For this study, the Uttarakhand state in the central Himalaya, India was targeted that comprised a total geographical area (TGA) of 53,483 km². The state shares borders with Himachal Pradesh in northwest & Uttar Pradesh in the south and international borders with Tibet in the north and Nepal in the west. Physiographically, Uttarakhand can be divided into three broad zones, viz., the Himalayas, the Siwalik, and the Terai region. Administratively, the state has 13 districts and houses a population of 10.09 million (69.77% rural and 30.23% urban) with a livestock population of 4.79 million and largely exhibits an agrarian and pastoralist economy with high dependence on forest resources. For detailed investigation, we selected the Bageshwar district (area of 2,302 km²) of Uttarakhand that is most centrally located and represents all broad features of the state (Figure 1). Bageshwar is largely hilly terrain covering Siwalik ranges and the high Himalayas. Pindar, Saryu (Sarju), Gomati, and Pungar are the main rivers flowing across the district. Administratively, the district comprised four Tehsils, viz., Bageshwar, Kapkot, Kanda, and Garur and three blocks, viz., Bageshwar, Garur, and Kapkot. As per the 2011 census, the total population is 259,898 (male 48% and female 52%) with 96% living in the rural areas. There are 874 inhabited villages in the district (Anonymous 2011). The community of the area is divided into three categories, viz., General, Scheduled Class, and Scheduled Tribe. The education status of the district is good, with an overall literacy rate of 80.01%, although it is much higher for males (92.33%) than females (69.03%). The district has 10.8% land area under agriculture, which is mainly rain-fed (average annual rainfall of 1,200–1,400 mm). Only 20% of agricultural land is irrigated. In addition, the district comprised 55% land area under forest, 5.42% cultivable barren land, 3.23% barren and uncultivable land, and 10.64% as permanent pasture and grazing land (Anonymous 2011). The district also has 273,051 livestock that forms an integral part of each household. These animals comprised cattle (37%), buffalo (10%), goats (40%), sheep (6.5%), and others (6.5%). In addition, there is also backyard poultry. As per the livestock census 2012, Uttarakhand exhibited low per capita availability of milk (387g/day/person), meat (2kg/person/year), and egg (27eggs/person/year); therefore, in rural places, there is high dependence on agriculture. However, the economy is collectively met from all these lands and largely subsistence-type. The majority of people are involved in the primary sector (agricultural activities), although some also work in secondary and tertiary sectors, such as private works, businesses, and government jobs. Generally, the community is greatly dependent on farming and natural resources and characterized as highly marginal with small and scattered land holdings, small production, and low income. The major foods of the community are rice, finger millet, wheat, barley, maize, pulses, and a wide variety of vegetables cultivated or collected from the wild. Occasionally, people also consume animal products (meat, ghee, buttermilk, milk, curd, etc.). Generally, the male population out migrates to earn better livelihoods, leading to dominance of womenfolk in the villages. It also results in a continuous increase in fallow lands and culturable wastelands. The district has limited health infrastructure mainly located in urban areas. As per the National Family Health Survey (2015–16), the prevalence of malnutrition in Uttarakhand among children under 5 years of age was 26.6% underweight and 33.5% stunting (Anonymous 2014). As per Food Policy Research data, the status of nutrition in Bageswar revealed that among the children <5 years, 23% exhibited stranded growth, 26.3% were underweight, and 45% anemic. In women of reproductive age, 41.3% were anemic while 24.9% had a body mass index <18.5 kg/m². For common health needs, rural communities are largely dependent on the traditional health care system (Ojha et al., 2020).

