Higher Dietary Diversity Score Research Articles

Savings Programmes and Food Security of Women and Their Children in Ethiopia

Women in low and middle-income countries are particularly vulnerable to food insecurity. The non-profit humanitarian organisation CARE has implemented village savings and loan associations (VSLAs), funded by the Canadian International Development Agency, in many Sub-Saharan African countries to enhance women’s access to savings and credit and empower them to tackle the challenges of food insecurity. Despite the importance of this innovative programme, its effects on food security outcomes have not been thoroughly examined. This study examined whether women’s participation in VSLAs was associated with food security of women and their children. Using data collected by CARE involving 1,077 women and their children in Ethiopia, our findings showed that VSLA participation was significantly associated with a higher dietary diversity score among women. The findings also suggest that under certain conditions, VSLAs targeting women may positively influence food security of women and their children.

Dietary diversity and preferences among pregnant women and its association with anaemia

Purpose This study aims to assess dietary choices of pregnant women and its relationship with their anaemia status. Design/methodology/approach A mixed-method study comprising a survey and three focus group discussions (FGDs). The survey included 380 adult pregnant women with data collected on food choices, preferences and haemoglobin (Hb) status. Findings More than 50% of women in the study had Hb concentration < 11.0 g/dl; mean Hb was 10.24 g/dl (SD = 1.59). Univariate analysis was used to generate descriptive tabulations for socio-demographic characteristics of respondents, dietary choices for women and anaemia status. T-test and bivariate analysis between dietary diversity score of the women among the food groups consumed as well as their anaemia (Hb) status. This showed that women with high dietary diversity score had improved Hb status (P = 0.003), and those who consumed meat and fish as well as dark leafy vegetables had significantly high diversity scores (P = 0.031 and P = 0.049). Thematic analysis was used for analysing qualitative data. Research limitations/implications The sample used in the study is unlikely to be fully representative of pregnant women in the Accra Metropolis. In addition, this study used a cross-sectional study design, making it difficult to establish causal associations between nutritional status and food choice of pregnant women. It does not also show variation in dietary practices by seasons of the year. The scope of the study did not allow for a detailed analysis, and this should be considered in future studies. Also, the study did not explore an obstetric factor like past bleeding history as well as the menstrual cycle of these pregnant women, as these factors are likely to interfere with the anaemia status of the pregnant women. Originality/value This paper contributes significant value by specifically focusing on and clarifying the complex relationship between dietary choices and aneamia among pregnant women. It also provides insights into the distinct dietary patterns and preferences of pregnant women, which may be contributing to the high prevalence of aneamia. The results of the study can inform the development of localized, evidence-based interventions to address this critical public health concern, ultimately leading to improved maternal and foetal health outcomes.

Dietary Inflammatory Index and Dietary Diversity Score Associated with Sarcopenia and Its Components: Findings from a Nationwide Cross-Sectional Study.

Little is known about the independent and joint effects of the energy-adjusted dietary inflammatory index (E-DII) and dietary diversity score (DDS) on sarcopenia and its components (low muscle mass, low muscle strength, and low physical performance). A total of 155,669 UK Biobank participants with ≥1 (maximum 5) 24 h dietary assessments were included in this cross-sectional analysis. We used logistic regression models to investigate the associations of E-DII and DDS with sarcopenia and its three components. We further examined the joint effects of E-DII and DDS on sarcopenia and its components using additive and multiplicative interaction analyses. We observed that lower E-DII and higher DDS were associated with lower odds of sarcopenia and its components. There were significant joint associations of E-DII and DDS with sarcopenia and low physical performance (p-interaction < 0.05) on the multiplicative interactive scale. Our study suggests that lower dietary inflammatory potential and higher dietary diversity might be important protective factors against sarcopenia and its components. More cases of sarcopenia and low physical performance might be preventable by adherence to a more anti-inflammatory diet combined with a higher dietary diversity.

