Household Diet Research Articles

Home gardens as a predictor of enhanced dietary diversity and food security in rural Myanmar

BackgroundHome gardens have been found to improve food security and dietary diversity in a wide range of settings. However, there is a need to place home gardens within the larger food and nutrition system landscapes that shape the construction of household diets. Myanmar offers a unique opportunity to study these research questions, given the decades of political isolation, high levels of food insecurity and poor nutrition levels.MethodsThe aim of our paper is to use household survey data from three distinctive agro-ecological settings in rural Myanmar to empirically analyse the role of home gardens in influencing household food insecurity and dietary diversity. Our analysis is based on unique survey data conducted in rural Myanmar. The sample includes 3230 rural households from three States/Districts (Magway, Ayeyarwady and Chin). Using information on two dimensions of food security, a series of variables capturing a household’s self-reported food security status and coping strategies when food is not available; and a measure of household’s dietary diversity based on 24-h recall data, we empirically estimate a household’s probability of being food insecure and the diversity of their diets.ResultsThere are statistically significant associations between access to home gardens and measures of food security and improved dietary diversity. In particular, for landless households, the ownership of home gardens/ fruits and vines is statistically significant and is associated with a 6.6 percentage points lower probability of a household having to change their diet, and a 7.9 percentage points lower probability of being in hunger.ConclusionsFrom a policy perspective, our results show that promoting home gardens among vulnerable households can improve food security and dietary diversity among vulnerable rural households in Myanmar.

An Empirical Evaluation of the Link between Women Participation in Village Savings and Loans Association (VSLA) and Poverty Reduction in Ethiopia

Women's participation is a fundamental prerequisite for gender equality and genuine democracy. It facilitates women's direct engagement in decision-making and is a means of ensuring better accountability to women. This paper assesses the impact of women participation in Village Savings and Loans Association (VSLA) on poverty reduction in Hawassa city, Ethiopia. Using a mixed research methodology, and applying propensity score matching, the study found that women participation in VSLA has a significant positive impact in increasing average monthly household income of participant woman. Besides, women participation in VSLA has a significant positive association with improvements in household diet, health, children's education, and women's involvement in household decisions. The study recommends a reinforcement of government and nongovernmental organizations in providing regular and need based capacity building trainings for VSLA participants followed by a concerted effort to link VSLA participants with formal microfinance institutions.

Urban and rural: differences in the diet of Argentine households according to income level and area of residence

The environment and the socioeconomic level are determinants of eating behavior because they affect availability, accessibility and food preferences. In order to describe the apparent consumption of food and the availability of energy and nutrients in urban and rural households in Argentina according to their income level, the 2004-2005 National Household Expenditure Survey was analyzed. The average apparent consumption of food and beverages was calculated in grams or milliliters of net weight per adult equivalent per day, for urban and rural households, and by household income per capita quintiles. Rural households made up 7% of the sample, and had a higher proportion of low-income families than urban households. There is different pattern of apparent consumption of food and beverages among rural and urban households in Argentina, and there are also differences between households according to the level of income in both environments. Knowing the content and magnitude of these contrasts is of great use in looking for strategies to improve the population's diet.

How do droughts impact household food consumption and nutritional intake? A study of rural India

Abstract This paper investigates the impacts of droughts on food expenditure and macronutrient consumption among rural Indian households. To isolate causal effects, I exploit random year-to-year variation in a dry shock, defined as the absolute deviation of rainfall below its long-run mean. I find that the dry shock has a statistically significant and negative effect on household nutrition. For a median dry shock, I estimate that households spend 1 percent less per capita per month on food and consume up to 1.4 percent fewer calories, protein, and fat. Disaggregating the effects by food group, I demonstrate that household diets become less balanced as a result of droughts: the dry shock leads households to rely primarily on cereals and to purchase less vegetables, fruits, pulses, and animal-sourced foods. Hence, droughts negatively impact not only the quantity but also the quality of rural household diets. Finally, I explore the potential channels for these effects. I argue that rather than higher food prices, a decline in household market and non-market income is the primary reason for lower household food consumption and nutrition during droughts. Taken together, these findings suggest that attaining food security amid extreme weather conditions requires an integrated approach that focuses on food not only for survival but also for leading a healthy and active life.

