Grant: Team - GACD Interv. scale-up - Primary Prev. of hyper and/or diabetetes in LMIC

In Ecuador, rural people, and particularly rural Indigenous people are disproportionately affected by both nutrient inadequacies as well as overweight and obesity. This double burden of malnutrition magnifies their risk of developing diet-related chronic diseases such as diabetes mellitus (DM) and hypertension (Hyp). In parallel, many rural Indigenous people in Ecuador have organized around alternative food networks (AFNs) such as farmers' markets to seek more sustainable livelihoods. These local AFNs support food environments and practices that hold strong potential to prevent DM and Hyp among participating farmers. For example, AFNs have been demonstrated to promote food literacy, favor consumption of fruits, vegetables and whole grains, and to place income in women's hands; these, in turn have all been associated with healthier nutritional status and reduced risk of diet-related chronic disease. Our research aims to evaluate specific AFN attributes for their measurable contribution to DM and Hyp prevention in order to leverage the most effective attributes for a stronger and broader positive impact. To do so, we will use validated instruments for assessing diet and physiological risk factors among AFN farming households and a comparison group of non-AFN neighbouring farmers, and we will use participatory qualitative research to determine the most effective implementation strategy for translating research findings into practice. Our implementing partners run an ongoing intervention for managing communication and knowledge-sharing among an estimated 132 Ecuadorian AFNs, positioning them as the cornerstone for streamlining research findings into practice. Through the implementation of our research findings, we expect to provide strategic and practical guidance for integrating health-sensitive attributes into the regular practices of AFNs as they continue to replicate and evolve in Ecuador and elsewhere.