The study was conducted from 2017 to 2019. To collect field data, we randomly selected 24 villages covering Garur Ganga, Saryu, and Gomati Valley of Garur and Kapkot blocks of the district. The selection of villages covered an altitude from 1,200 to 2,700 m above sea level. Largely, the area has a similar sociocultural structure though crops and plants vary with elevation. The criterion for village selection was to maximize the probability of including respondents from different altitudes, social statuses, and castes. Owing to the topography of the region, the villages lie on the fringes of the hills as well as in the high peaks of the region. Thus, it was assured that a probabilistic approach was to be taken. A detailed questionnaire was prepared to cover various broad areas of food intake. In addition, focused interviews were also arranged regarding knowledge, attitude and practices, dietary intake, and food habits. Since most farmers owned small landholding and were categorized as smallholders, for selecting a household (participant), we initially conducted a household listing operation in each selected village to provide a frame to include in the sample. Accordingly, a total of 25% households or a maximum of 30 households were sampled in each village with equal probability. Altogether, we sampled a total of 445 households across villages. Of the total respondents, 65% were women being the major workforce as men migrated to towns and cities for finding alternate employment. The median age of the interviewees was 38. A detailed list of all traditional agricultural practices, crops, and foods eaten by the local community, the local name of the species, its source of availability (cultivated or collected from wild), plant part used, the month of collection, seasonal consumption pattern, uses other than food during illness, and mode of use and application was prepared. We also explored major crops and cropping patterns in rain-fed and irrigated fields. As the majority of crop species were common, they were simply matched with the existing herbarium for identification purposes. We used standard plant nomenclature using IPNI (2021). An important part of the study was to assess the food and medicine interface of traditional crops and plants that are most commonly used by the marginal hill community. These practices are being used since eternity, descended from the inherited knowledge of the locals and indigenous population of Uttarakhand.

As women commence most household doings and take key decisions in food making, of the total respondents, a total of 100 women were targeted for 24-h dietary recall survey (FAO, 2018). These women were of the age group of 25–50 years. The study was repeated consecutively for three major seasons, viz., summer (March to June), monsoon (July to October), and winter (November to February). Common village measuring units (such as patha) were standardized to obtain an actual quantity of food intake by the participants to estimate the usual daily intake of food, and the frequency of intake was combined to obtain the optimum digits. Information on main ingredients and cooking methods was gathered for different traditional food recipes, cuisines, or herbal preparations. We considered those dishes that have been traditional in nature and were in practice through generations. The frequency of food intake for different species is gathered in three categories: daily (consumed regularly), weekly (consumed at least once in a week), and occasional (consumed at least once in a month or season). We considered median values of intake instead of mean to avoid skewness of data. As some species are preferred for healthcare also, we also gathered information on the illness being treated, therapy applied, and techniques used in treatment. To further assess the potency of a treatment using local crops and plants, we also interviewed local Vaidyas (herbal healers or folk medicine practitioners) using snowball sampling. It was through discussion with locals and other practitioners that we identified 30 healers who agreed to share information. Later on, they were interviewed to elucidate the potency of crops/plants for therapeutic purposes. For this, two general meetings (one in each valley) were organized in which the information gathered from the community was shared with vaidyas to provide a common viewpoint on the effectiveness of the dietary habit for treatment of illness/ailments. In addition, the healers also have knowledge and experience on the use of different crops and wild plants for its use in curing diseases and ailments. Other than vaidyas, 20 members of the native community also participated in each meeting. Information was gathered on the illness being tackled, plant parts used, processing (if any), and mode of application. All the data collected as above were arranged by listing all crops and wild plants used as food, dietary diversity and food groups consumed in different seasons, preference of traditional food in terms of nutrition and medicinal utility, and sociocultural significance of food items, if any.

Dietary diversity indices (DDI) provide us with quantified variables with outcomes that define the quality of diet taken by the communities. The study used two major indices in the study to quantify the quality and diversity of food taken by the community. The household dietary diversity score (HDDS) was used to check the food consumption and household access to a variety of food as well as a proxy for nutrient adequacy. Data were collected in accordance with the guidelines for measuring household and individual dietary diversity and with suggested 12-food group indicators (FAO, 2010). For all the three seasons (summer, monsoon, and winter), a 24-h dietary recall was taken from the respondents which was converted into Boolean variables (where 0 = food not taken and 1 = food taken) and finally summing up the values to obtain the HDDS. Another index implemented in the study is the Food Consumption Score (FCS) developed by the World Food Program to aggregate household-level data on diversity and frequency of food consumed during a specific duration (WFP, 2009). The indicator used a 7-day dietary recall and frequency of the food groups whose intake frequencies were noted in the questionnaire and after applying the respective weights to the food groups.

