Dietary diversity and food variety scores and their association with nutrition and health status of Indian children and adolescents: A multicenter study

Abstract

BackgroundThe objectives of this study were to 1) evaluate the dietary diversity scores (DDS) and food variety scores (FVS) among Indian children and adolescents aged 9–18 y; 2) compare the DDS and FVS in association with demographic, socioeconomic, and health characteristics (growth and hemoglobin [Hb] concentrations); and 3) determine DDS and FVS cutoffs to identify dietary micronutrient adequacy. MethodsThis study was performed in a subset (n = 1845) of children and adolescents enrolled in a multicenter study (2016–2017) from urban and rural areas of six Indian states. Height, weight, and Hb were measured, and anthropometric Z-scores were computed. Sociodemographic data were collected using a structured questionnaire. Dietary data collected by 24-h dietary recall were used to calculate the DDS and FVS. The mean adequacy ratio (MAR) for 10 micronutrients was computed. Receiver operating characteristic analysis was performed to define cutoffs of DDS and FVS. ResultsIn comparison with children and adolescents from rural areas, urban children and adolescents consumed more diverse diets (urban, 4.1 ± 1.1; rural, 3.5 ± 1; P < 0.01) and had a higher mean FVS (urban, 19.9 ± 5.7; rural, 15.9 ± 4.5; P < 0.01). Both the DDS and FVS were significantly correlated with each other (r = 0.860; P < 0.01) and were positively correlated with MAR, growth, and Hb (P < 0.001) and mother's educational level (P < 0.01). The cutoffs of ≥6.5 (DDS) and ≥17 (FVS) were determined to predict micronutrient adequacy. ConclusionsBoth the DDS and FVS can be used interchangeably for assessing growth, health status, and nutritional adequacy. Single cutoff values of the DDS and FVS may aid in prompt identification of children and adolescents with micronutrient inadequacy.