Dietary Diversity Status Research Articles

Food intake among smallholder cassava value chain households

PurposeThe purpose of this study is to compare food consumption and dietary diversity in smallholder cassava value chain households (CVCHs) and non-cassava value chain households (non-CVCHs).Design/methodology/approachA total of 572 rural households were selected using multi-stage sampling from Oyo and Kwara states, Southwest Nigeria. Socio-demographic, 24 h dietary recall and food frequency questionnaires were used to collect data. Household Dietary Diversity Score (HDDS) and the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) were measured.FindingsThe mean age of respondents was 49.1 ± 17.3 years, 68.3 per cent were female, household sizes ranged from 2-20 with an average of 8 members. Most households consumed monotonous staple-based diets mainly from roots and tubers, cereals and legumes. There was no significant difference in HDDS (6.70 ± 1.37 and 6.77 ± 1.12; p = 0.12) and MDD-W (4.78 ± 1.12 and 4.95 ± 1.16; p = 0.09) for CVCH and non-CVCH respectively. About one-third of all women did not achieve the MDD-W score required for micronutrient adequacy, with the main dietary gap being vitamin A-rich fruits and vegetables.Practical implicationsThe findings suggest that there was no influence of households’ involvement in cassava value chain activities on their pattern of food consumption and dietary diversity.Originality/valueWhile cassava value chain activities have potential for improved livelihoods among its actors, a nutrition-sensitive approach needs to be incorporated to translate this into their improved food consumption, dietary diversity and nutritional (particularly micronutrient) status.

Dietary Diversity among Preschoolers: A Cross-Sectional Study in Poor, Rural, and Ethnic Minority Areas of Central South China

The aim of this study was to document the dietary diversity status of preschool children in poor, rural, and ethnic minority areas of Central South China and examine its associated factors both at home and in preschools. A cross-sectional study including 1328 preschool children aged three or five years from two nationally designated poverty counties in Hunan Province was conducted. A dietary diversity score (DDS) was constructed to measure the dietary patterns based on the 24 h recall method. The mean DDS among the sample children was 5.77 (95% confidence interval: 5.70–5.83, range 1 to 9) with a standard deviation of 1.22. Both household characteristics (including the education level of the child’s primary caregiver and the nutritional knowledge of the caregiver) and preschool factors (including the nutritional knowledge of the child’s preschool principal and teachers, nutritional training to children, and the preschool kitchen manager) were positively associated with children’s DDS. The dietary diversity status of children in poor, rural, and ethnic minority areas of Central South China is much lower than that of their peers in other areas. Nutritional education should be provided to caregivers, preschool staff, and children to narrow the gap.

Are household food security, nutrient adequacy, and childhood nutrition clustered together? A cross-sectional study in Bankura, West Bengal

Research on different measures of food security and their interrelation in order to identify vulnerable households are scarce in India. The objective was to assess household food security (HHFS), nutrient adequacy, dietary diversity, and nutritional status of under-five children along with their interrelation in the slums of Bankura Municipality, West Bengal. A cross-sectional study was conducted during 2016-2017 among 240 households using two-stage 30-cluster random sampling. Information regarding socioeconomic characteristics, availability, and utilization of different poverty alleviation schemes was collected. HHFS was assessed by a validated HHFS scale-short form in Bengali and nutrient adequacy with 24-h recall method. The eldest under-five child in the family was measured for anthropometry using standard procedure and for dietary diversity with the Individual Dietary Diversity Score. Overall, 74 (29.1%) households had "food security," whereas 102 (44.3%) and 64 (26.6%) had, respectively, low and very low food security. Among 190 under-five children, 63 (35.3%) had single and 50 (25.5%) had multiple anthropometric failures. Overall, 89 (36.1%) households were deficient for both energy and protein and 111 (47.6%) had deficiency of either of these two. Indicators on the utilization of different poverty alleviation schemes were associated with low/very low food security. A "Composite Index of Food Scarcity" comprising of HHFS, nutrient adequacy, and dietary diversity was proposed which was found to have dose-response relationship with grades of anthropometric failure of under-five children. An index comprising of three indicators might help identify the vulnerable households in relation to food security more effectively than a single indicator.

