Leveraging the bioactive potential of forest foods to improve dietary diversity and prevent cancer risk in Northeast India

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Palanisamy, Raghu Raman, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5727903/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Natural solutions are increasingly sought for their potential to harness locally available food resources (LAFRs) and nontimber forest products (NTFPs) to reduce cancer risk among the Mizo tribal communities in Aizawl, Mizoram, India. Given that the prevalence of cancer is greater than that in neighboring states, understanding the dietary practices of these communities and leveraging local resources for their anticancer properties are critical. This study highlights the need to mitigate cancer incidence through improved dietary diversity and the incorporation of natural resource-based bioactive-rich foods, which aligns with Sustainable Development Goal 3 (good health and well-being). Methods A mixed-method approach was employed, combining structured questionnaires and focus group discussions to assess diet diversity among 170 Mizo tribes (78 females and 92 males) aged 27–54 years. Data collection included 24-hour dietary recall over seven consecutive days. Statistical analysis compared the actual intake of ten food groups with the Indian Council of Medical Research (ICMR) recommendations. Results This study revealed significant inadequacies in diet diversity among the Mizo tribes. Additionally, a comprehensive review of 121 scientific papers examined the anticancer properties of LAFRs and NTFPs. The review identified 60 LAFRs and 25 NTFPs demonstrating promising anticancer properties that require further clinical studies. Conclusions In conclusion, aligning nutritional interventions and community health initiatives with scientific evidence is essential. Leveraging the region's biodiversity and incorporating bioactive-rich nutraceuticals into the diet may improve overall health and reduce the incidence of cancer among these communities. Nutraceuticals Bioactive compounds Non-timber Forest Products Anticancer Local Food Resources Dietary diversity Forest foods Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Background In the current scientific milieu, interest in restoring locally available food resources (LAFRs) and nontimber forest products (NTFPs) and their value has increased owing to their promising therapeutic potential [ 74 ]. Northeast India serves as a reservoir of indigenous knowledge systems encompassing food, agriculture, medicine, and natural resources [ 68 ]. The northeast region has garnered attention because of its high biodiversity and prominent conservation agencies worldwide [ 2 ]. Mizoram, one of the seven sisters in the northeastern expanse of India, reflects its rich natural resources and ethnic and deep-rooted traditional culture [ 100 ]. "Mizo" was previously called Lushai. Mizoram has seven major tribes, including Hmar, Paihte, Pawi, Ralte, Lai, Mara, and Lusei, and they are known for their unique food habits, cooking practices, and ethnic culture among the other states of Northeast India [ 111 ]. The tribes in this area are known for their wild edibles, forest produce, local foods, and plants for food and other purposes [ 4 , 71 , 42 ]. Despite these resources, the community faces challenges such as an increasing population and a threat to potable drinking water. The treated water supply in hilly areas such as Mizoram is unavailable, forcing dependence on open sources such as streams and springs for consumption [ 61 ]. In developing regions, the accumulation of wastewater may involve bacteria and toxic ions, which can be treated with advanced technologies, including nanomaterials and nanocomposites such as Fe 3 O 4 -MnO 2 . This process protects water bodies and provides tangible benefits to the health of the population [ 52 ]. Despite its rich natural resources and vast diversity, Mizoram persistently holds the preeminence of peak Age Standardized Incidence Rate (ASIR) data between 2003 and 2010 in men and women. All instances of cancer analysis within the geographic confines of Mizoram are being vigilantly recorded. According to reports from the Population-Based Cancer Registry (PBCR), between 2012 and 2016, India had the highest incidence of cancer in both sexes particularly in North-East India marking an increase in cancer incidence and deaths [ 69 , 117 ]. In contrast to the second least inhabited state, Mizoram has the highest cancer rate in India [ 148 ]. Specifically, in the context of Mizoram, Aizawl presented the highest age-adjusted rate (AAR), 269.4, and a mortality rate of 152.7 among males. Prominently, within the Aizawl district of Mizoram, one out of every four males and one out of every five females are likely to develop cancer in the age groups 0–74 years [ 69 ]. Among women, lung cancer is a growing concern, with an incidence rate that is significantly higher than that of men [ 29 ]. Stomach cancer is more common among men, followed by lung, head & neck, colorectal, esophageal, urinary, liver, and prostate cancer. In women, lung cancer is accompanied by breast, cervical, head & neck, stomach, colorectal, liver, esophageal, and ovarian cancers [ 148 ]. These cancer rates and prevalence sites highlight the brutal truth of rising cancer cases in Mizoram compared with those in the neighboring states of India. The majority of the studies suggest that risk factors such as lifestyle patterns and ethnic dietary practices might be associated with the incidence of cancer in Mizoram. The consumption of locally made tobacco may also be a significant factor in the increasing prevalence of cancer [ 118 ]. Studies have shown that the frequent consumption of saum (fermented pork fat), smoked meat, dried and salted fish, and baking soda as an additive increases the probability of "stomach carcinoma" and other lifestyle diseases, particularly type 2 diabetes [ 94 , 59 ]. High-fat consumption is associated with an increased risk of breast cancer development [ 130 ]. Cancer treated with advanced methods and conventional methods is often accompanied by adverse health effects. Contemporary studies have highlighted the utilization of indigenous plants for treating various types of cancer [ 120 ]. A study revealed that the consumption of traditional foods contributes to improved intake of adequate nutrients and dietary diversification [ 93 ]. Social–behavioral change with improved knowledge, attitudes, and practices is effective through community-based interventions [ 35 ]. Given the strong associations between lifestyle, dietary practices, and cancer incidence in Mizoram, there is increasing interest in addressing rising health concerns. The region's biodiversity offers a wealth of indigenous plants and traditional foods that are not only central to the diet but also possess significant therapeutic potential. These natural resources, particularly those rich in bioactive compounds, can be harnessed to develop nutraceutical products. Integrating these nutraceuticals into the diet may help mitigate the adverse effects of conventional cancer treatments. "Nutraceuticals" refer to foods or foods that provide various therapeutic advantages, including disease treatment and/or prevention [ 97 ]. Nutraceuticals contain active phytochemicals that can be consumed as dietary boosters or incorporated into functional foods, offering health benefits that surpass those of basic nutrition [ 82 ]. They are believed to bolster human health and increase life expectancy, along with many other mechanisms that putatively prevent chronic diseases [ 30 ]. Carotenoids, polyphenols, phytosterols, phenolic acids, antioxidant vitamins, etc., are bioactive compounds that have provided great insights into the prevention of chronic diseases [ 47 ]. Mizoram tribal communities were mostly timberland inhabitants who depended on shifting cultivation, hinging on timber, non–timber, and local foods for sustenance [ 101 ]. Rural areas such as Mizoram often lack advanced medical facilities, with health centers being sparse, and instead, they rely on community health workers. This reliance and limited access may even lead to mortality due to a lack of awareness and delayed diagnosis [ 83 ]. However, given its eclectic botanical origins and traditional practices, Mizoram provides promising possibilities for exploring the nutraceutical and anticancer potential of local food resources and nontimber forest resources. The dependence on these natural resources may not only bridge nutritional gaps but also help lay the foundation for improved consumption of potentially rich functional foods. While previous studies have focused on cancer diagnosis and conventional treatment, this study addresses this gap by exploring the potential of nontimber forest products (NTFPs) and locally available food resources (LAFRs) in mitigating cancer incidence. This highlights the nutraceutical bioactive-rich potential of natural resources as a complementary strategy to enhance health outcomes and reduce the risk of cancer and other chronic diseases within Mizoram's tribal community. Assessing dietary diversity and quality plays a crucial role in designing nutritional interventions, promoting nutritional security, and supporting sustainable food production [ 41 ]. The Sustainable Developmental Goals (SDGs), initiated by the United Nations in 2015, comprise 17 broad objectives to address challenges such as eradicating poverty, climate change, inequality, and environmental disintegration to foster prosperity, peace, and justice within the community [ 37 ]. SDG 3, one of these goals, focuses on ensuring good health and well-being for people of all ages. This initiation is successful with coordinated efforts to address interconnected challenges by providing awareness, direct engagement, training, and support. Accordingly, our paper focuses on SDG 3, "good health and well-being" and the strategy focuses on highlighting the importance of natural resources that can help reduce chronic disease rates and enhance the overall health of the community. Methods Subjects The study was conducted among selected Mizo tribal communities, including Hmar, Lusei, Ralte, Lai (Pawi), and Mara (Lakher), residing in the Aizawl district. A random sampling method was adopted with a total of 170 (78 females and 92 males) participants aged 27-54 years for the evaluation of diet diversity. The subjects were represented by various professions, such as school teachers, college lecturers, university professors, doctors, drivers, skilled workers, Maids, and homemakers. The inclusion criteria for the human subjects in the study focused on capturing dietary habits during adulthood and middle age from selected Mizo tribal communities aged 27-54 years, as these age groups are critical for understanding their health conditions, particularly their cancer prevalence and risk factors. Individuals from non-Mizo tribes and those outside this age range were excluded to focus on the target population and minimize variability in dietary patterns, lifestyle practices, and health conditions that could influence cancer risk at different life stages. Study design and settings The data documentation and background analysis were conducted by developing a self-structured survey tool and tested randomly on a pilot basis with 20 people. A focus group discussion was subsequently conducted among 170 individuals to extrapolate the data and assess any ambiguities during the study. The current study used a mixed-method approach involving the 24-hour recall method to assess the diet diversity of the Mizo tribes and compared it with the RDA-Recommended Dietary Allowance 2020 (ICMR-Indian Council of Medical Research). The diet survey questionnaire also included questions to elicit information on eating habits, cooking practices, and lifestyle factors practiced by the selected tribes. Statistical analysis was carried out in this study to understand the actual intake of food groups compared with the ICMR recommendation. Additionally, the above study was supported by a scientific review investigating the available LAFRs and NTFPs around the Mizo tribal habitats. The relevant literature (original/review) was retrieved via digital sources such as Scopus, Lancet, ResearchGate, PubMed, Google Scholar, Science Direct, etc. The keywords used for the search were "Locally