Dietary intake and micronutrient adequacy among adults engaged in agriculture in rural Sri Lanka: Findings from a cross-sectional baseline survey

Authors: JOYCE, CAROLINE - University Of California, Davis; Caswell, Bess; GELLI, AULO - International Food Policy Researc Institute (IFPRI); HESS, SONJA - University Of California, Davis; SITISEKARA, HASARA - Wayamba University Of Sri Lanka; STEWART, CHRISTINE - University Of California, Davis; TAN, XIUPING - University Of California, Davis; JAYATISSA, RENUKA - Medical Research Institute Sri Lanka; PEIRIS, KALANA - World Food Programme; SILVA, RENUKA - Wayamba University Of Sri Lanka; OLNEY, DEANNA - International Food Policy Researc Institute (IFPRI)

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/21/2024
Publication Date: 1/30/2025
Citation: Joyce, C.A., Caswell, B.L., Gelli, A., Hess, S.Y., Sitisekara, H., Stewart, C.P., Tan, X., Jayatissa, R., Peiris, K., Silva, R., Olney, D.K. 2025. Dietary intake and micronutrient adequacy among adults engaged in agriculture in rural Sri Lanka: Findings from a cross-sectional baseline survey. Public Health Nutrition. 28(1). Article e35. https://doi.org/10.1017/S1368980025000072.
DOI: https://doi.org/10.1017/S1368980025000072

Interpretive Summary: Healthy diets that include adequate nutrient intakes and consumption of fruits and vegetables are critical for preventing disability and chronic diseases, and for optimal human function throughout life. The Fruits and Vegetables for Sustainable Healthy Diets (FRESH) initiative by One CGIAR aims to increase fruit and vegetable intakes, improve diet quality and support livelihoods in low and middle income countries. Using survey data from another livelihoods development program in rural Sri Lanka, we assessed food group consumption, adequacy of micronutrients in the diet and the contribution of fruits and vegetables to micronutrient intake. We found that grains - particularly rice - and coconut milk were the largest sources of energy. Rice, fish, dairy, pulses, chilies, and green leafy vegetables were the primary sources of micronutrients. However, consumption of fruits and vegetables and intakes of micronutrients were below recommendations. Increased intakes of fruits, vegetables and animal-source foods are needed to improve the diets of rural Sri Lankan adults.

Technical Abstract: Objective: To characterize food group intake and estimate usual nutrient intake among farming adults in rural Sri Lanka. Design: A baseline survey was conducted as part of an agriculture-based resilience program evaluation (Dec 2020–Feb 2021). Dietary intake was assessed using telephone-based 24-hour recalls (n=1283), with repeat recalls from 769 participants. Food group and nutrient intakes were estimated using standard recipes and Sri Lankan food composition data. Average intake of food groups, the relative contribution of food groups to total energy intake, and the relative contribution of fruits and vegetables (F&V) to micronutrient intake were calculated. The National Cancer Institute method was used to estimate mean usual nutrient intakes and the prevalence of adequate intake (PAI) of micronutrients. Differences by sex, district, and wealth quintile were assessed using t-tests and ANOVA. Setting: Forty-five rural villages throughout Sri Lanka. Participants: Farming adults from households in the program evaluation study area. Results: Grains and coconut milk provided 56% and 12% of total energy, respectively. Rice, fish, dairy, pulses, chilies, and green leafy vegetables were the primary sources of micronutrients. Participants consumed 118±117g vegetables and 71±243g fruit per day. PAI was <25% for iron, calcium, zinc, niacin, and vitamins C and B12, reflecting low consumption of animal-source foods (ASF; 80 g/day), whole grains, and certain F&V. Conclusions: We observed high consumption of rice and coconut milk, and low levels of micronutrient adequacy among Sri Lankan farmers. Increasing ASF and F&V consumption are needed to close micronutrient gaps. Additional research addressing barriers to consumption of micronutrient-rich foods is recommended.