Small Area Variations in Dietary Diversity Among Children in India: A Multilevel Analysis of 6-23-Month-Old Children

Front Nutr. 2022 Feb 16:8:791509. doi: 10.3389/fnut.2021.791509. eCollection 2021.

Abstract

Dietary diversity is an important indicator of child malnutrition. However, little is known about the geographic variation of diet indicators across India, particularly within districts and across states. As such, the purpose of this paper was to elucidate the small area variations in diet indicators between clusters within districts of India. Overall, we found that clusters were the largest source of variation for children not eating grains, roots, and tubers, legumes and nuts, dairy, vitamin A-rich vegetables and fruits, and other vegetables and fruits. We also found positive correlations between the district percent and cluster standard deviations of children not breastfeeding or eating grains, roots, and tubers, but negative correlations between the district percent and cluster standard deviation for the remaining seven outcomes. These findings underscore the importance of targeting clusters to improve child dietary diversity.

Keywords: India; dietary diversity; dietary intake; multilevel modeling; undernutrition.