Table 1.

Existing conceptual and theoretical frameworks that are relevant for nutrition equity.

Author(s)	Discipline	Geographical focus	Framework/theory	Description	How this adds to understanding of nutrition equity
Backholer et al., (2014)	Public health/health equity	Global	Framework for the likely impact of obesity prevention strategies on socioeconomic inequalities in population weight	Considers the role agency-structure theory for understanding the likely impact of population-level obesity prevention interventions on socioeconomic inequalities in health. Highlights that interventions that rely heavily on individual agency are more likely to increase socioeconomic inequalities in weight, whereas interventions that make structural changes to support healthy eating are less likely to do so.	Underlines importance of understanding assumptions behind degrees of agency; or structural change required; in different settings for obesity intervention.
Cadieux & Slocum, (2015)	Sociology/Geography/Critical food studies	Global South, US and Canada	Food Justice	Provides an introduction to food justice and comparison with allied concepts of food sovereignty, whilst critiquing analysis centred on mainstream paradigms of food security. Roots food justice in transformational practice, derived through examining gender, race, class and capitalist relations as experienced in wider processes of equity/trauma; exchange; land and labour.	Inequity as structural injustice is central to food justice approaches and is something we have adopted here to strengthen mainstream analysis, which often focuses only on income disparities, without always questioning how these might originate.
(Friel et al., 2007) (Friel and Ford, 2015) Friel and Ford (2015), (Friel et al., 2017)	Health equity	Global	Social and systemic determinants of obesity and health eating	Food and health inequities as based on broader social determinants, including: social stratification based on race, ethnicity, sex, age, lack of decent housing, work, welfare, inequities in access to natural and build environments. Systems science as a way of bringing stakeholders together to derive shared understandings of systemic drivers of unhealthy food.	Demonstrates how inequities in food and health eating are the sum of a number of different sub-systems which are part of people’s everyday living conditions. Links such conditions to clear policy choices and policy failures.
Food Ethics Council, (2020)	NGO and multilateral literature	UK (but with global links)	The Fairness Framework	Based on considerations of “whether all have enough, while avoiding some having too much (“fair share”); “all are protected and have the same chances, supported by an enabling environment (“fair play”); all are free to make their own decisions about food and have sufficient voice e. g. in public decision making (“fair say”)	Complementary to our work and has similarities to the tripartite framing (Karllson et al.) that we adapt as fairness (fair share), justice (fair play) and inclusion (fair say).
Hankivsky et al., (2014)	Health Equity	Canada	Intersectionality based policy analysis framework	Prioritises the complexity of human life, drawing on socially constructed categories such as race/ethnicity, gender and class; shaping historically and spatially contingent identities and experiences … leads to a set of questions on how problems are constructed, represented by and for different groups and how more transformative interventions can be produced via such analysis.	Important for demonstrating how key social science concepts, “[r]ooted in a long and deep history of Black feminist writing, Indigenous feminism, third world feminism, and queer and postcolonial theory” (p2) can be brought squarely into health policy analysis.
Herman et al., (2014)	Community health	USA & global	Life course perspective	Emphasises experience over the lifetime end widens environmental exposures to include social and biological characteristics: exposure to these different environments influences nutrition over the lifetime and is part of the production of intergenerational differences between groups.	A reminder that nutrition inequity is experienced as and derived from a set of experiences, environments and exposures that are neither purely biological nor purely social, but a combination of the two, which iterate over a lifetime and over generations (see also Nisbett 2019).
Harris & Nsbett, (2020)	Public health/Development Studies	Global	Basic determinants of malnutrition: Resources, Structures, Ideas and Power	Updates the classic UNICEF (1990) Framework to focus on basic determinants - including imbalances in different human and natural resources; ideas, institutions and other forms of structural power. Draws on Harris and Nisbett (2018) which also draws from social science and health equity literature to develop these concepts	Emphasises factors classically ‘black-boxed’ in nutrition frameworks and draws on classic social science and political economy considerations of the link between ideas, institutions and resources.