FCS was calculated using Equation 1 as follows:  FCS = A_staple   X_staple + A_pulses   X_pulses + A_veg   X_veg + A_fruits   X_fruits + A_meat   X_meat + A_sugar   X_sugar + A_dairy   X_dairy + A_oils   X_oils, (1) where, a ¬ i = Weight   of   each   group   ( Starch staples = 2 ,   Pulses = 3 ,   Vegetables = 1 ,   Fruits = 1 ,   Meat/fish/eggs = 4 ,   Milk = 4 ,   Sugar/Sweets = 0 . 5 ,   Fat = 0 . 5 ) .

xi = frequency of food consumed in past 7 days.

The nutrient adequacy ratio (NAR) was also calculated for the 13 nutritional indicators (viz., energy, proteins, carbohydrates, fats, vitamin B1, vitamin C, vitamin D, vitamin E, Ca, Mg, Fe, Na, and Zn) used in the study by dividing the participant’s actual intake of each nutrient by the recommended dietary allowance (RDA), and additionally the mean adequacy ratio (MAR) was calculated using the following equation (INDEX Project, 2018):

MAR=ΣNAR/(Number of Nutrients)

Food plants comprise significant nutritional and health benefits as they contain all the essential nutrients in the leaves, roots, stems, flowers, and fruits of many plants. Therefore, after collecting the information on traditional food plants and food habits of the communities, selected crops were assessed for their nutritional values from the Indian food composition developed by the ICMR, India (ICMR-ICFT 2017; Longvah et al., 2017). The species-specific values for energy, proteins, fats and carbohydrates, water-soluble and insoluble vitamins (such as thiamine—vit. B1; ascorbic acid—vit. C; ergocalciferol—vit. D; and tocopherol—vit E), and minerals (such as Ca, Fe, Mg, Na, and Zn) were undertaken. For some species, nutritional parameters were assessed from other research sources derived by searching Google Scholar and PubMed sources. The intakes, as classified on the basis of daily, weekly, and occasionally, were filtered and analyzed with respect to the nutritional information to obtain the average nutritional intake of individuals, although the rarely eaten foods were not included in the consumption analysis.

It was recorded that the community used as many as 68 food plant species comprising cereals, pseudo-cereals, millets, vegetables, pulses, fruits, spices and condiments, oilseeds, and medicinal and aromatic plants to fulfill their basic needs (Table 1). The main crops were rice (comprise 50% of agricultural land), finger millet (20%), wheat (19%), barley (5%), and maize (1.35%), and the cropping pattern differs in irrigated and unirrigated (rain-fed) agricultural lands. In irrigated fields, rice forms the major crop, although in some areas, wheat is also grown. In unirrigated fields, however, mixed cropping along with crop rotation has been the key feature. In such areas either dry rice, followed by wheat and millet, or millet followed by rice and wheat cultivation is followed on a 3-years crop rotation basis. Mix-cropping of pulses (lentil, urd, etc.) and oilseeds (mustard, sesame, soybean, etc.) was integral in rain-fed lands. Besides, the cultivation of a wide variety of minor crops, vegetables, and medicinal plants was also performed by the farmers. The main fruits of the study area were citrus, pear, mango, walnut, apple, peach, plum, apricot, litchi, etc. Most species were cultivated as vegetables (33.82%), followed by cereals and millets (15%), spices & condiments (14.71%), oilseeds (11.76%), fruits (10.29%), and aromatic species (2.9%) (Figure 2). A total of 35 species were also sold in local markets. In addition, a significant number of wild plants were collected from nearby forests to fulfill diverse needs.

