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Sharma A, Chanda S, Porwal A, Wadhwa N, Santhanam D, Ranjan R, Shah H, Adyanthaya S, Meena R. Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India. BMC Nutr 2024; 10:82. [PMID: 38845052 PMCID: PMC11154971 DOI: 10.1186/s40795-024-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups. OBJECTIVE To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy. METHODS Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives. RESULTS Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1-1.4), community motivators (aOR = 1.9, CI: 1.7-2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women. CONCLUSION Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.
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Affiliation(s)
- Anshita Sharma
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India.
| | - Srei Chanda
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Akash Porwal
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Namita Wadhwa
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Divya Santhanam
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Raghwesh Ranjan
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Hemang Shah
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Shachi Adyanthaya
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Ramavatar Meena
- Directorate of Integrated Child Development Services, Jaipur, Rajasthan, India
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Morton CM, Pullabhotla H, Bevis L, Lobell DB. Soil micronutrients linked to human health in India. Sci Rep 2023; 13:13591. [PMID: 37604890 PMCID: PMC10442378 DOI: 10.1038/s41598-023-39084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Trace soil minerals are a critical determinant of both crop productivity and the mineral concentration of crops, therefore potentially impacting the nutritional status of human populations relying on those crops. We link health data from nearly 0.3 million children and one million adult women across India with over 27 million soil tests drawn from a nationwide soil health program. We find that soil zinc availability is positively associated with children's linear height growth, and soil iron availability is positively associated with hemoglobin levels. The link between soil zinc and childhood stunting is particularly robust-a one standard deviation increase in satisfactory soil zinc tests is associated with approximately 11 fewer children stunted per 1000. We also find that this zinc-stunting relationship is strongest in wealthier households. Our results suggest that soil mineral availability impacts human nutritional status and health in at least some areas of India, and that agronomic fortification may be a beneficial intervention.
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Affiliation(s)
- Claire M Morton
- Mathematical and Computational Science Program, Stanford University, Stanford, USA.
| | | | - Leah Bevis
- Department of Agricultural, Environmental and Development Economics, Ohio State University, Columbus, USA
| | - David B Lobell
- Department of Earth System Science and Center on Food Security and the Environment, Stanford University, Stanford, USA
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Singh S, Venkateshmurthy NS, Brown KA, Maddury AP, Khatkar R, Jarhyan P, Prabhakaran D, Mohan S. Agricultural and Socioeconomic Factors Associated with Farmer Household Dietary Diversity in India: A Comparative Study of Visakhapatnam and Sonipat. SUSTAINABILITY 2023; 15:2873. [PMID: 37323772 PMCID: PMC7614637 DOI: 10.3390/su15042873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Using primary data from 479 farmer households, this study examined the associations between agricultural and socioeconomic factors and farmer household dietary diversity in Visakhapatnam and Sonipat. Cropping intensity was positively associated with farmers' household dietary diversity score (HDDS), suggesting that higher cropping intensity may expand the gross cropped area and improve food security among subsistence farmers. Distance to food markets was also significantly associated with farmer HDDS, which suggests that market integration with rural households can improve farmer HDDS in Visakhapatnam. In Sonipat, wealth index had a positive association with farmer HDDS, targeting the income pathway by improving farmer HDDS in this region. Considering the relative contribution of these factors, distance to food markets, cropping intensity, and crop diversity were the three most important factors affecting farmer HDDS in Visakhapatnam, whereas wealth index, cropping intensity, and distance to food markets emerged as the top three important factors contributing to farmer HDDS in Sonipat. Our study concludes that the associations between agricultural and socioeconomic factors and farmer HDDS are complex but context- and location-specific; therefore, considering the site- and context-specific circumstances, different connections to HDDS in India can be found to better support policy priorities on the ground.
