{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T15:09:25Z","timestamp":1780672165593,"version":"3.54.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>Global food security is currently a priority, especially amid a \u201cgrim regression\u201d that is undermining efforts to eradicate malnutrition by 2030. This perspective argues that the current crisis is not merely a supply chain disruption but a syndemic convergence where biological threats and economic instability interact to erode consumer agency. We posit that vulnerable populations are forced into a \u201clethal calculation,\u201d prioritizing immediate caloric survival over food security and long-term health, thereby becoming trapped in cycles of ultra-processed food consumption. To address this, we challenge the limitations of purely rational economic models and propose an integrated psychological framework that combines the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM). This integration accounts for the specific \u201cinternal determinants\u201d and \u201cperceived threats\u201d that drive decision-making in high-stress, low-income environments to achieve food system sustainability. Unlike previous studies that primarily apply the TPB and HBM to predict individual choices, this perspective uses their integration to propose a structural reorientation of food systems. We introduce the concept of \u201creverse-designed food systems\u201d as a conceptual bridge that aligns system architecture with the cognitive and behavioral constraints of consumers in high-stress environments. This approach shifts the focus from production-led efficiency to a consumer-centric structural design, where the system infrastructure assumes the cognitive load traditionally borne by individuals living in poverty.<\/jats:p>","DOI":"10.3389\/fnut.2026.1793312","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:29:00Z","timestamp":1780669740000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating the syndemic: a socio-psychological approach to food security and responsible consumption in low-income populations"],"prefix":"10.3389","volume":"13","author":[{"given":"Nahui Samanta","family":"N\u00e1jera-Segura","sequence":"first","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]},{"name":"Centro de Investigaci\u00f3n Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirug\u00eda, Universidad Aut\u00f3noma Benito Ju\u00e1rez de Oaxaca","place":["Oaxaca, Mexico"]},{"name":"Unidad Coronaria y Urgencias Cardiovasculares, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Mart\u00ednez-Vargas","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Ch\u00e1vez-Ceja","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Instituto Tecnol\u00f3gico de Tijuana, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Tijuana, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Carmen","family":"Avenda\u00f1o-Rito","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Cruz-Cruz","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Miriam","family":"Arango-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector Alejandro","family":"Cabrera-Fuentes","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]},{"name":"Centro de Investigaci\u00f3n Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirug\u00eda, Universidad Aut\u00f3noma Benito Ju\u00e1rez de Oaxaca","place":["Oaxaca, Mexico"]},{"name":"Divisi\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Instituto Tecnol\u00f3gico de Tijuana, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Tijuana, Mexico"]},{"name":"Hospital General de Zona No.1 Dr. Demetrio Mayoral Pardo, Instituto Mexicano del Seguro Social (IMSS)","place":["Oaxaca, Mexico"]},{"name":"R&D Group, Vice Presidency for Scientific Research and Innovation, Imam Abdulrahman Bin Faisal University","place":["Dammam, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra Nelly","family":"Leyva-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico del Valle de Etla, Tecnol\u00f3gico Nacional de M\u00e9xico","place":["Oaxaca, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12571-022-01266-z","article-title":"Revisiting food security in 2021: an overview of the past year","volume":"14","author":"Savary","year":"2022","journal-title":"Food Secur"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e13036","DOI":"10.1111\/mcn.13036","article-title":"COVID-19 and maternal and child food and nutrition insecurity: a complex syndemic","volume":"16","author":"P\u00e9rez-Escamilla","year":"2020","journal-title":"Matern Child Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.3390\/su17052233","article-title":"Drivers, barriers, and innovations in sustainable food consumption: a systematic literature review","volume":"17","author":"Nichifor","year":"2025","journal-title":"Sustainability"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1007\/s43621-025-01525-x","article-title":"Assessing food insecurity strategies across twelve countries from different income levels: a sustainability and food systems