# [R01] Prioritizing food systems interventions to reduce adolescents’ nutrition insecurity and malnutrition in low-income settings

> **NIH NIH R01** · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · 2024 · $657,757

## Abstract

ABSTRACT
Nearly one third of the world’s population lacks access to adequate food, and over three billion people cannot
afford a healthy diet. Nutrition insecurity - the lack of consistent access, availability, and affordability of foods and
beverages that promote well-being and prevent disease
- leads to both undernutrition and obesity/overweight: a
‘dual burden’ associated with high rates of non-communicable disease, particularly in low- and middle-income
countries (LMICs). This is especially true in informal urban settlements, where our work has shown that a lack
of formal infrastructure and access to services exacerbates underlying social and economic barriers to eating
well. Adolescence is an optimal time to intervene to reduce nutrition insecurity and malnutrition. However,
interventions seldom target adolescents, nor are they tailored to the lived experiences of adolescents or to the
broader systems that influence adolescent food choices and nutrition security. The overarching goal of this
project is to reduce nutrition insecurity and malnutrition among adolescents in LMICs. To do this we employ an
innovative combination of participatory ‘systems thinking’ methods, quantitative empirical data, and modeling.
We will work in informal and formal settlements in Nairobi, Kenya so that we can characterize differences in the
food systems between them, and understand how these differences, and other individual-, household- and
community-level factors, influence adolescents’ food choices. We will (Aim 1) physically mapping the food
environments of 10 schools (2 per neighborhood in each of 5 neighborhoods) and use a participatory systems
science toolkit that includes cognitive mapping and group-based modeling to understand how adolescents make
decisions around food.
In parallel, we will
quantify the influence of nutrition insecurity on dietary patterns,
malnutrition, and food preferences (Aim 2) by conducting surveys (using standardized measures of food and
water insecurity and the perceived food environment) with adolescents and their primary caregivers as well as
repeated 24-hour dietary recalls, and physical measurements (body mass index, micronutrient status, and
hemoglobin) with adolescents (n=700) at three time points. Food preferences will be assessed by conducting a
discrete choice experiment with the adolescents included in our sample. The data from Aims 1 and 2 will then
be used to co-design food systems interventions to improve adolescents’ food choices, nutrition security, and
malnutrition outcomes and rank them using stakeholder-derived multi-criteria decision analysis (Aim 3). We will
work with local policymakers and community leaders to prioritize interventions with the potential to transform
LMIC food systems that are experiencing urban growth based on their feasibility and likely impact. This project
will address an urgent need to develop double-duty interventions that address the root cause of undernutrition
and overweight/obesity ...

## Key facts

- **NIH application ID:** 10978662
- **Project number:** 1R01HD113723-01A1
- **Recipient organization:** RUTGERS BIOMEDICAL AND HEALTH SCIENCES
- **Principal Investigator:** Shauna Downs
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $657,757
- **Award type:** 1
- **Project period:** 2024-09-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10978662

## Citation

> US National Institutes of Health, RePORTER application 10978662, [R01] Prioritizing food systems interventions to reduce adolescents’ nutrition insecurity and malnutrition in low-income settings (1R01HD113723-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10978662. Licensed CC0.

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