Diets, Fruit and Vegetable Intake, and Nutritional Status in Sri Lanka: A Scoping Review

Suboptimal diets, including low fruit and vegetable (F&V) intake, are major contributors to malnutrition and non-communicable diseases (NCDs) in Sri Lanka. Understanding dietary patterns is essential for addressing these challenges. This scoping review synthesizes the literature on diet, F&V intake, and nutritional status across different population groups in Sri Lanka. Searches were conducted in PubMed in October 2023. In total, 30 publications on diet, 13 on F&V intake, and 26 on nutritional status met the inclusion criteria. Sri Lankan diets were found to be rice-dominant with limited variety of nutrient-dense foods such as animal-source foods (ASF) and F&V. Trends in nutritional status varied across life stages. Among children < 5, undernutrition was prevalent, with stunting affecting 14%-21%, wasting 10%-15%, and underweight 17%-21%. Anemia was found in 8%-15% of children < 5 and 25%-30% of pregnant women. Micronutrient deficiencies, particularly vitamin D, iron, and zinc, affected more than one-third of pregnant women. In adults, over one-third were overweight/obese, 8%-12% had diabetes, and 20%-25% had hypertension. Diet, F&V intake and nutrition outcomes also differed by socioeconomic, demographic, and geographic characteristics, with estate sector residents, Indian Tamil populations, and low-income groups disproportionately affected by poor diet quality, low F&V intake, insufficient nutrient intake and malnutrition, while women (vs. men) and urban (vs. rural/estate) residents exhibited higher prevalence of overweight/obesity and NCDs. This review revealed evidence gaps such as the lack of recent dietary intake data based on individual quantitative dietary assessments that limit understanding of current diet adequacy. Additionally, only one impact evaluation designed to improve diet was identified. More research is needed to understand how to effectively improve diet including increasing intake of F&V and ASF in Sri Lanka.