Current trends in household food insecurity, dietary diversity, and stunting among children under five in Asia: a systematic review

Background: Household food insecurity (HFI) and poor dietary diversity (DD) are major public health challenges in Asia, greatly contributing to stunting among children under five. While previous research has focussed primarily on African regions, this systematic review provides novel insights into the association between HFI, DD, and stunting within the Asian context.

Methods: We searched across six major databases for studies published between 2019 and 2023 exploring the association between HFI, DD, and stunting in children under five across Asia. We then extracted their characteristics, evaluation methods, and outcomes related to stunting for analysis.

Results: From 3215 records, 37 met the inclusion criteria. Most studies were from South Asia (n = 22), followed by Southeast Asia (n = 8), with fewer from West (n = 4), East (n = 2), and Central Asia (n = 1), highlighting geographical research gaps. We found high stunting rates among children under five, especially in South and Southeast Asia. Stunting was strongly linked to HFI and poor DD, suggesting that these factors are critical in addressing malnutrition. Socioeconomic factors, maternal education, and access to clean water also influence stunting outcomes.

Conclusions: Current research on HFI, DD, and stunting in Asia shows substantial variation, with the highest stunting rates in South and Southeast Asia. Limited data from Central and East Asia highlights the need for more comprehensive research in these regions. Addressing HFI and improving DD is critical for reducing stunting and achieving global nutrition targets by 2030.