Food Price Spikes are Associated with Increased Malnutrition Among Children in Andhra Pradesh, India

Sukumar Vellakkal, Jasmine Fledderjohann, Sanjay Basu, Sutapa Agrawal, Shah Ebrahim, Oona Campbell, Pat Doyle, David Stuckler (2015). Food Price Spikes Are Associated with Increased Malnutrition among Children in Andhra Pradesh, India. The Journal of Nutrition 145 (8), 1942-1949

8 Pages Posted: 23 Oct 2015

See all articles by Sukumar Vellakkal

Sukumar Vellakkal

Public Health foundation of India (PHFI)

Jasmine Fledderjohann

University of Oxford

Sanjay Basu

Stanford University - Center for Primary Care and Outcomes Research and Center for Population Health Sciences; Harvard University - Center for Primary Care

Sutapa Agrawal

Public Health Foundation of India

Shah Ebrahim

Public Health Foundation of India

Oona Campbell

London School of Hygiene and Tropical Medicine

Pat Doyle

LSHTM

David Stuckler

Oxford University

Date Written: August 1, 2015

Abstract

Background: Global food prices have risen sharply since 2007. The impact of food price spikes on the risk of malnutrition in children is not well understood.

Objective: We investigated the associations between food price spikes and childhood malnutrition in Andhra Pradesh, one of India's largest states, with > 85 million people. Because wasting (thinness) indicates in most cases a recent and severe process of weight loss that is often associated with acute food shortage, we tested the hypothesis that the escalating prices of rice, legumes, eggs, and other staples of Indian diets significantly increased the risk of wasting (weight-for-height z scores) in children.

Methods: We studied periods before (2006) and directly after (2009) India's food price spikes with the use of the Young Lives longitudinal cohort of 1918 children in Andhra Pradesh linked to food price data from the National Sample Survey Office. Two-stage least squares instrumental variable models assessed the relation of food price changes to food consumption and wasting prevalence (weight-for-height z scores).

Results: Before the 2007 food price spike, wasting prevalence fell from 19.4% in 2002 to 18.8%in 2006. Coinciding with India's escalating food prices, wasting increased significantly to 28.0% in 2009. These increases were concentrated among low- (x2: 21.6, P < 0.001) and middle- (x2: 25.9, P < 0.001) income groups, but not among high-income groups (x2: 3.08, P=0.079). Each 10.0 rupee ($0.170) increase in the price of rice/kg was associated with a drop in child-level rice consumption of 73.0 g/d (b: -7.30; 95% CI: -10.5, -3.90). Correspondingly, lower rice consumption was significantly associated with lower weight-for height z scores (i.e., wasting) by 0.005 (95% CI: 0.001, 0.008), as seen with most other food categories.

Conclusion: Rising food prices were associated with an increased risk of malnutrition among children in India. Policies to help ensure the affordability of food in the context of economic growth are likely critical for promoting children's nutrition.

Suggested Citation

Vellakkal, Sukumar and Fledderjohann, Jasmine and Basu, Sanjay and Agrawal, Sutapa and Ebrahim, Shah and Campbell, Oona and Doyle, Pat and Stuckler, David, Food Price Spikes are Associated with Increased Malnutrition Among Children in Andhra Pradesh, India (August 1, 2015). Sukumar Vellakkal, Jasmine Fledderjohann, Sanjay Basu, Sutapa Agrawal, Shah Ebrahim, Oona Campbell, Pat Doyle, David Stuckler (2015). Food Price Spikes Are Associated with Increased Malnutrition among Children in Andhra Pradesh, India. The Journal of Nutrition 145 (8), 1942-1949. Available at SSRN: https://ssrn.com/abstract=2677140

Sukumar Vellakkal (Contact Author)

Public Health foundation of India (PHFI) ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

HOME PAGE: http://www.phfi.org

Jasmine Fledderjohann

University of Oxford ( email )

Mansfield Road
Oxford, Oxfordshire OX1 4AU
United Kingdom

Sanjay Basu

Stanford University - Center for Primary Care and Outcomes Research and Center for Population Health Sciences ( email )

1070 Arastradero Road Office 282
Palo Alto, CA 94304
United States

Harvard University - Center for Primary Care ( email )

Cambridge, MA
United States

Sutapa Agrawal

Public Health Foundation of India ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

Shah Ebrahim

Public Health Foundation of India ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

Oona Campbell

London School of Hygiene and Tropical Medicine ( email )

Keppel Street
London, WC1E 7HT
United Kingdom

Pat Doyle

LSHTM ( email )

Keppel Street
London, WC1E 7HT
United Kingdom

David Stuckler

Oxford University ( email )

Mansfield Road
Oxford, Oxfordshire OX1 4AU
United Kingdom

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