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Affiliation(s)
| | | | - Kerry Ann Brown
- College of Life & Environmental Sciences, University of Exeter, Exeter EX4 4PY, UK
| | | | - Rajesh Khatkar
- Public Health Foundation of India, Gurgaon 122002, India
| | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, Gurgaon 122002, India
| | - Sailesh Mohan
- Centre for Chronic Disease Control, New Delhi 110016, India
- Public Health Foundation of India, Gurgaon 122002, India
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Shumayla S, Irfan EM, Kathuria N, Rathi SK, Srivastava S, Mehra S. Minimum dietary diversity and associated factors among lactating mothers in Haryana, India: a community based cross-sectional study. BMC Pediatr 2022; 22:525. [PMID: 36057585 PMCID: PMC9440519 DOI: 10.1186/s12887-022-03588-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Food adequacy and dietary quality in the lactation period are fundamental for maternal and child health. Lactating mothers are vulnerable to malnutrition because of increased physiological demand, monotonous diet, lactogenesis process, and increased nutrient requirements. The micronutrient adequacy especially among women is not ensured in Indian diet. The dual course of gender bias and poverty, along with lack of knowledge about diet quality are significant impediments in maintaining minimum dietary diversity among Indian women. The study aimed to assess the prevalence of minimum dietary diversity and associated factors among lactating women. METHODOLOGY A community-based cross-sectional study was conducted among 1236 lactating women through a multistage sampling procedure in Haryana state, India. Data were collected in Computer-assisted personal interviewing (CAPI) using a pretested structured interview schedule. Minimum Dietary Diversity for Women by Food and Agriculture Organization (FAO) was used to calculate the minimum dietary diversity. RESULTS The mean dietary diversity score among lactating women from the ten food groups was 6.35 ± 2.57 and the prevalence of minimum dietary diversity was 77.1%. The complete model revealed that both individual and household factors can explain the variation in dietary diversity intake. Furthermore, the result of model 2 explained that women aged 31 to 35 years (AOR 5.92,95% (1.87-18.77), graduation and above qualified women (AOR 1.98, 95% (0.96-4.09) and lactating women with high knowledge on nutrition (AOR 2.00, 95% (1.34-4.57) were the significant factors promoting minimum dietary diversity. CONCLUSION Three-fourths of the lactating women reached adequate minimum dietary diversity. Younger age, low educational level, and poor nutritional knowledge were significant constraints to achieving minimum dietary diversity. Further improvement in the minimum dietary diversity among lactating women is very much required. It is also advised that exiting platforms dispersing awareness on nutrition should be supported and strengthened.
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Affiliation(s)
- Shumayla Shumayla
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - E M Irfan
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Nishtha Kathuria
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Suresh Kumar Rathi
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India.
| | - Shobhit Srivastava
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Sunil Mehra
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
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Jain A, Wang W, James KS, Sarwal R, Kim R, Subramanian SV. Small Area Variations in Dietary Diversity Among Children in India: A Multilevel Analysis of 6–23-Month-Old Children. Front Nutr 2022; 8:791509. [PMID: 35252284 PMCID: PMC8890590 DOI: 10.3389/fnut.2021.791509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
Dietary diversity is an important indicator of child malnutrition. However, little is known about the geographic variation of diet indicators across India, particularly within districts and across states. As such, the purpose of this paper was to elucidate the small area variations in diet indicators between clusters within districts of India. Overall, we found that clusters were the largest source of variation for children not eating grains, roots, and tubers, legumes and nuts, dairy, vitamin A-rich vegetables and fruits, and other vegetables and fruits. We also found positive correlations between the district percent and cluster standard deviations of children not breastfeeding or eating grains, roots, and tubers, but negative correlations between the district percent and cluster standard deviation for the remaining seven outcomes. These findings underscore the importance of targeting clusters to improve child dietary diversity.
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Affiliation(s)
- Anoop Jain
- Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Weiyu Wang
- Harvard Center for Population and Development Studies, Cambridge, MA, United States
| | - K. S. James
- International Institute for Population Sciences, Mumbai, India
| | - Rakesh Sarwal
- National Institution for Transforming India (NITI) Aayog, Government of India, New Delhi, India
| | - Rockli Kim
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
- *Correspondence: Rockli Kim
| | - S. V. Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- S. V. Subramanian
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Wang Z, Chen Y, Tang S, Chen S, Gong S, Jiang X, Wang L, Zhang Y. Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China. Nutrients 2021; 13:nu13113908. [PMID: 34836163 PMCID: PMC8621596 DOI: 10.3390/nu13113908] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to evaluate the status of dietary diversity and nutrient intake among Han and Dongxiang smallholder farmers in poor rural areas of northwest China. In this cross-sectional study, dietary intake was assessed in 499 smallholder farmers aged 18–75 years from two nationally designated impoverished counties in Gansu Province, China, using three consecutive 24 h dietary recalls. The dietary diversity score (DDS) and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (range from 1 to 9) in participants was relatively low (3.81 ± 1.01). Consumption of grains was excessive, while consumption of vegetables, fruits, meat, beans, eggs, fish, and dairy was inadequate. The NAR values were higher in Han Chinese, with the exceptions of vitamin C, potassium, pyridoxine, and selenium (p < 0.05). For each nutrient, the high DDS group had a higher mean NAR (p < 0.05), except for pyridoxine. High household monthly income, being Han Chinese, high DDS, and being aged over 45 years were positively associated with mean adequacy ratio (MAR) of 14 micronutrients evaluated. Lack of dietary diversity and insufficient intake of essential micronutrients are public health concerns in northwest China. Nutrition education and other proper methods to address these issues are needed.
