Food environment, dietary patterns, and anthropometric outcomes of women in the Indian rural-urban interface

Urbanisation in low- and middle-income countries has created complex transformations in food environments. Particularly in the space between rural and urban areas, food environments, occupation structures, lifestyles, and dietary patterns undergo constant changes with important implications for nutrition and health. We study one such rural-urban interface around Bangalore city in South India, estimating how households’ interactions with different food sources are associated with women’s dietary diversity and anthropometric outcomes. The results show that households’ interaction with diverse food acquisition pathways, irrespective of their nutritional orientation, is associated with higher dietary diversity among women. However, greater diversity in food acquisition pathways can also increase exposure to modern and convenience-oriented food outlets. The processed and packaged foods offered by these outlets present potential long-term metabolic health risks. However, we find no evidence of these implications in the rural-urban interface of Bangalore, as household interaction with diverse food acquisition pathways is not associated with changes in body mass index and overweight/obesity prevalence. Instead, anthropometric outcomes are strongly associated with changes in demographic and socioeconomic factors. Overall, our findings suggest that urbanisation does not replace traditional food sources with modern outlets but rather creates a hybrid food environment that provides households with more options to make healthy but also less healthy nutritional choices. Policies aimed at improving consumer nutritional knowledge can increase the prevalence of healthy choices and thus ensure that interaction with diverse food sources increases dietary diversity without leading to long-term metabolic health risks.