A systematic review of diet, nutrition, and medication use among centenarians and near centenarians worldwide

Centenarians represent a phenomenon of successful aging, yet little is known about their lifestyle and health practices, including diet/nutrition, medication use, and health conditions. A protocol for this systematic review was registered previously(1). We systematically searched Medline, CINAHL, Scopus, and grey literature from 2000 to 2022, limited to quantitative studies published in English among adults aged 95 years or above. Two reviewers independently screened 3,392 records and identified and extracted data from 34 eligible studies. Additionally, they independently assessed the study quality using the Modified Newcastle-Ottawa Scale (mNOS)(2). Any disagreement was discussed and resolved with a third reviewer. In analysis, pooled prevalence was provided for categorical variables on demographics, lifestyles, medications, and diseases using % (95%CI); mean or median was provided for continuous variables. Due to study heterogeneity, we conducted a narrative synthesis for the associations between the exposures and outcomes. Over 70% of the included studies met 6/8 criteria based on the mNOS; nearly half did not mention or control for confounders in statistical analyses. The age ranged from 95-118y (32 studies: 100y+; 2 studies: mean age 97-98 y); the majority were females (75%; 95%CI: 71%,78%). Most centenarians did not smoke or drink [current smokers: 7% (5%, 9%); former smokers:16% (12%, 19%); daily drinkers: 27% (20%, 34%); former drinkers:21% (13%, 30%)]. Most centenarians were physically inactive (23%; 20%, 26%). Over 50% had normal weight (52%; 42%, 61%), 33% (14%, 52%) underweight, and 14% (8%, 20%) overweight. Regarding nutrition, the narrative synthesis suggests that centenarians had normal levels of albumin (3.8g/dL), total triglycerides (111mg/dL), total (188mg/dL), and HDL cholesterol (54mg/dL) but high levels of LDL cholesterol (109mg/dL). Regarding medications, nearly 50% took antihypertensive medications (49%; 14%, 84%) or other cardiovascular drugs (48%; 24%, 71%); they took a median of 5 (range: 2-7) drugs. Common conditions included impairment of basic activities of daily living (ADL) (54%; 33%, 74%), hypertension (43%; 21%, 65%), and diabetes (22%; 9%, 52%). In regression analyses among centenarians, high dietary diversity, lower salt preference, and weight status were significant factors for more independence in basic ADL, lower mortality, and greater longevity. For example, a high dietary diversity score was associated with a low mortality risk [0.93 (0.92, 0.94) per unit increase]; those who preferred salty food versus those who did not had a 3.6-fold risk of impaired ADL [adj.OR: 3.59 (1.14, 11.25)]. Being overweight vs. normal weight reduced the risk of ADL impairment [adj.OR: 0.84 (0.78, 0.91] while underweight increased this risk [adj.OR:1.34 (1.28, 1.41)]. Also, overweight [adj.OR: 0.92 (0.90, 0.94)] or abdominal obesity [adj.OR: 0.72 (0.52, 0.996)] reduced the likelihood of longevity per kg increase. This systematic review suggests a healthy lifestyle, good nutrition, and normal body weight may contribute to extreme longevity. Interpreting these summary findings should be cautious due to potential recall bias and heterogeneity of the included studies.

The Mediating Role of Psychological Balance on the Effects of Dietary Behavior on Cognitive Impairment in Chinese Elderly.

