How Seasonal Is the Minimum Dietary Diversity for Children Indicator? An Investigation in Three Countries on Three Continents: Senegal, Nepal and Peru

Abstract

Abstract Objectives A diverse diet helps to assure adequate micronutrient intakes and normal child growth and development. The revised minimum dietary diversity (MDD) indicator for children 6–23 months (>5 of 8 food groups) is often used to track dietary quality over time, but the influence of seasonality has not been explored. Methods We identified surveys with MDD data across seasons including national continuous Demographic Health Surveys in Senegal (2012–2017, N = 12,183) and Peru (2004–16, N = 36,044) and the PoSHAN substudy seasonal surveys (covering 3 seasons) in Nepal (2013–2016, N = 1364). MDD prevalence and mean food groups were estimated. In Senegal and Peru, data were disaggregated by rainy/dry season and month. Results In Senegal, MDD prevalence was similar in the rainy (10.8%) and dry (9.6%) seasons. In Nepal, MDD prevalence was stable at 35.1–34.9% from the monsoon of 2013 through the end of 2014, and then increased to 41.7–47.7% from the winter 2014 through monsoon seasons of 2015 and 2016. In Peru, the prevalence of MDD ranged from 62% in May to 72% in January, but region-season interactions were apparent, perhaps due to agro-ecological variability. Large variance existed for the MDD indicator for many datasets, with mean scores showing greater stability across seasons. Conclusions There can be periods of seasonal stability as observed in Senegal and the first two years of Nepal data, but also sustained change. Relative national stability can obscure seasonal patterns by, as seen in Peru. Variability by season may influence conclusions about change over time in some contexts if month of data collection is not considered. Funding Sources Bill & Melinda Gates Foundation and Feed the Future Innovation Lab for Nutrition, funded by the United States Agency for International Development under grant ID: AID-OAA-L-1–00006.