Food Access and Nutritional Status of Rural Adolescents in India: Pune Maternal Nutrition Study

Introduction: The relationships among food access, foods consumed, and nutritional status and health in developing countries are not well understood. Between 2013 and 2018, differences in the rural food environment and access to food, nutritional status, and body size in the rural villages where the Pune Maternal Nutrition birth cohort was recruited were measured and analyzed.

Methods: Food access measures included the number of shops per 1,000 population, water availability, and distance from the highway. A total of 418 adolescents (223 boys, 195 girls) aged 18 years had diet assessed by a quantitative food frequency questionnaire; height, weight, and waist measured; body fat percentage determined by dual x-ray absorptiometry; and blood biomarkers (vitamin B12 and hemoglobin) assayed.

Results: By village, the number of shops per 1,000 population ranged from 3.85 to 23.29. Boys and girls from the 2 villages with the highest food access, year-round water availability, and closest to the highway were heavier and had higher BMI, waist circumference, and body fat percentage compared with those from the lowest tertile of food access (p<0.05 for all, adjusted for SES). Across all villages, dietary diversity was poor and B12 insufficiency and anemia were prevalent. With easier access to food, consumption of staple foods decreased and outside food increased. On multivariate regression analysis, higher BMI of the adolescents was significantly associated with higher food access, along with higher weight at birth, socioeconomic scores, and daily energy consumption.

Conclusions: Results demonstrate a strong link between rural food access, foods consumed, and measures of nutritional status in an undernourished, mostly vegetarian, rural population.