Cognitive impairment, a significant problem in older adults, may be associated with diet. This study aims to examine the association between the dietary diversity score (DDS), dietary pattern (DP), and cognitive impairment in elderly Chinese. This research further explored the role of psychological balance (PB) as a mediator in the relationship between diet and cognitive impairment. A total of 14,318 older adults from the Chinese Longitudinal Healthy Longevity Study (CLHLS) in 2018 were included. Latent class analysis (LCA) was used to identify patterns in seven food varieties. Binary logistic regression models were used to determine factors associated with the DDS, DP, and cognitive impairment. The multiple mediation effect model was evaluated using model 6 in the PROCESS version 3.5 program. Among the participants, 4294 (29.99%) developed cognitive impairment. Compared to people in food variety group two or lower, people with a high dietary diversity score (DDS) had lower odds of cognitive impairment. Compared to DP1, DP2 (OR = 1.24, 95%CI = 1.09 to 1.40) was associated with a higher risk of cognitive impairment, and DP4 (OR = 0.79, 95%CI = 0.69 to 0.89) was associated with a lower risk of cognitive impairment. PB mediated the relationship between DDS, DP, and cognitive impairment, with a mediating effect of 27.24% and 41.00%. A DP that is rich in fruits, vegetables, red meat, fish, eggs, beans, nuts, and milk was related to a lower risk of cognitive impairment. PB has an indirect impact on cognitive impairment. Our findings underscore the importance of promoting a diverse diet, which may contribute to a lower risk of cognitive impairment in older adults. The PB of the elderly should also be taken into consideration.

Relationship between dietary diversity and sleep quality: a Chinese community-based study.

The objective of this study was to examine the association between dietary diversity and sleep quality among Chinese middle-aged and older adults. The Lifestyle and Healthy Aging of Chinese Square Dancer Study is a prospective, community-based cohort study that enrolled participants aged 45years and above from 2020 to 2021. Using the semiquantitative food frequency questionnaire to investigate the diets of study participants, and using the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Dietary diversity was assessed using two scoring methods covering ten food groups and 66 food items, respectively: the dietary diversity score (DDS) and the food variety score (FVS). The higher scores of DDS and FVS indicated greater dietary diversity and higher dietary quality. Logistic regression analysis explored the associations between these scores and sleep quality. A total of 2409 individuals with completed information on PSQI and FFQ were included in this study, of whom 767 (31.8%) had poor sleep quality. Participants with higher DDS were associated with an 18% lower odds of poor sleep quality compared to those with low DDS (OR = 0.82, 95% CI, 0.68-0.98). Participants in the highest quartile of the FVS had a 32% lower odds of poor sleep quality than those in the lowest quartile (OR = 0.68, 95% CI, 0.52-0.89). There was a positive correlation between higher FVS and DDS with better sleep quality. Therefore, ensuring a diverse diet may be beneficial for maintaining good sleep quality among middle-aged and older adults.

Magnitude and Predictors of Dietary Diversity among HIV-Infected Adults on Antiretroviral Therapy: The Case of North-Western, Ghana.

Though people living with HIV/AIDS require a good combination of antiretroviral therapy and healthy dietary habits for a quality life and positive medical outcomes, little is, however, known regarding the dietary practices of HIV-positive patients who receive antiretroviral therapy (ART) in the Lawra Municipality. This study assessed the magnitude and factors associated with dietary diversity among HIV-positive patients on antiretroviral therapy (ART). This study was a facility-based cross-sectional study of 269 study participants recruited using a systematic random sampling technique. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with their dietary diversity. This study shows that only 36 (13.4%) of the sample consumed a diversified diet with a mean dietary diversity score of 3.7 ± 0.99. Starchy staple foods (96.7%) and flesh food (92.9%) were the most consumed foods. Being a nonfarmer employee (AOR = 10.76, 95% CI = 1.03-112.35), not taking cotrimoxazole prophylaxis (AOR = 3.76, 95% CI = 1.02-14.37) and adults of age 18-27 years (AOR = 5.95, 95% CI = 1.18-30.07) were significant predictors of high dietary diversity. This study revealed that dietary diversity was a significant nutritional problem among HIV-positive adults in Lawra Municipal Hospital. Starchy staple foods and flesh food were the most consumed foods, while organ meats, dairy products, and eggs were eaten less. Having a secured salary paid job, not taking cotrimoxazole prophylaxis, and being a young adult were strong predictors of a high dietary diversity score. Therefore, efforts should be made to strengthen and improve the economic status and to educate these vulnerable groups on the need to adhere to cotrimoxazole prophylaxis uptake.

