Topical Area: Global Nutrition
Objectives : Most research on stunting in India ignores the role of diets, including the unusually high prevalence of lacto-vegetarianism (LVG). LVG is a concern in India because nutrient-dense animal-sourced foods (ASFs) are highly recommended in early childhood. We therefore explore how parental LVG is associated with linear growth and child dietary patterns in India.
Methods : We use the 2015-2016 National Family Health Survey-4 from India. Our primary outcomes are height-for-age Z scores (HAZ) and stunting (HAZ< -2) (N=214,165) for children 0-59m. We use 24-hour recall measures of whether a child consumed a specific food group in the past 24 hours both as a secondary outcome variable and as an explanatory variable in HAZ/stunting regressions. Our main explanatory variable is whether the child’s mother reports never consuming non-dairy ASFs (LVG). We use descriptive statistics to report patterns of LVG by state, rural/urban location, caste and wealth quintile, and patterns of HAZ, stunting and dietary outcomes by LVG status. We then use multivariate linear regression models to test for associations between our outcome variables and LVG, stratified by child age, and controlling for district fixed effects and an extensive array of child, parent, household and community controls.
Approximately 30% of mothers in India are estimated to be LVG, although LVG in some states is as high as 70%. Descriptive and regression evidence suggests that children of LVG mothers are much less likely to consume non-dairy ASFs, but more likely to consume dairy and pulses. In multivariate regressions for children 12 months and older, children of LVG mothers are 3.0 percentage points less likely to be stunted, and have 0.09 SDs higher HAZ, on average. Multivariate regressions also show that stunting/HAZ is strongly associated with a child consuming dairy products, but not with consumption of other ASFs.
Conclusions : Despite the widespread concern that children of LVG parents are more likely to be stunted, we find the opposite to be the case, seemingly because LVG children are more likely to consume dairy, and dairy is much more strongly associated with linear growth than other ASFs. From a policy perspective the results strongly emphasize the importance of dairy in both the LVG and non-LVG Indian diet.
Funding Sources : Bill & Melinda Gates Foundation through ARENA, led by International Food Policy Research Institute.