Assessing Dietary Intake Patterns Through Cluster Analysis Among Adolescents in Selected Districts of Bihar and Assam From India: A Cross-Sectional Survey

Abstract

Background: In the recent decade, dietary pattern assessment has evolved as a promising tool to describe the whole diet and represent inter-correlations between different dietary components. We aimed to derive the dietary patterns of adolescents (10–19 years) using cluster analysis on food groups and evaluate these patterns according to their socio-demographic profile.Methods: This community-based cross-sectional study was conducted in two districts, each from Bihar and Assam in India. Adolescents (10–19 years) were enrolled from both rural and urban areas. The dietary intake was assessed through a pre-validated single food frequency questionnaire. Cluster analysis was performed by a 2-step procedure to explore dietary patterns, pre-fixed at 2 clusters. Clusters were analyzed with respect to socio-demographic characteristics using binomial logistic regression.Results: A total of 826 girls and 811 boys were enrolled in the study. We found two major dietary patterns, namely a low- and high-mixed diet. The low-mixed diet (76.5% prevalence) had daily consumption of green vegetables, including leafy vegetables, with less frequent consumption of other foods. The high-mixed diet (23.5% prevalence) had more frequent consumption of chicken, meat, egg, and milk/curd apart from green vegetables. Adolescent boys had 3.6 times higher odds of consuming a low-mixed diet compared to girls. Similarly, adolescents with lower education grades and from marginalized social classes had two times higher odds of taking a low-mixed diet than their respective counterparts.Conclusions: The high consumption of a low-mixed diet and relatively less milk consumption limit the comprehensive growth of adolescents. Improvement in dietary intake of adolescents from marginalized sections of society can prove to be an important deterrent in mitigating India's nutritional challenges.

Undernutrition and anaemia among Indian adolescents: role of dietary diversity and hygiene practices

“…The findings from CNNS data show that 27⋅2 and 28⋅5 % of the adolescents are stunted and anaemic, and only 11 % of adolescents have adequate dietary diversity. Recent studies on adolescent dietary diversity and nutrition have found that only 24 % of adolescents have a high-mix diet (8) and inadequate dietary intake is significantly associated with poor nutritional outcomes among females in India (9) . Furthermore, access to improved WASH services have been found to have a significant impact on child nutritional outcomes (10)(11)(12) .…”

“…Chattopadhyay et al find a significant positive association between WASH practices (beyond household level availability) and nutritional outcomes of adolescent girls in three states (Bihar, Chhattisgarh and Odisha) of India ( 13 ) . But due to lack of comprehensive and representative data on adolescent nutrition, the scope of earlier studies is a limited to specific region or gender ( 8 , 9 , 13 , 14 ) . Two recent studies on adolescent malnutrition ( 15 ) and anaemia ( 16 ) conducted using CNNS (2016–18) data shows substantial socioeconomic and regional disparities in adolescent malnutrition.…”

Reasons and solutions for unhealthy food consumption and physical inactivity among school-going adolescents: A sequential mixed-methods study in Puducherry, South India

“…Similar to our study findings, Sharma et al . [ 20 ] in a community-based cross-sectional survey in Assam and Bihar highlighted that higher proportion of adolescent males consumed low-mixed diet and preferred junk foods. Likewise, in Chennai, a school-based cross-sectional study showed that insufficient physical activity was substantially higher among the female group.…”