Maternal dietary diversity during lactation and associated factors in Palghar district, Maharashtra, India

Dietary adequacy and diversity during the lactation period are necessary to ensure good health and nutrition among women and children. Behavioral interventions pertaining to health and nutrition counselling during pregnancy and lactation are critical for awareness about dietary diversity. The issue assumes salience for marginalized communities because of the Covid-19 pandemic and associated economic and societal disruptions. This paper assesses the dietary patterns among 400 lactating mothers in the tribal-dominated district of Palghar in Maharashtra, India in 2020. The study is based on primary data regarding consumption of 10 food groups among women across 10 food groups based on 24-hour recall period. The primary outcome variable was binary information regarding Minimum Dietary Diversity defined as consumption from at least 5 food groups. Econometric analysis based on multilevel models and item-response theory is applied to identify food groups that were most difficult to be received by mothers during the early and late lactation period. We find that the daily diet of lactating mothers in Palghar primarily consists of grains, white roots, tubers, and pulses. In contrast, the intake of dairy, eggs, and non-vegetarian food items is much lower. Only Half of the lactating women (56.5 percent; 95% CI: 37.4; 73.8) have a minimum diversified diet (MDD). The prevalence of lactating women with MDD was higher among households with higher income (73.1 percent; 95% CI: 45.2; 89.9) than those in lower income group (50.7 percent; 95% CI: 42.3; 58.9). Lactating Women (in early phase) who received health and nutrition counseling services are more likely (OR: 2.37; 95% CI: 0.90; 6.26) to consume a diversified diet. Food groups such as fruits, meat, poultry, fish, nuts, and seeds were among the rare food items in daily diet. The dietary pattern lacking in fruits, nuts, and heme (iron) sources indicates more significant risks of micronutrient deficiencies. The findings call for improving dietary diversity among lactating mothers, particularly from the marginalized communities, and are driven by low consumption of dairy products or various fruits and vegetables. Among the different food items, the consumption of micronutrient-rich seeds and nuts is most difficult to be accessed by lactating mothers. Also, diet-centric counseling and informing lactating mothers of its benefits are necessary to increase dietary diversity for improving maternal and child nutrition.

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Investigating differences in dietary patterns among a small cross-sectional study of young and old Pacific peoples in NZ using exploratory factor analysis: a feasibility study

BMJ Open ◽

10.1136/bmjopen-2018-023126 ◽

2019 ◽

Vol 9 (3) ◽

pp. e023126 ◽

Cited By ~ 1

Author(s):

Ridvan Tupai-Firestone ◽

Soo Cheng ◽

Joseph Kaholokula ◽

Barry Borman ◽

Lis Ellison-Loschmann

Keyword(s):

New Zealand ◽

Dietary Patterns ◽

Generational Differences ◽

Dietary Diversity ◽

Limited Range ◽

Healthy Diet ◽

Food Groups ◽

Cross Sectional ◽

Food Items ◽

The Relationship

ObjectivesObesity among Pasifika people living in New Zealand is a serious health problem with prevalence rates more than twice those of the general population (67% vs 33%, respectively). Due to the high risk of developing obesity for this population, we investigated diet quality of Pacific youth and their parents and grandparents. Therefore, we examined the dietary diversity of 30 youth and their parents and grandparents (n=34) to identify whether there are generational differences in dietary patterns and investigate the relationship between acculturation and dietary patterns.MethodsThe study design of the overarching study was cross-sectional. Face-to-face interviews were conducted with Pasifika youth, parents and grandparents to investigate dietary diversity, that included both nutritious and discretionary food items and food groups over a 7 day period. Study setting was located in 2 large urban cities, New Zealand. Exploratory factor analyses were used to calculate food scores (means) from individual food items based on proportions consumed over the week, and weights were applied to calculate a standardised food score. The relationship between the level of acculturation and deprivation with dietary patterns was also assessed.ResultsThree distinctive dietary patterns across all participants were identified from our analyses. Healthy diet, processed diet and mixed diet. Mean food scores indicated statistically significant differences between the dietary patterns for older and younger generations. Older generations showed greater diversity in food items consumed, as well as eating primarily a ‘healthy diet’. The younger generation was more likely to consume a ‘processed diet’. There was significant association between acculturation and deprivation with the distinctive dietary patterns.ConclusionOur investigation highlighted generational differences in consuming a limited range of food items. Identified dietary components may, in part, be explained by specific acculturation modes (assimilation and marginalised) and high socioeconomic deprivation among this particular study population.

