Household Food Production and Dietary Diversity in a Remote, Former Socialist Society: Panel Data Evidence from Tajikistan.

More than one-quarter of under-five children in the developing world are stunted, and those with poor nutrient intake are at risk of irreversible cognitive impairment. The purpose of this study was to determine the relationship between dietary diversity and child stunting in an Indonesian context. Dietary diversity was assessed using a maternal-reported checklist of 12 food groups, summed as a Household Dietary Diversity Score. Stunting was defined as <=-2.0 height-for-age z-score by WHO-Anthro 2005. Trained interviewers administered the household dietary diversity questionnaire to 768 households with children aged <5 years in East Java, Indonesia. Logistic regression models were constructed to test the association between dietary diversity and child stunting. The prevalence of child stunting was 39.4%, and the percentage of households consuming food groups high in protein and calcium, like dairy products (41%), and meat/poultry, (65%) was lower compared with other food groups. The unadjusted model revealed that higher dietary diversity scores were associated with lower likelihood of child stunting (OR=0.89; 95% CI=0.80-0.98). This relationship remained significant after adjustment for family size, maternal literacy, food expenditure, breastfeeding, energy, and protein intake (OR=0.89; 95% CI=0.80-0.99). The dietary diversity score was moderate, with consumption of dairy products and meat/poultry lowest among 12 food groups. Hence, population interventions should focus on promoting food groups currently lacking in maternal and child diet, including those rich in growth-promoting nutrients like dairy, meat/poultry. These results, from an Indonesian context, confirm the widely observed protective relationship between dietary diversity and child stunting.

Diet diversity in pregnancy and early allergic manifestations in the offspring.

BackgroundA diet that includes a variety of foods provides all the essential nutrients needed to meet nutritional requirements. However, the relationship between dietary diversity and adequate micronutrient intake has not been consistently established across various cultural contexts. Notably, no studies have successfully validated a link between dietary diversity scores and nutrient adequacy in Ethiopia. Therefore, we aimed to validate food variety and dietary diversity scores as proxy indicators of nutrient adequacy among pregnant women in Ethiopia.Materials and methodsA multi-stage systematic random sampling method was used to select study participants from March 1 to March 30, 2024. The multiple-pass 24-h dietary recall method, incorporating the standard nine food groups, was employed to estimate the dietary diversity score of pregnant women. The nutrient adequacy ratio (NAR) was calculated based on the mean adequacy ratio of various micronutrients. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoffs for dietary diversity and food variety scores by balancing sensitivity and specificity..ResultsMDD-W exhibited a positive correlation (ρ = 0.159, 95% CI: 0.065–0.250) (p = 0.001) and demonstrated strong predictive ability (AUC = 0.839, 95% CI: 0.80–0.88; p value = 0.001) for the mean adequacy ratio in assessing micronutrient adequacy. The sensitivity and specificity of the MDD-W at the standard cutoff of ≥5 food groups were found to be 69.9 and 5.3%, respectively. Additionally, the optimal cutoff points for dietary diversity and food variety scores in predicting micronutrient adequacy were determined to be 3.42 and 4.67, respectively. The food variety indicator based on nine food groups showed a negative correlation (ρ = −0.402, 95% CI: −0.137-0.053) (p > 0.05) and remained a poor predictor (AUC = 0.709, 95% CI: 3.49 to 4.03) of the mean adequacy ratio.ConclusionMDD-W was positively correlated with micronutrient intake adequacy and demonstrated good predictive ability. At the standard cutoff of ≥5 food groups, its sensitivity and specificity were 69.9 and 5.3%, respectively. However, the findings differed from those of other studies, and discrepancies with FAO recommendations regarding the cutoff values and performance levels of MDD-W were observed, indicating a need for further investigation.

