Abstract
Background: Dietary diversity in early life can prevent all forms of malnutrition and establish a healthier dietary pattern for later life, yet national and regional estimates are lacking. We aimed to estimate the proportion of infants and young children (IYC) meeting the minimum dietary diversity (MMD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We calculated the proportion of IYC (6-23 months) meeting the recently updated MDD, MMF, and MAD for 48 low and middle income countries. The proportion of IYC that met the MDD by region, rural/urban residence, and wealth quintile was calculated, and stunting cases that would have been averted if 90% of the IYC met their MDD was estimated. Findings: The proportion of IYC meeting MDD, MMF, and MAD was very low. Only 4/48 countries had >50% of IYC meeting MDD. Stark inequalities exist between countries, regions, rural/urban residence, and wealth quintiles. The lowest MDD was for Sub-Saharan Africa (18 %) and the highest for the Latin America & Caribbean (54%) region. A significant proportion of stunting cases could have been averted if ≥ 90% of IYC had met the MDD, which increased with higher per capita Gross National Income based on Purchasing Power Parity (GNI-PPP), women literacy, and food supply diversity (P< 0·05). Interpretation: Closing the gap in dietary inequalities between and within countries is urgently needed to prevent wider, long-term socio-economic and health inequalities. Diet quality targets should be set and monitored routinely to promote dietary diversity and prevent all forms of malnutrition. Funding Statement: This work was supported by the Agriculture for Nutrition and Health program of the Consultative Group for International Agriculture Research (CGIAR). Declaration of Interests: Both authors have nothing to disclose
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