Maternal Diets in India: Gaps, Barriers, and Opportunities

Abstract

Suboptimal dietary intake is a critical cause of poor maternal nutrition, with several adverse consequences both for mothers and for their children. This study aimed to (1) assess maternal dietary patterns in India; (2) examine enablers and barriers in adopting recommended diets; (3) review current policy and program strategies to improve dietary intakes. We used mixed methods, including empirical analysis, compiling data from available national and subnational surveys, and reviewing literature, policy, and program strategies. Diets among pregnant women are characterized by low energy, macronutrient imbalance, and inadequate micronutrient intake. Supply- and demand-side constraints to healthy diets include food unavailability, poor economic situation, low exposure to nutrition counselling, food restrictions and taboos, adverse family influence and gender norms, and gaps in knowledge. Intervention strategies with potential to improve maternal diets include food-based programs, behavior change communication, and nutrition-sensitive agriculture interventions. However, strategies face implementation bottlenecks and limited effectiveness in real-world at-scale impact evaluations. In conclusion, investments in systems approaches spanning health, nutrition, and agriculture sectors, with evaluation frameworks at subnational levels, are needed to promote healthy diets for women.

Micronutrient supplementation in pregnancy: a KAP survey with healthcare consultants in India

“…11 Education is a crucial part of prenatal care, but previous research has shown that women anticipate getting more nutrition advice from their doctor, midwife, or other healthcare than they do. 8 In our survey, healthcare professionals confirmed that they communicate the importance of nutrients via counselling, diet chart, videos and handouts. Nevertheless, this survey provides encouraging results to disseminate the importance of supplements in pregnancy and increase the use of DHA consumption in pregnant women and shows the need for appropriate guidelines for prescribing the supplements.…”

“…Therefore, it is imperative to start with DHA supplementation from the first trimester and up to 18 months of life. [6][7][8] The majority of HCPs prescribe a dose of 400 mg followed by 200 mg. 5 A survey conducted in the USA from 2003-2014 to evaluate the n-3 FA intake concluded that the estimated intakes of n-3 FA in pregnant women did not differ from non-pregnant women (100.6 versus 92.7 mg EPA+DHA in pregnant versus non-pregnant women aged 20-44 years). The estimated EPA+DHA intake by pregnant women is Prescriber % less than one-fifth of the required 520 mg/day of EPA+DHA for pregnant and lactating women, as recommended by the Workshop on the Essentiality of and Recommended Dietary Intakes recommendations.…”

Dietary diversity and association with non-communicable diseases (NCDs) among adult men (15–54 years): A cross-sectional study using National Family and Health Survey, India

“…The lowest diet diversity is found in the western part of India, whereas the southern-costal and eastern-costal parts of India have reported higher diet diversity (as in Fig 2A). Several factors, such as geographical availability of foods [48][49][50][51][52], accessibility to markets, purchasing capacity [53,54], level of education, individual tests, and preferences [55], etc., are the significant determinants of dietary diversity at the regional level in India [56,57]. PLOS GLOBAL PUBLIC HEALTH…”

Allergic sensitization to foods in India and other Low–Middle‐income countries

“…Maternal diet is carefully managed, food is prepared fresh and no processed foods are generally used. However, despite a variety of government policies, 65–75% of households could not afford a wholesome nutritious diet, which is usually poor in iron and other micronutrients, and many women suffer from anaemia 49 . In many urban areas in India, maternal obesity is increasing and may impact the incidence of atopic and allergy diseases in newborns 50,51 .…”