Unveiling the Dietary Tapestry: A Global Quest for Health and Sustainability in Traditional Populations

Investigating the Link Between Traditional Environments and Well-being

In a recently published article within the esteemed journal BMJ Open, a team of researchers has outlined a pioneering protocol for a thorough scoping review. This review seeks to explore the food environments of traditional peoples and communities (TPCs), which include indigenous groups and quilombolas (descendants of escaped African slaves).

The Challenge of Food Insecurity and Health Gaps in Traditional Communities

Traditional communities, characterized by their unique cultural identities and reliance on natural resources like plants, hunting, and fishing for sustenance, face significant challenges. Historical shifts in food systems, changes in lifestyle, the loss of ancestral lands, and migration have profoundly affected their traditional food practices. For example, a study in Mato Grosso do Sul, Brazil, revealed that 76.7% of households in five indigenous territories experienced food and nutritional insecurity, a rate significantly higher than the state average. Similarly, in the United States, 25% of American Indian/Alaska Native individuals grapple with food insecurity, twice the rate of White Americans.

These alterations in dietary customs have led to an increase in chronic health issues, including elevated blood pressure, obesity, and higher blood sugar levels. A 2019 Brazilian survey, for instance, indicated that 60% of non-village indigenous adults over 20 years old had at least one chronic disease. Food environments that provide easy access to high-energy, low-nutrient foods while limiting access to nutritious options are strongly linked to poor dietary quality.

The Pervasive Influence of Ultra-Processed Foods

The rise of ultra-processed foods, replacing traditional diets, not only compromises nutritional health but also disrupts economic and social structures, undermining the food sovereignty of TPCs. The Food and Agriculture Organization highlights the vital role of indigenous food systems in promoting equitable, sustainable development, climate resilience, and biodiversity conservation. Therefore, comprehending how TPC food environments are studied is essential for addressing these challenges effectively.

Framework for a Comprehensive Scoping Review

Brazilian researchers have developed a protocol for a scoping review designed to map existing research on TPCs' food environments and identify critical knowledge gaps. This review will adhere to the rigorous methodological framework established by the Joanna Briggs Institute for scoping reviews and will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist.

Methodology for Data Collection and Analysis

A systematic search will be conducted across major databases such as Medline (via PubMed), Web of Science, Embase, Anthropological Index Online, Global Health, and Scientific Electronic Library Online (SciELO). The search will also extend to grey literature, including theses, dissertations, and technical reports. While the review will accept articles in Portuguese, English, or Spanish, those in other languages will be translated using automated tools, supported by multilingual reviewers. Web of Science will focus on social sciences related to food, while Medline will cover health and nutrition studies. SciELO will be crucial for indexing Latin American literature, given the prevalence of traditional communities in the region. Global Health and Anthropological Index Online will broaden the scope to include public health policy and ethnographic research. Reference lists of selected articles will also be examined to capture any missed studies. Inclusion and exclusion criteria will be guided by the Population, Concept, and Context (PCC) framework.

Defining the Scope: Inclusion and Exclusion Parameters

The review will include studies focusing on TPC populations, excluding urban communities without ties to traditional practices. It will encompass studies addressing the food environment, defined as the economic, physical, sociocultural, and political surroundings that influence food intake and nutritional status. There will be no geographical, temporal, or language restrictions, although researchers acknowledge that the broad scope might complicate direct comparisons between TPC contexts across different nations.

Rigorous Review and Data Synthesis Process

Two independent reviewers will screen titles and abstracts, followed by a full-text analysis of selected studies. Qualitative analysis will be employed to capture essential cultural contexts and narratives. Data collected will include study objectives, publication year and country, study type, specific TPC focus, aspects of the food environment, and facilitators/barriers to interventions. The review will consider original research and relevant grey literature, excluding systematic reviews, meta-analyses, commentaries, and letters.

Addressing Bias and Ensuring Robustness

The primary characteristics of the chosen studies will be presented to facilitate narrative synthesis. Descending hierarchical classification will help identify thematic categories. IRaMuTeQ software will be utilized for textual analysis, and a similarity analysis will visualize connections between key concepts, terms, and sociocultural dynamics. The Risk of Bias in Non-Randomized Studies of Exposure (ROBINS-E) tool will assess bias from confounding factors, exposure measurement, participant selection, post-exposure interventions, missing data, outcome measurement, and outcome selection. Each item will be rated for low, some concern, high, or very high risk of bias. A plan for addressing heterogeneity and bias will involve subgroup analyses and stratification by community to ensure the study's robustness and accuracy.

The review is scheduled to run from August 2025 to August 2026, with findings intended for dissemination among policymakers, researchers, and community stakeholders.