi” By Thakwalakwa C, Flax V, Phuka J, Jaacks L. 5th Agriculture, Nutrition & Health (ANH) Academy Week, June 30 – July 2, 2020. ([pdf])
- “Drivers of Food Choice” By Blake, CE, Frongillo, EA, Warren, A, Wellard, K, Ickowitz, A, Schreinemachers, P, and Flax, V. 4th Agriculture, Nutrition & Health (ANH) Academy Week,Hyderabad, India, 24-28 June 2019.
- “Body size perceptions and food choice among normal and overweight mothers and children in Malawi” By Flax VL, Thakwalakwa C, Jaacks LM, Phuka JC. 4th Agriculture, Nutrition and Health (ANH) Academy Week, Hyderabad, India, 24-28 June 2019.
- “Body size perceptions and food choice among normal and overweight mothers and children in Malawi.” By Phuka JC, Thakwalakwa C, Flax VL, Jaacks LM. 4th FANUS Conference, Kigali, Rwanda, 25-30 August 2019.
- “Food Purchasing Decisions in Overweight Mother-child Dyads in Malawi (FS01-05-19).” By Flax VL, Thakwalakwa C, Jaacks L, Phuka J, Schnefke C. American Society for Nutrition 2019 Annual Meeting, Baltimore, Maryland, 8-11 June 2019.
- “Body Size Preferences and Food Choice Among Normal and Overweight Mothers and Children in Malawi (P10-070-19).” By Flax VL, Thakwalakwa C, Jaacks L, Phuka J. American Society for Nutrition 2019 Annual Meeting, Baltimore, Maryland, 8-11 June 2019.
- “Cross-country Comparison of Dietary Patterns and Obesity Among Women of Reproductive Age in Urban Sub-Saharan Africa (P10-069-19).” By Bliznashka L, Fink G, Flax V, Thakwalakwa C, Jaacks L. American Society for Nutrition 2019 Annual Meeting, Baltimore, Maryland, 8-11 June 2019.
- “Validation of a digitally displayed photographic food portion size estimation aid among women in urban and rural Malawi.”By Thakwalakwa C, Flax VL, Schnefke CH, Stobaugh H, Phuka JC, Coates J, Rogers B, Bell W, Colaiezzi B, Muth MK. 4th FANUS Conference, Kigali, Rwanda, 25-30 August 2019.
- “A food preference checklist for women in Malawi: Method development and results.” By Kantukle CT, Flax VL (presenter), Phuka JC, Jaacks LM. 3rd Agriculture, Nutrition & Health (ANH) Academy Week, Accra, Ghana, 25-29 June 2018.
Briefs
Research Brief
- Flax V, Thakwalakwa C, Phuka J, Jaacks L. (2020). “The Drivers of Food Choice in the Context of Overweight Among Women and Children in Malawi.”
Other
Open Access Data
Webinar Presentation
- “Changing values and food choice: implications for demand creation in LMIC” By Christine Blake, Valerie Flax, Matty Demont, & Salome Bukachi.
Blogs
- DFC blog by Dr. Valerie Flax
- “Food security and taste drive food choices in Malawi” blog post from University of Edinburgh