Abstract

Childhood malnutrition, associated with poor diet, is a clear public health threat in Sri Lanka, with high rates of under‐nutrition and micronutrient deficiencies coupled with the growing risk of overweight/obesity in urban locations. This study explored the dietary diversity and food intake of urban living Sri Lankan preschool children. A cross‐sectional analysis of the baseline data from a cohort study was conducted with parents/caregivers of children aged 2–6 years, from 21 preschool centres in Kurunegala District, Sri Lanka. Demographic and socio‐economic factors, dietary diversity score (DDS) (n = 597) and food intake (n = 458) (using a food frequency questionnaire) were assessed. Children had a mean DDS of 4.56 ± 0·85 out of 9, with most (91.1%) in the medium DDS category (DDS of 3.1–6.0), consuming rice as most common food. Lentils were consumed more than any meat or alternative food groups at all DDS levels. Child DDS differs with parent/caregiver age and ethnicity. Mean daily intakes of fruit (1.02) and vegetables (0.84) servings align with approximately half of national recommendations, with less than 20% of children meeting daily recommendations. More than one‐third consumed sugary snacks and confectionaries daily and 1 in 10 had them twice a day. Around 40% reported watching television while eating the evening meal. Despite the majority having reasonable DDSs (medium category), findings highlighted inadequate intakes of fruits and vegetables, excessive intakes of sugary snacks and unhealthy dietary and social behaviours, suggests the need for population‐based interventions to promote healthier dietary habits.

Highlights

  • Sri Lanka is a middle income country, experiencing rapid nutrition transition in response to urbanization and the globalized food system (Weerasekara, Withanachchi, Ginigaddara, & Ploeger, 2018)

  • The current study found that 4.4% of children scored low dietary diversity score (DDS), which is slightly lower than the proportion of under five year old Sri Lankan children (6%) who did not meet minimum dietary diversity requirements as reported in the 2012 National Nutrition and Micronutrient survey (Perkins et al, 2018)

  • The Sri Lanka National Nutrition and Micronutrient survey was conducted in 2012, the results were only published in 2018 (Perkins et al, 2018). This prevented the usage of the DDS assessment method described in the Sri Lanka National Nutrition and Micronutrient survey in our study, which was conceptualized, designed and data collected before the publication of national survey results including methodology

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Summary

Introduction

Sri Lanka is a middle income country, experiencing rapid nutrition transition in response to urbanization and the globalized food system (Weerasekara, Withanachchi, Ginigaddara, & Ploeger, 2018). Traditional Sri Lankan diets rich in cereals and fibre, are being replaced with more western diets rich in sugar, fat, animal-source products, and processed foods (Weerasekara et al, 2018) During this nutrition transition, both under and over-nutrition and micronutrient deficiencies are reported in young children as diet-related public health threats. Micronutrient deficiencies were prevalent in children under five years of age, including iron (33.6%), calcium (47.6%) and vitamin A (29.3%) (Jayatissa, Gunathilaka, & Fernando, 2014; Rajapaksa, Arambepola, Gunawardena, Rosa, & Opatha, 2011) These nutritional outcomes are associated with poor dietary habits of children (Semba et al, 2010; Smith & Haddad, 2015; Yu et al, 2016)

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