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Household food insecurity is associated with low dietary diversity among pregnant and lactating women in rural Malawi

Public Health Nutrition ◽

10.1017/s1368980018002719 ◽

2018 ◽

Vol 22 (4) ◽

pp. 697-705 ◽

Cited By ~ 4

Author(s):

Yunhee Kang ◽

Kristen M Hurley ◽

Julie Ruel-Bergeron ◽

Assumpta Bou Monclus ◽

Rachel Oemcke ◽

...

Keyword(s):

Food Insecurity ◽

Pregnant Women ◽

Dietary Diversity ◽

Cross Sectional Study ◽

Household Food Insecurity ◽

Food Groups ◽

Cross Sectional ◽

Lactating Women ◽

Rural Districts ◽

Household Food

AbstractObjectiveTo examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi.DesignCross-sectional study.SettingTwo rural districts in Central Malawi.SubjectsPregnant (n 589) and lactating (n 641) women.ResultsOf surveyed pregnant and lactating women, 66·7 and 68·6 %, respectively, experienced moderate or severe food insecurity and only 32·4 and 28·1 %, respectively, met MDD. Compared with food-secure pregnant women, those who reported severe food insecurity had a 0·36 lower DDS (P<0·05) and more than threefold higher risk (OR; 95 % CI) of not consuming meat/fish (3·19; CI 1·68, 6·03). The risk of not consuming eggs (3·77; 1·04, 13·7) was higher among moderately food-insecure pregnant women. Compared with food-secure lactating women, those who reported mild, moderate and severe food insecurity showed a 0·36, 0·44 and 0·62 lower DDS, respectively (all P<0·05). The risk of not achieving MDD was higher among moderately (1·95; 1·06, 3·59) and severely (2·82; 1·53, 5·22) food-insecure lactating women. The risk of not consuming meat/fish and eggs increased in a dose–response manner among lactating women experiencing mild (1·75; 1·01, 3·03 and 2·81; 1·09, 7·25), moderate (2·66; 1·47, 4·82 and 3·75; 1·40, 10·0) and severe (5·33; 2·63, 10·8 and 3·47; 1·19, 10·1) food insecurity.ConclusionsAddressing food insecurity during and after pregnancy needs to be considered when designing nutrition programmes aiming to increase dietary diversity in rural Malawi.

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Dietary Intake and Nutritional Status of Javanese Women in Rice Producing Areas: a Comparison between Lactating and Non-lactating Women

Indonesian Journal of Human Nutrition ◽

10.21776/ub.ijhn.2021.008.02.5 ◽

2021 ◽

Vol 8 (2) ◽

pp. 139

Author(s):

Ilmia Fahmi ◽

Ratna C Purwestri ◽

Judith Lauvai ◽

Ziba Barati ◽

Whelma Bell ◽

...

Keyword(s):

Nutritional Status ◽

Dietary Intake ◽

Maternal Nutrition ◽

Vegetable Consumption ◽

Cross Sectional Study ◽

Food Groups ◽

Cross Sectional ◽

Lactating Women ◽

Central Java ◽

Lactating Mothers

<p>Maintaining optimal maternal nutrition is essential for the mother’s health and the child’s growth and development. Throughout the lactating period, maternal nutrition is significant due to the child’s high nutritional needs. Therefore, an increase in food consumption is necessary. This research aimed to analyze the dietary intake and nutritional status of lactating and non-lactating women living in rice-producing areas in Central Java, Indonesia. A cross-sectional study was conducted from December 2014 to February 2015 in Demak Regency. As many as 375 participants were recruited and analyzed in this study. The results showed that the mean BMI-score of non-lactating mothers was higher than that of breastfeeding mothers (p=0.039). However, the nutritional status between the two groups of women was not significantly different. Significantly more lactating women consumed dark green leafy-colored vegetables (68.8%) and other vegetables (59.2%) than the non-lactating mothers (54.4%, p=0.065 and 36.8%, p=0.001, respectively). Regarding the selected macro and micronutrient intakes, statistically significant differences between the two groups of women could not be proven. In short, dietary intake between women within the different physiological statuses and BMI categories showed that they consumed around the same amount of macro-and micronutrient intakes and food groups, except for the high vegetable consumption among lactating women.</p>

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Prevalence of Undernutrition and Associated Factors among Lactating Mothers of Angecha District, Kembata Tembaro Zone, Southern Ethiopia

Journal of Nutrition and Metabolism ◽

10.1155/2021/6691982 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Moges Muluneh Boke ◽

Aman Yesuf ◽

Befikadu Tariku Gutema

Keyword(s):

Associated Factors ◽

Dietary Diversity ◽

Wealth Index ◽

Cross Sectional Study ◽

The Body ◽

Southern Ethiopia ◽

Food Groups ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Lactating Mothers

Background. Major reasons for malnutrition, particularly among those who live in low- and middle-income countries, are physiological vulnerability and inadequate intake. The objective of the study was to assess the prevalence of undernutrition and associated factors among lactating mothers of Angecha District, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted among randomly selected lactating mothers in Angecha District from March to April 2017. A pretested structured questionnaire was used to assess the prevalence of undernutrition and associated factors among lactating mothers. Undernutrition was defined as the body mass index of less than 18.5 kg/m2. A multivariable logistic regression model was fitted, and the adjusted odds ratio (AOR) at a p value less than 0.05 was used to determine a statistically significant association between predictors and outcome variables. Result. The prevalence of undernutrition among lactating mothers was 21.2% (95% CI: 17.52, 25.46). The odds of undernutrition were higher among lactating mothers in the younger age group (AOR 4.12 (95% CI: 1.25–13.63), compared to 36–49 years group), dietary diversity less than five food groups (AOR 2.4, 95% CI: 1.35–4.36), and not attending antenatal care (ANC) (AOR 2.90 (95% CI: 1.43–5.86), compared to those who attended ANC for 4 or more times). The odds of undernutrition among lactating women from 3rd quantile wealth index households reduced by nearly half (AOR 0.47, 95% CI: 0.23–0.98) compared to lactating mothers from 1st quantile wealth index households. Conclusion. Nearly one in every five lactating mothers was undernourished. Age, dietary diversity score, ANC visit, and wealth index were found to be the associated factors of undernutrition. Therefore, due attention should have to be given to increase the use of ANC.

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Delivering an Integrated Package of Maternal Nutrition Services in Andhra Pradesh and Telangana (India)

Food and Nutrition Bulletin ◽

10.1177/0379572119844142 ◽

2019 ◽

Vol 40 (3) ◽

pp. 393-408

Author(s):

Vani Sethi ◽

Khyati Tiwari ◽

Neha Sareen ◽

Suneeta Singh ◽

Chittaranjan Mishra ◽

...

