Exploring the Determinants of Minimum Dietary Diversity in Infants and Toddlers: Insights from Pakistan's Rural and Urban Populations
DOI:
https://doi.org/10.70749/ijbr.v3i3.852Keywords:
Minimum Dietary Diversity, Infants and Toddlers, Rural-Urban Disparities, Socioeconomic Determinants, Child NutritionAbstract
Determinants of Minimum Dietary Diversity (MDD) in infants and toddlers in rural and urban populations in Pakistan are explored in this study. MDD (consumption of foods from at least 4 food groups in 24 hours) is a marker of dietary quality and nutritional status. Selected rural and urban areas of Punjab were surveyed in a cross-sectional survey, including 600 infants and toddlers 5-20 months of age, and their primary caregivers. Structured surveys were used to collect data on dietary intake, socioeconomic factors, healthcare access, and food security. A total of 25% of children met the MDD criteria, with a significant difference of 48% in urban areas and 28% in rural areas (p < 0.001). Through multivariate logistic regression, it was found that several key determinants of MDD include maternal education (AOR: 2.4), household wealth (AOR: 3.1), market access (AOR: 2.7), healthcare utilization (AOR: 1.9), and food insecurity (AOR: 0.6). There were rural–urban disparities in maternal education and wealth as well as net access to markets. By contrast, rural children had less than half the consumption of fruits and protein-rich foods. The results suggest the importance of socioeconomic and infrastructural factors in explaining dietary diversity. Determinants of minimum dietary diversity (MDD) in Pakistan among infants and toddlers are examined in this study with emphasis on differences in these populations living in rural versus urban areas in Pakistan. Children living in urban areas have greater maternal education, wealth, and more access to healthcare and markets compared to children living in rural areas who suffer from food insecurity and socioeconomic challenges. Maternal education can be strengthened, market access increased, and structural inequalities addressed, contributing to increased dietary diversity and better nutrition and health outcomes for all children.
Downloads
References
Ali, Z. (2023). Resilient and healthy food systems in low-income settings. London School of Hygiene & Tropical Medicine,
Aqib, M. J. I. J. o. A., & Development, S. (2023). Unraveling Nutritional Landscapes: A Holistic Examination of Food Utilization, Sustainability, and Childhood Nutrition in Pakistan. 5(3), 124-137.
Ativor, P. S., & Salu, S. (2023). Minimum dietary diversity and associated factors among children aged 6-23 months in Ghana: a cross-sectional study. https://doi.org/10.21203/rs.3.rs-3255634/v1
Atosona, A., Mohammed, J. A., Issahaku, H., Saani, K., Addae, H. Y., & Azupogo, F. J. B. n. (2024). Maternal employment status and child age are positive determinants of minimum dietary diversity among children aged 6–23 months in Sagnarigu municipality, Ghana: a cross-sectional study. 10(1), 57. https://doi.org/10.1186/s40795-024-00865-7
Beressa, G., Whiting, S. J., & Belachew, T. J. N. J. (2024). Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial. 23(1), 3. https://doi.org/10.1186/s12937-023-00907-z
De Bruin, S., & Holleman, C. (2023). Urbanization is transforming agrifood systems across the rural–urban continuum creating challenges and opportunities to access affordable healthy diets: Background paper for The State of Food Security and Nutrition in the World 2023. https://doi.org/10.4060/cc8094en
Haq, S. U., Shahbaz, P., Abbas, A., Batool, Z., Alotaibi, B. A., & Traore, A. J. L. (2022). Tackling food and nutrition insecurity among rural inhabitants: Role of household-level strategies with a focus on value addition, diversification and female participation. 11(2), 254. https://doi.org/10.3390/land11020254
