Dietary Diversity Score Research Articles

Abdominal Pain of Functional Gastrointestinal Disorders in Dietary Diversity Patterns and Its Determinants among Healthy Adults in Jimma City, Southwest Ethiopia.

Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia. A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall). Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence. Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable.

Household food security and dietary diversity in south-eastern Nigeria.

The aim of this study was to investigate household food security (access) level and the dietary diversity of households in the Nsukka Local Government Area in South-eastern Nigeria. From 20 local communities of Nsukka, 390 women were randomly sampled from the women's group and asked to complete a survey that determined the Household Food Insecurity Access Scale scores and the Household Dietary Diversity Scores (HDDS). The descriptive results indicated a high level of food insecurity with 82.6% households reporting various degrees of food insecurity. Over half of the sampled population experienced insufficient food quality. They either ate unwanted food (65.9%), limited variety (63.1%), or unpreferred food (64.6%). Some households experienced insufficient food intake by going a whole day without food (38.2%), go to sleep hungry (45.1%), or have no food of any kind (49%). The analysis of variance showed no significant difference (p = 0.428) in the food security level of households headed by males as compared with those headed by females. Approximately 53.6% of households fell at or below the average HDDS; males headed 48% of these households, while females headed 64%. The chi-square test indicated factors associated with household food security including age, education, work status and income, whereas the gender of the household head, household size and marital status were not significantly associated. Public-private partnerships, nutrition orientation and food intervention programs could improve food security in this area.

Women empowerment in agriculture and its effect on household food security: evidence from Gamo Zone of Southern Ethiopia

BackgroundWomen empowerment and food security are supposed to be two mutually reinforcing goals of the 2030 Sustainable Development Agenda of the United Nations. However, the measurement of women’s empowerment and its relationship with household food security in the agricultural context is too limited, especially in Ethiopia. The main objective of this study is to examine the effect of women’s empowerment in agriculture on household food security in the Gamo zone of Ethiopia.MethodsCross-sectional data were collected from 385 dual-adult households, selected through a multistage random sampling procedure from two districts—Chencha and Kucha of Gamo zone in Ethiopia. The data were collected on the sample households’ demographic, socioeconomic, women empowerment, food consumption and livelihood activities—crop production, livestock holding and off-farm participation by interviewing both primary male and female decision-makers from each household. Household food security was measured using Calorie Availability, Household Food Consumption and Dietary Diversity Score, while women’s empowerment in agriculture was measured using the Abbreviated Women Empowerment in Agriculture Index. Ordinary Least Square, Two-Stage Least Square, Poisson and Instrumental Variable Poisson regression were used as analytical models.ResultsOur study shows that increases in women’s empowerment are positively and significantly associated with all food security indicators—adult equivalent calorie availability, household-level food consumption and dietary diversity. The result also shows that food security is positively related to the proportion of adult household members, age and education of primary female, landholding size, crop diversification, food crop production, the number of dairy cows owned and off-farm participation. However, food security is negatively related to household size.ConclusionThe implication of the finding is that stakeholders should give due attention to promoting women’s empowerment and eliminating the gender gap in agriculture through appropriate gender mainstreaming intervention in dual-adult households. Food security programmes could also gain from prioritizing female education and promoting agricultural diversification (crop and livestock) and off-farm income diversification strategies as valuable investments to improve household food security. This study is the first application of the Abbreviated Women’s Empowerment in Agriculture Index in Ethiopia as a predictor to household food security, and contributes to the women’s empowerment–household food security nexus literature in developing countries.

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

Access to healthy and affordable diet hinged on the realization of Sustainable Development Goal 2, higher productivity and, economic prosperity while it is difficult for a poorly nourished people to achieve optimum production of goods and services. This study assessed whether dietary diversity (DD) and nutritional status of adult men are associated with crop commercialization index (CCI) levels of agricultural households in two states of Southwestern Nigeria. This research utilized 352 farm households, comprising 277 adult male members. The individual version of dietary diversity score (DDS) of 9 food groups was used to calculate adult men's DDS over a 24-h recall. Anthropometric data was obtained using body mass index (BMI) while CCI levels was estimated for each agricultural household. Logistic regression and ordered logit models were used to examine the determinants of adult men's dietary diversity and nutritional status respectively. Hundred percent of adult men consumed starchy staples, with 11.2% consuming egg, 5.8% milk and milk products and 0.4% consuming organ meat over 24-h recall. Adult men of CCI 2 and CCI 4 agricultural households recorded overweight prevalence of >20% in Ogun state while the association between DDS and CCI was statistically insignificant suggesting that being a member of any of the CCI households may not guarantee the consumption of healthy diets among adult men. From Logit regression analysis, it is more likely for adult men with higher farm size to attain the minimum DDS of 4 food groups than those with smaller size of farmland (OR = 4.78; 95% CI: 1.94, 11.76; p = 0.001). The age, farm experience, and cassava marketing experience were positively related to the likelihood of obtaining the minimum DDS. For adult men to achieve a healthy diet, their diet pattern must incorporate a more diversified intake of food from different food groups capable of improving their nutritional status. This study emphasized the need for relevant stakeholders to provide adequate nutrition knowledge intervention programmes capable of improving the diets and nutrition of adult men and other members of farm households.

