Dietary Practices Among Young Children in Nepal’s Karnali Mountains: A Community-Based Study on Meal Frequency, Diversity, and Fruit or Vegetable Intake

Malnutrition is a significant public health challenge in low- and middle-income countries, especially in food-insecure areas including those in Nepal. Despite global efforts to improve infant and young child feeding (IYCF) practices, significant gaps remain in dietary diversity, meal frequency, and fruit or vegetable consumption. However, there is a lack of data from the highly food-insecure mountains of Nepal. This study examines the prevalence of key IYCF practices: minimum meal frequency (MMF), minimum dietary diversity (MDD), and fruit or vegetable consumption in the remote mountains of Karnali region of Nepal. A community-based cross-sectional study was conducted among 423 randomly selected mothers of children aged 6–23 months in Kalikot district. Face-to-face interviews were conducted using structured questionnaire. The prevalence of the three IYCF practices were assessed using frequency distribution and their association with socio-demographic factors were examined using chi-square tests (χ2) and multiple logistic regression. The study found that 78.5% of children met the MMF criteria, but only 24.1% achieved MDD, and 33.1% received any fruit or vegetable in the 24-hr preceding the survey. Father’s education was positively associated with all three indicators: MDD (adjusted odds ratio (AOR): 3.60; 95% confidence interval (CI):1.30, 9.95), MMF (AOR: 2.12; 95% CI: 1.06, 4.24) and fruits or vegetable consumption (AOR: 2.51; 95% CI: 1.25, 5.01). Mother’s education (AOR: 4.27; 95% CI: 1.61, 11.36) and recent child illness (AOR: 2.39; 95% CI: 1.42, 4.02) were also associated with MMF, while family type (AOR: 1.60; 95% CI: 1.05, 2.45) was associated with fruits or vegetable consumption. This study highlights significant gaps in IYCF practices, particularly low dietary diversity and inadequate fruit or vegetable intake. Addressing these challenges requires locally tailored interventions, including parental education programs that actively engage fathers, improved community-based nutrition initiatives, and strengthening maternal support systems to improve feeding during child illness. Given the region’s longstanding under-resourcing and food insecurity, future strategies should focus on strengthening local food systems to improve availability and consumption.