Abstract
Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status of 379 preschool children in North West Province of South Africa. A 24 h qualitative recall by mothers of their children’s food consumption was used to calculate DDS based on 12-foods groups following Food and Agriculture Organization protocols. DDS was calculated by counting each of 12-food groups and classified as low (≤4), medium (5–8) and high (9–12). The weight and height of children were measured and height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z-scores were calculated based on 2006 WHO standards. Stunting, underweight and thinness were defined as HAZ, WAZ and BAZ < −2SD, respectively. Linear and logistic regression analyses were used to assess the association between DDS and the nutritional indicators. Mean age for children was 4 ± 0.7 years, and the prevalence of stunting (29%), underweight (13%) and thinness (6%) was observed. Mean DDS was 4.39 ± 1.55 out of 12-food groups, with a prevalence of 61% and 39% for low and medium DDS, respectively. Cereals (100%) accounted for the main food group consumed, while fish and other seafood (17%) were the least consumed. Consumption of a diversified diet was associated with lower odds of being stunted [AOR = 0.25, 95%CI: 0.10 to 0.92] among the four-year olds, while in the unadjusted model, 5-year-olds had lower odds of being underweight [OR = −0.32, 95%CI: −0.57 to 0.07]. The findings of this study reinforce the importance of continued nutrition education of mothers, caregivers and preschool staff on the need to ensure consumption of diverse food sources in order to improve the nutritional status of children. Further studies are recommended on the association of DDS with the nutritional status, and factors associated with low dietary diversity among preschool children.
Highlights
IntroductionDietary diversity, defined as the total number of food groups consumed over a reference period, has gained prominence as a valid and reliable indicator of dietary adequacy among children [1]
Dietary diversity, defined as the total number of food groups consumed over a reference period, has gained prominence as a valid and reliable indicator of dietary adequacy among children [1].The diversity of foods provided to young children, meat, poultry, fish, eggs, fruits and vegetables, is recommended to improve micronutrient intakes [2]
The current study investigated the association between dietary diversity score and the nutritional status of preschool children aged three to five years in the North West Province of South Africa, using the FAO scoring system of 12 food groups over a 24 h reference period
Summary
Dietary diversity, defined as the total number of food groups consumed over a reference period, has gained prominence as a valid and reliable indicator of dietary adequacy among children [1]. The diversity of foods provided to young children, meat, poultry, fish, eggs, fruits and vegetables, is recommended to improve micronutrient intakes [2]. Lack of dietary diversity is a severe problem among poor populations from the developing world, especially in Africa [1,3]. Most of the diets consist of monotonous starchy staples, and often include little or no Children 2020, 7, 174; doi:10.3390/children7100174 www.mdpi.com/journal/children. Children 2020, 7, 174 animal products and few fresh fruits and vegetables [4]. Dependency on plant-based staples such as maize meal, in addition to low-cost fats and sugar, are barriers to optimal feeding [5].
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