Association between dietary diversity and cognitive impairment in community‐dwelling older adults

AbstractBackgroundMild cognitive impairment (MCI) is an intermediate state between normal cognitive aging and dementia, and it is a target population for interventions in dementia prevention. Dietary diversity is associated with the risk of dementia. However, the association between dietary diversity and MCI, remains unclear. The present study aimed to examine whether dietary diversity is associated with cognitive impairment, including MCI, in community‐dwelling older Japanese adults.MethodThis cross‐sectional study was conducted using data from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes. MCI and global cognitive impairment (GCI) were assessed using the Mini‐Mental State Examination and National Center for Geriatrics and Gerontology‐Functional Assessment Tool (NCGG‐FAT), which are multicomponent neurocognitive tests that include memory, attention, executive function, and processing speed. Participants with one or more cognitive decline were defined as having MCI. Dietary diversity was assessed using the diet variety score (DVS). DVS assessed the one‐week consumption frequency of ten food groups and either 0 or 1 point was allocated to each category based on the following responses: (1) “eat almost every day” (1 point), (2) “not eaten almost daily” (0 points). Older adults with a DVS of 3 or more points were defined as having high dietary diversity.ResultData included 8,987 older adults (mean age: 73.9 ± 5.5 years; men: 44.3%). The overall prevalence of MCI and GCI followed; 17.1% (n = 1,538) and 8.4% (n = 753), respectively. The proportion of patients with a high dietary diversity was 69.9% (n = 6,286). Multinomial logistic regression analysis revealed high dietary diversity was associated with MCI (OR 0.83, 95% CI 0.73‐0.94) and GCI (OR 0.77, 95% CI 0.65‐0.92) after adjusting for covariates.ConclusionThis study showed that high dietary diversity was associated with a lower proportion of MCI and GCI among older adults. Ingesting a wide variety of foods contributes to the enhancement of cognitive function among older adults.

The influence of nutrition knowledge, attitude, practices, and dietary diversity on obesity among market women in the Cape Coast Metropolis, Ghana: A cross-sectional study.

Obesity and overweight are major public health threat affecting many people globally. This study aimed to examine the role of nutrition knowledge (NK), attitude, practices, and dietary diversity (DD) on the prevalence of obesity among market women in Cape Coast, Ghana. This cross-sectional study was conducted at Abura and Kotokuraba markets in the Cape Coast Metropolis of Ghana. Apparently healthy female traders (n = 402) aged ≥18 years were selected randomly from the markets. DDwas assessed with dietary diversity score (DDS) using a 24hdietary recall method. NK, dietary practices, and attitudes were assessed using validated semistructured questionnaires. Body composition parameters were assessed using appropriate tools. Descriptive and binary logistic regression analysis were performed. Statistical significance was considered at p < 0.05. The prevalence of overweight was 31.84% and obesity was 39.30%. Majority of respondents had poor DDas about 91% had DDS <5. About 75% of the market women had no knowledge in nutrition. About 57% eat thrice daily and 82% take supper from 7 p.m. Knowledge in nutrition was significantly associated with body fat (OR = 0.45, 95% CI = 0.26-0.78, p = 0.004), body mass index (OR = 0.40, 95% CI = 0.28-0.71, p = 0.001), and waist-to-hip ratio (OR = 0.32, 95% CI = 0.19-0.56, p < 0.001). The prevalence of obesity and overweight was high among the market women. Poor NKand poor DDmay have influenced this. A campaign on better dietary practices and delivery of nutrition education may help to minimize the prevalence of obesity among market women.