Available Food Resources", "Nontimber Forest Products", "Nutraceuticals", "Functional Properties", "Bioactive compounds", "Anti-cancer properties", "Ethnomedicinal plants", "Anti-tumorous properties", "Noncommunicable Diseases" and "Anticancer plants". The acronyms "AND" and "OR" were included in the keyword search. The inclusion criteria explored the NTFPs and LAFRs found in and around the locality of the Mizoram tribes, study methods, findings, anticancer properties, and bioactive compounds of the identified plants. Studies not focused on anticancer properties, populations outside the selected Mizo tribes, and publication years not between 2000 and 2023 were excluded. From an initial collection of more than 140 scientific papers, only 121 papers meeting the inclusion criteria were considered for data extraction. The collected data were consolidated in the form of a table categorizing 60 identified LAFRs and 25 NTFPs, which serve as a promising reference to identify the research gap for further exploration and utilization of these natural resources for therapeutic potential in cancer prevention and treatment. Results The study advocates understanding the diet preferences (Table 1) and food group consumption (Table 2) prevailing practices related to lifestyle, eating, and cooking practices (Table 3). Statistical analysis was conducted to compare the intake of ten food groups with ICMR standards across different age groups and work groups (Figures 1,2, 3, 4, 5, and 6). Additionally, an attempt was made to review the availability of the LAFRs (Appendix Table 1) and NTFPs (Appendix Table 2) with their anticancer properties in and around their locality. This study explored bioactive compounds and their potential use in mitigating the risk of cancer incidence. Impact on dietary preferences The present study examined the dietary preferences of the selected tribes on the basis of their prioritized food options throughout the day for a week. Their top priority food options include Sawhchiar (Mizo fried rice), tea with bread, and snacks mostly sticky rice cakes and deep-fried items. The diet lacks milk and milk products with a limited intake of fruits and is mostly rich in carbohydrates and fats. Table 1 shows the dietary preferences of the local Mizo tribes. Impact on Food Group Consumption among Mizo Tribal Communities The dietary habits of the Mizo tribes were assessed for three consecutive days and compared with ICMR, the recommended dietary allowance, 2020. Men and women exhibited significant disparities between their actual intake and the RDA. Significant deficits were observed in milk and milk products, other vegetables, fruits, roots and tubers, nuts, and seeds. The consumption of cereals, animal foods, fats, and oils was excessively high compared with that of other food groups. The intake of green leafy vegetables exceeded the ICMR recommendations. Millets were excluded because they were not commonly available in Mizoram. They were neither consumed nor produced. Studies have shown that emphasizing millet consumption in the community will enable food security among the population [80]. Table 2 lists the food group consumption of the Mizo tribes. Table 2 Food group consumption of Mizo tribes for 3 consecutive days (n=170 adults) Food Groups Male n = 92 Nos (27 – 54yrs) Female n = 78 Nos (27 – 54yrs) ICMR RDA (g/day) Actual intake (g) %Excess /Deficit ICMR RDA (g/day) Actual intake (g) %Excess/ Deficit Milk & milk products 300 24 -92 300 36 -88 Cereals & millets 275 280 +1.82 200 208 +4 Other Vegetables 200 130 -35 200 105 -47.5 Roots and tubers (excluding potato) 100 41 -58.33 100 35 -65 Green leafy vegetables 100 114 +14 100 109 +9 Fruits 150 18 -88 150 22 -85.33 Animal foods 80 96 +20 60 67 +11.66 Pulses 80 40 -50 60 34 -43 Fats and oils 25 27 +8 15 17 +13.33 Nuts and seeds 30 11 -63.33 30 10 -66 Source: ICMR-NIN Expert Group on Nutrient Requirements for Indians, Recommended Dietary Allowances (RDAs) and Estimated Average Requirements (EAR) – 2020 *Notes: Millets were excluded from food group consumption because they are not commonly available in Mizoram. Foods such as fruits, vegetables, and whole grains significantly reduce the risk of chronic diseases, improve immunity, and lower infections. Owing to lifestyle risk factors such as physical inactivity, hypertension, and obesity, the Mizo tribal population is susceptible to high risks of developing cardiovascular diseases in the future [79]. A recent study of food group consumption among tribal groups revealed that the population mostly consumed less than three-fourths of their daily requirements compared with the RDA [102]. Nutritional deficiencies and excesses are due to a lack of knowledge of the significance of diet diversity. Dietary interventions and behavioral changes are needed in the community to combat nutritional deficiencies and prevent conditions such as obesity, diabetes, and chronic diseases. Food group consumption status compared with ICMR standards A hypothesis t-test was performed at the 5% significance level to check whether the actual intake of the sample tribal population aligns with the ICMR recommendations. Twenty different t-tests were conducted for each of the ten food groups in the study, considering gender-specific populations. The tests were carried out using Stats. Blue, an online statistical tool. The tests for both genders revealed statistically that milk and milk products, other vegetables, fruits, pulses, roots and tubers, nuts, and seeds consumed less than the ICMR recommendations. Green leafy vegetable consumption was higher than the recommended level. A similar study was conducted among Oraon tribes, highlighting their considerable consumption of tubers, vegetables, and green leafy vegetables [8]. Although cereal consumption seemed higher, the tests statistically concluded that the difference was insignificant compared with the ICMR recommendation. The consumption of animal-based foods was greater in males, whereas females consumed foods closer to the ICMR recommendation. Males consumed fats and oils at the recommended level, whereas females consumed more than the recommended level. The results of this discussion are illustrated in Figures 1 and 2. It is reasonable to study the differences in food habits on the basis of the nature of the work one does. The male and female populations were categorized as sedentary, moderate, and hard workers, respectively. One-way ANOVA was conducted to understand the possible differences between various work groups of males and females individually. The interesting observations revealed by ANOVA performed on the male and female populations separately are presented. In the case of the male population, the differences between the work groups in all ten considered food groups were evident by mere observation. However, it is essential to present the microscopic details of the consumption habits of various work groups individually for all ten food groups. The observations are given accordingly. The consumption of milk and milk products, roots and tubers, fruits, and pulses in the moderate work group was lower than that in the other two work groups, and none of the workgroups met the ICMR recommendation. The consumption of cereals by heavy workers is slightly greater than that of the other two work groups, and the overall consumption is in line with the ICMR recommendation. The consumption of other vegetables varies across workgroups and is below the ICMR recommendation. The consumption of green leafy vegetables by moderate-level workers was lower than that by the other two workers. However, moderate workers consume marginally less, and heavy workers consume slightly higher amounts and are statistically closer to the ICMR recommendation. Interestingly, overall consumption exceeds the ICMR recommendation because of higher consumption by the sedentary workgroup. There is no difference between the work groups in terms of the consumption of nuts and seeds, and consumption is below the ICMR recommendation. The consumption of animal foods by the moderate workgroup meets the ICMR recommendation, whereas the other two work groups consume foods above the ICMR recommendation. The consumption of fats and oils by all workgroups is up to the recommendation of the ICMR. In the case of females, there were significant differences among the sedentary and moderate workers for eight of the considered food groups except for the consumption of fats and oils, nuts, and seeds. The consumption of fats and oils by females is slightly greater than the ICMR recommendation. However, the moderate workgroup consumes green leafy vegetables and animal foods per the ICMR recommendation. The results of the above discussion are depicted in Figures 3 and 4. Age-wise analysis categorized males and females into three groups: 40 years and younger, 41–50 years, and older than 50 years. Among males, no significant differences in food group consumption were observed across age groups. For females, significant differences were found in the consumption of milk and milk products, other vegetables, animal foods, and pulses among the age groups. Females aged 50 and above consumed animal foods in line with ICMR recommendations, whereas younger groups exceeded the recommended intake. The results of the above discussion are presented in Figures 5 and 6. Impact on the prevailing practices among the Mizo tribes The comparative analysis conducted in the present study revealed both good and wrong practices among the Mizo people. These good practices contribute to their health, environment, and future, showcasing their culture's value for minimizing food waste and respecting traditional practices. Living close to nature in a less polluted environment reflects their deep-rooted respect for nature. However, social transition, urbanization, and alternate livelihoods have increased purchasing power and shifted more unhealthy practices, leading to various non-communicable diseases (NCDs). Pervasive lifestyle factors such as a sedentary lifestyle, stress, and less physical activity may increase the risk of cancer. The emerging reliance on instant and packaged foods not only nullifies health benefits but also deteriorates safer and healthier cooking practices. This serious shift in practice needs to be effectively addressed through community knowledge interventions and social and behavioral change practices to alleviate various disease conditions. The good and bad prevailing practices are presented in Table 3 below. Table 3 Good and bad prevailing practices recorded among the Mizo tribal community (n=170 adults) Category Good Practices Bad Practices Eating Habits Intake of Local Produce High Salt Intake Consumption of Green leafy vegetables Excessive Sugar Consumption Consumption of Bai (Boiled Vegetables) Processed Foods Consumption of fermented foods Skipping Meals Moderate use of spices Unbalanced Snacking Preparation and usage of ash filtrate Use of commercial baking soda Low oil consumption Increased use of saum (Fermented pork fat) Utilization of seasonal resources Smoked meat consumption Intake of a variety of protein sources Less intake of fruits Lifestyle Factors Utilization of traditional food preservation technique Sedentary Lifestyle Promotion of Home gardening Alcohol and Substance Abuse Purchase of Local produce to support local farmers Stress Living close to nature with less pollution Smoking Practice of sustainable resource management Less physical activity Cooking Practices Utilization of Fresh Ingredients Declining traditional cooking practices such as foraging of wild ingredients, traditional preservation methods, steaming of bamboo, etc. Boiling, steaming, grilling, and stewing methods Emerging Reliance on Packaged Foods A similar study revealed that the unique diet and lifestyle habits of Mizoram, such as fermented pork fat, smoked meat, and excessive use of salt, combined with habits such as nicotine water and betel leaves with raw areca nuts and excess lime chewing, significantly influence the risk of various diseases [89]. The use of ash filtrate (from burnt crop residue) in their diet to improve flavour and reduce cooking time has potential dietary implications because of its alkaline nature. Prolonged exposure to harmful compounds such as polycyclic aromatic hydrocarbons (PAHs) from burnt crop residue may increase the incidence of cancer [88, 22]. Observations from a study highlighted