Dietary Quality of Women of Reproductive Age in Low-Income Settings: A Cross-Sectional Study in Kyrgyzstan.

Aiperi Otunchieva,Angelika Ploeger,Jamila Smanalieva

doi:10.3390/nu14020289

Aiperi Otunchieva, Angelika Ploeger + Show 1 more

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https://doi.org/10.3390/nu14020289

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Abstract

Dietary diversity and adequate nutrient intake are essential for conducting a healthy life. However, women in low-income settings often face difficulties in ensuring dietary quality. This research assessed relationships between the dietary diversity, nutrient adequacy, and socio-economic factors among women of reproductive age (WRA) in Kyrgyzstan. A cross-sectional study was undertaken in four locations, including two rural and two urban areas in the north and south of Kyrgyzstan. A survey with pre-coded and open-ended questions was employed during the interviews of 423 WRAs aged 18–49. Data collection was conducted in March–May 2021. The average value body mass index (BMI) of WRA was 24.2 ± 4.6 kg/m2. The dietary diversity score (DDS) was higher among rural women (common language effect size) cles = 0.67, adjusted p < 0.001) in the northern region (cles = 0.61, p < 0.05) who have cropland (cles = 0.60, p < 0.001) and a farm animal (cles = 0.60, p < 0.05). Mean nutrient adequacy ratio (NAR) was below 1 in most micronutrients, whereas thiamine, riboflavin, vitamins B6 and C, folic acid, calcium, and magnesium were even lower than 0.5. Women with a kitchen garden or a cropland had better NAR energy (cles = 0.57), NAR carbohydrate (cles = 0.60), NAR fiber (cles = 0.60), NAR vitamin B1 (cles = 0.53), and NAR folic acid (cles = 0.54). Respondents who receive remittances and a farm animal have better NARs for energy, carbohydrates, fiber, vitamin B1, folic acid, iron, zinc, and mean adequacy ratio for 16 nutrients (MAR 16) than those who do not. Education and income have a negative correlation with dietary quality. This study contributes to the limited literature on the quality of diets in Kyrgyzstan. Hidden hunger and undernutrition are a severe problem among WRA in low-income settings. Recommendations are including study programs in nutrition, teaching households farming practices, and raising awareness on adequate nutrition.

Highlights

Around three billion people in the world could not afford healthy diets in 2019 [1].The term coined ‘triple burden of malnutrition’ refers to a situation when overnutrition, undernutrition, and micronutrient deficiency exist
1 in most macro-and micronutrients when calculated with recommendation for dietary intake (RDI), some of them being even lower than 0.5. These are the critical micronutrients such as vitamins B1, B2, B6, and C and folic acid, calcium, and magnesium. These results indicate that hidden hunger exists, and undernutrition is a severe problem among WRA in low-income settings in Kyrgyzstan
Women who have a least one farm animal had better dietary diversity score (DDS) in almost 60% of cases. These results indicate that women have more diversified diets in rural areas, in the northern region, and those who have cropland or a kitchen garden and at least one farm animal in comparison to those who live in cities in the south and do not possess a piece of land and a farm animal

Summary

Introduction

The term coined ‘triple burden of malnutrition’ refers to a situation when overnutrition, undernutrition, and micronutrient deficiency exist. It is a serious public health problem in low-income countries [2,3,4], including Kyrgyzstan. Micronutrient deficiency is a lack of vitamins and minerals crucial to health, and it may result from poor diet and diseases [3]. Consumption of low-nutrient and energy-rich diets may lead to obesity when vital micronutrients are still lacking in human organisms [5]. Issues of obesity are relevant in the developed world, and in developing countries that suffer from excessive energy intake leading to some non-communicable diseases [2]

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