Cross-Sectional Study on the Association between Dietary Patterns and Sarcopenia in Elderly Patients with Chronic Kidney Disease Receiving Conservative Treatment

Sarcopenia is a poor prognostic factor in patients with chronic kidney disease (CKD). Adequate dietary patterns are important for preventing sarcopenia; however, evidence regarding the underlying association between sarcopenia and diet is insufficient. Therefore, in this study, we aimed to investigate the association between sarcopenia and dietary patterns in CKD patients receiving conservative treatment. In this cross-sectional study, 441 patients with conservative CKD were examined using the Asian Working Group for Sarcopenia diagnostic criteria. CKD was defined as an eGFR of &lt;60 mL/min/1.73 m2 present for &gt;3 months. The participants were divided into sarcopenia and non-sarcopenia groups, and dietary patterns were compared between the two groups using the dietary variety score, a simple dietary survey method that investigates the weekly frequency of consumption of 10 food groups. Logistic regression analysis for CKD G3 showed that female sex (odds ratio (OR): 0.166, 95% confidence interval (CI): 0.086–0.320), increased body mass index (OR: 0.663, 95% CI: 0.590–0.745), and almost daily consumption of green/yellow vegetables (OR: 0.350, 95% CI: 0.176–0.695) were positively associated with non-sarcopenia. Although further prospective studies are required, the results suggest that low frequent consumption of vegetables is associated with sarcopenia in patients with CKD.

Impact of Cash Transfers on Household Food Security: Evidence from Families with Orphans and Vulnerable Children in Kenya

ABSTRACT In response to the devastation of the 1990s and early 2000s AIDS pandemic in Sub-Saharan Africa, Kenya introduced the Cash Transfers for Orphans and Vulnerable Children (CT-OVC) program. The program aimed to encourage the fostering and retaining of Orphans and Vulnerable Children (OVCs) within communities and enhance their human capital development. This study uses cluster-randomized longitudinal trial data to examine the program’s household food security impact, using three measures of the accessibility dimension of food security: per adult equivalent food consumption, household food group shares, and the household dietary diversity score (HDDS). After performing difference-in-differences analysis, we find that the transfers had a positive and highly significant impact on HDDS but a statistically insignificant impact on per adult equivalent food consumption. The results are robust to alternative propensity-score-matched specifications. We further observe hidden food source substitution as transfers provided households with greater freedom of food choices from their own purchases and less reliance on food gifts or aid, thereby improving dietary diversity while aggregate food consumption remained largely unchanged. Our findings provide fresh insights to relevant stakeholders such as government agencies, Non-Governmental Organizations (NGOs) involved with social action, particularly for OVCs, and food security researchers.

Maternal Factors Associated with Dietary Diversity Scores of Children aged 6-23 Months in Kwale County, Kenya.

Dietary Diversity (DD) is an important component of Infant and Young Child Nutrition (IYCN). Globally, it is recommended that children aged 6-23 months be fed on diverse diets as a public health measure in curbing malnutrition. In Kenya, stunting rates among children below the age of five years is 26% and diversifying of diets is still sub-optimal. The study sought to assess maternal factors associated with dietary diversity scores among children aged 6-23 months in Kwale County, where stunting stands at 29%. A cross sectional study design was adopted and a random sample of 244 mothers with children aged 6-23 months, residing in locations under Health and Demographic System Surveillance (HDSS) program participated in the study. Mothers aged 17-68 years were interviewed. Children's DD scores ranged from 0 to 5 with a mean of 2.2±0.9, only 8.2% of the children met the Minimum Dietary Diversity score (MDDs) of 4 food groups or more in a day. A bivariate regression analysis to determine factors associated with children's dietary diversity scores showed significant positive relationship with mother's educational level (r=0.186, P<.000, α=.01), household wealth index (r=0.163, P<.000, α=.01) and the child's age (r=0.396, P<.004, α=.01). The study concludes that mothers' level of education, households' wealth index and child's age are factors associated with dietary diversity scores of children. Higher dietary diverse scores were observed among older children in the study age categories, from wealthy families and under care of mothers with higher education levels. In the study area however, only 8.2% of children met the minimum dietary diversity score necessitating targeted nutrition education of mothers and implementation of economic development initiatives to boost availability and consumption of diverse diets. A consideration of child age specific interventions will also address nutritional needs and preferences at different stages.