Examining Dietary Change as a Determinant of Improving Child Nutritional Status in Bangladesh from 1992 to 2005 (OR10-07-19)

ObjectivesWe sought to quantify the impact of the transition in household diets in Bangladesh on the reduction of stunting in children from six months to two years of age over the 13-year period from 1992 to 2005. MethodsThis study utilizes data from four rounds of two linked survey systems: the Bangladesh Household [Income and] Expenditure Surveys (H[I]ES) and the Child [and Mother] Nutrition survey (C[M]NS). The households included in the C[M]NS were a subsample of those contained in the H[I]ES. Across all years, we analyzed 3484 children who were six to twenty-three months of age at the time of C[M]NS. Dietary change was measured through dietary patterns previously derived using principal component analysis. We used Blinder-Oaxaca decomposition to assess the impact of changing diets, other socioeconomic characteristics of households, and child level characteristics on child nutritional status over time. ResultsFor six dietary patterns, the prevalence of adherence changed over time. In a fully adjusted model, only the “modern” dietary pattern – characterized by processed soybean/palm oil, poultry and beef, beverages, generally more diversity, and less rice – was significantly associated with changes in child nutritional status. Indicators included in the decomposition models explained 64% of the observed change in length-for-age z-score (LAZ), 84% of the observed change in weight-for-age z-score (WAZ), and 180% of the observed change in weight-for-length z-scores (WFL). The dietary transition towards the “modern” diet over time was a significant predictor of better child LAZ and WAZ, but not quite significant for WFL (p-values: 0.005, 0.005, and 0.07, respectively). Other significant predictors of LAZ and WAZ included changes in household access to improved latrines and increased caregiver education. Increased household real income was not a significant predictor of improved nutritional status. ConclusionsChanges in household characteristics, namely more diverse diets and improved latrines, along with increasing caregiver education, were able to largely explain the changes in child nutritional status over time. Increasing income, however, did not independently improve child growth. This points to the need to focus on nutrition-specific and -sensitive interventions to continue to decrease child malnutrition. Funding SourcesThis publication has been produced with the assistance of the European Union and the UK Department for International Development. The contents of this publication are the sole responsibility of its authors and do not necessarily reflect the views of the European Union or the UK Department for International Development. Supporting Tables, Images and/or Graphs▪▪

Determinants of the Double Burden of Malnutrition at the Community Level in Bangladesh (P10-084-19)

ObjectivesWe use a community-level analysis to better understand the determinates of the nutrition transition in Bangladesh. MethodsWe utilize data from the nationally representative Food Security and Nutrition Surveillance Project collected in 13 rounds (2011–2015) in 4413 communities. Definitions of women’s overweight/obesity were BMI >23.0 and child undernutrition was height for age z-score <-2 standard deviations from the mean. Communities were divided into four categories: healthy (stunting <30%, overweight <30%), modern (stunting <30%, overweight ≥30%), undernourished (stunting ≥30%, overweight <30%), and double burden (stunting ≥30%, overweight ≥30%). Logistic regression analysis was used to determine which factors were associated with community adherence to each category. ResultsOver the period from 2011 to 2015, the proportion of women overweight increased from 30% to 40%, and the proportion of children stunted declined from 40% to 35%. There was a large reduction of the proportion of the population living in undernourished communities (47% to 24%) and a sizable increase in the proportion of the population in modern communities (17% to 36%). The proportion of the population in communities with a double burden of malnutrition increased from 24% to 30%.In multivariable logistic regression models, only wealth, household diets, and division of residence were significant determinants across community nutritional categorization. Healthy communities were characterized by fewer households in the wealthiest quintile and data collection prior to 2015. The odds of a community having a modern nutritional structure increased with the wealth of the area and increasing household dietary diversity. The odds of a community having an undernourished nutritional structure decreased with increasing wealth. A higher proportion of the population in the lowest wealth quintile and household dietary diversity was negatively associated with communities with a double burden of malnutrition. ConclusionsResults indicate that the double burden of malnutrition is not associated with urban residence, pointing to a need for programs in rural as well as urban areas. In addition, the rapid increase in the population living in modern communities points to a need to increase behavior change communication around what is needed for a healthy adult diet. Funding SourcesThis publication has been produced with the assistance of the European Union and the UK Department for International Development. The contents of this publication are the sole responsibility of its authors and do not necessarily reflect the views of the European Union or the UK Department for International Development. Supporting Tables, Images and/or Graphs▪