Haque, S., Salman, M., Hossain, M. S., Saha, S. M., Farquhar, S., Hoque, M. N., . . . Nutrition. (2024). Factors associated with child and maternal dietary diversity in the urban areas of Bangladesh. 12(1), 419-429. https://doi.org/10.1002/fsn3.3755
Islam, M. H., Nayan, M. M., Jubayer, A., Amin, M. R. J. F. S., & Nutrition. (2024). A review of the dietary diversity and micronutrient adequacy among the women of reproductive age in low‐and middle‐income countries. 12(3), 1367-1379. https://doi.org/10.1002/fsn3.3855
Jenkins, M., Jefferds, M. E. D., Aburto, N. J., Ramakrishnan, U., Hartman, T. J., Martorell, R., & Addo, O. Y. J. T. J. o. N. (2024). Development of a population-level dichotomous indicator of minimum dietary diversity as a proxy for micronutrient adequacy in adolescents aged 10–19 y in the United States. 154(9), 2795-2806. https://doi.org/10.1016/j.tjnut.2024.06.002
Kawecka, P., & Kostecka, M. J. J. o. H. I. (2024). The role of the family environment and parental nutritional knowledge in the prevention of behavioral feeding disorders in toddlers and preschool children–a narrative review. 10(1), 56-63. https://doi.org/10.5114/jhi.2024.140767
Kebede, A., Jirström, M., Worku, A., Alemu, K., Berhane, H. Y., Turner, C., . . . Berhane, Y. J. N. (2022). Residential food environment, household wealth and maternal education association to preschoolers’ consumption of plant-based vitamin A-rich foods: the EAT Addis survey in Addis Ababa. 14(2), 296. https://doi.org/10.3390/nu14020296
Nguyen, P. H., Sununtnasuk, C., Christopher, A., Ash, D., Ireen, S., Kabir, R., . . . Escobar-DeMarco, J. J. T. J. o. N. (2023). Strengthening nutrition interventions during antenatal care improved maternal dietary diversity and child feeding practices in urban Bangladesh: results of a quasi-experimental evaluation study. 153(10), 3068-3082. https://doi.org/10.1016/j.tjnut.2023.06.023
Paulo, H. A., Andrew, J., Luoga, P., Omary, H., Chombo, S., Mbishi, J. V., & Addo, I. Y. J. B. n. (2024). Minimum dietary diversity behaviour among children aged 6 to 24 months and their determinants: insights from 31 Sub-Saharan African (SSA) countries. 10(1), 160. https://doi.org/10.1186/s40795-024-00967-2
Qamar, T., Ibrahim, N., & Hamzah, N. A. A. Interventions and Treatment Setting for Major Depressive Disorder in Pakistan. https://doi.org/10.57239/pjlss-2024-22.2.001126
Qin, Y., Yue, A., Zhang, Y., Zhang, X., Gao, Y., Liang, S., . . . Qiao, N. J. F. i. P. H. (2024). Dietary diversity and development among early childhood children in rural China. 12, 1485548. https://doi.org/10.3389/fpubh.2024.1485548
Ravikumar, D., Spyreli, E., Woodside, J., McKinley, M., & Kelly, C. J. B. p. h. (2022). Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence. 22, 1-16. https://doi.org/10.1186/s12889-021-12414-z
Roba, A. A., Başdaş, Ö., Brewis, A., & Roba, K. T. J. B. o. (2024). Maternal and household factors affecting the dietary diversity of preschool children in eastern Ethiopia: a cross-sectional study. 14(3), e080616. https://doi.org/10.1136/bmjopen-2023-080616
Rotella, R., Soriano, J. M., Peraita‐Costa, I., Llopis‐González, A., Morales‐Suarez‐Varela, M. J. T. M., & Health, I. (2024). Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD‐W) tool in breastfeeding mothers in Madagascar. 29(7), 622-632. https://doi.org/10.1111/tmi.14004
Russell, A. L., Hentschel, E., Fulcher, I., Ravà, M. S., Abdulkarim, G., Abdalla, O., . . . Wilson, K. J. B. P. H. (2022). Caregiver parenting practices, dietary diversity knowledge, and association with early childhood development outcomes among children aged 18-29 months in Zanzibar, Tanzania: a cross-sectional survey. 22(1), 762. https://doi.org/10.1186/s12889-022-13009-y
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research

This work is licensed under a Creative Commons Attribution 4.0 International License.
