Background: Food and nutrition security continued to be a significant concern in the global food system. However, this system is not delivering optimal nutrition and health outcomes. Most low- and middle-income countries are burdened by persistent undernutrition and recently growing overweight and diet-related non-communicable diseases. One of the mechanisms for addressing this nutrition paradox is understanding consumers’ food choices and preferences. Thus, this study’s objective was to assess the patterns and trends of food consumption in a developing country context: the case of Amhara region, Ethiopia, and to identify market-based interventions involving specific foods and groups. Methods: A household-based cross-sectional study and multistage sampling technique were used to select study participants and collect data. A structured questionnaire was used for data collection, and the study adopted a descriptive research approach and a mix of complementary qualitative and quantitative methods in its analysis. A Household Dietary Diversity Score (HDDS) to describe the respondents’ food consumption pattern was used in the study. Results: Following FAO (2010)’s guideline, the HDDS score was calculated based on the intake of 12 food groups using a week recall data. The average HDDS was 8.5 out of 12 food groups. The average HDDS was relatively high, which might be related to the week recall in our data measurement period. Conclusion: This report seeks to understand consumers’ behavior by investigating several aspects of food choices, including household dietary diversity and food expenditures. The study also provides insights for researchers to further investigate the issue by adding other scientific databases and methods to draw more meaningful and implementable conclusions. Limitations: Although the sampling procedure was random, it might not be representative to study the patterns and trends of food consumption at a country or broad level due to its small size.

Background: The food system is an interdisciplinary global issue with substantial social and economic challenges. These challenges are most pronounced in developing countries, where chronic under-nutrition is prevalent. The long-standing notion has been to solve malnutrition and undernutrition primarily from the supply side through improving productivity and production. Nevertheless, addressing the nutrition paradox requires understanding consumers' food choices and its drivers. Methods: This study forms a part of a research project conducted in the ANRS, Ethiopia, in both urban and rural settings. To select study participants and collect data from the ANRS metropolitan cities, we used a household-based cross-sectional study and a multistage sampling technique. Data were collected using a structured questionnaire, and the study used a descriptive research method and a quantitative research approach in its analysis. PCA was used to identify which topics in the food system are most important to consumers. Results: To identify widely held consumer interests, respondents were asked to report their interest in several relevant topics. The results show that food systems' external impact, food safety, food nutrition, impact of other bodies on the food system, and food supply sustain ability are the most crucial food topics where consumers are interested. Conclusion: Concerned stakeholders who can help enhance household dietary practices in the study area; producers and other stakeholders who care about environmental sustainability and/or social values might use this information to adjust their production and marketing decisions to align with the food system topics that consumers identified as their priority. Limitations: While the PCA allows for the reduction of multiple indices into a single composite index, it may restrict the targeting of a particular aspect of the food system topic. As a result, the indices' meaning, and implications should be made while keeping the downsides in mind.

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