Interrelationships Between Household Chaos, Children’s ADHD Tendencies, and Diet Quality (P11-113-19)

ObjectivesHousehold environment, diet, and inattention/hyperactivity tendencies have been shown to influence children’s physical and cognitive development. However, these factors are often studied independently. Therefore, there is little knowledge on the interrelationships between household environment, diet, and children’s ADHD tendencies. This study aimed to investigate relationships between ADHD tendencies, household chaos, and diet quality among 4 and 5-year olds. MethodsFour and five-year-old children (n = 55, 22 females) were recruited from the East-Central Illinois area. Participants’ parents completed two surveys and a seven-day food record. The ADHD Rating Scale-IV Home Version questionnaire and the Confusion, Hubbub, and Order Scale (CHAOS) questionnaire were used to assess inattention/hyperactivity tendencies and household chaos, respectively. Diet records were analyzed using the Nutrition Data Systems for Research (NDSR) 2015 to estimate Healthy Eating Index 2015 scores (HEI-2015). All measures were self-reported by the child’s caregiver. ResultsUsing Spearman’s bivariate correlations, total HEI score was negatively and significantly related to hyperactivity tendencies (r = –.24, P = .04) and total raw scores (r = –.24, P = .04). CHAOS was positively and significantly related to inattention tendencies (r = .24, P = .04), hyperactivity tendencies (r = .31, P = .01), and total raw scores (r = .31, P = .01). CHAOS indicated no significant relationship with total HEI score. Using partial correlations while controlling for age, sex, income, and gender, household chaos was positively and significantly related to hyperactivity tendencies (r = .28, P = .03) and total raw scores (r = .28 P = .03). Additionally, total HEI score was no longer significantly related to inattention or hyperactivity tendencies. ConclusionsThese findings suggest that children’s tendencies of hyperactivity and inattention are associated with commotion in the household environment. Additional research is necessary to determine the potential of dietary factors in this relationship. Funding SourcesThis work was supported by the National Dairy Council and the Department of Kinesiology and Community Health.

Los cambios en los patrones de consumo de carnes en el mercado interno.

The objective of this research was to study the consumption of different cuts and types of meat by Uruguayan households in the last decade of the XX century and the first decade of XXI century. It involved a two-step estimation of an incomplete system of censored demand equations using household data from the two last national household income and expenditure surveys. Thirteen meat products were included in the analysis: six beef products, four from other meats (sheep, pork, poultry, and fish), and three generic mixed-meat products. A complete set of shor tterm income, own-price and cross-price elasticities were computed and reported with 90% confidence interval. The comparison between the two periods verified a decrease in the consumption of all meats, particularly beef. However, they continue being a dominant factor in household diets. Poultry meat substantially improved its relative consumption although cold cut meats and sausages consolidated as the most preferred among all meat products. The consumption of ground beef excelled among bovine cuts. Income level and household size showed a positive effect on the probability of spending on almost any meat. All meat items were necessary goods (η < 1) exhibiting income-inelastic responses. All of them behaved also as normal goods (e < 0) although showing different responses to price changes.

A sequential, exploratory, mixed-methods approach for development and validation of a context-specific knowledge, attitude and practice questionnaire on micronutrients for literate mothers of school-age children.

