Original Article Dietary diversity and anthropometric status of 6-36 months old children of Mumbai city

P Agashe Apurva, Pranali Pangerkar, Ghugre Padmini, A Shobha
2018 Indian J Child Health   unpublished
A high proportion of children in India are undernourished. The fourth National and Family Health Survey [1] indicated that 35.7% of Indian children under 5 years of age were underweight, 21.0% were wasted with 7.5% being severely wasted, and 38.4% were stunted. Young children under 2 years of age are highly vulnerable because they have relatively higher nutritional needs for their growth and development than older children in this age group. Good nutritional status depends on the provision of
more » ... th macro-and micro-nutrients, through a wide variety of foods and diverse diets. Dietary diversity (DD) is important as humans cannot obtain all the necessary nutrients from a single food. DD is also regarded as a pillar of food security, accessibility, availability, and utilization [2]. Moursi et al. conducted a study on 723 children in Madagascar, aged 6-23 months and observed that DD scores were positively correlated with mean micronutrient density adequacy [3]. Similarly, Potts et al. observed among American children that food variety was associated with nutrient adequacy [4]. DD has been established as a significant predictor of growth. More than a decade ago, Arimond et al. [5] highlighted the importance of DD in their analysis of demographic and health information for children aged 6-24 months in 11 countries in Africa and Latin America Rah and coworkers [6] observed in Bangladeshi children that reduced DD was strongly associated with stunting. Given the high prevalence of undernutrition in India, we aim to assess the feeding patterns, DD and its association with the nutritional status of urban slum children in Mumbai city. Mumbai city was chosen because the NFHS-4 report indicated that the percentage of stunting among slum children was 29.3%, 24.9% of children were wasted, and 30.7% were underweight. Furthermore, a report by the Society for Nutrition, Education and Health Action a voluntary organization, on approximately 1500 slum children indicated that about one-third of the children under 5 years of age had low weight for age, two-thirds (47%) had low height for age, and 17% had low weight for height [7]. METHODOLOGY Sample Selection A total of 823 children between 6 and 36 months were recruited from 16 slum areas located in the western suburbs of Mumbai city, after obtaining written informed consent from their mothers or main caregivers. All 16 slums were being looked after by two voluntary agencies, namely, Committed Communities Development Trust and the Centre for the Study of Social Change. A sampling frame ABSTRACT Background: Dietary diversity (DD) is an indicator of food security, accessibility, availability, and also a significant predictor of growth. Poor feeding practices are responsible for low DD which affects the nutritional status of child. Objective: The objective of the study was to assess the association of DD with nutritional status of urban slum children. Methodology: Data were collected using structured interview schedule on 823 children from 16 slums of western suburbs of Mumbai city. DD score was calculated using food frequency questionnaire as per Food and Agriculture Organization. Weight and height measurements of all children were taken using standard techniques, and nutritional status was assessed using Z scores in terms of wasting, stunting, and underweight as per the World Health Organization norms. Results: About 5.4% children were severely wasted, 10.2% children were severely underweight, and 24.7% children were severely stunted. About 22.1% children had low DD scores, 41.3% had scores indicating medium diversity, and 36.6% children had high scores for DD. Children who were severely undernourished, i.e. those whose Z scores were ≤3 tended to have lower DD scores than their better-nourished counterparts for all three nutritional status indicators-weight for height, weight for age, and height for age. Conclusion: DD plays an important role in improving the nutritional status of child. Therefore, there is need to educate mothers in terms of DD to improve nutritional status of children.