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Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal.
PLOS ONE ( IF 2.9 ) Pub Date : 2020-01-14 , DOI: 10.1371/journal.pone.0227873 Devendra Raj Singh 1, 2 , Saruna Ghimire 3 , Satya Raj Upadhayay 4 , Sunita Singh 5 , Umesh Ghimire 6
PLOS ONE ( IF 2.9 ) Pub Date : 2020-01-14 , DOI: 10.1371/journal.pone.0227873 Devendra Raj Singh 1, 2 , Saruna Ghimire 3 , Satya Raj Upadhayay 4 , Sunita Singh 5 , Umesh Ghimire 6
Affiliation
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BACKGROUND
Adequate nutrition is essential during the lactation period for better maternal and child health outcomes. Although food insecurity and dietary monotony (defined as less diverse diet), two important determinants of undernutrition, are endemic in the rural mountains of Nepal, insufficiently examined and assessed for risk factors in mothers during lactation, a life stage of high nutritional demand. This study aimed to assess the status and factors associated with food insecurity and dietary diversity among lactating mothers residing in the mountains of Nepal.
METHODS
A community-based cross-sectional study was conducted in an urban municipality in the mountainous Bajhang District of far-western Nepal. The sampling frame and strategy led to 417 randomly selected lactating mothers. Household Food Insecurity Access Scale (HFIAS) and the tool "Minimum Dietary Diversity for Women" developed by the Food and Agriculture Organization were used to measure food insecurity and dietary diversity, respectively. Additional information on socio-demographics and risk factors were collected. Multivariable logistics regression assessed correlates of study outcomes.
RESULTS
Overall, 54% of the households were food insecure, and over half (53%) of the mothers had low dietary diversity. Food insecurity status (mild food insecurity AOR = 10.12, 95% CI = 4.21-24.34; moderate food insecurity AOR = 8.17, 95% CI = 3.24-20.59, and severe food insecurity AOR = 10.56, 95% CI = 3.92-28.43) were associated with higher odds of dietary monotony. Likewise, participants with lower dietary diversity were 8.5 times more likely to be food insecure than those with higher dietary diversity (AOR = 8.48, 95% CI = 3.76-19.14). The monthly income of the family was positively associated with food insecurity. Participants' (AOR = 3.92 95%CI = 1.76-8.71) or spouses' (AOR = 2.90, 95% CI = 1.07-7.85) unemployment was associated with higher odds of being food insecure. Likewise, owning a cultivable land (AOR = 0.49, 95% CI = 0.28-0.84) and participant's unemployment status (AOR = 5.92, 95% CI = 3.02-11.63), were significantly associated with increased odds of dietary monotony.
CONCLUSION
The observed food insecurity and poor dietary diversity among lactating mothers, the correlates associated with these outcomes, may help local stakeholders to identify local health needs and subgroups for targeted interventions. Socioeconomically disadvantaged mothers should be specifically targeted for relevant programs and policies.
中文翻译：
尼泊尔山区城市哺乳期母亲的粮食不安全和饮食多样性。
背景 哺乳期充足的营养对于改善孕产妇和儿童的健康结果至关重要。尽管粮食不安全和饮食单一（定义为饮食多样化较少）是营养不良的两个重要决定因素，但在尼泊尔农村山区普遍存在，但对哺乳期（营养需求较高的生命阶段）母亲的危险因素没有进行充分的检查和评估。本研究旨在评估居住在尼泊尔山区的哺乳期母亲的粮食不安全和饮食多样性的状况和相关因素。方法 在尼泊尔西部偏远山区 Bajhang 地区的一个城市进行了一项基于社区的横断面研究。抽样框架和策略随机选择了 417 名哺乳期母亲。家庭粮食不安全获取量表（HFIAS）和联合国粮食及农业组织开发的工具“妇女最低膳食多样性”分别用于衡量粮食不安全和膳食多样性。收集了有关社会人口统计和风险因素的更多信息。多变量逻辑回归评估了研究结果的相关性。结果 总体而言，54% 的家庭粮食不安全，超过一半 (53%) 的母亲饮食多样性较低。粮食不安全状况（轻度粮食不安全 AOR = 10.12，95% CI = 4.21-24.34；中度粮食不安全 AOR = 8.17，95% CI = 3.24-20.59；严重粮食不安全 AOR = 10.56，95% CI = 3.92-28.43）与饮食单调的可能性较高有关。同样，饮食多样性较低的参与者出现粮食不安全的可能性是饮食多样性较高的参与者的 8.5 倍（AOR = 8.48，95% CI = 3.76-19.14）。 家庭月收入与粮食不安全呈正相关。参与者（AOR = 3.92 95% CI = 1.76-8.71）或配偶（AOR = 2.90，95% CI = 1.07-7.85）失业与粮食不安全的可能性较高有关。同样，拥有耕地（AOR = 0.49，95% CI = 0.28-0.84）和参与者的失业状况（AOR = 5.92，95% CI = 3.02-11.63）与饮食单调的可能性增加显着相关。结论 观察到的哺乳期母亲的粮食不安全和饮食多样性差以及与这些结果相关的相关性，可能有助于当地利益相关者确定当地的健康需求和亚组，以采取有针对性的干预措施。相关计划和政策应专门针对社会经济弱势母亲。
更新日期：2020-01-15
中文翻译：
尼泊尔山区城市哺乳期母亲的粮食不安全和饮食多样性。
背景 哺乳期充足的营养对于改善孕产妇和儿童的健康结果至关重要。尽管粮食不安全和饮食单一（定义为饮食多样化较少）是营养不良的两个重要决定因素，但在尼泊尔农村山区普遍存在，但对哺乳期（营养需求较高的生命阶段）母亲的危险因素没有进行充分的检查和评估。本研究旨在评估居住在尼泊尔山区的哺乳期母亲的粮食不安全和饮食多样性的状况和相关因素。方法 在尼泊尔西部偏远山区 Bajhang 地区的一个城市进行了一项基于社区的横断面研究。抽样框架和策略随机选择了 417 名哺乳期母亲。家庭粮食不安全获取量表（HFIAS）和联合国粮食及农业组织开发的工具“妇女最低膳食多样性”分别用于衡量粮食不安全和膳食多样性。收集了有关社会人口统计和风险因素的更多信息。多变量逻辑回归评估了研究结果的相关性。结果 总体而言，54% 的家庭粮食不安全，超过一半 (53%) 的母亲饮食多样性较低。粮食不安全状况（轻度粮食不安全 AOR = 10.12，95% CI = 4.21-24.34；中度粮食不安全 AOR = 8.17，95% CI = 3.24-20.59；严重粮食不安全 AOR = 10.56，95% CI = 3.92-28.43）与饮食单调的可能性较高有关。同样，饮食多样性较低的参与者出现粮食不安全的可能性是饮食多样性较高的参与者的 8.5 倍（AOR = 8.48，95% CI = 3.76-19.14）。 家庭月收入与粮食不安全呈正相关。参与者（AOR = 3.92 95% CI = 1.76-8.71）或配偶（AOR = 2.90，95% CI = 1.07-7.85）失业与粮食不安全的可能性较高有关。同样，拥有耕地（AOR = 0.49，95% CI = 0.28-0.84）和参与者的失业状况（AOR = 5.92，95% CI = 3.02-11.63）与饮食单调的可能性增加显着相关。结论 观察到的哺乳期母亲的粮食不安全和饮食多样性差以及与这些结果相关的相关性，可能有助于当地利益相关者确定当地的健康需求和亚组，以采取有针对性的干预措施。相关计划和政策应专门针对社会经济弱势母亲。
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