To develop and validate a context-specific comprehensive knowledge, attitude and practice (KAP) questionnaire for literate mothers on factors affecting micronutrient status of 6-10-year-old children. Sequential exploratory mixed-methods study using focus group discussions (FGD) and psychometric validation. Seven randomly selected villages with &gt;500 households with three to five family members each, in Ghatkesar sub-district, Medchal district, Telangana state, India.ParticipantsLiterate mothers from middle-income households with at least one child (6-10 years) for FGD (n 44), for testing the internal consistency (n 80) and for test-retest reliability (n 30). The themes for FGD were diet diversity, micronutrients, cooking and eating practices, national programmes and sunlight exposure. Knowledge among caregivers about sources of micronutrients, deficiency symptoms, cooking/eating practices was low, while attitude towards diet diversity and sunlight was good. Non-availability of fruits and vegetables was a barrier to diet diversity. About 72 % of the questions from the item pool were based on FGD. After content validity, 125 items were selected for the questionnaire which, upon psychometric validation, was reduced to an eighty-eight-item questionnaire with difficulty index of 0·10-0·91, discrimination index of 0·09-0·68, Cronbach's α of 0·78 (reliability of knowledge and attitude) and 0·50 (practice). A Bland-Altman plot showed good agreement between test and retest scores. The questionnaire developed and validated using a sequential exploratory mixed-methods approach can be used for assessing KAP on micronutrients and factors affecting consumption of diverse diets in rural Indian households.

Frequency of Food Pantry Use Is Associated with Diet Quality among Indiana Food Pantry Clients

Food-insecure households access food pantries to receive supplemental food, yet limited examination of the relationships of food pantry use or household food insecurity with diet quality and health has been documented among food pantry users. This study investigated the associations among food pantry use, household food security, body mass index, self-reported chronic disease and related conditions, and diet quality among food pantry users. Food pantry users in central Indiana were recruited for this cross-sectional study and surveyed for sociodemographic characteristics, food pantry use frequency, household food security, diet quality, and chronic disease and related conditions. Measurements of height and weight were obtained. Data from 270 participants, aged 21 to 80 years, were collected from June 2014 to December2015. Healthy Eating Index-2010 (HEI-2010) total score, component scores, and body mass index were analyzed across food pantry use and household food security groups using multiple linear regression. Odds of reporting chronic disease and related conditions were compared across food pantry use and household food security groups using logistic regression. Visiting food pantries more than once a month was associated with higher HEI-2010 total score (P=0.03) and Total Protein Foods score (P=0.05) than visiting less often. HEI-2010 scores were not significantly different across household food security groups. Body mass index was not different across food pantry use groups or household food security groups. Household food insecurity was associated with higher odds of reporting heart disease (age- and sex-adjusted odds ratio=2.65; 95% CI, 1.05-6.69) compared with household food security. Food pantry use frequency differentiates diet quality, and household food security status differentiates chronic disease and related conditions among low-resource food pantry user subpopulations.

Dietary Transition in India: Temporal and Regional Trends, 1993 to 2012.

Rapid economic growth, urbanization, and globalization have resulted in dietary transformation in India. Triple burden of malnutrition remains a significant concern, with high prevalence of undernutrition, widespread micronutrient deficiencies, and rising obesity. This article reviews the dietary transition in India by analyzing trends in food consumption across time and space. Household consumption survey data from 1993 to 2012 are analyzed to examine both national- and state-level trends to investigate how diets have changed and vary across the country. Typical Indian diets are characterized using k-mean cluster analysis and associated with socioeconomic and geographical aspects. The article finds that on average Indian household diets have diversified slowly but steadily since the 90s. Indians diets have shifted away from cereals to higher consumption of milk. However, progress on micronutrient-rich food groups such as fruits, vegetables, meat, and egg has been worryingly slow. Even by 2012, about a fifth of rural Indian households did not consume fruits or milk, while more than half of both urban and rural households did not consume any meat, fish, or eggs. Five predominant dietary types are identified. Sections of the Indian households do consume reasonably balanced diets, but large percentages consume cereal-focused, dairy-focused, or processed food heavy diets with high processed food content. Diets in India have not transformed sufficiently to overcome major gaps in intakes of micronutrient-rich foods. Large regional heterogeneities in diets call for regionally differentiated strategies to improve diets.