higher rates of tobacco use, excessive alcohol consumption, and poor lifestyle habits among the tribal population, leading to an increase in noncommunicable diseases (NCDs) [76]. NCDs such as diabetes, hypertension, cancer, and cardiometabolic diseases have become more prevalent, and India's healthcare system must adopt well-defined preventive and control strategies to address this challenge effectively [91]. Additionally, Mizoram's incidence of stomach cancer, the highest in India, seems to be linked to lifestyle factors and poor prevailing practices [95]. Given that Mizoram has the highest incidence of cancer in India and the possibility of increased risk of cancer incidence due to lifestyle and eating habits, it is crucial to consider preventive strategies. To address these challenges, this review explored the nutraceutical and anticancer properties of NTFPs and the LAFRs of Mizoram as promising natural solutions to mitigate the adverse effects linked to identified risk factors. Incorporating NTFPs and LAFRs into the diet could offer a valuable supplement for reducing cancer incidence and enhancing health outcomes among Mizo tribal populations. The subsequent tables summarize the bioactive compounds and the potential roles of the identified NTFPs and LAFRs. Nutraceutical and anticancer properties of LAFRs This review identifies LAFRs within the reach of the Mizo tribal community, aligns their bioactive compounds/compound classes, and promotes them as anticancer agents for potential therapeutic uses. LAFRs are readily available, free of cost, and significantly contribute to enhancing the overall well-being of the community [51]. The table shows that bioactive compounds such as flavonoids, polyphenols, and terpene alkaloids present in the identified plants are associated with potential anticancer properties. Several studies have highlighted the presence of bioactive compounds that are known to exhibit potential anticancer effects. Although few plants have been connected to address specific types of cancers, further in-depth studies are needed to confirm their efficacy. Furthermore, LAFRs rich in bioactive compounds underscore the importance of natural remedies with anticancer potential for the prevention of cancer. The study organizes bioactive compounds found in NTFPs and LAFRs on the basis of their cancer-preventive potential, grouping them based on their primary bioactive functions, such as antioxidative, anti-inflammatory, and apoptosis-inducing effects. Table 1 presents the identified LAFRs with their bioactive compounds/compound classes. The reader is referred to Table 1 in the Appendix for the lists of LAFRs, bioactive compounds/compound classes, and their potential usage. Nutraceutical and anticancer properties of NTFPs NTFPs are resources that exist naturally within forest ecosystems but are not typically cultivated [124]. These NTFPs contribute significantly to tribal populations that depend on their biodiversity, local consumption, sales, and livelihood diversification. NTFPs, which are rich in bioactive compounds such as terpenes, flavonoids, and phenolic acids, offer the potential to address various types of cancer, such as lung, liver, breast, and colon cancer, associated with environmental and lifestyle factors. These bioactive compounds complement conventional treatments by mitigating treatment aftereffects, improving treatment outcomes, and enhancing the overall well-being of cancer patients. Table 2 presents the identified NTFPs with their bioactive compounds/compound classes. The reader is referred to Table 2 in the Appendix for the lists of NTFPs, bioactive compounds/compound classes, and their potential usage. A total of 60 LAFRs and 25 NTFPs plant species of Mizoram have been explored, which offer promising potential anticancer compounds. The predominant methods of consumption, preparation, and parts that were observed in the original study retrieved various approaches, including decoction, paste, raw form, and other methods such as maceration and oil [58]. Owing to a lack of knowledge of the functional properties and active compounds, the incorporation of these sources into the diet has been limited. Limitations in the consumption of a variety of foods and the inefficient use of local foods are further averse to the health of the tribal community [70]. A literature review of the bioactive compounds in these LAFRs and NTFPs indicates that the regular consumption of these compounds has anticancer effects and lowers the risk of developing certain cancers. Traditional foods prepared from LAFRs and NTFPs exhibit medicinal properties that offer potential health benefits and therapeutic uses from their natural components [51]. However, research and clinical findings are needed to explore the efficacy and safety of cancer incidence and treatment. Discussion The Mizo community did not habitually consume a meal (lunch) in the afternoon. Instead, they consume snacks and other highly processed foods as their lunch option. Most of the food items consumed by the selected tribes were high in carbohydrates and fat, with a limited intake of fruits. Notably, their diet lacks milk and milk products. Meat consumption and highly processed foods emerged as top-priority options. Despite this, it is preferable to observe the consumption of green leafy vegetables and other vegetables in their diet. However, the combination of less physical activity along with high consumption of animal fats, fermented foods, smoked meat, and processed food items such as noodles, bread, and biscuits poses an increased risk of chronic diseases. Milk and milk products, other vegetables, fruits, roots and tubers, nuts, and seeds have notable deficits, whereas excessive cereals, animal foods, fats, and oils have been observed in the diet. Notably, the consumption of green leafy vegetables was greater among men and women. Millet was excluded from food group consumption because it is not commonly available in Mizoram. Millet is neither produced nor consumed, with rice being their staple food. Culture and urban development were also reasons for the shift in cultivation and consumption. Statistical analysis revealed a significant deficit in food group intake compared with the ICMR recommendations. In males, sedentary workers consumed more green leafy vegetables whereas heavy workers consumed cereals closer to ICMR recommendations. There were no significant differences between the sedentary and moderate workers among the females except for the intake of fats and oils, nuts, and seeds. The consumption of certain groups such as Green leafy vegetables, cereals, animal foods, and other vegetables was found to be higher among heavy workers, followed by sedentary workers whereas moderate workers consumed up to the recommended level or less than the recommended level. There were no significant differences in food group consumption among males across age groups. Age-wise differences were observed, with females aged 50 years and above consuming animal foods closer to the ICMR recommendations compared to younger age groups who exceeded the recommended intake. Traditional food practices such as the use of ash filtrate in place of baking soda, home gardening, and the consumption of probiotic-rich fermented foods are extremely good practices. However, lifestyle changes, including increased consumption of processed foods, high salt intake, and lack of physical activity, are leading to an increase in noncommunicable diseases. A recent study highlighted the NCD prevalence among tribal populations, with Mizoram facing various cancers due to lifestyle factors and poor dietary diversity. Given these prevalences, a review was conducted to explore the bioactive-rich LAFRs and NTFPs that address cancer risk. Limitations: This study's cross-sectional design limits conclusions between dietary habits and cancer incidence. The survey's self-reported dietary data may be subject to recall bias. Additionally, as this sample represents only specific Mizo tribal communities, generalizability to other populations may be constrained. Future longitudinal studies and randomized trials are planned to substantiate these findings and strengthen the applicability of nutraceutical interventions. These natural resources offer potential preventive strategies for Mizo communities. Implications for practice and policy This study highlights the value of bioactive-rich, locally available food resources (LAFRs) and nontimber forest products (NTFPs) in improving dietary health among Mizoram communities. Wider implications from this study include the following. National and international health policies could integrate bioactive-rich indigenous food resources into public health initiatives and promote dietary diversity and chronic disease prevention. Lessons can be learned from the Indian government's promotion of Ragi (finger millets) to revive the cultivation and consumption of Ragi through midday meal schemes and the Integrated Child Development Services (ICDS) to promote nutritional security and diversified diets. Policy measures could support the inclusion of LAFRs and NTFPs in state and national nutrition programs, enhancing diet quality for children and vulnerable groups. To ensure sustainability, policies could incentivize the responsible cultivation and harvesting of foods that preserve biodiversity and benefit local economies. Integrating LAFRs and NTFPs into community health initiatives provides a practical and culturally resonant approach to improving diet quality. The development of dietary guidelines specific to specific regions could emphasize locally grown bioactive-rich foods to fill dietary gaps. Training local health workers to advocate for traditional foods would support dietary changes that align with local practices and nutritional needs. Public awareness campaigns can highlight the health benefits of these foods, reinforcing their role in cancer prevention and chronic disease management. Collaborative research on bioactive compounds in indigenous foods across regions could provide a solid evidence base for their role in disease prevention. Such efforts align with global health goals and sustainable development goals related to health, food security, and biodiversity, supporting culturally relevant, sustainable health policies worldwide. Adequate research funding is needed to validate health benefits and position relevant indigenous foods as key resources in preventive health. Conclusion The diet diversity of the tribal communities was found to be inadequate in food groups such as fruits and vegetables, dairy products, millet, roots, tubers, nuts, and seeds supported by statistical analysis. The Mizo tribal community was found to be a natural inhabitant and has traditional knowledge of all the natural resources available to them. However, there is a pressing need to address and acknowledge their declining traditional practices, consumption of local food sources, and transition of eating habits and lifestyles, leading to an increased risk of cancer. The identified NTFPs and LAFRs contribute to the potential anticancer properties of various natural solutions, which need to be evaluated and strengthened in the direction of clinical research. Nutritional intervention and community health initiatives need to be aligned with scientific evidence. Harnessing the region's biodiversity and incorporating bioactive-rich nutraceuticals into the diet may enhance overall health and reduce the prevalence of cancer among these communities. This study illustrates the potential of NTFPs and LAFRs to enhance health outcomes through dietary interventions. Further research to validate these findings could strengthen public health strategies in Mizoram, supporting broader efforts to address diet-related chronic diseases. Promoting the consumption of bioactive-rich traditional foods through public health policies can help mitigate cancer incidence and improve overall health outcomes. These policies should encourage the preservation of traditional dietary practices and support community health initiatives that focus on educating populations about the health benefits of these local resources. Further clinical research on the anticancer properties of LAFRs and NTFPs is needed to validate their therapeutic potential and support the development of nutraceuticals. The global relevance of these findings extends beyond Mizoram, as other indigenous populations worldwide face similar dietary challenges. Integrating these foods into national and global cancer prevention strategies could provide a valuable approach to reducing cancer risk and supporting the health of vulnerable communities, aligning with broader sustainability and health goals, such as the Sustainable Development Goals (SDGs). Abbreviations AAR - Age-Adjusted Rate ASIR - Age Standardized Incidence Rate DST - Department of Science and Technology ICMR - Indian Council of Medical Research LAFRs - Locally Available Food Resources NCD - Non-Communicable Diseases NTFPs - Non-Timber Forest Products PBCR - Population-Based Cancer Registry PAHs - Polycyclic Aromatic Hydrocarbons RDA - Recommended Dietary Allowance SDG – Sustainable Development Goals ICDS - Integrated Child Development Service Declarations Ethics approval and consent to participate The study received approval from the Human Ethics Committee of Mizoram University (Approval No. MZU/HEC/2024/001) adhering to ethical guidelines for research involving human participants. The study was explained to the participants before the study. They were informed that all the data would be anonymous and would be reported only in the aggregate. All the participants acknowledged an informed consent statement to participate in the study. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. Competing Interests The authors declare the following financial interests which may be considered potential competing interests : The authors declare that financial support was granted by the Department of Science and Technology (DST), Government of India as part of the project. Funding The authors declare that financial support was granted by the Department of Science and Technology (DST) (Ref. DST/SEED/TSP/STI/2021/457), Government of India as part of the project. Authors’ contributions DP contributed to writing the original draft, review, editing, methodology, investigation, formal analysis, data curation, and conceptualization. JR provided supervision, conceptualization, project administration, and verification, and contributed to writing the original draft and review and editing. PT performed the formal analysis, software and data curation, data analysis, and conceptualization, and contributed to writing the original draft and review and editing. RR contributed to supervision, conceptualization, project administration, verification, and writing the original draft and review and editing. PN provided supervision, conceptualization, project administration, and verification, and contributed to writing the original draft and review and editing. Acknowledgements The authors extend heartfelt gratitude for the funding provided by the Department of Science and Technology (DST), Government of India, for the project: STI Hub for the ST Community, SEED Division (Ref. DST/SEED/TSP/STI/2021/457). We sincerely acknowledge the indispensable support provided by the Principal Investigators (PIs), Dr. Raghu Raman from Amrita Vishwa Vidyapeetham, Kerala, Prof. Lalnilawma Nitea, and Dr. Lalhmingliana Renthlei from Mizoram University, Mizoram. 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Crit Rev Food Sci Nutr. 2013;53(11):1202–1225. doi:10.1080/10408398.2012.692408. Yang Y, Chen H, Lei J, Yu J. Biological activity of extracts and active compounds isolated from Siegesbeckia orientalis L. Ind Crops Prod. 2016;94:288–293. https://doi:10.1016/j.indcrop.2016.08.023. Zeng J, Yu H. Integrated metabolomic and transcriptomic analyses to understand the effects of hydrogen water on the roots of Ficus hirta Vahl. Plants. 2022;11(5):602. https://doi:10.3390/plants11050602. Zhao Y Liu F & Lou H X. Zhong yao cai = Zhongyaocai = Journal of Chinese medicinal materials. 2010; 33(4) 555–556. Zhu H, Li B, Liu C, Chen R. Chemical constituents of Camellia sinensis var. assamica. Chin J Chin Mater Med. 2013. https://doi:10.4268/cjcmm20130925. Zhu J, Du C. Could grape-based food supplements prevent the development of chronic kidney disease? Crit Rev Food Sci Nutr. 2020;60(18):3054–3062. https://doi:10.1080/10408398.2019.1676195. Zhu SH, Zhang QJ, Chen Q, Zhou T, Yao RJ. Zhong yao cai = Zhongyaocai = Journal of Chinese medicinal materials. 2010;33(1) 53–55. Zomawia E, Zami Z, Vanlallawma A, Kumar NS, Zothanzama J, Tlau L, et al. Cancer awareness, diagnosis, and treatment needs in Mizoram, India: Evidence from 18 years trends (2003–2020). Lancet Reg Health Southeast Asia. 2023;17:100281. https://doi:10.1016/j.lansea.2023.100281. Table Table 1 is available in the Supplementary Files section. Additional Declarations Competing interest reported. The authors declare the following financial interests which may be considered potential competing interests: The authors declare that financial support was granted by the Department of Science and Technology (DST), Government of India as part of the project. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5727903","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":398394403,"identity":"79fc48ca-e441-4165-9099-0d9ed1382399","order_by":0,"name":"Devaprasanna Patrick","email":"","orcid":"","institution":"Department of Food Science and Nutrition, Amrita School of Physical Sciences, Coimbatore, Amrita Vishwa Vidyapeetham","correspondingAuthor":false,"prefix":"","firstName":"Devaprasanna","middleName":"","lastName":"Patrick","suffix":""},{"id":398394404,"identity":"3ffc534a-61bc-4328-bf7b-a3ccd040a3fb","order_by":1,"name":"Jancirani Ramaswamy","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIie3PPQrCMBTA8SeFukS6PgnYK1QEP+hlIgVdKngAKQHB1bWgh9Dd4YmgV1Dq4uLkpODiYqwKTomjYP5DPuD9CAGw2X6wAECoDSuA+f1zNZDaexi/IXlt+RozkwbA4dIfNLvjiSycd4tm4klnmTENaUmIeLrGXronh8dHRCQ3CnUkIBC8JLE3QwE8JvUXYnVuINFNkW6Awrk9iE/e1UQ6j1eEIm7+SkDM1RL1l07I1lhN98tRqEh5vnJrramGNIBFGRskvjcZrrKYEq+yGR62Jw0B/yRep4J87o5uPK9IxhGbzWb78+7kXkJ44LmUzQAAAABJRU5ErkJggg==","orcid":"","institution":"Department of Food Science and Nutrition, Amrita School of Physical Sciences, Coimbatore, Amrita Vishwa Vidyapeetham","correspondingAuthor":true,"prefix":"","firstName":"Jancirani","middleName":"","lastName":"Ramaswamy","suffix":""},{"id":398394405,"identity":"f9aedf11-759f-4273-9797-0ffd6db017ec","order_by":2,"name":"T. 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males\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/470ccd449ceb87ee72a233f1.png"},{"id":73252981,"identity":"e0a1b038-84a3-4442-bb50-9ded239abe34","added_by":"auto","created_at":"2025-01-08 08:19:04","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":22733,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFood habits based on workgroups – females\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/79e38260639fd34bd9507af0.png"},{"id":73252963,"identity":"0833b1b7-c59d-4f73-aa98-44dae2f8e7f7","added_by":"auto","created_at":"2025-01-08 08:19:03","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":40175,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFood habits based on age groups—males\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/954497eca410ac86bc22cba8.png"},{"id":73254737,"identity":"2c104f14-7034-467e-a956-3711c3e8d3ae","added_by":"auto","created_at":"2025-01-08 08:27:05","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":52160,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFood habits based on age groups– females\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/d6dc5987efd15aaed996d41e.png"},{"id":74933780,"identity":"ae1c3d44-4c6c-4587-b89f-334ffb50b511","added_by":"auto","created_at":"2025-01-28 12:53:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1311770,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/7bfbbc6e-cb56-467e-adfc-2b3f0cbb98a5.pdf"},{"id":73252962,"identity":"e6746cc5-3105-4e69-bf42-0c3c23a5d6d6","added_by":"auto","created_at":"2025-01-08 08:19:03","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32655,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixTables.docx","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/9778e1b2e0c3e2ff37f67360.docx"},{"id":73252965,"identity":"adddbce9-54a9-4173-bb2e-379e7301df45","added_by":"auto","created_at":"2025-01-08 08:19:03","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":56394,"visible":true,"origin":"","legend":"","description":"","filename":"Table1Top5prioritydietarypreferencesamongtheMizotribes.docx","url":"https://assets-eu.researchsquare.com/files/rs-5727903/v1/e360999bbbd8920e5b8ea6f8.docx"}],"financialInterests":"Competing interest reported. The authors declare the following financial interests which may be considered potential competing interests: The authors declare that financial support was granted by the Department of Science and Technology (DST), Government of India as part of the project.","formattedTitle":"Leveraging the bioactive potential of forest foods to improve dietary diversity and prevent cancer risk in Northeast India","fulltext":[{"header":"Background","content":"\u003cp\u003eIn the current scientific milieu, interest in restoring locally available food resources (LAFRs) and nontimber forest products (NTFPs) and their value has increased owing to their promising therapeutic potential [\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]. Northeast India serves as a reservoir of indigenous knowledge systems encompassing food, agriculture, medicine, and natural resources [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]. The northeast region has garnered attention because of its high biodiversity and prominent conservation agencies worldwide [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMizoram, one of the seven sisters in the northeastern expanse of India, reflects its rich natural resources and ethnic and deep-rooted traditional culture [\u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e]. \"Mizo\" was previously called Lushai. Mizoram has seven major tribes, including Hmar, Paihte, Pawi, Ralte, Lai, Mara, and Lusei, and they are known for their unique food habits, cooking practices, and ethnic culture among the other states of Northeast India [\u003cspan citationid=\"CR111\" class=\"CitationRef\"\u003e111\u003c/span\u003e]. The tribes in this area are known for their wild edibles, forest produce, local foods, and plants for food and other purposes [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Despite these resources, the community faces challenges such as an increasing population and a threat to potable drinking water. The treated water supply in hilly areas such as Mizoram is unavailable, forcing dependence on open sources such as streams and springs for consumption [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. In developing regions, the accumulation of wastewater may involve bacteria and toxic ions, which can be treated with advanced technologies, including nanomaterials and nanocomposites such as Fe\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e-MnO\u003csub\u003e2\u003c/sub\u003e. This process protects water bodies and provides tangible benefits to the health of the population [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite its rich natural resources and vast diversity, Mizoram persistently holds the preeminence of peak Age Standardized Incidence Rate (ASIR) data between 2003 and 2010 in men and women. All instances of cancer analysis within the geographic confines of Mizoram are being vigilantly recorded. According to reports from the Population-Based Cancer Registry (PBCR), between 2012 and 2016, India had the highest incidence of cancer in both sexes particularly in North-East India marking an increase in cancer incidence and deaths [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan citationid=\"CR117\" class=\"CitationRef\"\u003e117\u003c/span\u003e]. In contrast to the second least inhabited state, Mizoram has the highest cancer rate in India [\u003cspan citationid=\"CR148\" class=\"CitationRef\"\u003e148\u003c/span\u003e]. Specifically, in the context of Mizoram, Aizawl presented the highest age-adjusted rate (AAR), 269.4, and a mortality rate of 152.7 among males. Prominently, within the Aizawl district of Mizoram, one out of every four males and one out of every five females are likely to develop cancer in the age groups 0\u0026ndash;74 years [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAmong women, lung cancer is a growing concern, with an incidence rate that is significantly higher than that of men [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Stomach cancer is more common among men, followed by lung, head \u0026amp; neck, colorectal, esophageal, urinary, liver, and prostate cancer. In women, lung cancer is accompanied by breast, cervical, head \u0026amp; neck, stomach, colorectal, liver, esophageal, and ovarian cancers [\u003cspan citationid=\"CR148\" class=\"CitationRef\"\u003e148\u003c/span\u003e]. These cancer rates and prevalence sites highlight the brutal truth of rising cancer cases in Mizoram compared with those in the neighboring states of India.\u003c/p\u003e \u003cp\u003eThe majority of the studies suggest that risk factors such as lifestyle patterns and ethnic dietary practices might be associated with the incidence of cancer in Mizoram. The consumption of locally made tobacco may also be a significant factor in the increasing prevalence of cancer [\u003cspan citationid=\"CR118\" class=\"CitationRef\"\u003e118\u003c/span\u003e]. Studies have shown that the frequent consumption of saum (fermented pork fat), smoked meat, dried and salted fish, and baking soda as an additive increases the probability of \"stomach carcinoma\" and other lifestyle diseases, particularly type 2 diabetes [\u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. High-fat consumption is associated with an increased risk of breast cancer development [\u003cspan citationid=\"CR130\" class=\"CitationRef\"\u003e130\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCancer treated with advanced methods and conventional methods is often accompanied by adverse health effects. Contemporary studies have highlighted the utilization of indigenous plants for treating various types of cancer [\u003cspan citationid=\"CR120\" class=\"CitationRef\"\u003e120\u003c/span\u003e]. A study revealed that the consumption of traditional foods contributes to improved intake of adequate nutrients and dietary diversification [\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e]. Social\u0026ndash;behavioral change with improved knowledge, attitudes, and practices is effective through community-based interventions [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Given the strong associations between lifestyle, dietary practices, and cancer incidence in Mizoram, there is increasing interest in addressing rising health concerns. The region's biodiversity offers a wealth of indigenous plants and traditional foods that are not only central to the diet but also possess significant therapeutic potential. These natural resources, particularly those rich in bioactive compounds, can be harnessed to develop nutraceutical products. Integrating these nutraceuticals into the diet may help mitigate the adverse effects of conventional cancer treatments.\u003c/p\u003e \u003cp\u003e\"Nutraceuticals\" refer to foods or foods that provide various therapeutic advantages, including disease treatment and/or prevention [\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e]. Nutraceuticals contain active phytochemicals that can be consumed as dietary boosters or incorporated into functional foods, offering health benefits that surpass those of basic nutrition [\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]. They are believed to bolster human health and increase life expectancy, along with many other mechanisms that putatively prevent chronic diseases [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Carotenoids, polyphenols, phytosterols, phenolic acids, antioxidant vitamins, etc., are bioactive compounds that have provided great insights into the prevention of chronic diseases [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMizoram tribal communities were mostly timberland inhabitants who depended on shifting cultivation, hinging on timber, non\u0026ndash;timber, and local foods for sustenance [\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e]. Rural areas such as Mizoram often lack advanced medical facilities, with health centers being sparse, and instead, they rely on community health workers. This reliance and limited access may even lead to mortality due to a lack of awareness and delayed diagnosis [\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]. However, given its eclectic botanical origins and traditional practices, Mizoram provides promising possibilities for exploring the nutraceutical and anticancer potential of local food resources and nontimber forest resources. The dependence on these natural resources may not only bridge nutritional gaps but also help lay the foundation for improved consumption of potentially rich functional foods. While previous studies have focused on cancer diagnosis and conventional treatment, this study addresses this gap by exploring the potential of nontimber forest products (NTFPs) and locally available food resources (LAFRs) in mitigating cancer incidence. This highlights the nutraceutical bioactive-rich potential of natural resources as a complementary strategy to enhance health outcomes and reduce the risk of cancer and other chronic diseases within Mizoram's tribal community. Assessing dietary diversity and quality plays a crucial role in designing nutritional interventions, promoting nutritional security, and supporting sustainable food production [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Sustainable Developmental Goals (SDGs), initiated by the United Nations in 2015, comprise 17 broad objectives to address challenges such as eradicating poverty, climate change, inequality, and environmental disintegration to foster prosperity, peace, and justice within the community [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. SDG 3, one of these goals, focuses on ensuring good health and well-being for people of all ages. This initiation is successful with coordinated efforts to address interconnected challenges by providing awareness, direct engagement, training, and support. Accordingly, our paper focuses on SDG 3, \"good health and well-being\" and the strategy focuses on highlighting the importance of natural resources that can help reduce chronic disease rates and enhance the overall health of the community.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eSubjects\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted among selected Mizo tribal communities, including Hmar, Lusei, Ralte, Lai (Pawi), and Mara (Lakher), residing in the Aizawl district. A random sampling method was adopted with a total of 170 (78 females and 92 males) participants aged 27-54 years for the evaluation of diet diversity. The subjects were represented by various professions, such as school teachers, college lecturers, university professors, doctors, drivers, skilled workers, Maids, and homemakers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria for the human subjects in the study focused on capturing dietary habits during adulthood and middle age from selected Mizo tribal communities aged 27-54 years, as these age groups are critical for understanding their health conditions, particularly their cancer prevalence and risk factors. Individuals from non-Mizo tribes and those outside this age range were excluded to focus on the target population and minimize variability in dietary patterns, lifestyle practices, and health conditions that could influence cancer risk at different life stages.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design and settings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data documentation and background analysis were conducted by developing a self-structured survey tool and tested randomly on a pilot basis with 20 people. A focus group discussion was subsequently conducted among 170 individuals to extrapolate the data and assess any ambiguities during the study. The current study used a mixed-method approach involving the 24-hour recall method to assess the diet diversity of the Mizo tribes and compared it with the RDA-Recommended Dietary Allowance 2020 (ICMR-Indian Council of Medical Research). The diet survey questionnaire also included questions to elicit information on eating habits, cooking practices, and lifestyle factors practiced by the selected tribes. Statistical analysis was carried out in this study to understand the actual intake of food groups compared with the ICMR recommendation. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAdditionally, the above study was supported by a scientific review investigating the available LAFRs and NTFPs around the Mizo tribal habitats. The relevant literature (original/review) was retrieved via digital sources such as Scopus, Lancet, ResearchGate, PubMed, Google Scholar, Science Direct, etc. The keywords used for the search were \u0026quot;Locally Available Food Resources\u0026quot;, \u0026quot;Nontimber Forest Products\u0026quot;, \u0026quot;Nutraceuticals\u0026quot;, \u0026quot;Functional Properties\u0026quot;, \u0026quot;Bioactive compounds\u0026quot;, \u0026quot;Anti-cancer properties\u0026quot;, \u0026quot;Ethnomedicinal plants\u0026quot;, \u0026quot;Anti-tumorous properties\u0026quot;, \u0026quot;Noncommunicable Diseases\u0026quot; and \u0026quot;Anticancer plants\u0026quot;. The acronyms \u0026quot;AND\u0026quot; and \u0026quot;OR\u0026quot; were included in the keyword search. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria explored the NTFPs and LAFRs found in and around the locality of the Mizoram tribes, study methods, findings, anticancer properties, and bioactive compounds of the identified plants. Studies not focused on anticancer properties, populations outside the selected Mizo tribes, and publication years not between 2000 and 2023 were excluded. From an initial collection of more than 140 scientific papers, only 121 papers meeting the inclusion criteria were considered for data extraction. The collected data were consolidated in the form of a table categorizing 60 identified LAFRs and 25 NTFPs, which serve as a promising reference to identify the research gap for further exploration and utilization of these natural resources for therapeutic potential in cancer prevention and treatment.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study advocates understanding the diet preferences (Table 1) and food group consumption (Table 2) prevailing practices related to lifestyle, eating, and cooking practices (Table 3). Statistical analysis was conducted to compare the intake of ten food groups with ICMR standards across different age groups and work groups (Figures 1,2, 3, 4, 5, and 6). Additionally, an attempt was made to review the availability of the LAFRs (Appendix Table 1) and NTFPs (Appendix Table 2) with their anticancer properties in and around their locality. This study explored bioactive compounds and their potential use in mitigating the risk of cancer incidence.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eImpact on dietary preferences\u003c/h2\u003e\n\u003cp\u003eThe present study examined the dietary preferences of the selected tribes on the basis of their prioritized food options throughout the day for a week. Their top priority food options include Sawhchiar (Mizo fried rice), tea with bread, and snacks mostly sticky rice cakes and deep-fried items. The diet lacks milk and milk products with a limited intake of fruits and is mostly rich in carbohydrates and fats. \u0026nbsp;Table 1 shows the dietary preferences of the local Mizo tribes.