Patel Kamalesh Kumar, Vijay Jyoti, Saroja Arunesha Babu
Clinical Research Unit, All India Institute of Medical Sciences, New Delhi, India.
Institute of Health Management Research (IIHMR), Bangalore, Karnataka, India.
J Health Popul Nutr. 2024 Dec 19;43(1):219. doi: 10.1186/s41043-024-00716-y.
Malnutrition among children remains a critical public health challenge in India. WHO's IYCF model recommends that children should feed on five out of eight food categories daily. The objective of the study is to assess dietary diversity and associated risk factors among children, focusing on complex interplay of socio-economic and demographic factors.
The study utilized nationally representative data from the National Family Health Survey (NFHS-5) conducted in 2019-2021, focusing on a sample of 62,553 children aged 6-24 months. Minimum Dietary Diversity (MDD) was assessed using children received foods from ≥ 5 food group out of eight specified food groups over the 24 h preceding the survey. Logistic regression employed to examine the association between DD and its predictors (p value < 0.05).
Overall, 52% of the children were male, while the remaining 48% were female. Only 23.3% of the children across India achieved MDD. Mother's education was positively associated with dietary diversity (OR:1.15; 95% CI:0.92-1.4). Factors significantly associated with dietary diversity were children aged 19-23 months (OR:4.03; CI:3.46-4.69), working mothers (OR:1.30; 95% CI:1.14-1.5) and children belonged to middle (OR:1.22; CI:1.05-1.43) and rich socio-economic status (OR:1.48; CI:1.26-1.8) as compared to their counterparts. Additionally, no difference found in dietary diversity among male and female children (OR:1.01; CI:0.9-1.11) and urban and rural areas (OR:101; CI:0.87-1.17). Those children belonged to Northeast region had around 70% higher dietary diversity as compared to Central region.
This study highlights a concerning low prevalence of dietary diversity among young children in India. Interventions and policies should target on implementing comprehensive nutrition education programs for caregivers, coupled with targeted financial support and community engagement.
儿童营养不良仍是印度严峻的公共卫生挑战。世界卫生组织的婴幼儿喂养模式建议,儿童应每天食用八大类食物中的五类。本研究的目的是评估儿童的饮食多样性及相关风险因素,重点关注社会经济和人口因素的复杂相互作用。
该研究利用了2019 - 2021年进行的全国家庭健康调查(NFHS - 5)中的全国代表性数据,样本为62,553名6 - 24个月大的儿童。通过调查前24小时内儿童是否从八大指定食物组中的至少5个食物组获取食物来评估最低饮食多样性(MDD)。采用逻辑回归分析来检验饮食多样性与其预测因素之间的关联(p值<0.05)。
总体而言,52%的儿童为男性,其余48%为女性。印度全国仅有23.3%的儿童达到了最低饮食多样性。母亲的教育程度与饮食多样性呈正相关(比值比:1.15;95%置信区间:0.92 - 1.4)。与饮食多样性显著相关的因素包括19 - 23个月大的儿童(比值比:4.03;置信区间:3.46 - 4.69)、职业母亲(比值比:1.30;95%置信区间:1.14 - 1.5),以及与同龄人相比属于中等(比值比:1.22;置信区间:1.05 - 1.43)和富裕社会经济地位的儿童(比值比:1.48;置信区间:1.26 - 1.8)。此外,男童和女童之间(比值比:1.01;置信区间:0.9 - 1.11)以及城乡地区之间(比值比:1.01;置信区间:0.87 - 1.17)在饮食多样性方面未发现差异。与中部地区相比,东北地区的儿童饮食多样性高出约70%。
本研究凸显了印度幼儿饮食多样性普遍较低这一令人担忧的情况。干预措施和政策应旨在为照料者实施全面的营养教育项目,并提供有针对性的财政支持和社区参与。