Dietary Diversity and Nutritional Status of Female Residential Students in University of Dhaka, Bangladesh

Dietary Diversity and Nutritional Status of Female Residential Students in University of Dhaka, Bangladesh

Dietary diversity and nutritional status among women of reproductive age group in a selected rural community of Bangladesh

Background/context: Dietary diversity (DD) is universally recognized as a key component of healthy diets. Healthy diet is one of the most important determinants that can influence nutritional status of women of reproductive age.
 Materials and Methods: This cross sectional study was conducted in Shitpara village of Sreepur Upazila under Gazipur district during February to June 2013 to assess the dietary diversity and nutritional status of women of reproductive age. Convenient sampling technique was adopted to select 181 women. Interview schedule & checklist used as research instrument.
 Results: The mean(+/-s.d.)age of the respondents was 27.45+/-9.38 years, 133(80%) of them were married and 176(97.2%) are literate. Mean family size was 5.34+/- 2.386 persons and mean family income was 9611.05 Taka per month. Among 133 married women, 68(51%) have 2 or less than two children. Their mean(+/-s.d.) dietary diversity score was 5.13+/- 1.19 and majority 149(82%) of them having medium dietary diversity tercile (4-6). All of them ate carbohydrate types of food, 174(96.1%) protein rich foods & 83(45.9%) vit.A rich vegetables & fruits. Their mean BMI was 22.35 +/- 3.71 kg/ m2. Majority 118 (65%) of them having normal BMI and 22(12%) are under weight. Only 6(3%) of them are obese. Thoughdietary diversity was medium (4-6); relationship between dietary diversity and nutritional status could not be established.
 Conclusion:The qualitative measurement of dietary diversity is not sufficient enough to identify women at risk of under- or over nutrition.
 J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 36-40

Association between household dietary diversity and nutritional status of children (6\u201336 months) in Wenchi Municipality, Brong Ahafo Region, Ghana

BackgroundOne in five Ghanaian children is chronically malnourished. Childhood undernutrition remains a public health concern in Ghana; therefore, research is needed to identify modifiable risk factors to inform health programming. This study evaluated household dietary diversity (HDD) as a determinant of nutritional status of pre-school children in Wenchi Municipality, Ghana.MethodsAn analytical cross-sectional study involving 590 mother-child pairs was conducted in Wenchi Municipality. A two-stage cluster sampling procedure was used; clusters were first selected followed by the selection of children using simple random sampling. Socio-demographic, dietary, and anthropometric data were collected in face-to-face interviews. HDD scores were calculated using data from 24-h dietary recalls based on 12 standard food groups consumed by the households in the past 24 h preceding the survey and categorised into low (1–5 food groups) and high (6–12 food groups) HDD categories using the mean HDD score. Anthropometric indices (stunting, wasting, and underweight) were defined as anthropometric z-scores < − 2 standard deviations using the WHO growth standards. Chi-square and logistic regression analyses were used to study the association between HDD categories and stunting or wasting while controlling for potential confounders.ResultsThe mean age of the respondents was 27.3 [95% confidence interval = 26.8–27.8] years, and majority of them (58.3%) were within the age group 20–29 years. The prevalence rates of stunting, wasting, and underweight in the children were 38.6%, 11.0%, and 13.1%, respectively, while 36.4% of the households had low dietary diversity. There was no association between HDD categories and stunting (adjusted OR = 1.18, 95% confidence interval [CI] = 0.79–1.76, p = 0.409) or wasting (adjusted OR = 0.97, 95% CI = 0.54–1.73, p = 0.910).ConclusionsThere was a high prevalence of stunting in children and many households consumed less diverse diet in Wenchi Municipality. There is a lack of evidence of an association between HDD and stunting or wasting in the population studied. Interventions to improve child growth and HDD are needed to promote and protect child health.