Background Complementary feeding of infants and young children (IYC) 6–23 months is a critical factor for healthy growth and development. Dietary diversity (DD)‐‐the number of different food groups consumed‐‐is a proxy for micronutrient adequacy; minimum dietary diversity (MDD) is a WHO indicator used to assess the adequacy of complementary feeding in an IYC population. DD at the household level provides a measure of the food groups consumed in the home and thus potentially available for children. The comparison of household with child DD permits exploration of whether inadequate child DD is due to lack of availability in the home or intra‐household distribution to the child. Although a number of factors have been described in relation to child DD, the literature is limited regarding its relation with household DD. Objectives This study examined firstly, the association between household and child DD in poor, mostly rural areas of 3 diverse countries: Peru—a middle income country, Bangladesh and Sierra Leone—both low‐income countries; and secondly, this same association across three IYC age groups (6–8 months, 9–11 months, 12–23 months) in each country. Methods Data were collected as part of the endline surveys following implementation of CARE's Window of Opportunity intervention which aimed to improve the diet and growth of children 0–23 months. Randomly sampled households in the intervention districts were selected (Peru n=402, Bangladesh n=1905, Sierra Leone n=585). DD was derived from 24 hour dietary recalls of the child's intake and HH food group consumption. The foods consumed in each case were assigned to 7 food groups (WHO): cereals/tubers/roots, flesh foods, eggs, dairy, legumes, vitamin A fruits/vegetables and other fruits/vegetables. Household and IYC consumption were compared in bivariate analysis. Generalized linear modeling (GLM) was used to examine MDD (a dichotomous variable)—which was met when IYC consumed 4 or more of the 7 groups. Results MDD was met by 89% of children in Peru, 61% in Bangladesh, and 53% in Sierra Leone. For each food group, with the exception of dairy, more households than IYC consumed them in all 3 countries. A clear and steep increase in consumption of each food group was seen by child's age group in all countries; youngest children had the lowest frequency of consumption (). In country specific GLM models, increasing household DD was significantly associated with meeting MDD (Odds Ratio (OR) range 2.0 to 3.0), controlling for mother's education, household food security and child's age group. In these same models, compared to IYC 6–8 months, older children had strong, independent associations with meeting MDD; 9–11 months (OR range 3.2 to 5.3), and 12–23 months (OR range 6.0 to 10.7). Conclusions Infants 6–8 months were at significantly greater risk for not meeting MDD compared to children 9–11 and 12–23 months. While greater household DD decreased IYC risk for not meeting MDD, the comparison of foods consumed in the household versus the child's diet suggests that household DD, representing availability of foods, was not necessarily the main limiting factor. The variety of available food groups within the household, intra‐household distribution and/or caregiver selection of foods may all limit IYC DD. Future work should focus on understanding the barriers and facilitators for providing children with the full range of foods available so that DD among IYC, especially those in the youngest age group, can be improved. Support or Funding Information CARE USA; The Catholic University of America Household and Child Consumption of Food Groups in 3 Countries image

Recent literature, largely from Africa, shows mixed effects of own-production on diet diversity. However, the role of own-production, relative to markets, in influencing food consumption becomes more pronounced as market integration increases. This paper investigates the relative importance of two factors - production diversity and household market integration - for the intake of a nutritious diet by women and households in rural India. Data analysis is based on primary data from an extensive agriculture-nutrition survey of 3600 Indian households that was collected in 2017. Dietary diversity scores are constructed for women and households is based on 24-hour and 7-day recall periods. Household market integration is measured as monthly household expenditure on key non-staple food groups. We measure production diversity in two ways - field-level and on-farm production diversity - in order to account for the cereal centric rice-wheat cropping system found in our study locations. The analysis is based on Ordinary Least Squares regressions where we control for a variety of village, household, and individual level covariates that affect food consumption, and village fixed effects. Robustness checks are done by way of using a Poisson regression specifications and 7-day recall period. Conventional measures of field-level production diversity, like the number of crops or food groups grown, have no significant association with diet diversity. In contrast, it is on-farm production diversity (the field-level cultivation of pulses and on-farm livestock management, and kitchen gardens in the longer run) that is significantly associated with improved dietary diversity scores, thus suggesting the importance of non-staples in improving both individual and household dietary diversity. Furthermore, market purchases of non-staples like pulses and dairy products are associated with a significantly higher dietary diversity. Other significant determinants of dietary diversity include women's literacy and awareness of nutrition. These results mostly remain robust to changes in the recall period of the diet diversity measure and the nature of the empirical specification. This study contributes to the scarce empirical evidence related to diets in India. Additionally, our results indicate some key intervention areas - promoting livestock rearing, strengthening households' market integration (for purchase of non-staples) and increasing women's awareness about nutrition. These are more impactful than raising production diversity.

