Food systems undergo rapid changes in response to economic and market forces, and environmental and dietary changes. This study aimed to disentangle adaptation strategies in farm households balancing interests in the commercial aspects of farming and the consumption of nutritious foods. The area of interest was Central Myanmar, Pakokku region. A literature-based framework was used to identify entry points for adaptation strategies at the farm household level. A purposive sampling strategy was used to select smallholders (<5 acres), engaged in market-oriented agriculture (≥10 years). In 14 households, in-depth interviews were conducted, using a life course perspective depicting the household history in relation to agricultural developments and household food and nutrition security. The narratives of smallholders confirmed that household food and nutrition security was grounded in mixed livelihood strategies, including migration. Diet quality depended largely on income. Supportive strategies were a frugal lifestyle, responsible use of resources, participation in community activities, and different forms of social innovation. The study shows how the understanding of local diets provides insights in entry points for nutrition-sensitive agriculture, and suggests a need for alternative adaptation strategies, replacing those promoting specialization and intensification, for more holistic solutions that reinforce the flexibility and resilience of farmers.