title: Dietary intake patterns and nutritional status of women of reproductive age in Nepal: findings from a health survey.
abstract: BACKGROUND
  Improper dietary intake pattern in women of reproductive age in Nepal has resulted in the deficiency of essential nutrients. Adequate nutritional status and proper dietary intake pattern of women improves maternal and child health. The objective of this study was to assess the nutritional status and dietary intake pattern among the women and associated factors.
  
  
  METHODS
  Data collection at households and health check-up camps were conducted in selected Village Development Committees of nine districts in three ecological regions (Mountain, Hill and Terai) of Nepal from September 2011 to August 2012. Women of reproductive age (15 to 49 years) were the study subjects. At the household interview, structured questionnaires were used to obtain information on socio-demographic characteristics, anthropometric measurements, dietary intake pattern, consumption of junk foods, animal rearing, agricultural products, possession of kitchen garden, pregnancy status and anemia. Dietary intake pattern was determined by information collected through the structured questionnaires comprising of food items-cereals, pulses/legumes, vegetables, meat, fruits and milk and milk products. Health check-up camps were conducted in the local health facilities where qualified doctors, nurses and laboratory technicians performed physical examination of the women, confirmed their pregnancy and conducted hematocrit tests. The data was entered and analyzed using SPSS.
  
  
  RESULTS
  Altogether 21,111 women were interviewed. More than a quarter of the women in Terai were malnourished as indicated by low body mass index (BMI < 18.5 Kg/m(2)). Among the dietary intake pattern, the majority of women consumed cereals at least once a day in all three ecological regions. The majority of women in Mountain consumed pulses/legumes thrice a week. In Terai, the majority of women consumed vegetables thrice a week. In all three ecological regions, the majority of women consumed meat and meat products and fruits once a week. About thirty percent of women consumed milk and milk products once a day in all three ecological regions. The non-use of iodized salt by Terai women was the highest (5.3 %, n = 303). In all the ecological regions, cereals and vegetables were produced in the majority of the participants' households in comparison of fruits, poultry and goat/sheep. The women of age 15 to 24 years were 2.7 times more likely to be malnourished than women of 35 to 49 years age (aOR = 2.7, CI = 2.5,3.0). The unemployed women had nearly two times more chances of being malnourished than women doing manual work (aOR = 1.9, 95 % CI = 1.5,2.2). In Terai, women were five times more likely to be malnourished (aOR = 0.2, CI = 0.1,0.2) and 20 times more likely to be anemic (aOR = 0.05, CI = 0.04,0.07) than women in Mountain. The pregnant women were five times more likely to be anemic than non-pregnant women (aOR = 0.2, CI = 0.2,0.3).
  
  
  CONCLUSIONS
  The nutritional status of women of reproductive age is still poor especially in Terai and the dietary intake pattern is not adequate. It suggests improving nutritional status and feeding habits especially intake of meat, fruits and vegetables focusing on reproductive aged women.
authors.affiliation: Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; Public Health and Infectious Disease Research Center (PHIDReC), New Baneshwor Kathmandu, Nepal ; Central Department of Microbiology, Tribhuvan University, Kirtipur Kathmandu, Nepal.
authors.forename: Shiva
authors.initials: S
authors.lastname: Bhandari
authors.affiliation: Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; National Center for Health Professions Education, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal.
authors.forename: Jamuna Tamrakar
authors.initials: JT
authors.lastname: Sayami
authors.affiliation: Department of Internal Medicine, Lumbini Medical College, Kathmandu University, Tansen, Palpa Nepal.
authors.forename: Pukar
authors.initials: P
authors.lastname: Thapa
authors.affiliation: Department of Internal Medicine, Maharajgunj Medical College, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal.
authors.forename: Matina
authors.initials: M
authors.lastname: Sayami
authors.affiliation: Department of Surgery, Institute of Medicine, Tribhuvan University, Maharajgunj Kathmandu, Nepal.
authors.forename: Bishnu Prasad
authors.initials: BP
authors.lastname: Kandel
authors.affiliation: Multivitamin-mineral Supplementation Project, Health Resources Consultancy Pvt. Ltd., Kuleshwor Kathmandu, Nepal ; Central Department of Microbiology, Tribhuvan University, Kirtipur Kathmandu, Nepal.
authors.forename: Megha Raj
authors.initials: MR
authors.lastname: Banjara
keywords: Anemia; Body Mass Index; Dietary intake pattern; Nepal; Nutritional status; Reproductive age
references.citation: Am J Clin Nutr. 2000 May;71(5 Suppl):1280S-4S
references.pmid: 10799402
references.citation: J Epidemiol Community Health. 2001 Jun;55(6):399-403
references.pmid: 11350996
references.citation: Int J Obes Relat Metab Disord. 2001 Dec;25(12):1741-51
references.pmid: 11781753
references.citation: Public Health Nutr. 2006 Apr;9(2):204-11
references.pmid: 16571174
references.citation: Lancet. 2008 Feb 2;371(9610):417-40
references.pmid: 18206226
references.citation: Lancet. 2008 Jan 19;371(9608):243-60
references.pmid: 18207566
references.citation: Food Nutr Bull. 2008 Jun;29(2):132-9
references.pmid: 18693477
references.citation: Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):625-34
references.pmid: 21934611
references.citation: J Health Popul Nutr. 2011 Oct;29(5):494-9
references.pmid: 22106755
references.citation: Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:108-17
references.pmid: 22742605
references.citation: J Pregnancy. 2012;2012:630519
references.pmid: 22792466
references.citation: Nutr J. 2013 Jan 31;12:20
references.pmid: 23368953
references.citation: Cold Spring Harb Perspect Med. 2013 Jul 01;3(7):null
references.pmid: 23613366
references.citation: Lancet. 2013 Aug 3;382(9890):427-451
references.pmid: 23746772
references.citation: Lancet. 2013 Aug 10;382(9891):536-51
references.pmid: 23746780
references.citation: J Matern Fetal Neonatal Med. 2014 Jun;27(9):887-91
references.pmid: 24041147
references.citation: Eur J Clin Nutr. 2014 Feb;68(2):253-8
references.pmid: 24300911
references.citation: ISRN Nutr. 2013 Feb 05;2013:210287
references.pmid: 24967253
references.citation: Int J Public Health. 2014 Oct;59(5):697-706
references.pmid: 25074554
references.citation: Int J Health Policy Manag. 2014 Jul 24;3(2):71-6
references.pmid: 25114945
references.citation: Eur J Clin Nutr. 2015 Jan;69(1):107-13
references.pmid: 25205323
references.citation: Anemia. 2014;2014:561567
references.pmid: 25215230
references.citation: J Nepal Health Res Counc. 2014 Jan;12(26):8-13
references.pmid: 25574977
references.citation: BMJ. 2015 Sep 14;351:h4173
references.pmid: 26371218
references.citation: Int Sch Res Notices. 2015 Jan 15;2015:276469
references.pmid: 27347513