Income Paradox and Socioeconomic Determinants of Household Dietary Diversity in Rural Developing Contexts
DOI:
https://doi.org/10.56294/saludcyt20262604Keywords:
Dietary Diversity, Income Paradox, Socioeconomic Determinants, Rural Households, Food SecurityAbstract
Dietary diversity is a crucial indicator of nutritional adequacy and food security, especially in rural developing areas where access to varied foods remains limited. This study aimed to measure household dietary diversity and identify the socioeconomic and behavioral determinants that influence the Food Consumption Pattern Score (Pola Pangan Harapan/PPH) in Nagari Tandikek Utara, Padang Pariaman Regency, Indonesia. A cross-sectional quantitative design was employed, involving 150 households selected through proportional random sampling, with data collected using structured questionnaires, interviews, and field observations. Dietary diversity was assessed across nine food groups using the PPH method, while multiple linear regression analysis (SPSS 23) examined the effects of income, family size, eating habits, mother’s education, head of household’s education, and mother’s age. Results showed that the average PPH score was 51.69%, indicating low dietary diversity, with consumption predominantly centered on cereals (18.26%) and insufficient intake of legumes, animal-source foods, vegetables, and fruits. Regression findings confirmed an income paradox, as income had a significant negative effect (B = −9.398; p = 0.000), while family size (B = −2.294; p = 0.000) and mother’s education (B = −1.077; p = 0.000) also reduced dietary diversity; conversely, the household head’s education improved it (B = 1.070; p = 0.000). These findings indicate that dietary diversity is shaped by intersecting socioeconomic and demographic factors, highlighting the need for integrated strategies—combining nutrition education, gender-responsive approaches, and improved food access—to support progress toward achieving Zero Hunger (SDG 2) in rural communities.
References
1. Ruel MT, Alderman H. Nutrition-Sensitive Interventions and Programmes: How Can They Help to Accelerate Progress in Improving Maternal and Child Nutrition? The Lancet. 2013;382(9891):536–51. DOI: https://doi.org/10.1016/S0140-6736(13)60843-0
2. Kavle JA, Landry M. Addressing Barriers to Maternal Nutrition in Low‐ and Middle‐income Countries: A Review of the Evidence and Programme Implications. Matern Child Nutr. 2017;14(1). DOI: https://doi.org/10.1111/mcn.12508
3. Sharma I, Prima S Di, Essink D, Broerse JEW. Nutrition-Sensitive Agriculture: A Systematic Review of Impact Pathways to Nutrition Outcomes. Advances in Nutrition. 2021;12(1):251–75. DOI: https://doi.org/10.1093/advances/nmaa103
4. Serrano J, Puupponen-Pimiä R, Dauer A, Aura AM, Saura-Calixto F. Tannins: Current knowledge of food sources, intake, bioavailability and biological effects. Mol Nutr Food Res [Internet]. 2009 Sep 1;53(S2):S310–29. Available from: https://doi.org/10.1002/mnfr.200900039 DOI: https://doi.org/10.1002/mnfr.200900039
5. Friedman M, Levin CE, Choi S, Kozukue E, Kozukue N. HPLC Analysis of Catechins, Theaflavins, and Alkaloids in Commercial Teas and Green Tea Dietary Supplements: Comparison of Water and 80% Ethanol/Water Extracts. J Food Sci. 2006;71(6). DOI: https://doi.org/10.1111/j.1750-3841.2006.00090.x
6. Zerfu TA, Biadgilign S. Pregnant Mothers Have Limited Knowledge and Poor Dietary Diversity Practices, but Favorable Attitude Towards Nutritional Recommendations in Rural Ethiopia: Evidence From Community-Based Study. BMC Nutr. 2018;4(1). DOI: https://doi.org/10.1186/s40795-018-0251-x
7. Pandey VL, Dev SM, Jayachandran U. Impact of Agricultural Interventions on the Nutritional Status in South Asia: A Review. Food Policy. 2016;62:28–40. DOI: https://doi.org/10.1016/j.foodpol.2016.05.002
8. González L, Mesa SLR, López LPM, Herrera DMS, Estrada A. Inequalities in Food Consumption the Colombian Households: Results From the National Survey of Nutritional Status. Hacia La Promoción De La Salud. 2021;26(1):98–117. DOI: https://doi.org/10.17151/hpsal.2021.26.1.9
9. Girma S, Alenko A. ≪p>Women’s Involvement in Household Decision-Making and Nutrition Related-Knowledge as Predictors of Child Global Acute Malnutrition in Southwest Ethiopia: A Case–Control Study</P> Nutr Diet Suppl. 2020;Volume 12:87–95. DOI: https://doi.org/10.2147/NDS.S252342
10. Rosalina L, Amran R, Yuliana, Surya Mentari TA, Oktarina R, Fadillah R. Bioactive Compound Composition in Tea Varieties and Gambir for Biomedical Potential. Health Leadership and Quality of Life [Internet]. 2025 Sep 10;4:761. Available from: https://hl.ageditor.ar/index.php/hl/article/view/761 DOI: https://doi.org/10.56294/hl2025761
