Sustainable diets, indigenous food systems, and planetary health: a regionally grounded review with Meghalaya, India as a case study

Global food systems are major drivers of environmental degradation while failing to ensure optimal nutrition, particularly in low- and middle-income regions. Sustainable diets offer an integrative framework linking nutrition, environmental integrity, and socio-cultural sustainability. Indigenous food systems, especially in biodiversity-rich regions, represent context-specific pathways toward sustainable nutrition). Meghalaya, a predominantly tribal state in North-East India, provides a compelling case where rich agrobiodiversity and traditional food practices coexist with persistently high levels of undernutrition. This narrative review synthesizes interdisciplinary evidence on sustainable diets and planetary health and critically examines indigenous food systems using Meghalaya as a regionally grounded case study. Peer-reviewed literature and authoritative reports published between 2005 and 2024 were reviewed across nutrition, environmental science, ethnobotany, and food policy. National Family Health Survey-5 indicators are used solely to contextualize nutritional vulnerability, not as dietary intake data. Global evidence supports plant-forward dietary patterns for reducing environmental impacts and non-communicable disease risk. Indigenous food systems in Meghalaya align strongly with sustainable diet principles; however, structural constraints, nutrition transition, and gendered inequities limit their nutritional impact. NFHS-5 data highlight a paradox of ecological richness alongside high stunting and anemia, underscoring that biodiversity alone is insufficient to ensure nutrition security. We conclude that indigenous food systems hold significant potential to advance sustainable diets in Meghalaya, but translation into health gains requires integrated, context-specific strategies that address dietary quality, gender relations, health environments, and policy support.