(P24-063-23) Evaluating Minimum Dietary Diversity and Associated Parameters Among Females (15-49 Years) Towards Developing Food-Based Alternatives to Curb Anemia

Objectives: Iron deficiency is the strongest predictor of anemia among adolescent girls in India. Supplementation and fortification may make little difference in reducing Iron Deficiency Anemia (IDA) risk. Long-term dietary diversification is the most sustainable food-based strategy. Quantifying Minimum Dietary Diversity (MDD) is crucial in understanding nutritional anemia in women. The study evaluates the MDD and anemia awareness among females (15-49 years) in Ahmedabad, Gujrat. Products with high iron bioavailability were developed based on region-specific food preferences.

Methods: Women aged 15-49 were surveyed from two villages in Ahmedabad through a questionnaire (n=43) and MDD survey (n=33). Data on DD, 30-day food frequency, and potion size were collected using 24 hr. open recall method and a questionnaire (10 food groups) based on regionally available foods. The Rice-Wheat share (RW Share) and total Fe intake were quantified (daily, monthly). A separate survey (translated into the local language-Gujrati) assessed food preferences, anemia awareness, and measures to curb it. 

Results: The mean individual MDD Score was 5.9 out of 10, while the total average Fe intake was 7.6 ± 2.5 (3.8 ─ 12.4) mg/day. The average RW Share/day was estimated to be 59.9% (30.4 ─ 83.1%), while it was 54% (28 ─ 82%) monthly. The diet lacked micronutrient and protein-dense foods (vegetables, fruits, dairy). Some (40%) women were unaware of anemia, while another 40% recognized its symptoms and the use of iron tablets to manage the condition. Food-based alternatives were preferred over medicine/ supplements. 

Conclusions: The MDD score indicates moderate nutrient adequacy, but high RW share suggests higher odds of poorer iron status. Long-term increased consumption of staple cereals (with low bioavailable Fe) and lack of Fe absorption enhancers in the diet are associated with greater intensity of IDA in women, contributing to the district's high (~64%) prevalence. Public policies must be reoriented from the 'staple grain fundamentalism' to food-based interventions. A range of Fe-rich products (15─24 mg Fe/100g) using food-to-food fortification strategy are being developed with potentially high Fe bioavailability towards achieving the same. Ingredient selection and process optimization are done while bioavailability and sensory studies are underway. 

Funding Sources: IIT Bombay