Nutrition Transition and Changing Food Preferences in India

AbstractWe present empirical evidence on how changes in food preferences have contributed to nutrition transition, where the dietary pattern of households shifts away from traditional staples. Using household‐level time series cross‐section survey data for India, we estimate time varying demand elasticities, revealing evidence of the declining importance of cereals in Indian household diets. The estimates show that Indian demand for cereals has become more income inelastic and price elastic. We also find that cereals are a substitute rather than a complement to animal products in household diets. Since changes in elasticities can only be attributed to variation in utility parameters, this indicates that cereals are losing favour with Indian households. These findings have implications for Indian food policy design and implementation.

Land consolidation, specialization and household diets: Evidence from Rwanda

Despite rapid population growth, increasing land pressure and urbanization, farmers in Sub-Saharan Africa have not intensified their production in a sustainable manner and farming systems remain predominantly subsistence-oriented. In response, developing country governments increasingly implement programs that promote crop intensification and more commercially-oriented agricultural systems. Rwanda’s Crop Intensification Program (CIP), launched in 2007, is one such example. However, despite its apparent success in raising production of several priority crops, there are legitimate concerns about the food and nutrition security implications for households that are encouraged to consolidate their land, specialize in their production, and increasingly rely on markets for their food needs. Using recent household survey data and a propensity score matching difference-in-differences method, we find that participation in land consolidation activities had ambiguous consumption effects: it positively impacted on consumption of roots and tubers, but had a negative effect on meat, fish and fruits consumption and the potential availability of vitamin B12 in participants’ diets. This calls for a review of CIP implementation practices to enhance the program’s food and nutrition security outcomes, with improvements in market functioning and market access being potential starting points.

Contribution of Gleaning Fisheries to Food Security and Nutrition of Poor Coastal Communities in the Philippines

Gleaning for edible invertebrates on shallow reef flats is a chronic activity in the Philippines mainly for subsistence but also for supplemental family income. A case study carried out in five gleaning sites in the Visayas and Mindanao islands evaluated the contribution of reef gleaning to food security and nutrient adequacy of artisanal fishing households, among the poorest sectors in Philippine society. With a high proportion (38-75%) living in extreme poverty, dependence on gleaning as a source of energy and vital nutrients is very high. The typical diet of coastal households in the surveyed sites is mainly composed of rice (49%), fresh fish (10%) and gleaned invertebrates (14%). Individual members of coastal households consume an average of 930g of food daily, equivalent to energy (1891 kcal.day-1) and protein (62.7 g.day-1) intakes, exceeding national averages. Coastal communities have higher adequacy in protein (mean = 68%) than energy (mean= 43%), calcium (44%) and iron (29%) indicating diet of many households do not meet the daily recommended energy and nutrient intake (RENI). Significant contribution of gleaned seafood to protein intake of coastal families and highlight the need to formulate sound management policies to sustain the nutritional benefits from reef gleaning for marginal fishing communities.

Assessing Food Insecurity Trends and Determinants by using Mix Methods in Pakistan: Evidence from Household Pooled Data (2005-2014)

In this study, we try to indirectly quantify the welfare of people in Pakistan through measuring the food insecurity, malnutrition during last decade (2005-14). This study takes lead from earlier studies, in a sense; it covers two food price hike periods (2007 and 2011). So, it is important to understand, how food insecurity status and nutrition are affected by these shocks during this period. Thus, we use nationally representative data called as Household Income and Expenditure Survey (HIES) from 2005-2014. Pakistan Bureau of Statistics collects this data in five rounds; 2005-06, 2007-08, 2010-11, 2011-12, and 2013-14 comprised 81102 households. Results from the headcount ratios suggest that over the period food insecurity trends of the households raised from (58%) to (77%). we find urban households are more food insecure over the time as compared to rural households. Whereas, in qualitative terms of food insecurity, we use two food diversification measures; one is dietary diversity score and second one is share of staple food in total calories consumed by household, suggest that households dietary diversity score is good on average that is 9 out of 10 food groups and on the whole it is slightly improved from (8.8 %) to (9%) in previous 10 years. Interestingly, when we analyze the share of staple food in total calories, results suggest that major portion of a household's diet is consisting of staple food (wheat), (53%) and increased to (57%) from 2005 to 2014. We use the Heckman Approach to find out determinants of food insecurity. Results suggest that female headship plays a significant positive role in caloric intake, among the other variable head education, households' member with basic education and higher education, live stock ownership, consumption of livestock produced at home, farming, consumption of food crop produced at home and foreign and domestic remittances plays a significant positive role in caloric intake of food insecure households.