Karlsson et al. (2018), Nichols (2020); Salm et al. (2020)	Development studies/sustainable development	Global (mostly global south)	‘Tripartite’ understanding of distributional, recognition and procedural justice.	Equity as based on distributional justice (of power, resources, opportunities and impacts of policy); on recognition justice - i.e of different forms of everyday and historical injustice; and on procedural justice, i.e. fair process/fair participation in process. Draws on both liberal Rawlsian (distributional, procedural) and feminist philosophy of justice and equity, the latter influenced by Nancy Fraser.	Moves beyond overly simplistic definitions of equity as ‘fairness’ - particularly in relation to historical and ideological injustices such as racism and patriarchy. We adapt this in understanding micro- and macro- processes of power, labelled as unfairness; injustice and exclusion
(Madureira Lima and Galea, 2018))	Public health/Sociology	Global	Corporate practices and health	Describes the key mechanisms through which corporations exert their influence on health: influencing the political environment, preference shaping, the knowledge environment; the legal environment and the extra-legal environment.	Ultimately these corporate actions penetrate the social, cultural and political determinants of malnutrition. Underscores the importance of addressing corporate actions and power to address inequities in malnutrition.
(Marmot et al., 2008; WHO, 2008)	Health equity	Global	WHO Commission on Social Determinants of Health/Addressing health equity	Locates the root causes of ill health in broader failings in social and political systems; the unequal distribution of money, other resources and political power. The ‘social gradient’ in experiencing health inequity (including greater vulnerability and exposure to health damaging factors) means that all people are affected by their place in the social hierarchy, not only those at the bottom.	Highly influential in highlighting how population health problems can be traced to broader social, economic and political determinants and social position … but also that such problems are remediable and not immutable.
Odom et al. (2019)	Public health	Hawaii, USA	Pilinahā: An Indigenous Framework for Health	Framework derived from shared accounts of Indigenous community members in Kalihi, Honolulu, stressing “the 4 vital connections that people typically seek to feel whole and healthy in their lives: connections to place, community, past and future, and one’s better self.” (p32	An alternative to individualised conceptions of health and health behaviours - health is here theorised as distributed or community-wide, based in a strong community identity, and rooted in place and territory.
Perez-Escamilla et al., (2018)	Public health	Global	Nutrition disparities and the global burden of malnutrition	Maps socio and demographic, behavioural, biological and environmental drivers of nutrition disparities across the lifecourse. Emphasis on socio-economic disadvantage and factors working across the generations.	Highlights disparities across all different forms of malnutrition and across low, middle and high income countries. Emphasises nutrition outcomes as not only linked to income, race/ethnicity, but also multiple social determinants coming together and building up over lifetimes.
(S. Kumanyika, 2017; S. K. Kumanyika, 2019)	Health equity	USA	Equity Oriented Obesity Prevention Framework	Considers socio-economic and physical/food environment factors; and factors amenable to policy and systems change; as well as individual and community capacity. Highlights discrimination and social exclusion	Importance of understanding different factors (physical, sociocultural, economic, policy/political) in operation at both micro- and macro-levels. Emphasises capacity and agency of communities as central to intervention.
UNICEF (1990)	NGO and multilateral literature	Global	Strategy for Improving Nutrition of Children and Women in Developing Countries. Causes of Malnutrition and Death	Describes basic, underlying and Immediate causes of child and maternal malnutrition and malnutrition related deaths. Identifies, at an immediate level, the interaction of dietary intake and health status; at an underlying level, household food security, care for women and children, and health service and a healthy environment; and at a basic level, the political economy of potential resources and their control.	The classic public health framework for understanding the broader causes of malnutrition.
(Woods, Williams, Baker, Nagarajan, Sacks, 2021)	Public health	Global	The influence of corporate market power on health: exploring the structure-conduct-performance model from a public health perspective	Considers the public health impacts of highly concentrated (e.g. oligopolistic) market structures, including the use of anti-competitive market strategies by transnational food corporations, and the ways in which corporate and market power mediates the distribution and allocation of resources via market systems in society. Market concentration provides corporations with considerable structural and relational power over governments, including through their ability to control and move large amounts of capital investments across borders, which is enhanced under neoliberal globalization.	Helps to understand and redress nutrition inequities as relating to the considerable market power of transnational ultra-processed food corporations, and identifies a broader set of government policy actions (e.g. anti-trust, industrial, financial and trade and investment policies) that reduce market concentration and related instances of market failure. Guides understanding of how asymmetries in political and economic power can be addressed within food systems.