A recent study has pointed out that about 77 per cent of children in India aged 6-23 months do not meet the World Health Organization's (WHO) dietary diversity recommendations. This disturbing trend is particularly pronounced in central states like Uttar Pradesh, Rajasthan, Gujarat, Maharashtra, and Madhya Pradesh, where over 80 per cent of kids have been found to show inadequate dietary diversity. In contrast, Sikkim and Meghalaya are the only states reporting under 50 per cent prevalence.
Using data from the National Family and Health Survey (NFHS-5) conducted between 2019-21, researchers noted a decline in minimum dietary diversity failure from 87.4 per cent in 2005-06 (NFHS-3) to a concerning level above 75 per cent.
The WHO suggests using the Minimum Dietary Diversity (MDD) score to evaluate the quality of a child's diet -- it is considered to be diverse if it contains five or more food groups, including breastmilk, eggs, legumes and nuts, and fruits and vegetables.
The study revealed some improvements in dietary habits. For example, egg consumption increased from 5% to over 17%, and the intake of legumes and nuts rose from nearly 14% to over 17%. Additionally, there was a notable rise in the consumption of vitamin A-rich fruits and vegetables, which increased by 7.3 percentage points.
However, the findings also showed a decline in breast milk and dairy consumption, dropping from 87% to 85% and 54% to 52%, respectively. Factors contributing to dietary deficiencies included maternal education levels, rural residency, lack of access to mass media, and inadequate health counseling for children.
The authors also found that the children of illiterate and rural-residing mothers having no exposure to mass media, those born first and not exposed to counselling and health check-ups at Anganwadi or Integrated Child Development Services (ICDS) centres were more likely to be consuming diets deficient in diversity, as per the study published in the National Medical Journal of India.
Anaemic children and those having a low birth weight were also found to have a higher chance of consuming a non-diverse diet. Dr. Arun Gupta, a pediatrician and the central coordinator of the Breastfeeding Promotion Network of India (BPNI), who is not associated with this study expressed concern over the low breastfeeding rate in the country noting that the stagnation in national rates of early breastfeeding within the first hour of birth. He said this reflects a lack of priority in the health system to support new mothers.
According to him, many states are failing to initiate breastfeeding promptly. Gupta also blamed the rising number of Caesarean sections as a significant barrier to early breastfeeding because of misconception among healthcare workers that mothers who undergo C-sections are unable to breastfeed immediately.
To tackle the issue of inadequate diversity in children's diets, the authors of the study have called for a holistic approach from the government, including an improved public distribution system, intensified ICDS programme, use of social media and nutrition counselling through local self-governance.