Keyword(s):

Dietary Diversity ◽

Family Members ◽

World Health ◽

Primary Data ◽

Food Groups ◽

Space Technology ◽

Indian States ◽

Lactating Women ◽

Nutrition Services ◽

Feeding Programs

Background: Maternal spot feeding programs operational in southern Indian States are providing a package of nutrition services (food, micronutrient supplementation, deworming, gestation weight gain monitoring, and fortnightly nutrition health education) to pregnant women. These remain to be evaluated. Objective: We evaluated the maternal spot feeding programs in 2 Southern Indian states. Methods: Study design was cross-sectional entailing primary data collection (July to November 2016) on 360 pregnant and lactating women (of infants aged 0-6 months) per state and a review of the scheme’s management information system (MIS) beneficiaries’ records for the time period April 2014 to August 2017. To gain program functioning insights, open-ended interviews (n = 252) with state, district, and block program managers a state-level open space technology workshop was conducted. Results: Average days of meal consumption ranged from 19 to 21 days per month; spot meal enhanced high dietary diversity (≥6 food groups; 57%-59%) and consumption of eggs and milk (74%-96%) among pregnant and lactating women. On-the-spot consumption of iron, folic acid, calcium, and deworming was 18%, 87%, and 56%, respectively; 94% attended at least 1 of the 2 nutrition monthly counseling sessions. Majority (68%) of the beneficiaries were motivated to enroll by self-help groups or family members, suggesting the crucial persuasive role of peers and family members. Conclusion: Maternal spot feeding schemes can potentially deliver nutrition interventions outlined in the World Health Organization antenatal care guidelines 2016 for a positive pregnancy outcome. Research on schemes’ impact on birth outcomes, maternal depression, social norms, and its cost-effectiveness is needed.

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Only one in four lactating mothers met the minimum dietary diversity score in the pastoral community, Afar region, Ethiopia: a community-based cross-sectional study

Journal of Nutritional Science ◽

10.1017/jns.2021.28 ◽

2021 ◽

Vol 10 ◽

Author(s):

Getahun Fentaw Mulaw ◽

Fentaw Wassie Feleke ◽

Kusse Urmale Mare

Keyword(s):

Dietary Diversity ◽

Cross Sectional Study ◽

Meal Frequency ◽

Food Groups ◽

Community Based ◽

Cross Sectional ◽

Dietary Diversity Score ◽

Lactating Mothers ◽

Minimum Dietary Diversity

Abstract Maternal dietary feeding practice is one of the proxy indicators of maternal nutrient adequacy and it improves outcomes for both mothers and their offspring. The minimum maternal dietary diversity score of lactating women is defined as when the mother ate at least four and above food groups from the nine food groups 24 h preceding the survey regardless of the portion size. Therefore, the present study aimed to determine the minimum dietary diversity score (MDDS) and its predictors among lactating mothers in the Pastoralist community, Ethiopia. A community-based cross-sectional study design was employed on 360 lactating mothers using a multi-stage sampling technique from 5 January 2020 to 10 February 2020. Data were collected using questionnaires and anthropometry measurements. Data were entered using EPI-data 4.6.02 and exported into SPSS version 25. Statistical significance was declared at P-value <0⋅05 at multivariable logistic regression. Only one in four lactating mothers met the MDDS. The majority of them consumed cereals in the preceding 24 h of data collection. The most important predictors were maternal meal frequency (adjusted odds ratio (AOR) 6⋅26; 95 % confidence interval (CI) (3⋅51, 11⋅15)), antenatal care (ANC) follow-up one to three times and four and above times (AOR: 2⋅58; 95 % CI (1⋅24, 5⋅36), 4⋅77 (1⋅90, 11⋅95), respectively) and secondary paternal education (AOR 2⋅97; 95 % CI (1⋅44, 6⋅11)). The MDDS among lactating mothers was low. Paternal education, maternal meal frequency and ANC follow-up were the significant predictors. Therefore, to improve maternal dietary diversity score emphasis should be given to those predictors.