Contribution of exotic chicken breeds to dietary diversity of the rural households in Ethiopia

The study was conducted in midland and lowland agro-ecological zone of North western zone of Tigray, Ethiopia. Two districts were selected purposively based on their potential exotic chicken breed production. Out of the total chicken producers in the study area 264 farmers, 132 from each of the two districts were selected randomly using systematic random sampling methods. It was conducted in cross sectional survey data from 264 respondents in 2016. Its aim was to assess the contribution of producing exotic chicken to dietary diversity of the rural households with 24 hours recall method. The study examines the study area is characterized in a low dietary diversity mainly defined by starchy staples (grains, condiments, oil or fats) at the expense of protein sources (meat, fish, fruits, vegetables, eggs). The result also indicates that there is a higher probability of the exotic chicken producers groups to move from a medium dietary diversity status to a high dietary diversity status as compared with indigenous chicken producers. Based on the study result, there is possibility to improve dietary diversity and income of the households through introduction and dissemination of exotic chicken breeds to rural households. Hence, governmental and non-governmental organizations should help in intervention of exotic chicken breed to the farm households by giving different incentives.

The impact of integrated nutrition-sensitive interventions on nutrition and health of children and women in rural Tanzania: study protocol for a cluster-randomized controlled trial

BackgroundNutrition-sensitive interventions such as homestead production of diverse, nutrient-rich foods, coupled with behavior change communication, may have positive effects on the nutritional status and health of rural households engaged in agriculture, particularly among women and young children. Engagement of agriculture and health extension workers in these communities may be an effective way of delivering nutrition-sensitive interventions given the dearth of trained health care providers in many developing countries. This study aims to assess the effects of integrated homestead food production, food consumption and women’s empowerment interventions using a multi-sectoral approach on women’s and child’s health and nutrition.MethodsThis is a cluster-randomized community-based prospective study set in Rufiji district, a rural area in Eastern Tanzania. Ten randomly selected villages within the Rufiji Health and Demographic Surveillance Site (HDSS) in Eastern-Tanzania were paired and randomly assigned to the intervention or control arm. The Rufiji HDSS dataset was used to randomly sample households with women of reproductive age and children 6–36 months. The intervention includes provision of small agricultural inputs, garden training support, and nutrition and health counseling. This is delivered by community health workers and agriculture extension workers through home visits and farmer field schools. There are three time points for data collection: baseline, midline, and endline. Primary outcomes are women’s and children’s dietary diversity, maternal and child anemia status and growth (child stunting, child wasting, women’s BMI, and women and child hemoglobin).DiscussionThis integrated agriculture and nutrition intervention among rural farming households is a simple and innovative solution that may contribute to the reduction of undernutrition and disease burden among women and children in developing countries. Engaging already existing workforce in the community may facilitate sustainability of the intervention package.Trial registrationClinicalTrials.gov NCT03311698, Retrospectively registered on October 17, 2017.

Higher agrobiodiversity is associated with improved dietary diversity, but not child anthropometric status, of Mayan Achí people of Guatemala.

Child undernutrition remains one of the greatest challenges for public health nutrition in rural areas in developing countries. Interventions aiming to increase and conserve agrobiodiversity seem to be promising alternatives to improve child nutrition. However, the existing literature on these interventions is not conclusive about their effectiveness in combating child undernutrition. We tested the hypothesis that 'higher agrobiodiversity is associated with greater dietary diversity and better anthropometric status' in rural Guatemala.Design/Setting/SubjectsIn the summer of 2016, we conducted a cross-sectional study with a sample of 154 children (6-60 months). We conducted dietary recalls and structured interviews, measured children's weight and height, and visited food production systems (Milpas, home gardens, coffee plantations). Crop species richness, nutritional functional diversity, dietary diversity scores and anthropometric status were calculated. Higher food self-sufficiency, nutritional functional diversity and dietary diversity scores were positively correlated with higher crop and animal species richness. Contrarily, remoteness to the local market was negatively correlated with dietary diversity scores. However, higher dietary diversity scores were not correlated with better child anthropometric status. Better child anthropometric status was positively correlated with improved sanitary conditions and maternal education; and negatively correlated with large household size and frequent child morbidity. Agricultural diversification could diversify diets, increase nutrient availability and improve child anthropometry. However, these interventions need to be accompanied by sanitation improvements, family planning, nutritional education and women's empowerment to strengthen their positive effect on diet and nutrition.

Dietary diversity and anthropometric status and failure among infants and young children in Sri Lanka.