\u003c/p\u003e\n\u003ch2\u003eImpact on Food Group Consumption among Mizo Tribal Communities\u003c/h2\u003e\n\u003cp\u003eThe dietary habits of the Mizo tribes were assessed for three consecutive days and compared with ICMR, the recommended dietary allowance, 2020. Men and women exhibited significant disparities between their actual intake and the RDA. Significant deficits were observed in milk and milk products, other vegetables, fruits, roots and tubers, nuts, and seeds. The consumption of cereals, animal foods, fats, and oils was excessively high compared with that of other food groups. The intake of green leafy vegetables exceeded the ICMR recommendations. Millets were excluded because they were not commonly available in Mizoram. They were neither consumed nor produced. Studies have shown that emphasizing millet consumption in the community will enable food security among the population [80]. \u0026nbsp;Table 2 lists the food group consumption of the Mizo tribes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Food group consumption of Mizo tribes for 3 consecutive days (n=170 adults)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFood Groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale n = 92 Nos (27 \u0026ndash; 54yrs)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale n = 78 Nos (27 \u0026ndash; 54yrs)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eICMR\u003cbr\u003e\u0026nbsp;RDA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(g/day)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eActual intake (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%Excess\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e/Deficit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eICMR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRDA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(g/day)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eActual intake (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%Excess/\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDeficit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eMilk \u0026amp; milk products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;-88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eCereals \u0026amp; millets\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e+1.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; +4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eOther Vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;-47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eRoots and tubers (excluding potato)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-58.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;-65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eGreen leafy vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;+14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; +9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eFruits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-85.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eAnimal foods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e+20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e+11.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003ePulses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eFats and oils\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e+8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e+13.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eNuts and seeds\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-63.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eSource:\u003c/strong\u003e ICMR-NIN Expert Group on Nutrient Requirements for Indians, Recommended Dietary Allowances (RDAs) and Estimated Average Requirements (EAR) \u0026ndash; 2020\u003cbr\u003e\u0026nbsp;*Notes: Millets were excluded from food group consumption because they are not commonly available in Mizoram.\u003c/p\u003e\n\u003cp\u003eFoods such as fruits, vegetables, and whole grains significantly reduce the risk of chronic diseases, improve immunity, and lower infections. Owing to lifestyle risk factors such as physical inactivity, hypertension, and obesity, the Mizo tribal population is susceptible to high risks of developing cardiovascular diseases in the future [79]. A recent study of food group consumption among tribal groups revealed that the population mostly consumed less than three-fourths of their daily requirements compared with the RDA [102]. Nutritional deficiencies and excesses are due to a lack of knowledge of the significance of diet diversity. Dietary interventions and behavioral changes are needed in the community to combat nutritional deficiencies and prevent conditions such as obesity, diabetes, and chronic diseases.\u003c/p\u003e\n\u003ch2\u003eFood group consumption status compared with ICMR standards\u003c/h2\u003e\n\u003cp\u003eA hypothesis t-test was performed at the 5% significance level to check whether the actual intake of the sample tribal population aligns with the ICMR recommendations. Twenty different t-tests were conducted for each of the ten food groups in the study, considering gender-specific populations. The tests were carried out using Stats. Blue, an online statistical tool. The tests for both genders revealed statistically that milk and milk products, other vegetables, fruits, pulses, roots and tubers, nuts, and seeds consumed less than the ICMR recommendations. \u0026nbsp;Green leafy vegetable consumption was higher than the recommended level. A similar study was conducted among Oraon tribes, highlighting their considerable consumption of tubers, vegetables, and green leafy vegetables [8]. Although cereal consumption seemed higher, the tests statistically concluded that the difference was insignificant compared with the ICMR recommendation. The consumption of animal-based foods was greater in males, whereas females consumed foods closer to the ICMR recommendation. Males consumed fats and oils at the recommended level, whereas females consumed more than the recommended level. The results of this discussion are illustrated in Figures 1 and 2.\u003c/p\u003e\n\u003cp\u003eIt is reasonable to study the differences in food habits on the basis of the nature of the work one does. The male and female populations were categorized as sedentary, moderate, and hard workers, respectively. One-way ANOVA was conducted to understand the possible differences between various work groups of males and females individually. The interesting observations revealed by ANOVA performed on the male and female populations separately are presented. In the case of the male population, the differences between the work groups in all ten considered food groups were evident by mere observation. However, it is essential to present the microscopic details of the consumption habits of various work groups individually for all ten food groups. The observations are given accordingly.\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003cbr\u003eThe consumption of milk and milk products, roots and tubers, fruits, and pulses in the moderate work group was lower than that in the other two work groups, and none of the workgroups met the ICMR recommendation. The consumption of cereals by heavy workers is slightly greater than that of the other two work groups, and the overall consumption is in line with the ICMR recommendation. The consumption of other vegetables varies across workgroups and is below the ICMR recommendation. The consumption of green leafy vegetables by moderate-level workers was lower than that by the other two workers. However, moderate workers consume marginally less, and heavy workers consume slightly higher amounts and are statistically closer to the ICMR recommendation. Interestingly, overall consumption exceeds the ICMR recommendation because of higher consumption by the sedentary workgroup. There is no difference between the work groups in terms of the consumption of nuts and seeds, and consumption is below the ICMR recommendation. The consumption of animal foods by the moderate workgroup meets the ICMR recommendation, whereas the other two work groups consume foods above the ICMR recommendation. The consumption of fats and oils by all workgroups is up to the recommendation of the ICMR. In the case of females, there were significant differences among the sedentary and moderate workers for eight of the considered food groups except for the consumption of fats and oils, nuts, and seeds. The consumption of fats and oils by females is slightly greater than the ICMR recommendation. However, the moderate workgroup consumes green leafy vegetables and animal foods per the ICMR recommendation. The results of the above discussion are depicted in Figures 3 and 4.\u003c/p\u003e\n\u003cp\u003eAge-wise analysis categorized males and females into three groups: 40 years and younger, 41\u0026ndash;50 years, and older than 50 years. Among males, no significant differences in food group consumption were observed across age groups. For females, significant differences were found in the consumption of milk and milk products, other vegetables, animal foods, and pulses among the age groups. Females aged 50 and above consumed animal foods in line with ICMR recommendations, whereas younger groups exceeded the recommended intake. The results of the above discussion are presented in Figures 5 and 6.\u003c/p\u003e\n\u003ch2\u003eImpact on the prevailing practices among the Mizo tribes\u003c/h2\u003e\n\u003cp\u003eThe comparative analysis conducted in the present study revealed both good and wrong practices among the Mizo people. These good practices contribute to their health, environment, and future, showcasing their culture\u0026apos;s value for minimizing food waste and respecting traditional practices. Living close to nature in a less polluted environment reflects their deep-rooted respect for nature. However, social transition, urbanization, and alternate livelihoods have increased purchasing power and shifted more unhealthy practices, leading to various non-communicable diseases (NCDs). Pervasive lifestyle factors such as a sedentary lifestyle, stress, and less physical activity may increase the risk of cancer. The emerging reliance on instant and packaged foods not only nullifies health benefits but also deteriorates safer and healthier cooking practices. This serious shift in practice needs to be effectively addressed through community knowledge interventions and social and behavioral change practices to alleviate various disease conditions. The good and bad prevailing practices are presented in Table 3 below.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 Good and bad prevailing practices recorded among the Mizo tribal community (n=170 adults)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood Practices\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBad Practices\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"9\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEating Habits\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eIntake of Local Produce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eHigh Salt Intake\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eConsumption of Green leafy vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eExcessive Sugar Consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eConsumption of Bai (Boiled Vegetables)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eProcessed Foods\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eConsumption of fermented foods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eSkipping Meals\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eModerate use of spices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eUnbalanced Snacking\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003ePreparation and usage of ash filtrate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eUse of commercial baking soda\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eLow oil consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eIncreased use of saum (Fermented pork fat)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eUtilization of seasonal resources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eSmoked meat consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eIntake of a variety of protein sources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eLess intake of fruits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLifestyle Factors\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eUtilization of traditional food preservation technique\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eSedentary Lifestyle\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003ePromotion of Home gardening\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eAlcohol and Substance Abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003ePurchase of Local produce to support local farmers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eStress\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eLiving close to nature with less pollution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eSmoking\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003ePractice of sustainable resource management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eLess physical activity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCooking Practices\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eUtilization of Fresh Ingredients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eDeclining traditional cooking practices such as foraging of wild ingredients, traditional preservation methods, steaming of bamboo, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 273px;\"\u003e\n \u003cp\u003eBoiling, steaming, grilling, and stewing methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 254px;\"\u003e\n \u003cp\u003eEmerging Reliance on Packaged Foods\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eA similar study revealed that the unique diet and lifestyle habits of Mizoram, such as fermented pork fat, smoked meat, and excessive use of salt, combined with habits such as nicotine water and betel leaves with raw areca nuts and excess lime chewing, significantly influence the risk of various diseases [89]. The use of ash filtrate (from burnt crop residue) in their diet to improve flavour and reduce cooking time has potential dietary implications because of its alkaline nature. Prolonged exposure to harmful compounds such as polycyclic aromatic hydrocarbons (PAHs) from burnt crop residue may increase the incidence of cancer [88, 22].