Agricultural Commercialization and Dietary Transitions in Traditional Food Systems in Indonesia.

Background: The impacts of agricultural commercialization on nutrition are highly contested. Agriculture-nutrition linkages are complex and context-dependent and may result in trade-offs between different dietary outcomes. Objectives: This study compared dietary patterns between children in oil palm and non-oil palm-adopting Indigenous households in two oil palm contexts in Indonesia: "plasma" smallholder oil palm in West Kalimantan and oil palm plantation labor in Papua. Methods: Using 24-h dietary recall data from children aged between 12 and 59 mo in West Kalimantan (696 children; 963 recalls across two seasons) and Papua (345 children), we compared quantities of foods consumed at the food group level between children in oil palm and non-oil palm Indigenous households. We also compared the probabilities of consuming ultraprocessed foods. Results: Children living in oil palm-adopting households in West Kalimantan consumed lower quantities of cereals and dark green leafy vegetables (DGLVs), more dairy and eggs, and were more likely to have consumed processed meat and sugar-sweetened beverages. In Papua, children living in households engaged in oil palm plantation labor consumed lower quantities of tubers and fish, but more cereals, DGLVs, and legumes. They were also more likely to have consumed ultraprocessed refined grains and bakery products. Conclusions: Associations between agricultural commercialization and children's diets are context-dependent and may reinforce local dietary transitions. These may include increased consumption of some healthy foods in some contexts, but also be associated with diets linked to negative health outcomes, including reduced consumption of some nutrient-rich foods and increased consumption of ultraprocessed foods.