Scientific literature on food and nutrition security in primary health care: A scoping review

There is a growing interest in the scientific community regarding Primary Health Care practices aiming at assessing and addressing Food and Nutrition Security. The focus is usually on outcomes, instruments and effectiveness, with no concern regarding theories or concepts. We aimed to map the theoretical frameworks regarding practices towards Food and Nutrition Security in Primary Health Care and describe its conceptualisations based on Ludwik Fleck's epistemological approach. We conducted a scoping review, including 14 databases. Within the 56 publications, the notion of Food and Nutrition Insecurity as a risk for health without further theorisations predominates. Other two minor theoretical frameworks coexist: Food and Nutrition Security as a social determinant of health and as the realisation of a human right. Few publications present Food and Nutrition Security conceptualisations. Of those who define it, there is great variability in the content and sources used. The most elaborated and homogenous conceptualisations are in the human rights group. This review exposes how the disputes surrounding a concept mostly built on policy and international relations penetrate the scientific field. When studying topics in the interface between science and health practices, notably those where controversies exist, researchers should explicitly express their theoretical and conceptual backgrounds.