Food Systems Approach to Improve Diet and Nutritional Outcomes: Integration of Three Studies Conducted in Rural Communities in Sri Lanka

Background/Aims: Food system involves all the elements and activities that relate to the production, processing, distribution, preparation and consumption of food, and the outputs of these activities. Methods: Three different studies were conducted to investigate and analyze how food production systems contribute and influence people's dietary intake and nutritional outcomes. Results: In Study 1, meals prepared using menus containing locally available foods were provided to school children in a rural school along with comprehensive food and nutrition education program for 10 months. At the end of the intervention, school children showed an improvement of dietary intake compared with baseline. Meals contributed >20% in macronutrients and energy, and >25% of micronutrients in the actual daily intake of children. In Study 2, a rural community was encouraged to have organized home gardens (OHG) and their dietary intakes were compared with households with non-organized home gardens (NOHG). The families with OHG consumed significantly higher amount of calcium, iron, vitamin C and vitamin A and achieved greater dietary diversity compared with households with NOHG. In Study 3, Healthiness Index for 58 snacks prepared using local foods was evaluated using nutrient profiling models. Ranking of healthiness of foods showed that most of the snacks available in the food outlets were 'less healthy' and not suitable for regular consumption. All three studies interlinked the importance of informed food choices for the people. Conclusion: The studies collectively suggest changes in consumer behavior can open pathways to more sustainable food systems that enhance food security and nutrition.