Small island developing states face challenges in cultivating healthy food systems and are currently bearing substantial burdens of obesity and type 2 diabetes. Local food production—rooted in collective local and Indigenous traditions, self-sufficiency, and climate-adaptive agricultural practices—has long emphasised a fibre-rich, plant-based diet; however, common histories of dietary colonialism have replaced local, small-scale farming and fisheries with non-nutritive cash crops, intensive livestock operations, and high-quality food exportation. Along with declines in traditional food availability, the resulting food import dependence has fostered a diabetogenic ecosystem composed of energy-dense cereal products, animal-based fats, and processed foods. The destabilisation of local food sectors undermines small island social and cultural systems, contributes to impoverishment and food insecurity during natural disasters, and, ultimately, can reduce diet quality and increase type 2 diabetes risk. Despite ongoing marginalisation of traditional local food systems, locally produced foods such as starchy roots, legumes, fruits, and seafood persist as nutritious and ecologically relevant cornerstones of self-determined local economic productivity and dietary health. Findings from community and epidemiological work suggest that local food production—bolstered by local and Indigenous agroecological knowledge, cultural preservation, and collective agency—can aid in reclaiming healthy and climate-resilient small island food systems.
The Lancet Planetary Health, Volume 6, February 2022,