The main characteristics of traditional farming are that it is performed on small and fragmented land holdings and is subsistence-type and labor-intensive, therefore practiced as family farming. It is largely organic in nature as the community uses only farmyard manure (FYM) to maintain soil fertility. The traditional food system comprised a combination of food plants, wild edibles, and other cuisines, etc., and there was a preference for traditional food items/dishes that maintained taste, nutrition, and cultural values. Women are at the center of the traditional food systems that undertake diverse roles from seed selection, storage, agriculture field preparation, weeding, harvesting, storage, cooking, etc., protecting farm diversity and maintaining dietary diversity within the community. The community strongly believed that the traditional food items substantiate their energy, protein, and carbohydrate requirements, particularly of women who performed extensive physical works at households and farms. An assessment of average food self-sufficiency revealed that communities would produce a significant share of their household need from their farms. For generations, the community has been successful in extending proper local governance in a decentralized manner to various resources, such as land, forest, and water, on which the traditional food system is intensely reliant. All these resources form an integral part of the local socioecological systems. All natural resources are maintained with the perspectives for proper access, harvest cycles, and equitable distribution, which is key to sustaining local food systems and diets.

It was noticed that the dietary habits of the local community are influenced by seasons as per the availability of crops and wild plants. Some seasonal food items are also brought to the local market, and people can procure them from the market if it is not grown by them. An assessment of 24-h dietary recall of the community against the recommended dietary allowance (RDA) indicated that a large share of daily energy requirements of a working woman was fulfilled by traditional diets only (Figure 2). The community prefers energy-rich foods in their diets. An assessment of energy requirement of the age group of 19–50 years against the RDA revealed that traditional crops fulfill 78.97% requirement during summer, 73.29% during monsoon, and 92.88% in winter (Tables 2, 3). The energy intake was higher during winter than in monsoon. During winter, the community consumes more energy-rich foods such as Eleusine coracana, Dioscorea bulbifera, Glycine max, and Amaranthus caudatus (Table 4). Protein intake was recorded as 60.90 g/day in summer, 61.73 g/day in monsoon, and 77.85 g/day in winter, which is higher than the recommended intake; however, it can be attributed to the amount of labor performed for various works. Fat intake was confined within the RDA limits that reduce the risk of cholesterol-linked diseases. The traditional food also supports higher carbohydrate content in winter (345 g/day) than summer (298 g/day) and monsoon (277 g/day). Traditional food supports a higher intake of vitamin D within tolerable limits. Occasional consumption of meat and fish products also met nutrient demands. A low intake of calcium and sodium was observed, although the requirement of the latter element is met from natural salts. The study clearly revealed that traditional food crops are an important asset to food and nutritional security even in remotely located villages.

An investigation of the household dietary diversity score (HDDS) was also undertaken to assess the households’ access to a variety of foods (Table 5). It was interesting to note that most households were consuming adequate nutritional food in all the seasons, and none of them were placed with low dietary scores. The HDDS ranged from 4 to 10, being maximum in winter, followed by summer and monsoon months. The communities were fed well in all the food groups with daily consumption of cereals, oils and fats, vegetables, and milk products as well as meat and related products in all the seasons. The consumption of meat products was low in monsoon. There was low consumption of sugar edibles and fruits in almost all the seasons, although vitamin C–rich fruits were consumed in ample quantity in winter.

The average nutrition adequacy ratio (NAR) for all the nutritional parameters was 9.51 with a mean adequacy ratio of 0.73, which promises good quality of food intake by the communities living in remote locations. Although the anthropometric was not undertaken, it was recorded that the community was not eating junk food, sugar additives, and other unhealthy dietary markers. It reduces the chances of obesity, diabetes, and other similar ailments. The population is found taking better intake of nutrition that can be an indicator of low risks of diabetes and other ailments as well.

It was interesting to note that traditional diets form a rich source of nutrients (Table 4). The most common mode to use species is in the form of cooked, direct ingestion, as an ointment, and applying it directly either by crushing, powder, or adding the part as it is (Figure 3). In terms of plant parts used for treating the ailments, they include seeds (32.89%), fruits (21.05%), and leaves (18.41%) followed by bulbs, seed oils, and others, etc. (Figure 4). Most species had multipurpose uses ensuring food and nutritional security as well as medicinal efficacy for curing minor ailments (Figure 5). The community had species-specific knowledge on the use and application of various species. A total of 43 species were reportedly used as dietary supplements and food additives with definite physiological benefits during different ailments. Such species are commonly consumed as cooked food; thus, it can be categorized as neutraceutical or bioceutical. Other common methods comprised ingestion (15 species), ointment (eight species), and direct application (seven species).

