Abstract
Aim
This paper aims to assess the prevalence of minimum diet diversity (MDD) and minimum acceptable diet (MAD) among Indian children aged 6–23 months. Additionally, the study seeks to understand the factors that contribute to children meeting the WHO-recommended criteria for MDD and MAD.
Method
We performed a quantitative analysis of food intake of children aged 6–23 months utilizing nationally representative cross-sectional data from the National Family Health Survey (2019–2021). We calculated the percentage of children within this age group who met the criteria for MDD and MAD. Furthermore, we estimated the predictors of MDD and MAD among these children using logistic regression analyses.
Results
We found that children aged 6–23 months in India had a remarkably low prevalence of both MDD and MAD, with rates of 25% and 10.5%, respectively. The likelihood of receiving MAD was significantly reduced for children whose mothers had no education and had low body mass index (BMI). While the household’s wealth status was found to be significantly associated with MDD, no significant association was observed between wealth status and MAD. We also found a significant association between low diet diversity and wasting, and between MAD and no anaemia.
Conclusion
Integrating counselling on IYCF practices into antenatal and postnatal care services should be a priority. Additionally, efforts should be made to increase awareness about the significance of maintaining a diverse and nutritionally balanced diet for children. There should also be a focus on creating awareness about meal frequency for promoting optimal child growth.
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Data availability
The NFHS-5 data is a publicly available data set from the Demographic Health Survey Program portal.
Code availability
The authors are willing to share codes upon request.
References
Acharya A, Pradhan MR, Das AK (2021) Determinants of minimum acceptable diet feeding among children aged 6–23 months in Odisha, India. J Public Health Nutri 24(12):3834–3844
Agrawal S, Kim R, Gausman J, Sharma S, Sankar R, Joe W, Subramanian S (2019) Socio-economic patterning of food consumption and dietary diversity among Indian children: evidence from NFHS-4. J Eur J Clin Nutri 73(10):1361–1372
Ahmad I, Khalique N, Khalil S, Maroof M (2017) Complementary feeding practices among children aged 6–23 months in Aligarh, Uttar Pradesh. J J Family Med Primary Care 6(2):386
Ahmed KY, Page A, Arora A, Ogbo FA (2020) Trends and factors associated with complementary feeding practices in Ethiopia from 2005 to 2016. J Maternal Child Nutri 16(2):e12926
Belay DG, Taddese AA, Gelaye KA (2022) Minimum acceptable diet intake and its associated factors among children age at 6–23 months in sub-Saharan Africa: a multilevel analysis of the sub-Saharan Africa demographic and health survey. J BMC Public Health 22(1):684
Christian P, Murray-Kolb LE, Khatry SK, Katz J, Schaefer BA, Cole PM et al (2010) Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. J Jama 304(24):2716–2723
Dhami MV, Ogbo FA, Osuagwu UL, Agho KE (2019) Prevalence and factors associated with complementary feeding practices among children aged 6–23 months in India: a regional analysis. J BMC Public Health 19(1):1–16
Duan Y, Yang Z, Lai J, Yu D, Chang S, Pang X et al (2019) Exclusive breastfeeding rate and complementary feeding indicators in China: a national representative survey in 2013. Nutrients. 2018; 10: 249. J Public Health Nutri 22(1):95–103
Fernandez C, Kasper NM, Miller AL, Lumeng JC, Peterson KE (2016) Association of dietary variety and diversity with body mass index in US preschool children. J Pediatrics, 137(3)
Gautam KP, Adhikari M, Khatri RB, Devkota MD (2016) Determinants of infant and young child feeding practices in Rupandehi, Nepal. J BMC Res Notes 9(1):1–7
Green R, Milner J, Joy EJ, Agrawal S, Dangour AD (2016) Dietary patterns in India: a systematic review. J British J Nutri 116(1):142–148
Horwitz A, Kennedy ET, Howson CP (1998) Prevention of micronutrient deficiencies: tools for policymakers and public health workers. https://doi.org/10.17226/5962
IIPS I (2021) National Family Health Survey-5. Retrieved from Mumbai. http://rchiips.org/nfhs/factsheet_nfhs-5.shtml. Accessed 03-01-2023
Joe W, Rajpal S, Kim R, Laxmaiah A, Harikumar R, Arlappa N et al (2019) Association between anthropometric-based and food-based nutritional failure among children in India, 2015. Mater Child Nutri 15(4):e12830
Kambale RM, Ngaboyeka GA, Kasengi JB, Niyitegeka S, Cinkenye BR, Baruti A et al (2021) Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study. J BMC Pediatrics 21(1):1–9
Kaur A, Malik G, Sharma N, Mittal R (2016) The new Indian middle class consumption preference towards convenience foods–A Grounded theory approach. J Pacific Business Rev Int 1(3):31–38
Khamis AG, Mwanri AW, Ntwenya JE, Kreppel K (2019) The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. J BMC Pediatrics 19(1):1–9
