Food commercialization, hidden hunger and malnutrition: A study of food and nutrition security, focusing on the marginalized society in Sri Lanka

From 2016 to 2019, a collaborative research project between the Rajarata University of Sri Lanka and the Department of Organic Food Quality and Food Culture, University of Kassel, Germany, was carried out to investigate the food commercialization, hidden hunger, and malnutrition in marginalized societies in Sri Lanka. Consuming a healthy diet, maintaining good health, and chronic diseases is a challenge for those struggling with poverty and food insecurity for various reasons in Sri Lanka, including limited financial access. Unhealthy food increases the adverse outcomes experienced by the food insecurity of individuals. The commercialization of the food system has led to issues of nutritional problems in Sri Lanka. Sri Lanka is moving from traditional diets based on nutrient foods to highly processed, low nutrient food. Simultaneously, rapid demographic, social, and economic changes are underway, leading to increased urbanization and changes in food systems. This transition refers to recent global shifts in a dietary pattern such as higher intakes of saturated fats, sugars and refined foods, and lower intakes of fiber-rich foods, driven by technological advances that have made energy-dense, micronutrient-poor foods cheaply available on the global food markets. This nutrition transition leads to diet-related diseases, such as undernutrition, micronutrition deficiencies, obesity, and non-communicable diseases. Thus, a comprehensive study was done to examine the Sri Lankan food and nutrition and health situation, especially food transition and nutritional problems. This study intends to fill the existing knowledge and policy gaps for food and nutrition governance in Sri Lanka, especially in marginalized societies. This study could empower the Sri Lankan food system by moving towards sustainability and contributes to the existing scientific work globally in the context of food and nutrition governance. This research study's overall thematic objective is to address the connection between food system commercialization, hidden hunger, and malnutrition. Notably, the focus is on food security and nutrition security in marginalized societies in Sri Lanka, with special attention being given to food culture and governance. This research used an interdisciplinary mixed-method approach. As a first step, identified parameters that have underpinned the dietary change in Sri Lanka based on literature data and the current situation. In this survey, found that colonial and postcolonial dynamics had a significant impact on cultural changes. This has directly impacted Sri Lankan food culture and nutrition status and is connected to current nutrition problems. Changes in traditional diets towards a more Western diet, promoting as higher fat and sugar content, are expected to result in higher incidence of dietary-related non-communicable diseases, as well as micronutrient deficiencies. Thus, the dissemination of traditional knowledge and popular campaigns must continue. As a second step was investigated food and nutrition-related knowledge, attitude, and practice (KAP) on nutrition status according to FAO guidelines. The research results clearly showed that reproductive-age women have a low level of nutritional knowledge and most women have a positive attitude about receiving nutritional knowledge but have low-level practice about a healthy diet. Furthermore, knowledge, practices, and attitudes of women largely affect their BMI status and household food security. As third step, was used MDD-W according to FAO guidelines first time in Sri Lanka. In this survey identified these societies had poor diets with imbalanced macronutrients and alarmingly low intakes of some key micronutrients. These results also confirmed the posed hypothesis, which showed that urban slum women reported higher levels of food insecurity than women from remote rural areas. Furthermore, monotonous diets are rice-based, with little consumption of fruits and vegetables. Moreover, this study provided a better understanding of women´s determinants of dietary behaviour and valuable information on planning programs to prevent the risk of reproductive-aged women in marginalized areas (MDD-W). This study found that MDD-W is higher in rural households than in urban households. Women´s meal patterns are inadequate, and food choices are characterized by highly refined cereal products, high sugar, and high-fat products compared to healthier food choices (mostly unprocessed foods). Furthermore, this research finding helps to understand the diversity of food and the food transition. The study further confirmed that low dietary diversity impacts nutrition status and health. Based on the results of this research, there is a need to enhance nutrition education about diet diversity as well as food security among reproductive women. Further studies can be conducted to investigate the strategic nutrient intake and micronutrition problems in these areas among women and children. The study demonstrated that food and nutrition policies change due to changes in political regimes. Thus, this study found that local governments play a role in increasing access to healthy foods and reducing access to unhealthy food. The study identified that the food transition and socioecological patterns are important factors in the politics of policymaking.