perspective","volume":"6","author":"Slim","year":"2025","journal-title":"Discover Sustain"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"102164","DOI":"10.1016\/j.foodpol.2021.102164","article-title":"Viewpoint: the case for a six-dimensional food security framework","volume":"106","author":"Clapp","year":"2022","journal-title":"Food Policy"},{"key":"ref6","volume-title":"Health Behavior Theories","author":"Glanz","year":"2017"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S118","DOI":"10.1016\/j.amepre.2016.08.003","article-title":"Biobehavioral factors that shape nutrition in low-income populations: a narrative review","volume":"52","author":"Laraia","year":"2017","journal-title":"Am J Prev Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1186\/1471-2458-14-342","article-title":"The effects of food advertising and cognitive load on food choices","volume":"14","author":"Zimmerman","year":"2014","journal-title":"BMC Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1629046","DOI":"10.3389\/fpubh.2025.1629046","article-title":"Influencing factors and mechanisms promoting proactive health behavior intention: an integration of the health belief model and the theory of planned behavior","volume":"13","author":"Fang","year":"2025","journal-title":"Front Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/S2213-8587(22)00220-0","article-title":"Food security and nutrition in the world","volume":"10","author":"Burki","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1177\/00333549251403898","article-title":"Social isolation and sedentary behavior: a syndemic driving the metabolic crisis in the United States","volume":"141","author":"Melby","year":"2026","journal-title":"Public Health Rep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3236","DOI":"10.1017\/S1368980020003493","article-title":"Poverty and food insecurity may increase as the threat of COVID-19 spreads","volume":"23","author":"Pereira","year":"2020","journal-title":"Public Health Nutr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"100755","DOI":"10.1016\/j.gfs.2024.100755","article-title":"Food and nutrition security under changing climate and socioeconomic conditions","volume":"41","author":"Rosegrant","year":"2024","journal-title":"Glob Food Secur"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e269655","DOI":"10.1590\/1806-9479.2022.269655","article-title":"Food challenges, technological changes and food geopolitics","volume":"62","author":"Flexor","year":"2024","journal-title":"Rev Econ Sociol Rural"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"100156","DOI":"10.1016\/j.advnut.2023.100156","article-title":"Local food system approaches to address food and nutrition security among low-income populations: a systematic review","volume":"15","author":"Garrity","year":"2024","journal-title":"Adv Nutr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"101087","DOI":"10.1016\/j.eist.2025.101087","article-title":"Enacting justice in food systems transitions: a critical lens on governance, power and participation","volume":"59","author":"L\u00f3pez Cifuentes","year":"2026","journal-title":"Environ Innov Soc Transit"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1007\/s10460-024-10601-3","article-title":"Valuing farmers in transitions to more sustainable food systems: a systematic literature review of local food producers\u2019 experiences and contributions in short food supply chains","volume":"42","author":"O\u2019Connor","year":"2025","journal-title":"Agric Hum Values"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3687","DOI":"10.3390\/nu16213687","article-title":"Psychological theoretical frameworks of healthy and sustainable food choices: a systematic review of the literature","volume":"16","author":"Lo Dato","year":"2024","journal-title":"Nutrients"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"31277","DOI":"10.1007\/s10668-024-04466-z","article-title":"Extending the theory of planned behaviour to predict sustainable food consumption","volume":"26","author":"Arya","year":"2024","journal-title":"Environ Dev Sustain"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1528016","DOI":"10.3389\/fnut.2025.1528016","article-title":"Exploring the role of health consciousness and environmental awareness in purchase intentions for green-packaged organic foods: an extended TPB model","volume":"12","author":"Li","year":"2025","journal-title":"Front Nutr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Organ Behav Hum Decis Process"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12966-015-0324-z","article-title":"The theory of planned behaviour and discrete food choices: a systematic review and meta-analysis","volume":"12","author":"McDermott","year":"2015","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1080\/13683500.2025.2522246","article-title":"A critical review of the theory of planned behaviour in tourism research","volume":"29","author":"Esfandiar","year":"2025","journal-title":"Curr Issues Tour"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0275312","DOI":"10.1371\/journal.pone.0275312","article-title":"Predicting