Intersecting Burdens: Minimum Dietary Diversity, Wealth, and Undernutrition among 6-59 months children in Uttar Pradesh, India

Background: Dietary diversity is a key factor of child nutrition, yet its effect across different forms of undernutrition is not fully understood. Therefore, this study aims estimate the link between dietary diversity and undernutrition among children in Uttar Pradesh, and evaluate the moderating effect of socio-economic status on this relationship. Materials and Methods: Data from the NFHS-5 (2019–21) were analyzed for 29,196 children aged 6–59 months. Nutritional status was classified using WHO child growth standards. Graphical representation and chi-square tests are used to assess the association between malnutrition with background characteristics. Multinomial logistic regression is used to identify predictors of nutritional outcomes. R studio software was used to analyze the data. Results: Stunting (43.6%) was most prevalent in children aged 36–59 months, while wasting and underweight were found in the 6–23-month age group (p < 0.001). Boys had a higher prevalence of malnutrition than girls. Child from poorer households had significantly higher risks of stunting (RRR = 1.59), underweight (RRR = 1.57), and multiple undernutrition (RRR = 1.90). Maternal education showed a protective effect across all forms of undernutrition. The effect of low dietary diversity was not significant in adjusted models, but an interaction term revealed that its negative impact was pronounced among children from poor households especially for multiple undernutrition (RRR = 2.89; p < 0.001). Conclusion: Undernutrition is primarily affected by poverty/low maternal education, rather than dietary diversity alone. Low dietary diversity impact on nutritional status is prominent in poorer households. Targeted, multi-sectoral interventions that promote maternal education, dietary improvements, and healthcare access are essential to reduce nutritional disparities among children in Uttar Pradesh.