Vitamin B12 is associated negatively with anemia in older Chinese adults with a low dietary diversity level: evidence from the Healthy Ageing and Biomarkers Cohort Study (HABCS)

ObjectiveThe associations between plasma vitamin B12 level and anemia under different dietary patterns in elderly Chinese people are poorly understood. We aimed to examine the associations between plasma vitamin B12 levels and anemia under different dietary patterns in adults aged 65 years and older in nine longevity areas in China.MethodsA total of 2405 older adults completed a food frequency questionnaire at the same time as a face-to-face interview. The dietary diversity score (DDS) was assessed based on the food frequency questionnaire, with the low DDS group referring to participants with a DDS score ≤ 4 points. Vitamin B12 levels were divided into two groups of high (>295 pg/mL) and low (≤ 295 pg/mL) with the median used as the cut-off point. Sub-analyses were also performed on older adults divided into tertiles of vitamin B12 levels: low (< 277 pg/mL), medium (277–375 pg/mL) and high (> 375 pg/mL) to study the association of these levels with anemia.ResultsSix hundred ninety-five (28.89%) of these people were diagnosed with anemia and had a mean age of 89.3 years. Higher vitamin B12 levels were associated with a decreased risk of anemia (multi-adjusted OR, 0.59, [95% CI, 0.45 ~ 0.77] P < 0.001) in older adults with a low DDS, whereas no significant association between vitamin B12 levels and anemia was found in older adults with a high DDS in a full-model after adjustment for various confounding factors (multi-adjusted OR, 0.88, [95% CI, 0.65 ~ 1.19], P = 0.41).ConclusionThe relationship between vitamin B12 levels and the prevalence of anemia was significant only when the level of dietary diversity in the older adults was relatively low. The dietary structure of the population should be taken into consideration in combination in order to effectively improve anemia status by supplementing vitamin B12.

Association between Food Consumption Patterns and Handgrip Strength among Adults Aged ≥55 Years in Indonesia: A Cross-Sectional Analysis from the IFLS-5

We aimed to examine the association of food consumption patterns, measured by dietary diversity score (DDS) or food consumption score (FCS), with handgrip strength (HGS) among adults aged ≥55 years in Indonesia. This is a cross-sectional study involving 4351 middle-aged and older adults from the Indonesian Family Life Survey Fifth Wave (IFLS-5), collected in 2014–2015. A weighted linear regression model was used to examine the association of DDS or FCS with HGS in crude and adjusted models. In the adjusted models and compared to those with low DDS or poor FCS, those with medium/high DDS and borderline/acceptable FCS were associated with a higher mean of HGS. Good food consumption patterns, as reflected by high DDS or acceptable FCS, were shown to be significantly associated with stronger HGS among adults aged 55 years or above. More targeted nutritional interventions to promote good food consumption patterns may help improve HGS among middle-aged and older adults in Indonesia.

Effect modification of dietary diversity on the association of air pollution with incidence, complications, and mortality of type 2 diabetes: Results from a large prospective cohort study

BackgroundIt remains unknown whether the dietary diversity score (DDS) could modify the association of long-term exposure to individual air pollutants and the mixture of various pollutants with the incidence, complications, and mortality of type 2 diabetes (T2D). MethodsWe included 162,579 participants from the UK Biobank who had ≥ one 24-h dietary assessment and were free of diabetes or diabetes complications before their last response date of the 24-h dietary assessment. Exposure to benzene, NOx, NO2, SO2, PM10, and PM2.5 was estimated at each participant's residential location using a bilinear interpolation algorithm based on air dispersion models on a 1 km × 1 km grid. The DDS was calculated based on repeated 24-h dietary assessments. The outcomes were the incidence, complications, and mortality of T2D. Associations of individual pollutants and multiple pollutants mixtures with outcomes were assessed using Cox proportional hazards regression models and the quantile g-computation approach, respectively. We further stratified these analyses by DDS. ResultsDuring a median of 10.1 years of follow-up, 2978 participants developed incident T2D, 1181 developed T2D complications, and 242 died due to T2D. Long-term single-pollutant and multi-pollutant exposure were associated with elevated risk of incidence, complications, and mortality of T2D. For example, for incident T2D, the hazard ratio and 95 % confidence interval for each quantile increase were 1.155 (1.095, 1.215) for the air pollution mixture. We observed significant interactions between air pollution (benzene, NOx, NO2, PM10, PM2.5, and the air pollution mixture) and DDS (P-interaction <0.05), with the corresponding associations being significantly weaker in adults with high DDS than in those with low DDS. ConclusionHigher dietary diversity may attenuate the harmful impacts of air pollution on T2D-related outcomes. A higher diversity diet could be used to prevent the onset and progression of T2D induced by long-term exposure to various air pollutants.

