Table 2_South Asia-specific adaptation of Mediterranean diet principles: a mixed-methods review for practical and sustainable dietary habits.doc

South Asia, home to nearly 2 billion people, faces a dual burden of persistent malnutrition and rapidly rising rates of obesity, type 2 diabetes, and cardiovascular diseases. Dietary patterns are dominated by refined cereals, low intake of fruits, vegetables, and whole grains, limited protein quality, and imbalanced fat composition, compounded by cultural practices and the growing penetration of ultra-processed foods. This mixed-method review systematically synthesized dietary intake data and contextual barriers to evaluate the transferability of Mediterranean Diet (MD) principles to South Asia. Unlike broader continental frameworks, our approach integrates local foods, cultural traditions, and environmental realities to design two region-specific dietary pyramids for vegetarian and non-vegetarian populations. The adapted model emphasizes higher consumption of whole grains, legumes, fruits, and vegetables, the inclusion of affordable high-quality protein sources, and a balanced use of locally available fats, while placing sweets and ultra-processed foods at the top of the pyramid with clear limits. Beyond nutrient adequacy, our analysis highlights structural barriers, economic affordability, entrenched food traditions, limited nutritional awareness, environmental pressures, and food safety challenges that must be addressed to ensure feasibility. Policy action, nutrition education, women’s empowerment, climate-smart agriculture, and fortification strategies emerge as key enablers for a sustainable dietary transition in the region.
Systematic review registrationhttps://osf.io/d7j4m/

拥有近20亿人口的南亚地区，正面临着持续性营养不良与肥胖、2型糖尿病及心血管疾病患病率快速上升的双重负担。当地膳食结构以精制谷物为主，水果、蔬菜与全谷物摄入量不足，蛋白质品质欠佳，脂肪构成失衡，加之文化习俗的影响以及超加工食品的普及率不断提升，进一步加剧了这一问题。本项混合方法研究综述系统整合了膳食摄入数据与背景层面的阻碍因素，旨在评估地中海饮食（Mediterranean Diet, MD）原则在南亚地区的可迁移性。与更宽泛的大陆性膳食框架不同，本研究结合当地食物资源、文化传统与现实环境，为素食与非素食人群分别设计了两款符合区域特色的膳食金字塔。优化后的膳食模式强调增加全谷物、豆类、水果与蔬菜的摄入量，纳入可负担的优质蛋白质来源，并均衡使用本地可得的脂肪类食物，同时将甜食与超加工食品置于金字塔顶层并明确限定摄入量。除了满足营养充足性要求外，本研究还分析了诸多需加以解决的结构性障碍，包括经济可负担性、根深蒂固的饮食传统、营养认知水平有限、环境压力以及食品安全挑战，以确保该膳食模式具备可行性。政策举措、营养教育、女性赋权、气候智慧型农业以及食品强化策略，成为推动该地区实现可持续膳食转型的核心助力因素。系统综述注册链接：https://osf.io/d7j4m/