Assessing the rural food environment for advancing sustainable healthy diets: Insights from India

World agricultural production has seen significant growth in the past four decades, yet malnutrition remains a persistent problem, particularly in the global south and more so in the rural areas. Need for a holistic approach to food systems is becoming crucial in designing policies that support the transition to sustainable and healthy diets. The present study is aimed to understand the rural food environment in the Telangana state in southern India by analyzing the combination of external and personal factors affecting food choices, attitudes, and consumption behavior. We developed a scoring-based methodology to assess the external and personal domains and dimensions to understand the food environment. The results showed that rural households favored carbohydrate-rich food groups obtained mostly from their own production or subsidized sources. On the other hand, protein and micronutrient-rich food groups were neglected due to affordability and preference for taste, cultural factors, and the limitations of external food environment. The findings of this study provide a deeper understanding of the food environment in low and middle-income countries (LMICs) conext. By highlighting the interplay between agriculture, food environments, and nutrition outcomes, this study contributes to the ongoing effort to address the global malnutrition crisis and support the development of healthier and more sustainable food systems. These findings can be useful to guide policy actions towards achieving food security and nutrition in the rural regions where food environments are under rapid transitions in the LMICs. [Display omitted] •Inadequate knowledge of food environments limits effectiveness of nutritional interventions.•Study presets a scoring method to analyze the food environment more precisely.•Households preferred readily available and accessible energy-dense foods.•Nutrition literacy interventions may help in promoting healthier diets.•Food environment research is vital to design policies to support transition towards healthy diets.