Khandelwal S, Kondal D, Chakravarti AR, Dutta S, Banerjee B, Chaudhry M, Patil K, Swamy MK, Ramakrishnan U, Prabhakaran D, Tandon N, Stein A (2022) Infant young child feeding practices in an Indian maternal–child birth cohort in Belagavi, Karnataka. J Int J Environ Res 19(9):5088
Lee SE, Talegawkar SA, Merialdi M, Caulfield LE (2013) Dietary intakes of women during pregnancy in low-and middle-income countries. J Public Health Nutri 16(8):1340–1353
Menon P, Bamezai A, Subandoro A, Ayoya MA, Aguayo VM (2015) Age-appropriate infant and young child feeding practices are associated with child nutrition in I ndia: insights from nationally representative data. J Mater Child Nutri 11(1):73–87
Modugu HR, Khanna R, Dash A, Manikam L, Parikh P, Benton L et al (2022) Influence of gender and parental migration on IYCF practices in 6–23-month-old tribal children in Banswara district, India: findings from the cross-sectional PANChSHEEEL study. J BMC Nutri 8(1):10
Morris SS, Cogill B, Uauy R (2008) Effective international action against undernutrition: why has it proven so difficult and what can be done to accelerate progress? Lancet 371(9612):608–621. https://doi.org/10.1016/s0140-6736(07)61695-x
Nguyen PH, Kachwaha S, Tran LM, Sanghvi T, Ghosh S, Kulkarni B et al (2021) Maternal diets in India: gaps, barriers, and opportunities. J Nutrients 13(10):3534
Pandey S, Kashima S (2021) Effects of dairy intake on anthropometric failure in children ages 6 to 23 mo consuming vegetarian diets and fulfilling minimum dietary diversity in India. J Nutrition 91:111446
Perkins JM, Jayatissa R, Subramanian S (2018) Dietary diversity and anthropometric status and failure among infants and young children in Sri Lanka. J Nutrition 55:76–83
Rammohan A, Goli S, Singh D, Ganguly D, Singh U (2019) Maternal dietary diversity and odds of low birth weight: empirical findings from India. J Women health 59(4):375–390
Rao KM, Balakrishna N, Arlappa N, Laxmaiah A, Brahmam G (2010) Diet and nutritional status of women in India. J J Human Ecol 29(3):165–170
Salehi-Abargouei A, Akbari F, Bellissimo N, Azadbakht L (2016) Dietary diversity score and obesity: a systematic review and meta-analysis of observational studies. J Eur J Clin Nutri 70(1):1–9
Shridhar G, Rajendra N, Murigendra H, Shridevi P, Prasad M, Mujeeb M et al (2015) Modern diet and its impact on human health. J J Nutri Food Sci 5(6):1
Temesgen H, Yeneabat T, Teshome M (2018) Dietary diversity and associated factors among children aged 6–23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study. J BMC Nutri 4(1):1–8
Tiwari S, Bharadva K, Yadav B, Malik S, Gangal, P, Banapurmath C, Zaka-Ur-Rab Z, Deshmukh U, Visheshkumar –, Agrawal R (2016) Infant and young child feeding guidelines, 2016. J Indian Pediatrics 53:703-713.
UNICEF (2019) Comprehensive national nutrition survey: 2016–2018. https://www.unicef.org/india/reports/comprehensive-national-nutrition-survey-2016-2018. Accessed 03-01-2023
Unisa S, Saraswat A, Bhanot A, Jaleel A, Parhi RN, Bhattacharjee S et al (2021) Predictors of the diets consumed by adolescent girls, pregnant women and mothers with children under age two years in rural eastern India. J Biosocial Sci 53(5):663–682
Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA (2007) Child development: risk factors for adverse outcomes in develo** countries. J Lancet 369(9556):145–157
World Health Organization (2009) Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. https://www.who.int/publications/i/item/9789241597494. Accessed 04-01-2023
World Health Organization (2010a) Indicators for assessing infant and young child feeding practices: part 1: measurement. https://www.who.int/publications/i/item/9789240018389. Accessed 04-01-2023
World Health Organization (2010b) Indicators for assessing infant and young child feeding practices: part 2: measurement. Accessed 04-01-2023
World Health Organization (2021) Indicators for assessing infant and young child feeding practices: definitions and measurement methods. https://www.who.int/publications/i/item/9789240018389. Accessed 04-01-2023
Acknowledgements
The authors gratefully acknowledge the International Institute of Population Sciences (IIPS), Mumbai, India, and the Demographic and Health Survey (DHS) Program for allowing us to access the NFHS-5 data set.
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This paper is based on secondary data, and the authors received no funding for this analysis.
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Abdul Jaleel planned, conducted the statistical analysis, and wrote the paper. K. Venkatesh supervised and validated the analysis, and reviewed and edited the paper. C.S. Surya Goud and Sapavat Shankar validated the analysis, and reviewed and edited the paper.
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Jaleel, A., Surya Goud, C.S., Shankar, S. et al. Nourishing the future: exploring the factors influencing minimum diet diversity and minimum acceptable diet among Indian children aged 6–23 months. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-02085-y
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DOI: https://doi.org/10.1007/s10389-023-02085-y