Defining a Dichotomous Indicator for Population-Level Assessment of Dietary Diversity Among Pregnant Adolescent Girls and Women: A Secondary Analysis of Quantitative 24-h Recalls from Rural Settings in Bangladesh, Burkina Faso, India, and Nepal

BackgroundThe Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements. ObjectiveThis study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15–49 y in LMICs. MethodsWe used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60. ResultsIn the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%). ConclusionsThe WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15–49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.

Evaluating the impact of improved crop varieties in the Sahelian farming systems of Niger

Most people in Niger still rely heavily on agriculture as a source of income. However, low productivity, climate change, soil infertility, pests, and diseases are challenges faced by this sector. As a result, the nation suffers from a severe problem of food insecurity. Many investigations indicate that adopting improved crop varieties(ICVs) increases agricultural productivity. Using information gathered from 1784 farmers, this study assesses the effects of adopting improved crop varieties (ICVs) on household welfare. To analyze the data, we employ endogenous switching regression (ESR) and inverse probability-weighted regression adjustment (IPWRA) techniques. The analysis shows that the ICVs adoption significantly improves household income and food access in Niger's Sahelian region. The ESR model's average treatment effects estimate shows that the ICVs adoption raised per capita income, food expenditure, and household dietary diversity score (HDDS) by 75 %, 1.81 %, and 36.49 %, respectively. The IPWRA model yields similar results.Therefore we conclude that adopting ICVs has substantial dynamic benefits that improve household welfare in Sahel Niger by increasing their probability of escaping poverty, food insecurity, and malnutrition. The farmer's knowledge of improved crop varieties significantly influenced favorably the decision to adopt, suggesting that intensifying dissemination and encouraging the promotion of drought-tolerant crop varieties among farmers, development agencies, researchers, and policymakers could be a crucial plan of action to combat poverty, food insecurity, and malnutrition in the Sahelian region.

Behavioral model-guided nutritional counseling could improve the dietary practice and nutritional status of elders in Ethiopia: a quasi-experimental study

BackgroundPhysiological, pathological, and socioeconomic changes occurring in older people negatively influence food intake, utilization, nutritional status, and health. These problems are deeply rooted in low socio-economic settings and could partly be addressed through systematic behavioral change approaches. Hence, this study was to evaluate the effect of behavioral model-guided nutritional counseling on the dietary intake and nutritional status of elders.MethodsA one-armed pre- and post-test quasi-experimental design was conducted on 293 community-dwelling older adults aged above 60 years from January to May 2022. A health education tool was developed and validated using health beliefs and the theory of behavioral change. The sessions were delivered by trained nurses through home-to-home visits every week lasting 45–60 min for up to two months. Data on nutritional knowledge, dietary intake, and body weight were captured using standardized questionnaires and measurements. The primary outcome was captured using the validated mini-nutritional assessment (MNA) tool and classified accordingly. The data was analyzed using Stata software, where it is presented in tables, graphs, and summary statistics. A paired t-test and the p-value were used to identify statistically significant effects of the intervention.ResultsA total of 263 elders were involved in the experiment, and modeled nutritional counseling significantly improved the knowledge score from 7.58 (± 1.05) to 11.6 (± 1.37) (P < 0.001) at the pre- and post-intervention periods. A significant improvement has been shown in the consumption of dairy products, fruits, and animal-source foods and, importantly, in the mean dietary diversity score (p < 0.001). As a result, the burden of malnutrition was significantly lower in the post-intervention period (9.6%: 7.9–11.3) compared to baseline (12.5%: 11.4–13.8). There is a significant increase in the mini-nutrition assessment score (MD = 0.30; p = 0.007). The mean body weight and the body mass index did not change significantly after the intervention (p > 0.05).ConclusionTargeted behavioral model-guided nutritional counseling could help promote perception, diversify dietary consumption, and reduce the risk of undernutrition among elders. Particular attention to older people with the use of participant-centered nutritional behavioral change interventions coupled with livelihood support could help reduce undernutrition among older people.Trial registrationClinical Trial Registration-URL: www.clinicaltrials.gov, identifier number: NCT04746664, first released 10/02/2021.