We investigate the association between child dietary diversity and anthropometric status and failure in Sri Lanka while accounting for other child and household factors by employing multivariable logistic and linear regression analyses. Using a nationally representative survey of children ages 6 mo to 59 mo, child dietary diversity was based on the 24-h recall of a child's food intake across seven food groups. The minimum dietary diversity was a score of four or above. Anthropometric status (i.e., height for age (HAZ), weight for age, and weight for height z-scores) and failure (i.e., stunting, wasting, and underweight) were calculated. The prevalence of stunting, wasting, and underweight was 15%, 21%, and 26%, respectively. The prevalence of inadequate dietary diversity was 9%. Child dietary diversity was positively associated with HAZ (b = 0.02; standard error = 0.01; P = 0.04) but not with any indicator of anthropometric failure. However, low birth weight, wealth, and location were strong risk factors for anthropometric status and failure. Analyses stratified by child age indicated that dietary diversity was positively associated with anthropometric status for children ages 24 mo to 59 mo (HAZ: b = 0.03; standard error = 0.01; P = 0.02). Mixed associations were found for children ages 6 mo to 12 mo and there were no associations for children ages 12 mo to 24 mo. Child dietary diversity predicted anthropometric status among children ages ≥24 mo. Interventions to address both proximal and distal risk factors for anthropometric status may be necessary in Sri Lanka to reduce anthropometric failure among infants and young children.

Dietary diversity and nutritional status among children in rural Burkina Faso.

Burkina Faso has a seasonal malnutrition pattern, with higher malnutrition prevalence during the rainy season when crop yields are low. We investigated the association between dietary diversity and nutritional status among children aged 6-59 mo during the low crop yield season in rural Burkina Faso to assess the role of dietary diversity during the lean season on childhood nutritional status. Caregivers reported the dietary diversity of the past 7 d, consisting of 11 food groups, summed into a scale. Anthropometric measurements were taken from all children. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores were calculated based on 2006 WHO standards. Stunting, wasting and underweight were defined as HAZ, WHZ and WAZ <-2 SD, respectively. Multivariable regression models adjusting for potential confounders including household food insecurity and animal ownership were used to assess the relationship between anthropometric indices and dietary diversity. Of 251 children enrolled in the study, 20.6% were stunted, 10.0% wasted and 13.9% underweight. Greater dietary diversity was associated with greater HAZ (SD 0.14, 95% CI 0.04 to 0.25) among all children. There was no association between dietary diversity and wasting or mid-upper arm circumference in this study. Increasing dietary diversity may be an approach to reduce the burden of stunting and chronic malnutrition among young children in regions with seasonal food insecurity.

Household Food Insecurity along an Agro-Ecological Gradient Influences Children's Nutritional Status in South Africa.

The burden of food insecurity and malnutrition is a severe problem experienced by many poor households and children under the age of five are at high risk. The objective of the study was to examine household food insecurity, dietary diversity, and child nutritional status in relation to local context which influences access to and ability to grow food in South Africa and explore the links and associations between these and household socio-economic status. Using a 48-h dietary recall method, we interviewed 554 women from randomly selected households along a rural–urban continuum in three towns situated along an agro-ecological gradient. The Household Dietary Diversity Scores (HDDS) and the Household Food Insecurity Access Scale (HFIAS) tools were used to measure household dietary diversity and food insecurity, respectively. Anthropometric measurements with 216 children (2–5 years) from the sampled households were conducted using height-for-age and mid-upper arm circumference (MUAC) as indicators of stunting and wasting, respectively. The key findings were that mean HDDS declined with decreasing agro-ecological potential from the wettest site (8.44 ± 1.72) to the other two drier sites (7.83 ± 1.59 and 7.76 ± 1.63). The mean HFIAS followed the opposite trend. Stunted growth was the dominant form of malnutrition detected in 35% of children and 18% of children were wasted. Child wasting was greatest at the site with lowest agro-ecological potential. Children from households with low HDDS had large MUAC which showed an inverse association among HDDS and obesity. Areas with agro-ecological potential had lower prevalence of food insecurity and wasting in children. Agro-ecological potential has significant influence on children’s nutritional status, which is also related to household food security and socio-economic status. Dependence on food purchasing and any limitations in households’ income, access to land and food, can result in different forms of malnutrition in children. Responses to address malnutrition in South Africa need to be prioritized and move beyond relying on food security and nutritional-specific interventions, but rather on nutrition-specific and sensitive programs and approaches; and building an enabling environment. Land availability, agriculture (including climate-smart agriculture especially in drier areas), and wild foods usage should be promoted.