\u003c/p\u003e\n\u003cp\u003eObservations from a study highlighted higher rates of tobacco use, excessive alcohol consumption, and poor lifestyle habits among the tribal population, leading to an increase in noncommunicable diseases (NCDs) [76]. NCDs such as diabetes, hypertension, cancer, and cardiometabolic diseases have become more prevalent, and India\u0026apos;s healthcare system must adopt well-defined preventive and control strategies to address this challenge effectively [91]. Additionally, Mizoram\u0026apos;s incidence of stomach cancer, the highest in India, seems to be linked to lifestyle factors and poor prevailing practices [95]. Given that Mizoram has the highest incidence of cancer in India and the possibility of increased risk of cancer incidence due to lifestyle and eating habits, it is crucial to consider preventive strategies. To address these challenges, this review explored the nutraceutical and anticancer properties of NTFPs and the LAFRs of Mizoram as promising natural solutions to mitigate the adverse effects linked to identified risk factors. Incorporating NTFPs and LAFRs into the diet could offer a valuable supplement for reducing cancer incidence and enhancing health outcomes among Mizo tribal populations. The subsequent tables summarize the bioactive compounds and the potential roles of the identified NTFPs and LAFRs.\u003c/p\u003e\n\u003ch2\u003eNutraceutical and anticancer properties of LAFRs\u003c/h2\u003e\n\u003cp\u003eThis review identifies LAFRs within the reach of the Mizo tribal community, aligns their bioactive compounds/compound classes, and promotes them as anticancer agents for potential therapeutic uses. LAFRs are readily available, free of cost, and significantly contribute to enhancing the overall well-being of the community [51]. The table shows that bioactive compounds such as flavonoids, polyphenols, and terpene alkaloids present in the identified plants are associated with potential anticancer properties. Several studies have highlighted the presence of bioactive compounds that are known to exhibit potential anticancer effects. Although few plants have been connected to address specific types of cancers, further in-depth studies are needed to confirm their efficacy. Furthermore, LAFRs rich in bioactive compounds underscore the importance of natural remedies with anticancer potential for the prevention of cancer. The study organizes bioactive compounds found in NTFPs and LAFRs on the basis of their cancer-preventive potential, grouping them based on their primary bioactive functions, such as antioxidative, anti-inflammatory, and apoptosis-inducing effects. Table 1 presents the identified LAFRs with their bioactive compounds/compound classes.\u003c/p\u003e\n\u003cp\u003eThe reader is referred to Table 1 in the Appendix for the\u0026nbsp;lists of LAFRs, bioactive compounds/compound classes, and their potential usage.\u003c/p\u003e\n\u003ch2\u003eNutraceutical and anticancer properties of NTFPs\u003c/h2\u003e\n\u003cp\u003eNTFPs are resources that exist naturally within forest ecosystems but are not typically cultivated [124]. These NTFPs contribute significantly to tribal populations that depend on their biodiversity, local consumption, sales, and livelihood diversification. NTFPs, which are rich in bioactive compounds such as terpenes, flavonoids, and phenolic acids, offer the potential to address various types of cancer, such as lung, liver, breast, and colon cancer, associated with environmental and lifestyle factors. These bioactive compounds complement conventional treatments by mitigating treatment aftereffects, improving treatment outcomes, and enhancing the overall well-being of cancer patients. Table 2 presents the identified NTFPs with their bioactive compounds/compound classes.\u003c/p\u003e\n\u003cp\u003eThe reader is referred to Table 2 in the Appendix for the\u0026nbsp;lists of NTFPs, bioactive compounds/compound classes, and their potential usage.\u003c/p\u003e\n\u003cp\u003eA total of 60 LAFRs and 25 NTFPs plant species of Mizoram have been explored, which offer promising potential anticancer compounds. The predominant methods of consumption, preparation, and parts that were observed in the original study retrieved various approaches, including decoction, paste, raw form, and other methods such as maceration and oil [58]. Owing to a lack of knowledge of the functional properties and active compounds, the incorporation of these sources into the diet has been limited. Limitations in the consumption of a variety of foods and the inefficient use of local foods are further averse to the health of the tribal community [70]. A literature review of the bioactive compounds in these LAFRs and NTFPs indicates that the regular consumption of these compounds has anticancer effects and lowers the risk of developing certain cancers. Traditional foods prepared from LAFRs and NTFPs exhibit medicinal properties that offer potential health benefits and therapeutic uses from their natural components [51]. However, research and clinical findings are needed to explore the efficacy and safety of cancer incidence and treatment.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe Mizo community did not habitually consume a meal (lunch) in the afternoon. Instead, they consume snacks and other highly processed foods as their lunch option. Most of the food items consumed by the selected tribes were high in carbohydrates and fat, with a limited intake of fruits. Notably, their diet lacks milk and milk products. Meat consumption and highly processed foods emerged as top-priority options. Despite this, it is preferable to observe the consumption of green leafy vegetables and other vegetables in their diet. However, the combination of less physical activity along with high consumption of animal fats, fermented foods, smoked meat, and processed food items such as noodles, bread, and biscuits poses an increased risk of chronic diseases. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMilk and milk products, other vegetables, fruits, roots and tubers, nuts, and seeds have notable deficits, whereas excessive cereals, animal foods, fats, and oils have been observed in the diet. Notably, the consumption of green leafy vegetables was greater among men and women. Millet was excluded from food group consumption because it is not commonly available in Mizoram. Millet is neither produced nor consumed, with rice being their staple food. Culture and urban development were also reasons for the shift in cultivation and consumption. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStatistical analysis revealed a significant deficit in food group intake compared with the ICMR recommendations. In males, sedentary workers consumed more green leafy vegetables whereas heavy workers consumed cereals closer to ICMR recommendations. There were no significant differences between the sedentary and moderate workers among the females except for the intake of fats and oils, nuts, and seeds. The consumption of certain groups such as Green leafy vegetables, cereals, animal foods, and other vegetables was found to be higher among heavy workers, followed by sedentary workers whereas moderate workers consumed up to the recommended level or less than the recommended level. There were no significant differences in food group consumption among males across age groups. \u0026nbsp;Age-wise differences were observed, with females aged 50 years and above consuming animal foods closer to the ICMR recommendations compared to younger age groups who exceeded the recommended intake. Traditional food practices such as the use of ash filtrate in place of baking soda, home gardening, and the consumption of probiotic-rich fermented foods are extremely good practices. However, lifestyle changes, including increased consumption of processed foods, high salt intake, and lack of physical activity, are leading to an increase in noncommunicable diseases.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA recent study highlighted the NCD prevalence among tribal populations, with Mizoram facing various cancers due to lifestyle factors and poor dietary diversity. Given these prevalences, a review was conducted to explore the bioactive-rich LAFRs and NTFPs that address cancer risk. Limitations: This study\u0026apos;s cross-sectional design limits conclusions between dietary habits and cancer incidence. The survey\u0026apos;s self-reported dietary data may be subject to recall bias. Additionally, as this sample represents only specific Mizo tribal communities, generalizability to other populations may be constrained. Future longitudinal studies and randomized trials are planned to substantiate these findings and strengthen the applicability of nutraceutical interventions. These natural resources offer potential preventive strategies for Mizo communities.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplications for practice and policy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study highlights the value of bioactive-rich, locally available food resources (LAFRs) and nontimber forest products (NTFPs) in improving dietary health among Mizoram communities. Wider implications from this study include the following.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNational and international health policies could integrate bioactive-rich indigenous food resources into public health initiatives and promote dietary diversity and chronic disease prevention. Lessons can be learned from the Indian government\u0026apos;s promotion of Ragi (finger millets) to revive the cultivation and consumption of Ragi through midday meal schemes and the Integrated Child Development Services (ICDS) to promote nutritional security and diversified diets. Policy measures could support the inclusion of LAFRs and NTFPs in state and national nutrition programs, enhancing diet quality for children and vulnerable groups.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo ensure sustainability, policies could incentivize the responsible cultivation and harvesting of foods that preserve biodiversity and benefit local economies. Integrating LAFRs and NTFPs into community health initiatives provides a practical and culturally resonant approach to improving diet quality. The development of dietary guidelines specific to specific regions could emphasize locally grown bioactive-rich foods to fill dietary gaps. Training local health workers to advocate for traditional foods would support dietary changes that align with local practices and nutritional needs. Public awareness campaigns can highlight the health benefits of these foods, reinforcing their role in cancer prevention and chronic disease management.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCollaborative research on bioactive compounds in indigenous foods across regions could provide a solid evidence base for their role in disease prevention. Such efforts align with global health goals and sustainable development goals related to health, food security, and biodiversity, supporting culturally relevant, sustainable health policies worldwide. Adequate research funding is needed to validate health benefits and position relevant indigenous foods as key resources in preventive health.