11. Malapit H. Women in Agriculture and the Implications for Nutrition. 2019;58–67. DOI: https://doi.org/10.1079/9781786399311.0058
12. Alexandri C, Kevorchian C. Food Consumption Diversity in Romania. Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca Horticulture. 2015;72(1). DOI: https://doi.org/10.15835/buasvmcn-hort:10747
13. Baraldi LG, Steele EM, Canella DS, Monteiro CA. Consumption of Ultra-Processed Foods and Associated Sociodemographic Factors in the USA Between 2007 and 2012: Evidence From a Nationally Representative Cross-Sectional Study. BMJ Open. 2018;8(3):e020574. DOI: https://doi.org/10.1136/bmjopen-2017-020574
14. Ghosh PK, Das P, Goswam DR, Islam A, Chowdhury S, Mollah MMH, et al. Maternal Characteristics Mediating the Impact of Household Poverty on the Nutritional Status of Children Under 5 Years of Age in Bangladesh. Food Nutr Bull. 2021;42(3):389–98. DOI: https://doi.org/10.1177/0379572121999016
15. Girard A, Self JL, McAuliffe C, Olude O. The Effects of Household Food Production Strategies on the Health and Nutrition Outcomes of Women and Young Children: A Systematic Review. Paediatr Perinat Epidemiol. 2012;26(s1):205–22. DOI: https://doi.org/10.1111/j.1365-3016.2012.01282.x
16. Green R, Cornelsen L, Dangour AD, Turner RA, Shankar B, Mazzocchi M, et al. The Effect of Rising Food Prices on Food Consumption: Systematic Review With Meta-Regression. BMJ. 2013;346(jun17 1):f3703–f3703. DOI: https://doi.org/10.1136/bmj.f3703
17. Yosef S, Jones AD, Chakraborty B, Gillespie S. Agriculture and Nutrition in Bangladesh. Food Nutr Bull. 2015;36(4):387–404. DOI: https://doi.org/10.1177/0379572115609195
18. Oliveira SF de, Vianna RP de T, Palmeira P de A, Ferreira FEL de L, Moreira PVL, Neta A da CP de A, et al. Social Determinants of the Transition in Food Consumption in Paraíba, Brazil, Between 2008 and 2018. Nutrients. 2025;17(15):2550. DOI: https://doi.org/10.3390/nu17152550
19. Schnabel L, Kesse‐Guyot E, Allès B, Touvier M, Srour B, Herçberg S, et al. Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-Aged Adults in France. JAMA Intern Med. 2019;179(4):490. DOI: https://doi.org/10.1001/jamainternmed.2018.7289
20. Baker P, Friel S. Processed Foods and the Nutrition Transition: Evidence FromAsia. Obesity Reviews. 2014;15(7):564–77. DOI: https://doi.org/10.1111/obr.12174
21. Koppmair S, Kassie M, Qaim M. Farm Production, Market Access and Dietary Diversity in Malawi. Public Health Nutr. 2016;20(2):325–35. DOI: https://doi.org/10.1017/S1368980016002135
22. Mascarenhas JMO, Ribeiro‐Silva R de C, Assis AMO, Santana MLP de, Moraes LTLP de, Barreto ML. Identification of Food Intake Patterns and Associated Factors in Teenagers. Revista De Nutrição. 2014;27(1):45–54. DOI: https://doi.org/10.1590/1415-52732014000100005
23. Suryana S, Fitri Y, Yunianto AE, Bustami B, Lusiana SA. Nutritional Education to the Nutritional Maternal Knowledge and Iron Intake Among Toddlers With Anemia. Open Access Maced J Med Sci. 2022;10(E):1434–9. DOI: https://doi.org/10.3889/oamjms.2022.7017
24. Abuya B, Ciera J, Kimani‐Murage E. Effect of Mother’s Education on Child’s Nutritional Status in the Slums of Nairobi. BMC Pediatr. 2012;12(1). DOI: https://doi.org/10.1186/1471-2431-12-80
25. Whitney C, Lanzanova D, Muchiri C, Shepherd K, Rosenstock TS, Krawinkel M, et al. Probabilistic Decision Tools for Determining Impacts of Agricultural Development Policy on Household Nutrition. Earth S Future. 2018;6(3):359–72. DOI: https://doi.org/10.1002/2017EF000765
26. Salmela J, Kouvonen A, Mauramo E, Rahkonen O, Roos E, Lallukka T. Associations of Childhood and Adult Socioeconomic Circumstances With Recommended Food Habits Among Young and Midlife Finnish Employees. BMC Nutr. 2022;8(1). DOI: https://doi.org/10.1186/s40795-022-00557-0
27. Dangour AD, Hawkesworth S, Shankar B, Watson L, Srinivasan CS, Morgan EH, et al. Can Nutrition Be Promoted Through Agriculture-Led Food Price Policies? A Systematic Review. BMJ Open. 2013;3(6):e002937. DOI: https://doi.org/10.1136/bmjopen-2013-002937
28. Giskes K, Avendaño M, Brug J, Kunst AE. A Systematic Review of Studies on Socioeconomic Inequalities in Dietary Intakes Associated With Weight Gain and Overweight/Obesity Conducted Among European Adults. Obesity Reviews. 2010;11(6):413–29. DOI: https://doi.org/10.1111/j.1467-789X.2009.00658.x
29. Gonzalgo MR, Nackeeran S, Mouzannar A, Blachman‐Braun R. Socioeconomic Differences Associated With Consumption of a Plant-Based Diet: Results From the National Health and Nutrition Examination Survey. Nutr Health. 2022;30(2):253–9. DOI: https://doi.org/10.1177/02601060221109669
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