Dietary Diversity in Nepal: A Latent Class Approach

BACKGROUND: Nutritional status has important implications for labor productivity, lifetime earnings, and country-wide economic development. Dietary diversity is an important contributor to nutrition. OBJECTIVE: To identify how patterns of food consumption are related to dietary diversity and to measure the potential for policy interventions to influence diet complexity. METHODS: Household dietary diversity scores were constructed using data from 11 809 rural and urban households surveyed in Nepal between 2013 and 2016. Diversity scores were based on 7-day recall information on food purchases and food consumed directly from agricultural production. Reported consumption from 14 food groups was mapped into 4 distinct dietary patterns via latent class analysis. Ordered probit regressions were used to identify factors associated with observed diet patterns. RESULTS: Diets are heterogeneous and map into 4 clusters along a continuum of complexity. Three identified diets are vegetarian and 1 is nonvegetarian. Diet complexity is associated with geography and socioeconomic features of the sample. On average, poor and agricultural households have less complex diets and households receiving remittances have more complex and higher quality diets. Road density is positively correlated with diet complexity. We find evidence of modest reductions in diet quality over the sample period. CONCLUSIONS: Results confirm heterogeneous dietary behavior of Nepalese households. The identified patterns could be used to more effectively target policies directed at nutrition education or efforts to improve health by diversifying and improving the nutritional quality of household diets, for example, through supplemental feeding programs, home garden promotion, or targeted food assistance programs.