Study on the Assessment of Dietary Intake, Gut Health and Immune Status in Rickshaw Drivers Aged 25-45 Years in Mumbai, Maharashtra

Abstract

Rickshaw drivers form a vulnerable and often overlooked occupational group exposed to multiple health challenges due to prolonged working hours, sedentary behavior, irregular eating habits, and limited access to healthcare. The interrelationship between dietary intake, gut health, and immune status remains underexplored in this segment of urban informal workers. This study aims to assess these domains and explore their associations to inform targeted nutritional interventions. Methods: A cross-sectional study was conducted among 101 male rickshaw drivers aged 25–45 years in Mumbai, Maharashtra, using convenience sampling. Data collection included a 24-hour dietary recall, Food Frequency Questionnaire (FFQ), Gastrointestinal (GI) Health Assessment Questionnaire, and Immune Status Questionnaire (ISQ), along with self-reported anthropometric and socio-demographic information. Statistical analyses were performed using descriptive statistics, ANOVA, and chi-square tests via SPSS (Version 21). Results: Mean energy and protein intakes were 1646.23 ± 438.07 kcal and 49.11 ± 14.12 g/day respectively, both significantly below the Recommended Dietary Allowance (RDA). Fiber intake averaged 28.15 ± 9.22 g, reaching approximately 93% of the RDA. The dietary pattern showed frequent consumption of low-nutrient street foods and low intake of diverse whole grains and pulses. GI symptoms were prevalent, indicating compromised gut health in a majority of participants. Immune status was significantly associated with age (p=0.013), marital status (p=0.049), alcohol consumption (p=0.032), and household size (p=0.001), though no significant relationship was found between overall nutrient intake and immune status. Conclusion: This study highlights notable dietary inadequacies, poor gut health, and compromised immunity among rickshaw drivers in Mumbai. The findings suggest that while dietary intake remains suboptimal, immune health may be more strongly influenced by lifestyle and socio-demographic factors. There is a critical need for comprehensive, community-based interventions that promote dietary awareness and improve gut and immune health among Auto Rickshaw Drivers.

Introduction

1. Introduction:

Sustainable transportation is vital for eco-friendly urban living, and auto-rickshaws play a key role in India’s urban mobility. However, auto-rickshaw drivers in cities like Mumbai face serious occupational health risks due to:

• Long, irregular work hours

• Constant exposure to pollution and noise

• Poor nutrition and limited healthcare access

These conditions contribute to digestive issues, musculoskeletal discomfort, poor immunity, and a higher risk of non-communicable diseases (NCDs). This study aimed to evaluate the relationship between dietary intake, gut health, and immune status among auto-rickshaw drivers aged 25–45 years in Mumbai.

2. Methodology:

• Study Design: Cross-sectional study

• Sample: 101 auto-rickshaw drivers (aged 25–45)

• Inclusion Criteria: Non-smokers, non-drug users, and those without chronic GI diseases

• Data Collection Tools:

  • Socio-demographic and lifestyle questionnaires

  • Anthropometric measures (height, weight, BMI)

  • 24-hour dietary recall & Food Frequency Questionnaire (FFQ)

  • Gastrointestinal health questionnaire

  • Immune Status Questionnaire (ISQ)

• Analysis: Conducted using SPSS with significance set at p < 0.05

3. Key Findings:

a. Immune Status Distribution:

• 7.9% had very poor immunity

• 52.5% had reduced immunity

• 39.6% had moderate immunity

b. Significant Associations with Immunity:

• Age (p = 0.013)

• Marital Status (p = 0.049)

• Household Size (p = 0.001)

• Alcohol Consumption (p = 0.032)

No significant link was found between immunity and income, occupation, education, or tobacco use.

4. Nutritional Assessment:

• Energy and macronutrient intakes were below RDA across all groups

• Protein intake was lowest in the very poor immunity group (84% RDA)

• Fiber intake was relatively high, but not statistically different across immunity groups

• Heavy reliance on street food (vada pav, samosa, sugary drinks), with minimal intake of vegetables, fruits, and antioxidant-rich foods

5. GI Health and Immunity:

Statistically significant links were found between gut health and immune function:

• Gastric function, GI inflammation, small intestine, pancreas, and colon health were all significantly worse in the poor immunity group (p < 0.05)

• Poor gut health symptoms were strongly associated with reduced immune scores

6. Nutrient Intake vs GI Health:

• No significant correlations between nutrient intake and GI symptoms

• However, trends indicated that better fiber intake was associated with improved gut health

Conclusion

The study emphasizes the multifactorial health burden faced by rickshaw drivers in Mumbai, particularly in relation to dietary inadequacy, compromised gut function and poor immune status. While macronutrient intake was below recommended levels, the real challenge was in food choices dominated by processed, low-nutrient street food and irregular meal patterns. Despite moderate awareness and availability of food, knowledge-action gaps persisted, influenced by occupational demands, lifestyle habits, and lack of targeted education. The absence of strong correlations between nutrient intake and immune function suggests that behavioral and environmental factors have a stronger immediate impact on immune and gut health than diet alone. These insights can inform targeted public health policies and urban workforce wellness programs to improve quality of life among informal sector workers. The study addresses the urgent need for behavior-centered dietary interventions, stress management strategies, and health education programs tailored to the lifestyle of informal occupational groups like rickshaw drivers.

References

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Copyright

Copyright © 2025 Ms. Krisha Shah, Dr. Nisha Bellare. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.