Simple indicators of dietary diversity are associated with micronutrient adequacy for women of reproductive age in resource‐poor settings

Abstract

Women of reproductive age living in resource‐poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce, and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from household surveys, to serve as proxy indicators of micronutrient adequacy for population‐level assessment. We used 5 existing data sets (3 from Africa; 2 from Asia) with repeat 24‐hr recalls to construct 8 candidate dietary diversity scores (DDS) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. DDS varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between micronutrient intakes and requirements in each site. All 8 DDS were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver‐operating characteristic analysis showed moderate predictive strength for the best choice indicators. Simple DDS hold promise as proxy indicators of micronutrient adequacy. [Support: USAID, through FANTA/AED]