Determinants of dietary diversity and drivers of food choice among low-income consumers in urban Kenya, Malawi and Zimbabwe.

Rapid urbanisation affects lifestyle and eating habits, predominantly causing a dietary shift that adds challenges to meet dietary recommendations within a complex food system. This research investigated dietary diversity and food choice drivers among low-income consumers in three urban settlements (Nairobi, Kenya; Bulawayo, Zimbabwe and Lilongwe, Malawi, representing rapid, moderate and slow urban growth patterns, respectively) as a first step towards improving diets across cultures and geographies. Mixed methods data collection was employed for this study. Qualitative methods such as rapid foodscape appraisal workshops and food stories in selected low-income settlements in Nairobi, Bulawayo and Lilongwe were utilised to collect information on the food environments (food balances, infrastructure, safety, policies and institutions). Quantitative data such as socio-demographic characteristics and dietary diversity were collected via structured questionnaires using Cognitive Edge's SenseMaker® (n = 890, 450 and 440 for Nairobi, Bulawayo and Lilongwe, respectively). The dietary intake of respondents was assessed using a 24-h recall, which was then converted to the food group diversity score (FGDS). Different levels of compounded stress affected dietary diversity and quality, including high food prices, concerns about sanitation and hygiene and the role of food standards regulation bodies. The mean FGDS across all locations was lower than the recommended cut-off of 5 (4.5, 2.8 and 2.6 across Nairobi, Zimbabwe and Lilongwe, respectively). Additionally, in Nairobi, there were gender differences in diet diversity, with men having a higher dietary diversity score than women (4.6% vs. 4.3%; p = 0.004). The majority of respondents in Lilongwe (65%) reported price as the most important driver of food choice, compared to 38% in Nairobi and 42% in Bulawayo. Our observation of poor-quality diets provides further evidence of the need for food policies that are cognisant of the nutrition and health of the growing population of the urban poor. Such policies would focus on lowering the costs of nutritious foods as well as ensuring food safety within the complex food system observed in the urban low-income environment.

Dietary Diversity and Mild Cognitive Impairment in Middle-Aged and Older Chinese People: A Cross-Sectional Study.

The evidence concerning dietary diversity and cognitive function remains insufficient. To investigate the association of dietary diversity score (DDS) with mild cognitive impairment (MCI) and cognitive performance in different domains. Data from The Lifestyle and Healthy Aging of Chinese Square Dancer Study was used in this study. DDS was constructed based on the intake frequencies of 9 food groups assessed by a validated food frequency questionnaire. MCI was diagnosed by Petersen's criteria. A neuropsychological test battery was used to assess the performance on cognitive domains, and test scores were standardized to Z scores. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios and their 95% CIs, respectively. Among 1,982 participants, the mean (SD) age was 63.37 (5.00) years, 1,778 (89.71%) were women, and 279 (14.08%) had MCI. Compared to the DDS quartile (0, 6], the multivariable-adjusted odds ratios (95% CI) were 0.74 (0.48, 1.15) for DDS quartile (6, 7], 0.65 (0.43, 0.97) for DDS quartile (7, 8], and 0.55 (0.37, 0.84) for DDS quartile (8, 9]. Furthermore, higher DDS was positively associated with better performance of cognitive domains, including global cognitive function (β= 0.20, 95% CI: 0.12, 0.30), episodic memory (β= 0.21, 95% CI: 0.07, 0.35), attention (β= 0.15, 95% CI: 0.03, 0.26), language fluency (β= 0.24, 95% CI: 0.10, 0.38), and executive function (β= - 0.24, 95% CI: - 0.38, - 0.10). This study indicated that higher DDS was associated with better cognitive function among middle-aged and older Chinese people.

