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Background: Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middleincome countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supplyside 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: SixDrivers of Food Choice projects (2016-2022) provided transcripts from17 focus group discussions and 343 interviews conducted in Ghana,Guinea, India, Kenya,Tanzania, andVietnam.Qualitative thematic analysiswas 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 in- fluences. 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. [ABSTRACT FROM AUTHOR]

Multiple recent global nutrition initiatives have recommended actions to transform food systems to improve food environments and food choice. This study aimed to identify actions recommended by these initiatives and understand their similarities and differences. Twelve global nutrition initiatives were reviewed, collectively spanning 13 action themes and accompanying strategies. Action themes were analyzed according to primary focus on either food environments and their food system drivers or food choice. Representation of the 13 actions varied across initiatives. Some actions overlapped; others were infrequently represented. Strategies targeting food environments and their food system drivers were more frequently recommended than strategies targeting food choice for 11 of the 13 action themes. Although these global initiatives share a mission to improve nutrition through food systems and food environments, less attention has been allocated to individual food choice and sustainability. • We analyzed the recommended actions of 12 global nutrition initiatives. • Global nutrition initiatives overlap in recommendations for a healthier food system. • Strategies aimed to modify food environments more than food choice for most actions. • Attention is needed to create demand for healthy diets by improving food choice. [ABSTRACT FROM AUTHOR]

This study aimed to determine if the Turner et al. (2018) framework allows researchers to identify and study relationships between food environments and individual food choice in diverse contexts and if updates to the framework are warranted. We mapped evidence from 15 drivers of food choice projects to the framework, using thematic analysis to identify common drivers within the food environment across countries and emergent characteristics not listed in the framework. The framework contained breadth and depth of content necessary to identify common drivers – prices and affordability, availability, and vendor and product properties. Insights regarding common drivers and emergent characteristics may inform iterative development of conceptual and empirical research and reinforce current strategies seeking to improve nutrition and health outcomes in LMICs through targeted policies and interventions. • Frameworks align theoretical concepts and empirical research to set research agendas and inform policies and interventions. • The Turner et al. (2018) framework is useful for food environment and food choice research in diverse settings. • Food prices and affordability, availability, and quality and safety may be entry points to promote sustainable healthy diets. • Food environment concepts should consider food safety perspectives, social forces, gender dynamics, stability, and food system drivers. [ABSTRACT FROM AUTHOR]

The world's food systems and environments have been changing dramatically, concomitant with changes in over- and undernutrition. We elaborate the science of food choice to better understand, analyze, and respond to relationships between changing food environments and food choice. The science of food choice is concerned with generating knowledge about causal drivers of food choice decision making processes and behavior within immediate food and social environments. Three fundamental and interconnected questions undergird this science; 1) what do people eat from the options available and accessible?; 2) how do people interact with food environments?; and 3) why do people decide to acquire, prepare, distribute, and consume foods as they do? Not all food choice behavior is rational, reflexive, or discrete, but is embedded in wider activities of daily lives. The science of food choice involves understanding influences from multiple systems that drive food choice for deriving sound, actionable policy, and programmatic recommendations. • Food systems and environments have changed concomitant with over- and undernutrition. • Not all food choice behavior is rational, reflexive, or discrete. • Food choice is embedded in wider activities of daily lives. • We elaborate the science of food choice to understand food environments and choice. [ABSTRACT FROM AUTHOR]