Association between Maternal Dietary Diversity and Low Birth Weight in Central India: A Case-Control Study

Low birth weight (LBW) is one of the major public health challenges in India. LBW etiology is multifactorial and linked to multiple determinants, including maternal undernutrition and sociodemographic characteristics. The objective of the present endeavor was to assess how maternal dietary diversity and other sociodemographic factors among marginalized populations are associated with the incidence of LBW. The study was a part of the community-based intervention that aimed to improve maternal and child health in the Morena district of Madhya Pradesh, a state in central India. In this case-control study, cases were defined as mothers with an LBW child (<2500 grams) and controls as mothers without an LBW child. A quantitative survey was done with women of reproductive age, having at least one child aged 0–24 months. We calculated the dietary diversity based on the number of food groups consumed during pregnancy by women on a daily basis. Stepwise logistic regression models were built to test for associations between sociodemographic and dietary diversity variables and LBW incidence. There were 157 mothers with and 214 without an LBW child. Women’s diets mainly consisted of grains, such as wheat, rice, maize, and roots and tubers. Eggs and meat were consumed by less than 1% of the women. There were 20% lesser chances of an LBW child with increasing maternal dietary diversity scores (odds ratio: 0.79; 95% CI: 0.65, 0.96). The poor maternal diet quality during pregnancy may result in adverse birth outcomes with long-term consequences in a child

Assessing Dietary Intake Patterns Through Cluster Analysis Among Adolescents in Selected Districts of Bihar and Assam From India : A Cross-Sectional Survey

Background: In the recent decade, dietary pattern assessment has evolved as a promising tool to describe the whole diet and represent inter-correlations between different dietary components. We aimed to derive the dietary patterns of adolescents (10–19 years) using cluster analysis on food groups and evaluate these patterns according to their socio-demographic profile. Methods: This community-based cross-sectional study was conducted in two districts, each from Bihar and Assam in India. Adolescents (10–19 years) were enrolled from both rural and urban areas. The dietary intake was assessed through a pre-validated single food frequency questionnaire. Cluster analysis was performed by a 2-step procedure to explore dietary patterns, pre-fixed at 2 clusters. Clusters were analyzed with respect to socio-demographic characteristics using binomial logistic regression. Results: A total of 826 girls and 811 boys were enrolled in the study. We found two major dietary patterns, namely a low- and high-mixed diet. The low-mixed diet (76.5% prevalence) had daily consumption of green vegetables, including leafy vegetables, with less frequent consumption of other foods. The high-mixed diet (23.5% prevalence) had more frequent consumption of chicken, meat, egg, and milk/curd apart from green vegetables. Adolescent boys had 3.6 times higher odds of consuming a low-mixed diet compared to girls. Similarly, adolescents with lower education grades and from marginalized social classes had two times higher odds of taking a low-mixed diet than their respective counterparts. Conclusions: The high consumption of a low-mixed diet and relatively less milk consumption limit the comprehensive growth of adolescents. Improvement in dietary intake of adolescents from marginalized sections of society can prove to be an important deterrent in mitigating India's nutritional challenges

Income-based inequality in full immunization coverage of children aged 12-23 months in Eastern India: A decomposition analysis

Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of income-based inequality in the full immunization of children aged 12–23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (−13.5%) and age of the child (−2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums