Understanding Dietary Diversity, Dietary Practices and Changes in Food Patterns in Marginalised Societies in Sri Lanka

Micronutrient malnutrition is a serious public health problem in developing countries, including Sri Lanka. Most frequently, micronutrient malnutrition is experienced by the poorest households due to cereal-based, monotonous diets that lack dietary diversity. Sri Lankan traditional food system is changing day by day. In parallel, nutrition deficiencies, malnutrition, and noncommunicable diseases are the most significant problems today in Sri Lanka. Therefore, understanding dietary diversity and dietary changes in Sri Lanka must be studied to address related public health issues. This study investigates nutrition adequacy, dietary diversity, dietary practice, and traditional food pattern changes in different marginalised areas in Sri Lanka. A cross-sectional survey was done using 24 h food recall and an administrative questionnaire for 400 women of reproductive age (WRA) (18–49 years old) in marginalised areas in Sri Lanka. The random sampling method was used for data collection. The research confirmed that different areas had poor dietary practices, with macronutrient imbalance and alarmingly low intakes of micronutrients. Interestingly, the diversity of food was higher in rural areas than in urban areas. Approximately 83% of women in urban areas did not meet minimum dietary diversity (MDD-W). Overall, about 63% of reproductive age women did not meet MDD-W and food security. The mean MDD-W for both areas was low. Significant differences in MDD-W levels were found in the two areas (F = 90.483, p < 0.05). The sample showed a significant positive correlation between MDD-W and area, monthly income, educational level, food source, BMI level and health status (R(2) = 360; p < 0.01). This sample did not find that the consumption of traditional varieties of foods and agrobiodiversity are decreasing. Additionally, the study confirmed that low dietary diversity impacts nutrition status and health. The results highlight that the leading causes for low diet diversity are decreased dependence on own production, increased purchasing food at markets, lack of suitable lands to cultivate, agro-commercialisation, less knowledge of food and nutrition, loss of traditional food culture, low income and high prices of food. Inappropriate food patterns, nutrition policies and governance in Sri Lanka are the main factors to the nutrition findings. The study finding will help the decision-making authorities or policymakers to design suitable nutrition programs for vulnerable people in marginalised areas and to use these to strengthen a sustainable food and nutrition system in Sri Lanka.