Summary. Dietary diversity is associated with household or individual food availability and intake of nutrients from different food groups and is an important component of nutritional outcome. This study examined the Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) of three dietary diversity indices and their relationship with the nutritional status of adolescents and adults in rural regions of two states in India, Wardha district in Maharashtra and Koraput district in Odisha, in 2014. Individual dietary diversity was calculated using 24-hour diet recall (FS 24hr ) data and household dietary diversity was measured with food frequency data using Berry's index (DDI) and food scores (FS FFQ ). The nutritional status of individuals was assessed using anthropometric indices. The diets in both locations were cereal dominated. It was observed that 51% of adolescent boys and 27% of adolescent girls had 'thinness' and stunting. The prevalence of undernutrition was higher among adult women (48%) than adult men (36%). The mean diversity indices were FS 24hr of 8, DDI of 89-90 and FS FFQ of 64-66 in the two locations. The FS 24hr was found to be positively correlated with the NAR of all nutrients while DDI and FS FFQ were correlated with seven and six nutrients, respectively. The DDI and FS 24hr showed an association with MAR if the two locations were combined together. Sensitivity and specificity analysis showed that FS 24hr gave more true positives than false positives and the area under the Receiver Operating Characteristic curve was 0.68, implying that this measure truly differentiates individuals having low dietary diversity with low MAR from those with low dietary diversity and a high MAR. All three measures of dietary diversity showed a linear association with the nutritional outcomes of adults, while in the adolescent group only DDI showed a relationship. It is concluded that 24-hour diet recall is a good measure for studying the relationship between dietary diversity and nutritional status in adults.

Farming is the main livelihood of a majority of people in India. The country is also home to a large population of undernourished people. This indicates potential for mainstreaming the nutrition dimension in the farming system to impact on nutrition outcomes. A Farming System for Nutrition (FSN) study was conducted in two agro-ecologically different locations from 2013–2018, to explore the feasibility of nutrition-sensitive agricultural interventions. The baseline survey in 2013–2014 revealed that the population in the study area was largely undernourished and that household diets were cereal-dominated. The FSN model was designed in consultation with community members, to increase availability of nutrient-dense cereals and pulses, by enhancing production and crop diversification at the farm level, promoting cultivation of nutrient-rich fruits and vegetables in nutrition gardens and supporting interventions to promote access to animal foods. Nutrition awareness initiatives were undertaken to build capacity at the local level and translate production diversity to consumption diversity. An endline survey was conducted in 2017 (July-October), following three years of intervention. Crop, vegetable and animal food production and food consumption was compared with the baseline data. There was evidence of higher production and consumption of nutrient rich foods, improved household dietary diversity; and understanding and acceptance of nutrition-sensitive agriculture. The number of items consumed under each food group, frequency of consumption of food and average per capita intake of nutrient-rich foods were found to have improved. The results provide evidence regarding feasibility of location-specific FSN models to promote sustainable and healthy diets, using locally available plant and animal food resources, to address nutrition deficiencies in farm families.

Agriculture is the predominant livelihood for 70 % of the population living in rural India, and food expenses occupy a major proportion of their household budget. Rural household diets suggest that agricultural growth has contributed to increasing calorie intake with very minimal effect on the intake of protein and micronutrients. This in turn causes weak positive impact of agriculture on household dietary diversity and nutrient adequacy. Given the prevalence of high levels of under-nutrition and a large population dependent on agriculture, recent thinking globally on leveraging agriculture for nutrition security has encouraged the agricultural sector to realign its focus not only to increase food production, but also to address under-nutrition. Against this background, an exploratory study was conducted in resource poor villages of Wardha and Koraput districts in the states of Maharashtra and Odisha in India, to investigate how location-specific Farming System for Nutrition (FSN) interventions can potentially improve the diversity of household diets and nutrition outcomes. A detailed baseline study was undertaken to identify the existing disconnect between agriculturenutrition linkages. In the study locations, the proportion of all forms of under-nutrition, vitamin A deficiency and iron-deficiency anaemia among children <5-years of age appeared unacceptably high. A high prevalence rate of chronic energy deficient (CED) women and anaemic pregnant women was also observed. A higher risk of under-nutrition and micronutrient deficiency among household members was associated with substandard living conditions of the surveyed households. Cropping systems in Wardha were primarily dominated by rain-fed commercial cash crops while rain-fed subsistence farming predominated in Koraput. Households in both study locations were found to have cereal-dominated diets with average daily consumption of pulses, fruits and vegetables, and milk and milk products well below the recommended daily intake level, indicating low dietary diversity. In both Wardha and Koraput, CED in adults (>18 years) significantly increased as the dietary diversity score (DDS) decreased from high to low. In Koraput, the prevalence rate of anaemia in adolescent girls and women significantly increased, as the DDS decreased. We conclude that food and diets lacking diversity and without nutrition-sensitive farming systems (either commercial-or subsistence-based) may not be appropriate to improve household nutrition and health status. Our findings provide a basis for structuring integrated agriculture-nutrition programmes or a FSN approach to diversifying household food and diets, for improving nutrition and health in India.

Dietary Diversity, with foods from all food groups is necessary to meet the requirements for essential nutrients which lead to good health. This study examines whether different dietary diversity indices have relationship with the nutritional status of school children aged 6 to 12 years, in two different regions of India: Wardha district, Maharashtra and Koraput district, Odisha. Dietary diversity was calculated using three methods: Individual food scores calculated using 24 hour diet recall (FS_24hr) data; household dietary diversity using Berry's index (DDI) and food scores calculated using food frequency data (FS_FFQ). Anthropometric indices were used to assess the nutritional status of school aged children. The Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) were calculated as indicators of nutrient adequacy. The relationship between NAR, MAR and three different diversity indices, dietary diversity and anthropometric indices were analyzed. Overall, 38% of 6 to 12 year school aged children were found to be undernourished. The NAR was &lt;70% for all nutrients except protein, energy, thiamine and niacin and MAR was found to be &lt;70% of requirement with mean of 60.5% in both locations. The dietary diversity was found to be relatively better in Wardha when compared with Koraput. The mean diversity indices in both the locations were FS_24hr 7.56, DDI 89 and FS_FFQ 62.9. Overall most of the nutrient adequacy and mean adequacy were correlated with all three dietary diversity indices when both locations were studied together. However all three dietary diversity indices failed to show any relationship with nutritional status of school children aged 6-12 years from both locations taken together.

Sectio Caesarea is an action to deliver a baby weighing more than 500 grams, through an incision in the intact uterine wall. The increase in cesarean section rates has not been able to improve the final condition of the neonate and can even increase the risk of maternal mortality and morbidity. The purpose of this study was to determine the Relationship between Anemia and Nutritional Status with the Wound Healing Process in Postoperative Sectio Caesarea Patients in the Hospital Postpartum Room. This study was conducted based on analytical research methods using a cross-sectional approach. the results of the Chi-square test analysis obtained a value of ρ value = 0.001 (ρ < 0.05), where Ha is accepted and H0 is rejected, so there is a significant relationship between Anemia and the Wound healing Process in Postoperative Sectio Caesarea patients in the Hospital Postpartum Room.