Maternal Diets in India: Gaps, Barriers, and Opportunities.

Phuong Hong Nguyen,Kalpana Beesabathuni,Sebanti Ghosh,Vani Sethi,Bharati Kulkarni,Purnima Menon,Tina Sanghvi,Shivani Kachwaha,Lan Mai Tran

doi:10.3390/nu13103534

Abstract

Suboptimal dietary intake is a critical cause of poor maternal nutrition, with several adverse consequences both for mothers and for their children. This study aimed to (1) assess maternal dietary patterns in India; (2) examine enablers and barriers in adopting recommended diets; (3) review current policy and program strategies to improve dietary intakes. We used mixed methods, including empirical analysis, compiling data from available national and subnational surveys, and reviewing literature, policy, and program strategies. Diets among pregnant women are characterized by low energy, macronutrient imbalance, and inadequate micronutrient intake. Supply- and demand-side constraints to healthy diets include food unavailability, poor economic situation, low exposure to nutrition counselling, food restrictions and taboos, adverse family influence and gender norms, and gaps in knowledge. Intervention strategies with potential to improve maternal diets include food-based programs, behavior change communication, and nutrition-sensitive agriculture interventions. However, strategies face implementation bottlenecks and limited effectiveness in real-world at-scale impact evaluations. In conclusion, investments in systems approaches spanning health, nutrition, and agriculture sectors, with evaluation frameworks at subnational levels, are needed to promote healthy diets for women.

Highlights

Poor maternal nutrition before and during pregnancy is a significant public health concern due to adverse consequences both for mothers and for their children
This paper aims to (1) assess maternal dietary patterns in India; (2) examine enablers and barriers in adopting recommended diets; (3) review current policy and program strategies in India to improve dietary intakes and assess their effectiveness
Intakes of essential micronutrients such as iron, vitamin A, riboflavin, vitamin C, and folic acid were less than 50% of RDA among most pregnant women (~50–80%) [15]

Summary

Introduction

Poor maternal nutrition before and during pregnancy is a significant public health concern due to adverse consequences both for mothers and for their children. Maternal undernutrition remains a global concern, with 24% of women in South Asia having low body mass index (BMI) [1]. Poor diet during pregnancy has been associated with adverse pregnancy outcomes [2], which, in turn, increase child susceptibility to cardiometabolic diseases in later life [6]. Despite this evidence, maternal diets in low- and middle-income countries (LMICs) suffer from macronutrient and micronutrient imbalance, and are predominantly plant-based [7]. Many women have concurrent deficiencies of essential micronutrients such as iron, zinc, vitamins B12 and D, and iodine through their reproductive years [1]. A study from Guatemala, India, Pakistan, and Democratic Republic of the Congo reported that more than 80% of women had inadequate intakes of essential micronutrients [8]

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