Household Food Insecurity and Dietary Saturated Fat in Rural Appalachia

Purpose: To explore the relationship between food insecurity and dietary saturated fat intake in rural Central Appalachia. Design: Cross-sectional analysis of baseline data from a longitudinal interventional studySample: Baseline assessment of dietary saturated fat intake and food security in volunteers who had resided in rural Central Appalachia for at least five years and were enrolled in a cooking skills class.Method: Volunteers (n=56, 89.3% female) completed the USDA Household Food Security Survey Module (HFSSM) and Diet History Questionnaire-II. Average age was 56.5 (range 18-76) years. Average intake of saturated fat was calculated using DietCalc software. Food security was measured using the HFSSM. Descriptive and inferential statistical analyses were conducted using SAS, v. 9.3 with an alpha level of .05.Findings: High or marginal food security was experienced by 75% with 25% of participants experiencing low/very low food security. Average daily saturated fat was 26 grams. Significant findings included greater saturated fat consumption in men; lower saturated fat consumption with older age; older age being associated with lower food insecurity; and no association between food insecurity and saturated fat intake. Average daily saturated fat gram intake was significantly lower for females than males; the group means were 23.6 (SD = 12.4) and 49.6 (SD = 15.0) for these two groups, respectively (t = 4.8, P < .001). For every 10-year increase in age, there was a 2.7 gram decrease in daily saturated fat intake.Conclusions: Historical food traditions and method of food preparation likely contribute to the lack of an association between high food security and saturated fat intake in rural Appalachia. Food insecurity was not associated with saturated fat intake in our sample. Additional research is needed to determine to the full impact of food insecurity on dietary fat intake in Appalachia.Keywords: Food Insecurity, Appalachian Region, Fatty Acids Saturated, Poverty DOI: http://dx.doi.org/10.14574/ojrnhc.v19i1.568 Acknowledgments: This study was funded by the National Institute of Nursing Research Grant 5K23NR014883-02.

The contribution of smallholder agriculture to the nutrition of rural households in a semi-arid environment in South Africa

The contribution of own food production to the nutrition of households in two neighbouring, rural, semi-arid settlements was investigated. A survey of a 10% probability sample (n=131) of households in Sekuruwe and Ga-Molekane in the Mokgalakwena Local Municipality, Waterberg District Municipality, Limpopo Province, South Africa, conducted in 2001, provided data on household composition, income (cash and kind), poverty status, expenditure and agriculture, including a detailed account of the types and quantities of food that were purchased during the month preceding the date of the interview. For each household the food obtained from the different types of agriculture they practised was quantified. Protein, iron and Vitamins A and C were selected as indicators to assess the contribution of purchased and own produced food to the food intake of households. Food composition tables were used to estimate the nutrient content of the different foods. To assess the contribution of irrigated home gardening to food intake of households, Drum &amp; Drip micro-irrigation systems which enabled irrigated vegetable production on an area of 36 m2 were installed on the residential sites of 10 volunteer households in the study area. The results confirmed that income is the most important determinant of household food security in rural South Africa. However, food obtained from various types of dry-land agriculture contributed significantly to household nutrition and without farming the food security of households would be reduced, especially among the ultra-poor. Small-scale irrigated vegetable production was shown to have the potential to substantially raise the amount of the Vitamins A and C available to households but did not address the lack of protein in the diet of ultra-poor households and the lack of iron in the diet of all households.Keywords: household food security, nutrition, poverty, rural agriculture, semi-arid, dry-land farming, irrigated home gardening, micro-nutrients, protein, iron, Vitamin A, Vitamin C

