Predictors of the diets consumed by adolescent girls, pregnant women and mothers with children under age two years in rural eastern India

Unisa, Sayeed; Saraswat, Abhishek; Bhanot, Arti; Jaleel, Abdul; Parhi, Rabi N; Bhattacharjee, Sourav; Purty, Apollo; Rath, Sudhira; Mohapatra, Babita; Lumba, Avinash; Sinha, Sonali; Kejrewal, Nita; Agrawal, Neeraj; Bhatia, Vikas; Ruikar, Manisha; Sethi, Vani

doi:10.1017/s0021932020000462

Cited by 11 publications

(13 citation statements)

References 12 publications

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“…Findings from studies identified during the literature review corroborated findings from the empirical analysis [ 21 , 22 , 24 , 30 , 31 , 32 , 35 , 36 ]. Mothers belonging to richer households were about two times more likely to consume a diverse diet (≥5 food groups) [ 21 , 36 ].…”

Section: Resultssupporting

confidence: 62%

“…Subnational data on dietary intake among PW based on 24-h recall of 10 food groups were available for some states (Uttar Pradesh [ 21 ], Bihar, Odisha, and Chhattisgarh [ 22 ] ( Figure S1 ). In Uttar Pradesh, only about a fifth of PW achieved dietary diversity (consumed ≥5 food groups in a day), while about third of PW in Bihar and more than half of PW in Odisha and Chhattisgarh consumed diverse diets.…”

Section: Resultsmentioning

confidence: 99%

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Maternal Diets in India: Gaps, Barriers, and Opportunities

et al. 2021

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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.

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Section: Resultssupporting

confidence: 62%

Section: Resultsmentioning

confidence: 99%

Maternal Diets in India: Gaps, Barriers, and Opportunities

et al. 2021

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“…Studies suggest that under-consumption of micronutrient dense food is common in both "worse-off " and "better-off " contexts (Keats et al, 2018;Mitsopoulou et al, 2020) which has been linked, at least partially, to fast food substitution (Li et al, 2020). The limited studies of adolescents in rural South Asia suggest that dietary patterns are strongly linked to socioeconomic status and gender in Bangladesh (Blum et al, 2017;Thorne-Lyman et al, 2020) and Eastern India (Unisa et al, 2020). The role of seafood as a source of micronutrients in the diets of vulnerable populations that are highly dependent on aquatic foods is critical (Coulthard et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Export-Driven, Extensive Coastal Aquaculture Can Benefit Nutritionally Vulnerable People

Mamun

Murray

Sprague

et al. 2021

Front. Sustain. Food Syst.

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Export-orientated shrimp and prawn farming in coastal ghers has been associated with negative environmental, social, and nutritional impacts. This study challenges these perceptions based on field observations from four communities in South West Bangladesh. Most households observed (>60%) were either directly involved in seafood farming or engaged elsewhere in the seafood value chain. Our study set out to establish how the type and location of aquaculture impacted on access to and consumption of aquatic animals. Additionally, we assessed the effects of both household socioeconomic status and intra-household food allocation on individual diet and nutritional outcomes. We used a blended approach, including a 24-h consumption recall on two occasions, analysis of the proximate composition of aquatic animals and biomarkers from whole blood from a sample of the target population. The diverse polyculture systems generated broad social benefits, where “export-oriented” production actually supplied more food locally than to global markets. Key findings: (1) worse-off households achieved higher productivity of farmed aquatic animals on smaller landholding than better-off households with larger landholdings; (2) vegetable production on gher dikes was a significant source of nutrition and income in lower saline gradients; (3) more fish was eaten in lower saline gradients although fish consumption was highly variable within and between households; (4) intra-household allocation of specific foods within diets were similar across communities; (5) recommended nutrient intakes of protein and zinc exceeded daily requirements for adolescent females, but energy, calcium, and iron were below recommended intake levels; (6) n-3 LC-PUFA, expressed as percentage of total fatty acids, in whole blood samples of adolescent females declined with ambient salinity level regardless of household socioeconomic status; (7) analysis of aquatic animals consumed found that mangrove species and tilapia harvested from higher saline ghers contained high levels of desirable PUFAs. These findings suggest that export-driven, extensive coastal aquaculture can be nutrition sensitive when co-products are retained for local consumption.

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“…Furthermore, the dietary diversity of all target groups in Bihar was poorer than in the other two studied states. 10 Many factors contribute to these trends in daily nutrition for Indian states such as Bihar. High production and low pricing of rice and processed cereals may provide easier accessibility for families to afford.…”

Section: Introductionmentioning

confidence: 99%

Tradition, taste and taboo: the gastroecology of maternal perinatal diet

Lunkenheimer

Bürger

Akhauri

et al. 2021

BMJNPH

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BackgroundMaternal malnutrition is a major source of regional health inequity and contributes to maternal and infant morbidity and mortality. Bihar, a state in eastern India adjacent to Jharkhand and West Bengal, has relatively high neonatal mortality rates because a large portion of infants are born to young mothers. Bihar has the second-highest proportion of underweight children under 3 in India, with infant mortality rates of 48 per 1000 live births. Maternal malnutrition remains a major threat to perinatal health in Bihar, where 58.3% of pregnant women are anaemic.MethodsWe examined dietary beliefs and practices among mothers, mothers-in-law and community members, including Accredited Social Health Activists (ASHAs), using focus group discussions (n=40 groups, 213 participants), key informant interviews (n=50 participants) and quantitative surveys (n=1200 recent mothers and 400 community health workers). We report foods that are added/avoided during the perinatal period, along with stated reasons underlying food choice. We summarise the content of the diet based on responses to the quantitative survey and identify influencers of food choice and stated explanations for adding and avoiding foods.Key findingsAnalyses for all methodologies included gathering frequency counts and running descriptive statistics by food item, recommendation to eat or avoid, pregnancy or post partum, food group and health promoting or risk avoiding. During pregnancy, commonly added foods were generally nutritious (milk, pulses) with explanations for consuming these foods related to promoting health. Commonly avoided foods during pregnancy were also nutritious (wood apples, eggplant) with explanations for avoiding these foods related to miscarriage, newborn appearance and issues with digestion. Post partum, commonly added foods included sweets because they ease digestion whereas commonly avoided foods included eggplants and oily or spicy foods. Family, friends, relatives or neighbours influenced food choice for both mothers and ASHAs more than ASHAs and other health workers.Perinatal dietary beliefs and behaviours are shaped by local gastroecologies or systems of knowledge and practice that surround and inform dietary choices, as well as how those choices are explained and influenced. Our data provide novel insight into how health influencers operating within traditional and biomedical health systems shape the perinatal dietary beliefs of both mothers and community health workers.

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Predictors of the diets consumed by adolescent girls, pregnant women and mothers with children under age two years in rural eastern India

Cited by 11 publications

References 12 publications

Maternal Diets in India: Gaps, Barriers, and Opportunities

Maternal Diets in India: Gaps, Barriers, and Opportunities

Export-Driven, Extensive Coastal Aquaculture Can Benefit Nutritionally Vulnerable People

Tradition, taste and taboo: the gastroecology of maternal perinatal diet

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