The average food consumption score of the communities was 73.46, which is a good sign of food diversity intake among communities ranging from a minimum score of 55.55 and a maximum score of 87.00. The average cumulative probability for the entire crop species intake in the FCS was above 0.6, showing higher diversity of intake (Figure 6).

Traditional food plants are rich sources of nutrients and chemical compounds that are used by the body to function properly and maintain health. An assessment of the nutritional status of crops plants revealed the presence of diverse components, such as proteins, fats, carbohydrates, vitamins, and minerals, in traditional foods and diets (Supplementary Annexure 1). Many species comprised high energy content (>3.5–5.5 kcal/g), such as Sesamum indicum, Trachyspermum ammi, Oryza sativa, Cannabis sativa, Brassica juncea, Glycine max subsp. soja, Lepidium sativum, Linum usitatissimum, Echinochloa frumentacea, Bauhinia variegata, and Glycine max. While Zea mays, Vigna mungo, Triticum aestivum, Setaria italica, Phaseolus vulgaris, Fagopyrum esculentum, Perilla frutescens, Vigna unguiculata, Vigna umbellata, Trigonella foenum–graecum, and Macrotyloma uniflorum exhibits medium energy content (2.5–3.5 kcal/g), Asparagus, Bauhinia variegata, Benincasa hispida, Brassica campestris, Brassica juncea, Brassica nigra, Brassica oleracea, Cannabis sativa, Capsicum annuum, and Chenopodium album exhibited high protein content (>20–43 g/100 g). Similarly, Cannabis sativa, Perilla frutescens, Sesamum indicum, Brassica juncea, Linum usitatissimum, Lepidium sativum, and Trachyspermum ammi comprised high fat content (20–49 g/100 g). Many local species were also rich in vitamins and other nutrients (Supplementary Annexure 1). Thus, the data clearly reveal that the nutritional energy value (can be calculated as the sum of food energies of all components) of the traditional food systems was very high.

The use of plants and food recipes has been a fundamental component of all rural house treatment systems as it is the most easily accessible resource available to the local community at the time of medical urgency. The local communities are well aware of the potency of food crops and their utility for treating various ailments and illnesses. Although they may not be known for the scientific reason as to how these food crops work in the body in treating the ailment. Since such treatments have been in practice for centuries, they apply it as the best affordable means. A literature survey on traditional crops clearly exhibited high medicinal value ranging from antifungal, anti-inflammatory, decreasing risks of cancer, reducing the risk of diabetics, etc. (Supplementary Annexure 2). Oryza sativa, Eleusine coracana, Glycine max, Vigna umbellata, and Macrotyloma uniflorum were good sources of carbohydrates, while Brassica juncea, Sesamum indicum, and Lepidium sativum provided worthy fat sources. Some species also exhibited aphrodisiac, antimicrobial (fungal and bacterial), antidiabetic, cardioprotective, anticancer, analgesic, antianemic, hepatoprotective, immunomodulatory, swelling & cholesterol-reducing, blood sugar lowering, etc. characteristics. It clearly revealed that local food has enough provisions for appropriate diets to satisfy the nutritional and energy needs along with a good balance of vitamins and micronutrients to the local community. It is essential to perform diverse functions, such as from boosting the immunity to therapeutic actions and repair of cellular damage to the healing of wounds and ailments, thus acting as protective shields against different ailments.

An important aspect of the interface of food and medicine is the use of diverse food recipes and the community’s hyperawareness of its potency for curing different illnesses (Table 6). The use of food recipes varies with seasons. The mode of preparation, ingredients, cooking process, and intake frequency differs. The community uses foods with warm potency in monsoon and winter. Such species are Amaranthus virdis, Chenopodium album, Dioscorea bulbifera, Hordeum vulgare, Eleusine coracana, and Macrotyloma uniflorum, while, cool potency food such as Cucumis sativus, Coriandrum sativum, Oryza sativa, and Raphanus sativus were taken usually in summer. Several other criteria also work in selecting the food, such as people prefer eating meat products and coarse grain cereals more at higher altitudes due to cold. Other than achieving wellness, the traditional recipes also help address seasonal health issues. There is significant scope to prepare many new food dishes from traditional recipes to attract the market.