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Impacts of Eating Behaviors of Pregnant and Lactating Women on the Nutritional Status of Children under 6 Months in the Lake-Chad Region

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1830378 ◽

2020 ◽

pp. 24-38

Author(s):

Abdel-Aziz Ousmane Mahamat ◽

Marie Modestine Kana Sop ◽

Himeda Makhlouf ◽

Marlyne-Joséphine Mananga

Keyword(s):

Nutritional Status ◽

Eating Behaviors ◽

Dietary Diversity ◽

Food Groups ◽

Lactating Women ◽

Lake Chad ◽

Breastfeeding Rate ◽

Modifiable Factors ◽

Nutritional Status Of Children ◽

The Impact

Background: Malnutrition causes real problems, especially for the survival and growth of children on the one hand and for the health of pregnant and lactating women on the other. Purpose: The purpose of our study is to evaluate the impact of pregnant and lactating women's eating behaviors on the nutritional status of children under 6 months in the Lake Chad Region. Methods: A cross-sectional, descriptive and analytical study of 380 patients including 106 pregnant women 137 lactating women and 137 children under 6 months of age identified in few hospitals and health centers in the Lake Chad Region was conducted from October 1 to November 30, 2017, using a questionnaire administered to pregnant and lactating women after their consent. The 24-hour recall and the frequency of consumption of the food groups allowed us to evaluate the food intake of the surveyed women. The nutritional status of mothers and children was assessed by anthropometric and biochemical measures. The data was analyzed using the SPSS version 20 software. The Chi-square test allowed us to establish the correlations between the different variables at a significance level set at 5%. Results: This study found that only 8.5% and 10.9% of pregnant and lactating women respectively had satisfactory dietary diversity scores. The exclusive breastfeeding rate was 11.7% and the immediate initiation rate for breastfeeding after delivery was 50.4%. The children had 19% wasting, 31.4% stunting, 34.3% underweight and 56.4% anemia. Respectively, 34% and 29% of pregnant and lactating women were malnourished; 17% and 10.2% were at risk of malnutrition, with 60.6 % and 50% prevalence of anemia respectively. Conclusion: The modifiable factors that significantly influenced the nutritional status of children were: maternal feeding behaviors such as low dietary diversity scores and daily meals lack of hygiene and sanitary follow-up, underweight and presence of children anemia in mothers.

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Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal

Public Health Nutrition ◽

10.1017/s1368980015000671 ◽

2015 ◽

Vol 18 (17) ◽

pp. 3201-3210 ◽

Cited By ~ 40

Author(s):

Sigrun Henjum ◽

Liv Elin Torheim ◽

Andrew L Thorne-Lyman ◽

Ram Chandyo ◽

Wafaie W Fawzi ◽

...

Keyword(s):

Urban Area ◽

Energy Intake ◽

Dietary Diversity ◽

Economic Status ◽

Food Groups ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Lactating Women ◽

Dietary Recall ◽

The Mean

AbstractObjectiveThe main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables.DesignA cross-sectional survey was performed during 2008–2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA.SettingBhaktapur municipality, Nepal.SubjectsLactating women (n 500), 17–44 years old, randomly selected.ResultsThe mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women’s educational level and socio-economic status, and was higher in the winter.ConclusionsThe low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.

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Undernutrition and Associated Factors among Lactating Mothers in Dega Damot Woreda, Northwest Ethiopia

Journal of Nutrition and Metabolism ◽

10.1155/2020/4627278 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Hunegnaw Almaw Derseh ◽

Liknaw Bewket Zeleke ◽

Melese Linger Endalifer ◽

Esmael Ali Muhammad ◽

Terefe Derso

Keyword(s):