Dietary diversity and nutritional status of street food consumers in Oyo, south western Nigeria

Street food is an affordable and acceptable source of dietary intake remarkable for its high consumption in developing countries. The aim of this study was to assess the dietary diversity and nutritional status of street food consumers in Oyo, a Nigerian urban town. The study was cross-sectional in design. A semi-structured questionnaire was used to elicit information on the socio-economic characteristics, consumption of street food and a single 24hr dietary recall from 385 street food consumers in Oyo town of Oyo State. The nutritional status of the respondents was assessed with the use of anthropometric indices-weight (kg) and height (m) to estimate the Body Mass Index (BMI) which was classified as Underweight (<18.5kg/m 2 ), Normal (18.5-24.9 kg/m 2 ), Overweight (25.0- 29.9 kg/m 2 ) and Obese (≥30.0kg/m 2 . Dietary Diversity was based on the number of food groups consumed in the previous 24hours and a Dietary Diversity Score (DDS) ranging from 0 to 9 was constructed from a 9-food group model. The mean age of the respondents was 38.8±12years, majority (87%) were male and 59.7% were self-employed. About 40% spent half of their income on food while 10% spent more than three-quarters on food. More than 60% consumed street food daily, 82.1% indicated street meal as the most preferred street food whilst snacks and beverages were preferred by only 13%. Majority (74.0%) consumed street foods in the afternoon and about 20% in the morning. Four out of 10 respondents had low DDS, about half had medium DDS and 10% had high DDS. The nutritional status indicated 25.2% to be overweight while 3.1% and 6.2% were found to be underweight and obese, respectively. A significant association was found between the dietary diversity and nutritional status of the respondents. This study revealed that street food consumers in the ancient town of Oyo, Nigeria were either overweight or obese and their dietary diversity was low. Keywords: Street food, Consumers, Dietary Diversity, Nutritional status, South Western, Nigeria

DIETARY DIVERSITY AND ITS RELATIONSHIP WITH NUTRITIONAL STATUS AMONG ADOLESCENTS AND ADULTS IN RURAL INDIA.

Dietary diversity is associated with household or individual food availability and intake of nutrients from different food groups and is an important component of nutritional outcome. This study examined the Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) of three dietary diversity indices and their relationship with the nutritional status of adolescents and adults in rural regions of two states in India, Wardha district in Maharashtra and Koraput district in Odisha, in 2014. Individual dietary diversity was calculated using 24-hour diet recall (FS24hr) data and household dietary diversity was measured with food frequency data using Berry's index (DDI) and food scores (FSFFQ). The nutritional status of individuals was assessed using anthropometric indices. The diets in both locations were cereal dominated. It was observed that 51% of adolescent boys and 27% of adolescent girls had 'thinness' and stunting. The prevalence of undernutrition was higher among adult women (48%) than adult men (36%). The mean diversity indices were FS24hr of 8, DDI of 89-90 and FSFFQ of 64-66 in the two locations. The FS24hr was found to be positively correlated with the NAR of all nutrients while DDI and FSFFQ were correlated with seven and six nutrients, respectively. The DDI and FS24hr showed an association with MAR if the two locations were combined together. Sensitivity and specificity analysis showed that FS24hr gave more true positives than false positives and the area under the Receiver Operating Characteristic curve was 0.68, implying that this measure truly differentiates individuals having low dietary diversity with low MAR from those with low dietary diversity and a high MAR. All three measures of dietary diversity showed a linear association with the nutritional outcomes of adults, while in the adolescent group only DDI showed a relationship. It is concluded that 24-hour diet recall is a good measure for studying the relationship between dietary diversity and nutritional status in adults.