Are cash transfers the answer for child nutrition in sub‐Saharan Africa? A literature review

AbstractEarly evidence is ambiguous on the effects of cash transfer programmes on children, but until the last few years there has been little focus on Africa. We review the literature on 20 cash transfer schemes, including 12 from sub‐Saharan Africa. Such interventions have shown improvements in household diet and, in some cases, to agriculture, but have not always improved child health. However, a larger perspective focusing on two key time periods for nutrition—adolescence and the first 1,000 days of life reveals more opportunities for impact. In particular, the opportunity to empower young women to access secondary education and the reduction of adolescent pregnancy rates can improve the health of African children. Cash transfer programmes show promise, though there is room for improvement.

Agricultural inputs and nutrition in South Asia

There are a number of potential pathways leading from agricultural input decisions to nutrition outcomes of farm households. These have special resonance in less developed areas of South Asia given widespread undernutrition problems, market failures and restricted access to land and other key assets and inputs, as well as ongoing debates around the implications that the green revolution has held for nutritional outcomes. A number of initiatives, including the Leveraging Agriculture for Nutrition in South Asia (LANSA) project have been undertaking research that addresses these linkages. The objectives of this paper are to systematically review the recent evidence on linkages between agricultural inputs and diet and nutrition outcomes of farm households in South Asia, place relevant LANSA research within the context of this review, and draw implications for policy, practice and the future research agenda. We focus on land and livestock assets and the set of productivity enhancing inputs in the form of irrigation, seed and agrochemicals. We report on a systematic review of recent evidence based on observational data on the links between these agricultural inputs and assets and diet and nutrition outcomes of farm households in India, Pakistan, Bangladesh, Afghanistan and Nepal. We find that the literature has slowly but steadily grown since previous reviews conducted in the early 2010s, but that there is still a long way to go. Review results suggest that while there is no indication that land ownership or size by themselves have clear associations with farm household dietary or nutrition outcomes, land productivity is more clearly associated with improved outcomes. Yet the literature linking specific inputs such as improved seeds or irrigation with nutrition remains very thin. The literature appears strongest for the case of links between livestock keeping and dietary and nutrition outcomes. This is particularly the case with animals reared for milk, with the evidence indicating milch animal ownership improves household milk intakes and thereby influences the growth of children. Priorities for future research include the formulation and testing of more specific hypotheses relating to input-nutrition linkages and more strenuous efforts to improve causal identification in this literature.

"Then you raise them with Shirchoy or cookies": Understanding influences on delayed dietary diversity among children in Tajikistan.

Dietary diversity is a key component of infant and young child feeding (IYCF) as well as adult health. In Tajikistan, a predominantly rural, former Soviet country in Central Asia, we conducted formative research to identify barriers to dietary diversity and strategies for nutrition behaviour change. In Spring, 2016, mixed‐methods data collection took place across 13 villages in all five regions, collecting collaborative mapping; structured assessments of stores and markets; home visits for dietary recalls; food storage, preparation, and meal observations; focus groups with pregnant women, mothers of young children, fathers, and mothers‐in‐law; and in‐depth expert interviews with local nutrition and health influentials. Overall, maternal diet was adequate in terms of diversity (only 13% reported <5/10 food groups in the past 24 hr); however, only 42% of index children 6–24 months met WHO guidelines for diversity, and only 34% met minimum acceptable diet criteria. In addition to issues of poverty and food scarcity, qualitative data reveal many behavioural barriers to timely introduction of diverse complementary foods. Women's strategies focused on gradual introduction of household diet components, without regard for diversity or nutrition. Foods such as meat were seen as costly and thus inappropriate for IYCF, and food taboos (i.e., fresh vegetables) further reduced diversity. Infant food preparation methods such as grinding were seen as impractical, and many foods were withheld until children develop teeth. Possible nutrition education strategies include point‐of‐purchase campaigns to improve availability and appeal of IYCF‐friendly foods, as well as influencing other key household members through mosques, schools, and health care providers.