Nutritional Status ◽

Associated Factors ◽

Dietary Diversity ◽

Sampling Technique ◽

Northwest Ethiopia ◽

Nutrition Status ◽

Cross Sectional ◽

Lactating Women ◽

Household Food ◽

Lactating Mothers

Introduction. Nutritional status of lactating women is highly linked with the overall nutritional status of population. Undernutrition during lactation results in increased morbidity and mortality to the mother and her child. The literature is dearth regarding to nutrition status of lactating mothers in developing countries such as Ethiopia. Objective. The aim of this study was to assess undernutrition and associated factors among lactating mothers having child 6–23 months in Dega Damot Woreda, Northwest Ethiopia. Methods. A community-based cross-sectional study was conducted from March 21 to April 19, 2018. Simple random sampling technique was employed to recruit a total of 733 participants. Data were collected by using an interview-administered questionnaire and entered into EpiData version 4.2 and transferred to SPSS version 20 for further analysis. Factors associated with undernutrition were identified using multivariable logistic regression at a p value of less than 0.05 at 95% confidence interval. The direction and strength of association was interpreted using adjusted odds ratio. Results. In this study, the magnitude of undernutrition among lactating women was 21.8%. Being unmarried (AOR: 2.65, 95% CI: 1.54, 4.53), their first pregnancy <18 years (AOR: 2.34, 95% CI: 1.42, 3.87), having more than 5 number of pregnancies (AOR: 2.79, 95% CI: 1.55, 5.03), inadequate dietary diversity score (AOR: 2.1, 95% CI: 1.16, 3.83), and household food insecurity (AOR: 3.68, 95% CI: 2.35, 5.77) were significantly associated factors with undernutrition. Conclusions. The prevalence of undernutrition among lactating women was found to be high. Programs should do better in enhancing activities of agricultural production to reduce household food insecure and to increase accessibility of diversified diet. Other researchers better to do other studies to identify main factors of undernutrition using a qualitative study.

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Maternal Employment and Children's Dietary Diversity Scores in Southwestern Guatemala (P10-039-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-039-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Caitlin Lowery ◽

Vanessa Oddo ◽

Kristen Hurley ◽

Jessica Jones-Smith ◽

Joel Gittelsohn ◽

...

Keyword(s):

Maternal Employment ◽

Qualitative Data ◽

Dietary Diversity ◽

Food Group ◽

Food Groups ◽

Daily Consumption ◽

Food Purchasing ◽

Logistic Regression Models ◽

Food Items ◽

Employed Women

Abstract Objectives To assess the relationship between maternal employment and children's dietary diversity in rural Guatemala. Methods A mixed-method design was used to compare quantitative findings on children's dietary diversity collected from Food Frequency Questionnaires (FFQs) (n = 802), with qualitative data from in-depth interviews (IDIs) with a sub-sample of participants (n = 20). Mothers reported the number of times per week their child consumed select food items from seven food groups (grains, legumes, vitamin A-rich fruits & vegetables, other fruits & vegetables, eggs, dairy and meat). The total for each food item was then divided by seven to find the number of times the child consumed each food per day. Then, the daily consumption of all food items within a category was totaled for each food group. If the total for the food group was at least one, the child was given one point for daily consumption, with a maximum dietary diversity score (DDS) of seven. Using multivariate linear regression, we compared the DDS of children of employed mothers to the DDS of children of unemployed mothers. We used separate multivariate logistic regression models to estimate the association between maternal employment and consumption of each food group. Models were adjusted for maternal (age, education, marital status, parity), child (age, sex), and household (size) characteristics. IDIs explored the mechanisms by which food purchasing and preparation, as well as child-feeding behavior differed for employed and unemployed women. Results Maternal employment (versus unemployment) was associated with higher dietary diversity scores for children (β = 0.3; 95% CI: 0.06,0.54). The odds of consuming each food group did not differ significantly between children of employed and unemployed women, except for dairy (OR: 1.9, 95% CI: 1.0, 2.6), but the general trend suggested children of employed women were more likely to consume six of the seven food groups. Qualitative data indicates that employed women purchase higher quality and greater quantities of food. Conclusions Maternal employment is associated with higher children's dietary diversity scores in rural Guatemala. Quantitative and qualitative data suggests that maternal employment is related to food purchasing behavior. Funding Sources Mathile Institute & Global Obesity Prevention Center at Johns Hopkins Bloomberg School of Public Health.

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