Assessment of food consumption pattern in Uttar Pradesh: A dietary diversity study

Nutrition status of people is decided by the dietary habits of people of a region and it has substantial implications for the quality of life of its population. In this background, a study had been undertaken with the objective of understanding dietary habits with special reference to dietary diversity and nutritional status among rural population. The study is based on the primary data collected in Baghpat district of Uttar Pradesh during the year 2014-15. The body mass index, one of the indicator of nutrition status reveals about 10 per cent men, 20 per cent women, 30 per cent boys and 35 per cent girls were coming under underweight and remaining fell in overweight category. Nutrition awareness among the female groups was better than male groups and anganwadi workers were the key informants. The actual consumption of all the food groups were about 50 per cent less than the recommended dietary allowance (RDA) across all the categories. Home produced milk consumption was near to RDA and market depended pulses were more deficient in their consumption. The Individual Diet Diversity Score (IDDS) ranged from 7.6 to 8.0; womens’ dietary diversity score was slightly less than men, similar was the case with children. Simpson Index of Dietary Diversity (SIDD) ranged from 0.69 to 0.77. As evidenced from this study, household production enhances food accessibility, hence, promotion of diversified cropping pattern could be a right strategy for enhancing nutritional security in rural areas. Further, this study suggests to target men as well women for sensitization and awareness programme about importance of food and nutrition to achieve nutritional security of all in particular women.

Lean-Season Food Transfers Affect Children's Diets and Household Food Security: Evidence from a Quasi-Experiment in Malawi

Background: There is evidence that social transfers increase food consumption, improving the quantity and quality of food consumed by poor households. Questions remain on how to improve the effectiveness of social programs.Objective: The aim was to assess the impact of a lean-season food transfer on household food security, diet, and nutrition status of young children during the lean season in Malawi and to understand processes through which transfers operated.Methods: This was a longitudinal, quasi-experimental study based on 2 survey rounds in the Zomba district in Malawi. Data were collected from 60 communities randomly selected among food-insecure villages. Twenty households were randomly selected for interviews within each community. Study outcomes included household expenditures and food consumption (measured by using 7-d recall) and child-level dietary diversity (measured by using 24-h recall) and nutritional status (anthropometric measurements). We followed a mixed-methods approach involving child- and household-level assessments, as well as interviews with community stakeholders. We estimated program impact by combining propensity score matching and difference-in-difference methods.Results: The per capita effect of food transfers on food expenditure was estimated at 36 Malawian kwachas/d, corresponding to an increase of 19% from baseline. There was evidence of increased iron availability in household intake. Highly significant effects were found on children's dietary diversity score, corresponding to an increase of 15%, as well as a positive effect on weight-for-height z scores (WHZs) of >0.25 SDs. Effects on food expenditure and dietary diversity were robust to alternative matching specifications, although the effect on WHZs was not. Examination of the targeting of the transfer showed evidence of large errors of inclusion and exclusion.Conclusion: During the lean season in food-insecure settings, where important declines in food insecurity, diet quality, and nutrition status are present, food transfers may have a protective effect on household food security and diets of young children.

Impact of the National Crusade against Hunger (CNCH) on anemia and dietary diversity among Mexican children

The National Crusade against Hunger (CNCH by its initials in Spanish) is a social inclusion and wellbeing strategy aimed at combating poverty, social marginalization and malnutrition in Mexico. The CNCH intervention was launched in Mexico during the current presidential term (2013 – 2018).ObjectiveTo assess the impact exerted by CNCH food assistance programs on the dietary diversity and nutritional status of children at one‐year follow‐up.MethodsA comparative study was conducted with two cohorts of children under five years of age: 1. CNCH intervention group (n=1500) and 2. Control group (n=800). Assessment was performed in two stages: at baseline (2014) and at one‐year follow‐up (2015). The study used a randomized, probabilistic design based on a nationally representative sample. The children in both cohorts were residents of highly and very highly marginalized localities. A differences‐in‐differences estimator was combined with generalized linear models to estimate CNCH impact on anemia and dietary diversity indicators.ResultsThe probability of suffering from anemia was lower in the CNCH than in the control group children (p=0.021). Furthermore, those in the CNCH group were more likely to consume cereals (p=0.022), leguminous vegetables (p&lt;0.001), and fruit and vegetables (p=0.006) than were those in the control group (p=0.001).ConclusionThe CNCH social food assistance programs contribute to [U1] dietary diversity and anemia reduction in children under five. It is recommended to monitor the care strategies in each program and to improve targeting in the most socially deprived households.

