Two billion South Asians face a nutrition paradox that could reshape global health strategy. While Mediterranean diets consistently rank among the world's healthiest eating patterns, their direct application in South Asia crashes against cultural realities, economic constraints, and environmental pressures that make olive oil and fish-heavy regimens impractical for most families from Mumbai to Dhaka.
This comprehensive mixed-methods analysis addresses that gap by creating region-specific dietary pyramids tailored for vegetarian and non-vegetarian South Asian populations. The adapted framework prioritizes locally available whole grains like millet and brown rice, emphasizes affordable legume proteins such as lentils and chickpeas, and incorporates traditional cooking fats while maintaining Mediterranean principles of high fruit and vegetable intake. The model explicitly relegates ultra-processed foods and sweets to pyramid peaks with clear consumption limits.
The adaptation represents more than nutritional tweaking—it acknowledges that effective dietary interventions must navigate entrenched cultural food practices, limited nutritional literacy, and economic realities where families spend up to 60% of income on food. The research identifies critical implementation barriers including women's limited decision-making power in food choices, climate pressures on local agriculture, and food safety challenges in supply chains. Unlike Western dietary interventions that often ignore socioeconomic context, this approach integrates policy recommendations for nutrition education, agricultural diversification, and strategic food fortification. The framework offers a blueprint for culturally responsive nutrition interventions that could influence dietary guidance across similar developing regions facing the double burden of malnutrition and rising chronic disease rates.