The health status of Bageswar reveals that the children below 5 years are impacted with anemia, stranded growth, and are underweight. Similarly, the women of reproductive age are anemic with less bodyweight, thus influencing their lactation ability. A major reason for this is the lack of proteinaceous food and timely supply of tonics and other medicines. Fortunately, there are a large number of local food plants that can supplement such dietary needs of the community. For example, species such as Eleusine coracana, Setaria italic, Glycine max, Amaranthus caudatus, Fagopyrum esculentum, Chenopodium album, Punica granatum, Vigna umbellata, Syzygium cumini, Spinacia oleracea, and Urtica ardens are useful to avoid anemia. In addition, in case of stunted growth, consumption of Eleusine coracana, Glycine max, Glycine soja, Setaria italica, Vigna umbellata, Brassica juncea, Fagopyrum esculentum, and Linum usitatissimum is considered beneficial. Likewise, to enhance breast milk, consumption of Eleusine coracana, Glycine max, Glycine soja, Phaseolus vulgaris, Spinacia oleracea, Amaranthus caudatus, Fagopyrum esculentum, and Brassica oleracea var. capitata is advisable. There are also many protein-rich traditional recipes such as Bhatia/Jaula, Bhatt ke dubake, Bhatt ka fana, Bhatt mathi ki sabzi, Bhatt papad ke sabzi, Chudkani, and Sonta (Lobia) ka chaise. (Table 6). The traditional recipes can also help overcome anemic conditions by consuming Chaulai ki roti, Jhangora/Madira ki roti, Kutu ki roti, Kauni ki roti, Madua ki roti, Sonta (Lobia) ki bedu roti, Bathua ki sabzi, Bichhu/Kandali ka saag, Barmola/Rooki ki sabzi, Jhankara ka saag/Tinari, etc. There is a need to make people aware of these plants and dishes to consume them for treating such illnesses.

The implications of this research are of both academic importance and practical significance to ensure food–medicine security and avoid malnutrition among rural communities. For food security, a sustainable food production system is highly demanding. The study established a better understanding of the intersection between traditional food, dietary diversity, nutritional quality, and medicinal efficacy. It highlighted the need to conserve and continue with the traditional food systems as it is in the best interest of the people. We expect that the study would receive greater attention from policy planners and developmental workers that will not only salvage the dwindling traditional dietary system but also ensure a healthy dietary cover to the marginal hill communities. The local government should recognize the role of traditional food and dietary systems in meeting community necessities and support appropriate policies and programs to continue with it. It should support better financial incentives to farmers to continue traditional agriculture and dietary practices. It would empower the local communities to manage traditional food and dietary systems not only to feed themselves and preserve crop gene pools but also to sell produces in markets. Greater awareness of the masses and policy planners is desired on the beneficial aspects of traditional crops and wild plants. In addition, proper documentation of traditional knowledge related to local crops, cropping practices, local delicacies and recipes, and herbal preparation is highly desirable for future use. Such an approach will not only promote and nurture traditional food systems but also support local sociocultural and ecological systems and provide a sustainable solution for nutrition security. This requires location-specific strategies and trade-offs so as to develop a synergy in terms of food security and environmental gains with minimum transformations. Other than government support, public investment in various forms is also required. In addition, there is a need for proper scientific investigation on nutritional/anti-nutritional and therapeutic efficiencies in food items and herbal preparation as the current state of knowledge is highly limiting on these aspects. There is a need to make some traditional food, recipes, cuisines, and ingredients appropriate for recent times that may attract a significant population outside. The local government should incentivize the traditional system so that it creates new values and job opportunities for youngsters. It is expected that the study would lead to advancement of a renewed thinking on traditional agriculture for food and nutritional security as well as sustainable rural development all over. It is a global challenge to conserve traditional food systems and maintain healthy diets that have been sustainably used for generations and can have an important synergy with SDGs (Wang et al., 2018).