Analysis of the Dietary Diversification of Sedentary and Pastoral Households in Niger

Food is made up of complex and multidimensional elements whose implementation requires significant measurement tools. The overall objective of this work is to assess food consumption within sedentary and pastoral households. This is a cross-sectional study. The methodology used is a food survey of 845 households. The result of this study is that the food groups most stocked by both urban and rural households are cereals (urban 95.7%, rural 79% and pastoral 94.4%) followed by spices/condiments (urban 74.3%, rural 67.5% and 74.4%). The least stocked food groups in urban areas are fruits and vegetables, while the availability of meats in stored speculation is almost non-existent in rural and pastoral areas. The average household food consumption score is 68.10±21.04; 43.29±13.27 and 44.96±13.77 respectively in urban, rural and pastoral areas. We also note a lack of diversity in the diet of rural and pastoral households. Indeed, the average household dietary diversity score is 6.84±1.91; 5.53±1.49 and 5.13±1.29 respectively in urban, rural and pastoral areas. Dietary diversity as well as the average consumption score are associated with household living conditions. In short, the assessment of consumption is an important element in characterizing the household diet.

Leveraging men's education as an effective pathway for improving diet quality: Evidence from rural India.

Investing in nutrition sensitive sectors such as education can be an effective strategy for combatting malnutrition. In this paper we analyze the role that men's education plays in determining dietary diversity outcomes using primary data from 3600 households across four districts of India. Dietary diversity scores were calculated to reflect the quality of food intake, for households and women. Men's education level was considered as the primary driver of diet diversity. To establish a causal link between men's education and diet diversity, the education level of parents and siblings were used as instrumental variables. We find that men's education levels are associated with significantly higher diet diversity scores both for the household and for women. The role of men's education continues to be a significant determinant of diet quality after controlling for household and individual- level confounding factors including the education level of the woman. The results are consistent across different definitions of the diet diversity score and reference period. Methodologically we extend the evidence on the education-nutrition pathway from being associational to causal in nature. Results from this study point to the benefits of leveraging men's education as an effective pathway for improving nutritional outcomes within households.

Effect of market participation on the food and nutrition security status of the rural smallholder farmers: the case of Limpopo and Mpumalanga provinces, South Africa

IntroductionHunger and malnutrition remain serious issues in developing countries, particularly in rural regions. Increased market participation of smallholder farmers can result in improved livelihood and nutrition outcomes. However, smallholder farmers encounter several obstacles that hinder their ability to participate in the market. As a result, the objective of this study is to investigate the factors that influence market participation and its impact on household nutrition security.MethodsThe study relied on secondary data gathered from a sample size of 1,520 people. About 389 of smallholder farmers participated in the market.Results and DiscussionThe results from Food Consumption Score (FSC) cut-off points showed that in the overall sample households, 54% were within the acceptable food consumption diets (&amp;gt;35), while 30 and 16% were in the borderline (21.5–35) and poor diets (0–21), respectively. According to the Household Dietary Diversity Score (HDDS) findings, 57% of smallholder farmers in the total population sample consumed highly diverse diets (consisting of at least six food groups), while 25 and 18% of smallholder farmers consumed diets with medium dietary diversity (consisting of 4–5 food groups) and low dietary diversity (consisting of at most three food groups), respectively. The results from marginal analysis showed that gender of household head, receiving social grants and higher wealth index had a positive impact on market participation. The results from Poisson endogenous treatment effect model showed that household size, ownership of livestock, social grant, wealth index, access to market information, and involvement in crop production had a positive and statistically significant impact on household nutrition security. On the other hand, agricultural assistance showed a negative and significant impact on household nutrition security.Conclusion and RecommendationsIt can be concluded that an improvement in agricultural assistance can improve the household nutrition security status. The improvement of agricultural assistance is more associated with improvement of extension services, which can lead to more production of diverse crops and more market participation. Health extension workers need to do more nutrition programs and workshops in rural areas. These programs and workshops will be intended on providing nutrition education, which will create awareness to smallholder farmers on diverse and balanced food items they should produce, sell, and consume.

Water insecurity is associated with greater food insecurity and lower dietary diversity: panel data from sub-Saharan Africa during the COVID-19 pandemic