Household dietary diversity, vitamin A consumption and food security in rural Tigray, Ethiopia.

To describe: household dietary diversity across four zones in Ethiopia; the relationship between household dietary diversity and consumption of vitamin A-rich foods; and the relationship between household dietary diversity and food security status. This was a cross-sectional survey. Data were collected using structured questionnaires in the local language. Household dietary diversity scores measured types of foods households consumed, and households were classified by food security status using a modified version of the Household Food Insecurity Access Scale. An ordinal logistics regression model was created to assess the relationship between three tiers of dietary diversity (low, medium and high) and food security while controlling for agricultural zone, educational variables and household characteristics. Rural households in Tigray, Ethiopia. Three hundred households in Tigray, Ethiopia, were interviewed. Of the households, 23, 47 and 30 % had low, medium and high dietary diversity, respectively. Among households with high dietary diversity, eggs and fruit were the most common foods added to the diet. In the fully adjusted model, participants who reported being food secure had 1·8 increased odds of greater dietary diversity (95 % CI 1·0, 3·2) compared with participants who were food insecure. Food security was positively associated with dietary diversity. In order to enhance health, interventions that improve dietary diversity and vitamin A consumption should remain important areas of focus for health leaders in the region.

Diet diversity and nutritional status among adults in southwest China.

BackgroundWith rapid urbanization in the past decades, diet diversity continues to increase in China. The present cross-sectional study aims to explore the association between dietary diversity and nutritional status among adults in southwest China.MethodsThis study used data from 2011–2012 National Nutritional Survey in Yunnan Province, southwest China (N = 1105).Data of three consecutive 24-hour dietary recalls were used to calculate dietary diversity scores (DDS) and nutrient adequacy ratio (NAR). Body mass index and waist circumference were used to determine nutritional status. Surveylogistic procedure of SAS 9.2 software was used to examine the association between DDS and obesity by estimating odds ratio (OR) and 95% confidence intervals (CI).ResultsThe mean DDS was 5.2 (SD 1.1) out of nine points. Being female, younger age, belonging to Han ethnicity, having higher educational level and household income were positively associated with DDS (all P<0.05). As DDS increased, consumption also increased in most food groups except grains and vegetables. People with medium and high DDS (DDS = 5 and DDS ≥6, respectively) ingested more energy than the recommended quantity(NAR = 1.1 and 1.2, respectively). However, the intakes of Calcium and Vitamin A were seriously inadequate even for people with high DDS (NAR≤0.5). With potential confounders adjusted, people with medium and high DDS were at higher risk of general and central obesity than people with DDS ≤4 (OR = 1.4–1.9, P<0.01).ConclusionsOur data indicated that high DDS was associated with excessive energy intake and obesity among adults in southwest China. Although dietary diversity is widely recommended, public health messages should give less emphasis on dietary diversity.

How is dietary diversity related to haematological status of preschool children in Ghana?

ABSTRACTBackground: The role of dietary diversity on blood biomarkers may be significant, but the evidence is limited.Objective: This study assessed the association between dietary diversity and haematological status of children aged 6-59 months controlling for various known confounders.Design: The analysis in this study is based on the 2014 Ghana Demographic and Health survey data.The study involved 2,388 pre-school children aged 6-59 months who constituted the sub-sample for anaemia assessment.Results: The mean haemoglobin concentration (Hb) was 10.2 g/dl ± 1.50 (95 % CI: 10.1 to 10.3), and anaemia prevalence (Hb < 11 g/dl) among children aged 6-59 months was 66.8 % (CI: 63.7 to 69.8). In multivariable logistic regression analysis,continued breastfeeding [Adjusted odds ratio (AOR) = 1.9 (95% CI: 1.19–2.91], 12–23 months of age (AOR = 2.4 (95% CI: 1.40–3.98), having fever in last two weeks (AOR = 1.7 (95% CI: 1.20–2.45, birth interval ≤ 24 months (AOR = 1.9 (1.20–2.84), and poorest wealth quintile (AOR = 2.6 (95% CI: 1.48–4.48) were positively associated with anaemia.Conclusion: The current study showed that factors other than poor dietary diversity predicted anaemia among children aged 6–59 months in Ghana.