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Affiliation(s)
- Zhuo Wang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (Z.W.); (Y.C.); (S.T.); (S.C.)
| | - Youhai Chen
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (Z.W.); (Y.C.); (S.T.); (S.C.)
| | - Shihua Tang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (Z.W.); (Y.C.); (S.T.); (S.C.)
| | - Siqi Chen
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (Z.W.); (Y.C.); (S.T.); (S.C.)
| | - Shaoqing Gong
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Xinying Jiang
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA
- Correspondence: (L.W.); (Y.Z.)
| | - Ying Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (Z.W.); (Y.C.); (S.T.); (S.C.)
- Correspondence: (L.W.); (Y.Z.)
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Connors K, Jaacks LM, Prabhakaran P, Veluguri D, Ramanjaneyulu GV, Roy A. Impact of Crop Diversity on Dietary Diversity Among Farmers in India During the COVID-19 Pandemic. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.695347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Crop diversity is thought to have small, positive impacts on dietary diversity among farming households, particularly when market access is restricted. Policy responses to the COVID-19 pandemic severely restricted market access. To date, no study has explored the relationship between crop and dietary diversity in this context. To address this gap, we used longitudinal data collected from 833 farmers across 12 states in India at three time points between May and August 2020. Dietary diversity was measured using a modified version of the FAO Minimum Dietary Diversity score for women, which has been used in representative samples of the Indian population in both men and women. Eight food groups were included: (1) starchy staples (rice, wheat, and potatoes), (2) pulses, (3) nuts, (4) vegetables, (5) fruits, (6) dairy, (7) eggs, and (8) fleshy foods (meat, poultry, and fish). Multivariate polynomial logistic regression was used to estimate the association between crop and dietary diversity. Models were adjusted for educational attainment, caste, farm size, having a kitchen garden, and livestock ownership. Participants were, on average, 42.2 years old and 94.2% were male. Dietary diversity decreased over the study period, especially between baseline and follow-up 1, when lockdown measures were the most restrictive (34.2% of participants experienced a decline compared to 16.1% from follow-up 1 to follow-up 2). Compared to farmers who cultivated 1 crop (monocroppers), farmers who cultivated 2 crops or 3 or more crops were significantly less likely to experience a decline in dietary diversity from baseline to follow-up 1: adjusted relative risk (RR) (95% confidence interval [CI]), 0.52 (0.35, 0.78) and 0.48 (0.31, 0.75), respectively. There was no significant association between crop diversity and change in dietary diversity from follow-up 1 to follow-up 2, when phased re-opening had begun. These findings suggest that farmers with greater crop diversity in India were more resilient to market disruptions from the COVID-19 pandemic. Thus, while the links between crop and dietary diversity may be small under normal circumstances, diversifying production systems may play an increasingly important role, as there is greater uncertainty due to global events such as pandemics and climate change.
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Factors influencing household pulse consumption in India: A multilevel model analysis. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2021; 29:100534. [PMID: 34164257 PMCID: PMC8202232 DOI: 10.1016/j.gfs.2021.100534] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/11/2021] [Accepted: 03/14/2021] [Indexed: 11/21/2022]
Abstract
Pulses (also known as legumes) are important in achieving nutrient adequacy in India due to their quality protein content. This study compared district-level pulse production and consumption across India, and household and district-level determinants of pulse intake, including availability, accessibility and affordability, using multi-level models in nationally representative datasets for 2011-12. The per capita consumption was about 50% of recommended intake (80 g/day), even in high-producing districts. District-level pulse production was associated with household pulse intake (2.73 × 10-8 [5.19 × 10-9, 4.94 × 10-8]) and market accessibility (-0.0077 [-0.0133, -0.0021]). Affordability (absolute price of pulse) was also associated with household intake. While agricultural policies relating to pulses have been oriented towards improving pulse output and productivity, forward-looking policies to improve pulse intake should focus on demand-side factors, such as improved market accessibility and the affordability of pulses relative to other foods.
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Key Words
- APS, Area and Production Statistics
- Accessibility
- Affordability
- Availability
- CES, Consumer Expenditure Survey
- CI, Confidence Interval
- HH, Household
- India
- MLM, Multilevel Model
- Multilevel model
- NSSO, National Sample Survey Office
- PDS, Public Distribution System
- Pulses
- SC, Scheduled Caste
- ST, Scheduled Tribe
- VDSA, Village Dynamics in South Asia
- VPC, Variance Partition Coefficient
- g, Grams
- kg, Kilograms
- p.a., Per annum
- p.c., Per capita
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