There is growing recognition that water insecurity – the inability to reliably access sufficient water for all household uses – is commonly experienced globally and has myriad adverse consequences for human well-being. The role of water insecurity in food insecurity and diet quality, however, has received minimal attention. Data are from panel surveys conducted during 2020–21 among adults involved in smallholder agriculture in Niger (n = 364, 3 rounds), Nigeria (n = 501, 5 rounds), Senegal (n = 501, 5 rounds), and Ghana (n = 543, 5 rounds). We hypothesized that household water insecurity (measured using the brief Household Water Insecurity Experiences Scale) would be associated with greater individual food insecurity (using 5 of the 8 Food Insecurity Experiences Scale items) and lower dietary diversity (using the Minimum Dietary Diversity Score for Women). At baseline, 37.1% of individuals were living in water-insecure households and of these, 90.6% had some experience of food insecurity. In multilevel mixed-effects regressions, individuals living in water-insecure households had 1.67 (95% CI: 1.47, 1.89) times higher odds of reporting any food insecurity experience and were estimated to consume 0.38-fewer food groups (95% CI: -0.50, -0.27) than those living in water-secure households. Experiences with suboptimal water access and use are associated with poor nutrition. The pathways by which water insecurity impacts nutrition should be identified. Global and national food and nutrition security policies could be strengthened by monitoring and developing strategies to address household water insecurity.

Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia

IntroductionThe upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine...

Non‐tariff measures and household welfare: Evidence from Ghana

AbstractMost studies on the impacts of non‐tariff measures (NTMs) on economic outcomes are at the macro‐level with limited micro‐level studies. This study uses primary data on 604 commercial farm households in Ghana to examine the relationship between NTMs and household welfare outcomes. The results show that NTMs are positively associated with assets, household expenditure and income but negatively associated with food expenditure, household dietary diversity score (HDDS) and poverty probability index (PPI). We find that the results are not likely to be driven by unobserved heterogeneity. Our results suggest that the potential mechanisms through which NTMs influence welfare outcomes are household income and expenditure. The main implication of the study is that a reduction in the number of customs formalities and the cost of testing and certification can facilitate trade and contribute to the economic development of commercial farm households.

Effect of dietary diversity on incident of disability in community-dwelling older adults with sarcopenia: A 40-month follow-up longitudinal study

BackgroundSarcopenia is a clinical issue in older adults that leads to serious adverse health outcomes, including disability. The present study investigated whether dietary diversity affects the incidence of disability in older adults with sarcopenia. MethodParticipants were 759 Japanese older adults with sarcopenia (mean age 77.2 ± 6.0 years; 44.4 % men) who were aged ≥65 years at the time of the examination. Sarcopenia was diagnosed according to the recommendations of the European Working Group on Sarcopenia in Older People 2. Dietary diversity was assessed using a diet variety score. This diet variety score assessed the one-week consumption frequency of ten food groups, according to the following responses: “eat almost every day” (1 point), or “not eaten almost daily” (0 points). Older adults with a diet variety score of 3 or more points were defined as having high dietary diversity. Incident disability was certified by long-term care insurance (mean follow-up duration 32 months). ResultsThe cumulative disability incidence rates in the older adults with low dietary diversity and high dietary diversity were 23.3 % and 16.9 %, respectively. Cox proportional hazards regression analysis revealed high dietary diversity was associated with a lower risk of incident disability in older adults with sarcopenia (hazard ratio 0.66, 95 % confidence interval 0.47–0.92; p = 0.015), after adjusting for covariates. ConclusionsThis longitudinal study revealed that high dietary diversity is associated with a lower risk of incident disability among sarcopenic Japanese older adults.

Development and validation of an occurrence-based healthy dietary diversity (ORCHID) score easy to operationalise in dietary prevention interventions in older adults: a French study.

Healthy diet and dietary diversity have been associated with healthy ageing. Several scores have been developed to assess dietary diversity or healthy diets in epidemiological studies, but they are not adapted to be used in the context of preventive nutrition interventions. This study aimed to develop an occurrence-based healthy dietary diversity (ORCHID) score easy to implement in the field and to validate it using dietary data from older participants in the latest French food consumption survey (INCA3). The ORCHID score was made of several components representing the consumption occurrences of twenty food groups, in line with French dietary guidelines. The score was then validated using dietary data (namely three 24-h recalls and a food propensity questionnaire) from 696 participants aged 60 years and over in the INCA3 survey. Score validity was evaluated by describing the association of the score with its components, as well as with energy intakes, solid energy density (SED) and the probability of adequate nutrient intakes (assessed by the PANDiet). Higher scores were associated with more points in healthy components such as 'fruits' and 'vegetables' (r = 0·51, and r = 0·54, respectively). The score was positively associated with the PANDiet (r = 0·43) and inversely associated with SED (r = -0·37), while no significant association was found with energy intakes. The ORCHID score was validated as a good proxy of the nutritional quality of French older adults' diets. It could therefore be a useful tool for both public health research and nutrition interventions.