Food choices are affected by more than economic access.6,7 In households vulnerable to food insecurity, conceptualizations of what is a good or healthy diet may reflect a preference formore satiatingfoods,8 which contrasts with perceptions in resourcerich
contexts where healthy diets are defined as low in fat, sugar, and sodium.9,10 Globalization has increased the availability of manufactured foods
worldwide.11 The consumption of basic grains and other fiber-rich foods
has declined, and that of animal products, sugar, and manufactured foods
has increased.11,12 These changes bring an increased double burden of
disease, in which conditions associated with undernutrition coexist
with those associated with overnutrition,13 disproportionately affecting
the poor.14