sustainable food consumption across borders based on the theory of planned behavior: a meta-analytic structural equation model","volume":"17","author":"Shen","year":"2022","journal-title":"PLoS One"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"105086","DOI":"10.1016\/j.foodqual.2023.105086","article-title":"Sustainable food consumption across Western and non-Western cultures: a scoping review considering the theory of planned behaviour","volume":"114","author":"Randall","year":"2024","journal-title":"Food Qual Prefer"},{"key":"ref26","volume-title":"An Approach to Environmental Psychology","author":"Mehrabian","year":"1974"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e70065","DOI":"10.1002\/pa.70065","article-title":"Young household intentions to prevent food waste: an application of the theory of planned behavior and health belief model","volume":"25","author":"Habib","year":"2025","journal-title":"J Public Aff"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1007\/s44187-025-00559-4","article-title":"Exploring consumer intentions to purchase organic food with the health belief model and theory of planned behavior","volume":"5","author":"Singh","year":"2025","journal-title":"Discov Food"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1177\/10901981221109138","article-title":"Structural barriers to HIV prevention and services: perspectives of African American women in low-income communities","volume":"49","author":"Rimmler","year":"2022","journal-title":"Health Educ Behav"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"734991","DOI":"10.3389\/fnut.2021.734991","article-title":"Improving healthy food choices in low-income settings in the United States using behavioral economic-based adaptations to choice architecture","volume":"8","author":"Anderson","year":"2021","journal-title":"Front Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.3758\/s13423-019-01655-0","article-title":"Hunger increases delay discounting of food and non-food rewards","volume":"26","author":"Skrynka","year":"2019","journal-title":"Psychon Bull Rev"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.3390\/nu16142335","article-title":"Health belief model predicts likelihood of eating nutrient-rich foods among US adults","volume":"16","author":"Glick","year":"2024","journal-title":"Nutrients"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.jsams.2018.11.004","article-title":"Health belief model scale and theory of planned behavior scale to assess attitudes and perceptions of injury prevention program participation: an exploratory factor analysis","volume":"22","author":"Gabriel","year":"2019","journal-title":"J Sci Med Sport"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"102928","DOI":"10.1016\/j.foodpol.2025.102928","article-title":"Low-income citizens\u2019 evaluation of policy interventions to promote healthy food choices","volume":"135","author":"Caso","year":"2025","journal-title":"Food Policy"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.3390\/su11051222","article-title":"Flipping the tortilla: social-ecological innovations and traditional ecological knowledge for more sustainable Agri-food systems in Spain","volume":"11","author":"Guerrero Lara","year":"2019","journal-title":"Sustainability"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"521","DOI":"10.3390\/foods10030521","article-title":"Resilience of community food systems (CFS): co-design as a long-term viable pathway to face crises in neglected territories?","volume":"10","author":"Turetta","year":"2021","journal-title":"Foods"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"104496","DOI":"10.1016\/j.cities.2023.104496","article-title":"The role of short food supply chains in advancing the global agenda for sustainable food systems transitions","volume":"141","author":"Petruzzelli","year":"2023","journal-title":"Cities"},{"key":"ref38","first-page":"53","article-title":"Aspectos cualitativos de la inseguridad alimentaria dentro de la crisis de salud venezolana","volume":"38","author":"Herrera-Cuenca","year":"2021","journal-title":"Cuad CENDES"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.tifs.2021.02.062","article-title":"Understanding, promoting and predicting sustainable diets: a systematic review","volume":"111","author":"Biasini","year":"2021","journal-title":"Trends Food Sci Technol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s11920-020-01200-0","article-title":"Food insecurity and eating disorders: a review of emerging evidence","volume":"22","author":"Hazzard","year":"2020","journal-title":"Curr Psychiatry Rep"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1793312\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:29:02Z","timestamp":1780669742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1793312\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":40,"alternative-id":["10.3389\/fnut.2026.1793312"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1793312","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"article-number":"1793312"}}