Malnutrition from poor diet is a persistent issue in Sri Lanka, especially among women and children. High rates of undernutrition and micronutrient deficiencies are documented among rural poor communities(1). Household food production may enhance maternal and child nutrition directly by increasing access to diverse foods and indirectly by providing income to diversify diets(2). This study explores the cross-sectional relationship between household food production and individual dietary diversity among women aged 18-45 years and children aged 2-5 years in Batticaloa district, Sri Lanka. We randomly selected 450 low-income mother-child pairs receiving a Samurdhi subsidiary, having a home garden. Through face-to-face interview, we gathered information on the types of crops grown and livestock reared in the preceding 12 months. Production quantity and utilization were also detailed. Additionally, socio-demographic information and market access were obtained. To measure women’s dietary diversity (DD), we used a scale based on 10-food groups and a 7-food group scale for children. Women who consumed five or more food groups were defined as meeting the Minimum Dietary Diversity of Women (MDD-W), whereas children who consumed of four or more food groups met the minimum standards. Multiple linear regression and binary logistic regression were used to identify the factors predicting individual DD. Complete data for 411 pairs were analysed. The results showed, only 15.3% of the women met MDD-W, with a mean DDS of 3.3 (SD = 1.2). Children had a mean DDS of 3.3 (SD = 1.2), and 41.1% of them met the minimum diversity. Regression analysis indicated that growing leafy vegetables was positively associated with increased dietary diversity of women (β = 0.337; 95% CI: 0.13, 0.54; p = 0.001) and children (β = 0.234; 95% CI: 0.05, 0.42; p = 0.013) but not with meeting the minimum diversity. Moreover, monthly income above 35,000 LKR, higher education level, a secondary income source and food security were also positively associated with women’s DD. Conversely, living further away from the main road reduced the women’s DD. Interestingly, livestock ownership was only associated with women meeting the MDD-W, but not for children. For children, monthly income was a strong predictor of DD and meeting minimum diversity. Surprisingly, living far from the market was associated with increased DD in children (β = 0.018; 95% CI: 0.01, 0.03; p = 0.013), while distance to main road had a similar effect as in women. Notably, selling their produce at the market contributed to meeting the minimum dietary diversity in children (β = 0.573; 95% CI: 0.14, 1.02; p = 0.013). These findings suggest that enhancing household food production could play a crucial role in improving dietary diversity and addressing malnutrition, particularly in rural Sri Lankan communities, and potentially in other similar settings.

Backgroun: The increasing variety of foods and food groups in the diet helps to ensure adequate intake of essential nutrients and promotes good health. The main objective was to determine the diet quality of women, infants, and young children in agricultural mitigation period of Burkina Faso. Methods: A 24-h dietary open recall was used to collect all foods taken by women, infants, and young children in Centre-West region of Burkina Faso. The dietary diversity (DD) score was equal to the number of consumed food groups for infants (6-23 months) according to WHO recommendations and for women and young children (24-59 months) according to food and agriculture organization (FAO). Three DD classes were determined for the individual average DD. For each DD class, food consumption profile was determined by food items or groups consumed by at least 50 percent of women, infants, and young children according to FAO guide. Results: The study was conducted among 971 women, 419 infants, and 189 young children. Regarding the dietary diversity score (DDS), 16.3, 39.2, and 44.5 percent of women and 12.7, 49.7, and 37.6 percent of young children had low (&lt; 5), average (= 5), and high (&gt; 5) rates, respectively. Furthermore, DDS was low (&lt; 4), average (= 4) and high (&gt; 4) in 22.9, 12.6, and 64.4 of infants, respectively. The consumption rates of roots/tubers, dairy products, eggs, and fruits were very low regardless of the women, infants, and young children DDS in times of agricultural mitigation. Conclusion: The diet of women and young children was a little more diversified compared to infants.

