Food deprivation among adults in India: an analysis of specific food categories, 2016-2021

Anoop Jain; Smriti Sharma; Rockli Kim; S V Subramanian

doi:10.1016/j.eclinm.2023.102313

Food deprivation among adults in India: an analysis of specific food categories, 2016-2021

EClinicalMedicine. 2023 Nov 20:66:102313. doi: 10.1016/j.eclinm.2023.102313. eCollection 2023 Dec.

Authors

Anoop Jain¹, Smriti Sharma², Rockli Kim^{3

4}, S V Subramanian^{5

6}

Affiliations

¹ Boston University School of Public Health, 715 Albany St. Boston, MA, 02118, USA.
² Tata Trusts, R.K. Khanna Tennis Stadium, Africa Avenue, New Delhi, India.
³ Division of Health Policy & Management, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, South Korea.
⁴ Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
⁵ Harvard Center for Population and Development Studies, Cambridge, MA, 02138, USA.
⁶ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.

Abstract

Background: Adult undernourishment remains pervasive throughout India, and often results from food deprivation, which refers to the inadequate consumption of foods with caloric and nutrient significance. Therefore, understanding the extent to which food groups are missing from an individual's diet is essential to understanding the extent to which they are undernourished.

Methods: We used data from two National Family Health Surveys conducted in 2016 and 2021 for this cross-sectional analysis. The study population consisted of women and pregnant women between the ages of 15-49, and men between the ages of 15-54. We examined shifts in the percentage of people not consuming dairy, pulses/beans/legumes, dark leafy green vegetables, fruits, eggs, and fish and meat among women, pregnant women, and men between the two time points. We also examined these patterns by household wealth and education, two important markers of socioeconomic status.

Findings: Overall, we found that fewer women, pregnant women, and men were not eating each of the six food groups in 2021 than in 2016. Additionally, the gap in food group consumption between women, pregnant women, and men in the lowest and highest socioeconomic groups shrank between 2016 and 2021. Yet, food group deprivation remained most prevalent among those in the lowest socioeconomic groups. The two exceptions for this were for eggs and meat/fish. Nevertheless, the majority of India's poorest and least educated adults are not consuming high-quality protein sources, including dairy, the consumption of which is far more common among wealthier and more educated Indian adults.

Interpretation: Our results show that fewer adults were not consuming important food groups in 2021 than in 2016. However, many of India's poorest and least educated adults are still not consuming high-quality sources of protein or fruits, two food groups that are essential for good health. While adults might be getting protein and nutrients from pulses, legumes, beans, and other vegetables, efforts are needed to improve affordability of, and access to, high-quality sources of protein and fruits.

Funding: This work was supported by the Bill & Melinda Gates Foundation, INV- 002992.

Keywords: Adult food consumption; Food deprivation; Food group consumption; India; National Family Health Survey.