Enhancing Dietary Diversity in Rural South Asia: Insights from Agricultural Production Diversity, Food Environments, and Household Factors

by  Afrin Zainab Bi ¹, Samira Choudhury ², A.N.M. Faijul Kabir ², and Prakashan Chellattan Veettil ¹

The Challenge of Low Dietary Diversity in Rural South Asia

Malnutrition, in its various forms including undernutrition, overnutrition, and micronutrient deficiencies is a significant challenge in low- and middle-income countries (LMICs), despite significant advancement in food production and supply. Poor quality diets contribute to various forms of malnutrition, including high rates of child undernutrition such as stunting and wasting, micronutrient deficiencies among women and children, and increasing rates of overweight and obesity, particularly in South Asia. Despite ongoing efforts to enhance food security, many households in rural South Asia still face challenges in achieving a diverse diet. Meals are typically dominated by staple foods such as rice, wheat, and maize and negligible portions of nutrient dense foods such as fresh fruits, vegetables and animal-sourced foods. Our study from two rural South Asian countries, India and Bangladesh, found low dietary diversity, with a mean score of only 3.69 out of 10 food groups consumed over a 24-hour period.  This indicates that many households are consuming a limited variety of different food groups.

What Affects Dietary Diversity in Rural South Asia?

Our study explored factors that influence dietary diversity in rural regions of India and Bangladesh, with a focus on agricultural production diversity, food environment characteristics, and household level factors. We argue that food environment is a key driver of dietary behaviours, which refers to the “interface where people interact with the wider food system to acquire and consume foods”. Food environment factors such as the shortest distance to markets and the density of green grocers were indirectly associated with dietary diversity through the types of food items purchased. For example, living closer to markets or in areas with more green grocers enabled households to access fresh and diverse food options, which in turn led to higher dietary diversity.

About 87% of rural smallholder farm households in Bangladesh and 70% in India primarily rely on agriculture for their livelihoods. Since these households usually consume a significant share of what they produce at home, increasing production diversity with various kinds of crops and livestock species is often seen as an effective strategy to enhance dietary diversity. Surprisingly, our study found that agricultural production diversity (the variety of crops and livestock produced by the household) had no direct association with dietary diversity. This finding suggests that simply increasing the range of crops grown by farmers does not necessarily translate into improved diets, at least not without addressing other factors such as food access and affordability.

In addition, the study found that wealth index, years of education of the respondent, and the types of food purchased in the last month were all directly and positively associated with dietary diversity. Households with higher wealth had more resources to purchase a variety of foods, and respondents with more education had better diets. Furthermore, those who purchased a greater variety of food items were more likely to have a diverse diet.

What can be done to improve dietary diversity?

The findings of this study have important implications for improving nutrition in rural South Asia. While increasing agricultural production diversity may seem like a logical solution, the results suggest that interventions focused solely on agricultural practices may not be sufficient. Instead, the following approaches are likely to be more effective:

1. Improving market access: Enhancing access to markets especially for more remote rural areas is crucial. Reducing the distance to markets can help households access a wider variety of nutritious foods. In particular, promoting the availability of green grocers and other outlets selling fresh produce and nutrient-dense foods could significantly boost dietary diversity.
2. Addressing food affordability: The cost of a healthy diet is a significant barrier to improving dietary diversity. Policies that make nutritious foods more affordable, such as subsidies for fruits, vegetables, and other micronutrient-rich foods, could help low-income households diversify their diets.
3. Improving education and socio-economic status: Long-term improvements in dietary diversity will also require addressing broader socioeconomic factors, such as improving wealth and educational opportunities. These factors enable households to make healthier food choices and purchase a wider variety of foods.

Conclusion

In conclusion, improving dietary diversity in rural South Asia requires a multifaceted approach that goes beyond agricultural production diversity. This study offers valuable evidence for policymakers and organizations working to combat malnutrition in rural South Asia. Interventions that target improvements in food environment factors such as better access to food outlets, making healthy foods more affordable, and enhancing nutrition education may help rural households improve their dietary intake and nutrition.