BackgroundMaize is the most important staple crop for food security and livelihood of smallholder farmers in many parts of sub-Saharan Africa, but it alone cannot ensure food security. Cropping patterns must be diversified to ensure an adequate supply and economic access to greater variety of foods for smallholder farm households. This study measured the effect of crop diversification on household dietary diversity in a selected study locale using a survey of 300 randomly stratified farm households in 10 villages located in the Babati, Kongwa and Kiteto districts of Tanzania.ResultsBased on multiple regression analysis, the study found that simply increasing Simpson’s Index does not influence dietary diversity of farm households due to the presence of interaction effect between Simpson’s Index and crop income. It is much more critical and significant to increase the revenue generated from diversified crops along with other socioeconomic endowment and behavioral characteristics of farm households. This is particularly applicable to poorer smallholder farmers who receive crop income less than US$85 per sales transaction and per season. Particularly, marginal and smallholders might be exposed to the effects of crop diversification and crop income toward increasing in their household dietary diversity score.ConclusionUnder average crop income scenarios, households that diversify their crop production tend to increase their dietary diversity from their existing dietary diversity score at a decreasing rate. However, under below average crop income threshold scenarios, farmers tend to increase their dietary diversity score from their existing score at an increasing rate when they diversify into high-value crops that attract relatively high farm gate values and accrue higher net revenues from the market. Monthly food expenditure also tends to positively influence household dietary diversity, indicating that farm households that spend more on market-purchased food have consistent increases in the their dietary diversity scores at the household level. This study concludes that improving economic access to variety of foods at the smallholder household level by diversifying diets through increased crop diversification should be encouraged within maize-based farming systems of the study locale, through integration of micronutrient-rich foods such as vegetables.

Association of dietary diversity changes and mortality among older people: A prospective cohort study

Dietary diversity, nutritional status, and agricultural commercialization: evidence from adult men of rural farm households.

Research has shown mixed findings on the link between production diversity and household dietary diversity. The question is whether this link holds for children. In this study we examine the relationship between household's agricultural production diversity and child dietary diversity, and between production diversity and child nutritional status. Smallholder farm households (n = 1067) and children (n = 1067) aged 3-16 years from two then nationally designated poverty counties in Gansu Province of China were interviewed in 2019. Production diversity was assessed with the production richness score and production diversity score. Production diversity was calculated from agricultural production data covering a period of 12 months. Child dietary diversity was assessed with food variety score (FVS) and dietary diversity score (DDS). DDS was calculated based on 9 food groups using a 30-day recall method. Data were analysed using Poisson and Probit regression models. We find that both agricultural production richness score and revenue generated from selling agricultural products are positively associated with food variety score, with the relationship being stronger for the latter. Moreover, production diversity score is positively associated with children's dietary diversity score whereas negatively associated with their probability of being stunted, but not with their probabilities of being wasted or zinc deficient. Household social economics status were also positively associated with child dietary diversity.

PurposeThis study aims to explore dietary diversity (DD) and nutritional status of adolescents among rural farm households in Southwestern Nigeria. It analyses whether higher commercialization levels of farm households translate to better nutrition.Design/methodology/approachThis study was conducted in Ogun and Oyo States of Southwestern Nigeria, using primary data from 352 farm households with a total of 160 adolescent members. The individual version of dietary diversity score (DDS) of nine food groups was used to calculate adolescent DDS over a 24-h recall period. World Health Organization AnthroPlus software was used in analyzing adolescents’ anthropometric data (height-for-age z-score and body mass index-for-age z-score) while household crop commercialization index (CCI) was estimated for each farm household. Separate logit models were used to examine the drivers of adolescents’ DD and malnutrition.FindingsThe study findings indicated that 100% of the adolescents consumed starchy staples while 0%, 3.1% and 12.5% consumed organ meat, milk/milk products and eggs, respectively. Results revealed that 74.1% and 21.2% of boys were stunted and thin while the prevalence in adolescent girls was 50.7% and 9.3%, respectively. Prevalence of stunting was found to be very high (60%–83%) in all the four CCI levels’ households indicating that belonging to highly commercialized households (CCI 3–4) may not necessarily translate to better nutrition of adolescent members. Food expenditure (p < 0.01) and access to piped water (p < 0.01) negatively influenced adolescents’ stunting mainly because of lower expenditure on food items and lower percent of household having access to piped water, respectively, while education (p < 0.01) had positive effects on adolescents’ DD.Originality/valuePrevious studies have contributed to the body of knowledge concerning the link between agricultural commercialization and nutrition using under-five children of the households. However, to the best of the authors’ knowledge, this is the first study that investigated the influence of CCI on DDS and nutritional status of adolescent members of farm households in Nigeria. This study fills this existing knowledge gap in investigating adolescents’ DD and malnutrition among smallholder farm households.

Dietary Diversity and Self-Reported Memory Deterioration in Chinese Adults: A Prospective Study

Dietary diversity among households living in Kilombero district, in Morogoro region, South-Eastern Tanzania

Dietary Diversity Among U.S. Infants and Toddlers: Associations With Caregiver Sociodemographic Characteristics