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe diet diversity of the tribal communities was found to be inadequate in food groups such as fruits and vegetables, dairy products, millet, roots, tubers, nuts, and seeds supported by statistical analysis. The Mizo tribal community was found to be a natural inhabitant and has traditional knowledge of all the natural resources available to them. However, there is a pressing need to address and acknowledge their declining traditional practices, consumption of local food sources, and transition of eating habits and lifestyles, leading to an increased risk of cancer. The identified NTFPs and LAFRs contribute to the potential anticancer properties of various natural solutions, which need to be evaluated and strengthened in the direction of clinical research. Nutritional intervention and community health initiatives need to be aligned with scientific evidence. Harnessing the region's biodiversity and incorporating bioactive-rich nutraceuticals into the diet may enhance overall health and reduce the prevalence of cancer among these communities. This study illustrates the potential of NTFPs and LAFRs to enhance health outcomes through dietary interventions. Further research to validate these findings could strengthen public health strategies in Mizoram, supporting broader efforts to address diet-related chronic diseases.\u003c/p\u003e \u003cp\u003ePromoting the consumption of bioactive-rich traditional foods through public health policies can help mitigate cancer incidence and improve overall health outcomes. These policies should encourage the preservation of traditional dietary practices and support community health initiatives that focus on educating populations about the health benefits of these local resources. Further clinical research on the anticancer properties of LAFRs and NTFPs is needed to validate their therapeutic potential and support the development of nutraceuticals. The global relevance of these findings extends beyond Mizoram, as other indigenous populations worldwide face similar dietary challenges. Integrating these foods into national and global cancer prevention strategies could provide a valuable approach to reducing cancer risk and supporting the health of vulnerable communities, aligning with broader sustainability and health goals, such as the Sustainable Development Goals (SDGs).\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eAAR -\u0026nbsp;\u003c/strong\u003eAge-Adjusted Rate\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eASIR -\u0026nbsp;\u003c/strong\u003eAge Standardized Incidence Rate\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDST -\u0026nbsp;\u003c/strong\u003eDepartment of Science and Technology\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eICMR -\u0026nbsp;\u003c/strong\u003eIndian Council of Medical Research\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLAFRs -\u0026nbsp;\u003c/strong\u003eLocally Available Food Resources\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNCD -\u0026nbsp;\u003c/strong\u003eNon-Communicable Diseases\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNTFPs -\u0026nbsp;\u003c/strong\u003eNon-Timber Forest Products\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePBCR -\u0026nbsp;\u003c/strong\u003ePopulation-Based Cancer Registry\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePAHs -\u0026nbsp;\u003c/strong\u003ePolycyclic Aromatic Hydrocarbons\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRDA -\u0026nbsp;\u003c/strong\u003eRecommended Dietary Allowance\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSDG \u0026ndash;\u0026nbsp;\u003c/strong\u003eSustainable Development Goals\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eICDS\u003c/strong\u003e- Integrated Child Development Service\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003econsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received approval from the Human Ethics Committee of Mizoram University (Approval No. MZU/HEC/2024/001) adhering to ethical guidelines for research involving human participants. The study was explained to the participants before the study. They were informed that all the data would be anonymous and would be reported only in the aggregate. All the participants acknowledged an informed consent statement to participate in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare the following financial interests which may be considered potential competing interests\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eThe authors declare that\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efinancial support was granted by the Department of Science and Technology (DST), Government of India as part of the project.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efinancial support was granted by the Department of Science and Technology (DST) (Ref. DST/SEED/TSP/STI/2021/457), Government of India as part of the project.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDP contributed to writing the original draft, review, editing, methodology, investigation, formal analysis, data curation, and conceptualization. JR provided supervision, conceptualization, project administration, and verification, and contributed to writing the original draft and review and editing. PT performed the formal analysis, software and data curation, data analysis, and conceptualization, and contributed to writing the original draft and review and editing. RR contributed to supervision, conceptualization, project administration, verification, and writing the original draft and review and editing. PN provided supervision, conceptualization, project administration, and verification, and contributed to writing the original draft and review and editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors extend heartfelt gratitude for the funding provided by the Department of Science and Technology (DST), Government of India, for the project: STI Hub for the ST Community, SEED Division (Ref. DST/SEED/TSP/STI/2021/457). We sincerely acknowledge the indispensable support provided by the Principal Investigators (PIs), Dr. Raghu Raman from Amrita Vishwa Vidyapeetham, Kerala, Prof. Lalnilawma Nitea, and Dr. Lalhmingliana Renthlei from Mizoram University, Mizoram. We are also indebted for the support extended by the Co-Principal Investigators (Co-PIs) Dr. Prema Nedungadi from Amrita Vishwa Vidyapeetham, Kerala, and Dr. Baby Zaithanpuii Hmar from Mizoram University, Mizoram. Special thanks to the project coordinators, Mr. Pushkar Joshi from Amrita Vishwa Vidyapeetham, Kerala, and Ms. Janet Lalremruati from Mizoram University, Mizoram, for their dedicated support throughout the project.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdel-Lateef E Mahmoud F Hammam O El-Ahwany E El-Wakil E Kandil S et al Bioactive chemical constituents of Curcuma longa L Rhizomes extract to inhibit the growth of the human hepatoma cell line (hepg2) Acta Pharm (Zagreb Croatia) 2016;66(3):387\u0026ndash;98. https://doi.org/10.1515/acph-2016-0028.\u003c/li\u003e\n\u003cli\u003eAgrahar-Murugkar D Subbulakshmi G Preparation techniques and nutritive value of fermented foods from the Khasi tribes of Meghalaya Ecol Food Nutr 2006;45(1):27\u0026ndash;38. https://doi.org/10.1080/03670240500408336.\u003c/li\u003e\n\u003cli\u003eAkhter N Alam M Amin Khan MR Sharmin S Emon NU Bakar Siddique MA et al Therapeutic potentials of Adenostemma lavenia (L) OKuntze evidenced into an array of pharmacological effects and ligand‒receptor interactions Heliyon 2023;9(4). https://doi.org/10.1016/j.heliyon.2023.e15541.\u003c/li\u003e\n\u003cli\u003eAsati BS Yadav DS Diversity of horticultural crops in the northeastern region ENVIS Bull Himalayan Ecol 2004;12(1):1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eAzizan A Xin LA Abdul Hamid NA Maulidiani M Mediani A Abdul Ghafar SZ et al Potentially bioactive metabolites from pineapple waste extracts and their antioxidant and \u0026alpha;-glucosidase inhibitory activities by 1H NMR Foods 2020;9(2):173. https://doi.org/10.3390/foods9020173.\u003c/li\u003e\n\u003cli\u003eBabu PAS Aafrin BV Archana G Sabina K Sudharsan K Krishnan KR et al Polyphenolic and phytochemical content of Cucumis sativus seeds and study on the mechanism of preservation of nutritional and quality outcomes in enriched mayonnaise Int J Food Sci Technol 2016;51(6):1417\u0026ndash;24. https://doi.org/10.1111/ijfs.13109.\u003c/li\u003e\n\u003cli\u003eBatiha GES Beshbishy AM Elewa Y Taha A Chemical constituents and pharmacological activities of garlic (Allium sativum L): a review Nutrients 2020;12(872). https://doi.org/10.3390/nu12030872.\u003c/li\u003e\n\u003cli\u003eBisai S Dutta S Mohapatra PKD Traditional food consumption pattern and nutritional status of Oraons: An Asian Indian indigenous community Front Sustain Food Syst 2023;7(969264).\u003c/li\u003e\n\u003cli\u003eBora NS Kakoti BB Gogoi B Goswami AK Ethno-medicinal claims phytochemistry and pharmacology of Spondias pinnata: a review Int J Pharm Sci Res 2014;5:1138\u0026ndash;45. https://doiorg/1013040/IJPSR0975-82325(4).\u003c/li\u003e\n\u003cli\u003eCamarda L Di Stefano V Del Bosco SF Schillaci D Antiproliferative activity of citrus juices and HPLC evaluation of their flavonoid composition Fitoterapia 2007;78(6):426\u0026ndash;9. 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Cancer awareness, diagnosis, and treatment needs in Mizoram, India: Evidence from 18 years trends (2003\u0026ndash;2020). Lancet Reg Health Southeast Asia. 2023;17:100281. https://doi:10.1016/j.lansea.2023.100281.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nutraceuticals, Bioactive compounds, Non-timber Forest Products, Anticancer, Local Food Resources, Dietary diversity, Forest foods","lastPublishedDoi":"10.21203/rs.3.rs-5727903/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5727903/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eNatural solutions are increasingly sought for their potential to harness locally available food resources (LAFRs) and nontimber forest products (NTFPs) to reduce cancer risk among the Mizo tribal communities in Aizawl, Mizoram, India. Given that the prevalence of cancer is greater than that in neighboring states, understanding the dietary practices of these communities and leveraging local resources for their anticancer properties are critical. This study highlights the need to mitigate cancer incidence through improved dietary diversity and the incorporation of natural resource-based bioactive-rich foods, which aligns with Sustainable Development Goal 3 (good health and well-being).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA mixed-method approach was employed, combining structured questionnaires and focus group discussions to assess diet diversity among 170 Mizo tribes (78 females and 92 males) aged 27\u0026ndash;54 years. Data collection included 24-hour dietary recall over seven consecutive days. Statistical analysis compared the actual intake of ten food groups with the Indian Council of Medical Research (ICMR) recommendations.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThis study revealed significant inadequacies in diet diversity among the Mizo tribes. Additionally, a comprehensive review of 121 scientific papers examined the anticancer properties of LAFRs and NTFPs. The review identified 60 LAFRs and 25 NTFPs demonstrating promising anticancer properties that require further clinical studies.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn conclusion, aligning nutritional interventions and community health initiatives with scientific evidence is essential. Leveraging the region's biodiversity and incorporating bioactive-rich nutraceuticals into the diet may improve overall health and reduce the incidence of cancer among these communities.\u003c/p\u003e","manuscriptTitle":"Leveraging the bioactive potential of forest foods to improve dietary diversity and prevent cancer risk in Northeast India","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-08 08:18:57","doi":"10.21203/rs.3.rs-5727903/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6feac790-4459-4f62-9465-162409e51722","owner":[],"postedDate":"January 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-28T12:53:24+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-08 08:18:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5727903","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5727903","identity":"rs-5727903","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}