Women’s control over money and time tied to better diets

Women’s ability to control money, time and household decisions may be the strongest factor in whether they can eat nutritious food, according to researchers writing in The Conversation. The finding matters because global progress on women’s nutrition has stalled despite years of programs focused on food access and education.

The researchers, Lydia O’Meara and Paula Dominguez-Salas, said their multidisciplinary team reviewed 518 studies from 125 low- and middle-income countries. Their analysis identified 143 factors that influence what women can eat and produced what they described as the first evidence-based framework of women’s food environments.

The team reported that agency — a woman’s ability to make food decisions, control household finances, manage her time and move freely — was the most important driver of diet quality. Food availability and household income still matter, the authors said, but they were not the top factor in the review.

Hidden hunger remains widespread

The researchers cited global nutrition data showing that women carry the largest burden of malnutrition worldwide. More than two-thirds of women of childbearing age lack enough of at least one micronutrient, such as iron, even when they may be eating enough calories.

That form of deficiency is often called “hidden hunger,” according to the researchers, because it can occur without obvious food shortage. They also cited data showing anemia among women has worsened since 2012, rising from 28% to 31%.

In sub-Saharan Africa, the researchers said, the gap in food insecurity between men and women is widening. They cited estimates that 80% of women of reproductive age in the region are affected by micronutrient deficiencies.

Household power shapes meals

In many low-resource settings across Africa, Latin America and the Asia-Pacific, the researchers said, women’s diets are shaped by who controls household spending and by social rules about who eats first. Men or older women may make food purchasing decisions, while younger women can face less control over cash, heavier unpaid work and limits on movement.

The review found a mismatch between what researchers study and what appears to matter most. Nutrition knowledge, or food literacy, appeared in 57% of the studies reviewed, the authors said. Women’s agency appeared in about one-third of the studies, even though the review identified it as the strongest lever for improving diets.

The researchers argued that programs focused only on teaching women what to eat may fail if women lack the power to act on that information. They said climate change, urbanization, conflict and global food systems can also reduce access to nutritious food, with gender inequality shaping who feels the strain first.

The review also found that women with strong social networks, including nearby family, friends and neighbors, often had better diets. The researchers said those networks can help share the work of getting food, cooking and caring for children.

Policy implications

The authors said nutrition and agriculture policies should address women’s bargaining power, decision-making authority and control over income. They also said policymakers should account for time burdens, mobility limits, food allocation within households and cultural norms that restrict movement.

The researchers backed the United Nations’ March 2025 adoption of Minimum Dietary Diversity for Women as a global development indicator. They said the measure can serve as a proxy for whether women are getting needed vitamins and minerals.

The review also pointed to gaps in evidence. The researchers said studies often focus on communities that are easier to reach, such as places near roads or health infrastructure, while women in remote areas, conflict zones and climate-affected regions are underrepresented.

O’Meara and Dominguez-Salas said future research should include more primary data collection with national researchers who understand local languages and social dynamics. They also cited their work in northern Uganda showing that automated mobile phone surveys can reach people in places where sending research teams is difficult.

This story draws on original reporting from Medical Xpress.