Antenatal care follow-up was significantly associated with a higher probability of high dietary diversity score among pregnant women in okra-producing areas of western Ethiopia: proportional odds model.

Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.

Status of household dietary diversity and associated factors among rural and urban households of Northern Uganda

BackgroundIn Northern Uganda, 21 and 52.4% of children under five are underweight and stunted, respectively while 32.9% of pregnant women are anemic. This demographic situation suggests among other issues, a lack of dietary diversity among households. Good nutrition practices that confer dietary quality such as dietary diversity are known to depend on nutrition knowledge and attitude and are shaped by sociodemographic and cultural factors. However, there is a paucity of empirical evidence to support this assertion for the variably malnourished population of Northern Uganda.MethodsA cross-sectional nutrition survey was conducted among 364 household caregivers (182 from two locations in Northern Uganda; Gulu District (the rural) and Gulu City (the urban), selected through a multistage sampling approach. The aim was to determine the status of dietary diversity and its associated factors between rural and urban households of Northern Uganda. The household dietary diversity questionnaire and the food frequency questionnaire on a 7-day reference period were used to collect data on household dietary diversity whereas multiple choice questions and the five points Likert Scale were used to determine knowledge and attitude toward dietary diversity. Consumption of ≤ 5 food groups were regarded as low in dietary diversity, 6–8 food groups as medium and ≥ 9 as high dietary diversity score using the FAO 12 food groups. An Independent two-sample t-test was used to differentiate the status of dietary diversity between the urban and rural areas. The Pearson Chi-square Test was used to determine the status of knowledge and attitude while Poisson regression was used to predict dietary diversity based on caregivers’ nutritional knowledge and attitude and their associated factors.ResultsThe 7-day dietary recall period revealed that dietary diversity was 22% higher in urban (Gulu City) than in the rural area (Gulu District) with rural and urban households achieving medium (score of 8.76 ± 1.37) and high (score of 9.57 ± 1.44) dietary diversity status, respectively. Diets in both locations were dominated by starchy cereals and tubers while animal-source foods and fruits and vegetables were the least consumed. A higher proportion (51.65%) of urban respondents had good nutrition knowledge toward dietary diversity compared to their rural counterparts (23.08%) and a significantly higher proportion (87.91%) of the former exhibited positive attitude towards dietary diversity than the rural counterparts (72.53%). Application of the Poisson regression shows that nutritional knowledge was a positive predictor of dietary diversity in the rural (β = 0.114; ρ = 0.000) than in the urban areas (β = -0.008; ρ = 0.551). Caregivers attitude had no significant effect across locations. In terms of associated factors, marital status is a positive predictor of dietary diversity in the urban (β = 1.700; ρ = 0.001) than the other location (β = -2.541; ρ = 0.008). Whereas education level of household caregiver and household food expenditure show negative effects across the two locations, the educational level of the household head is an outlier as it positively predicted dietary diversity in the rural (β = 0.003; ρ = 0.002) when compared to urban area (β = -0.002; ρ = -0.011).ConclusionRural households in Northern Uganda have medium-level dietary diversity with urban households having high dietary diversity. Diets in both locations are dominated by starchy cereals and roots and tubers. The urban–rural food divide can be harmonized through nutrition education and outreach, specifically focusing on the FAO 12 food groups. Attitude toward consumption of fruits and vegetables which are seasonally abundant would improve dietary diversity and nutritional outcomes in the study area.

Dietary diversity during Covid-19 pandemic: A case of households in Lurambi and Malava sub-Counties, Kakamega County

Dietary diversity is a qualitative and proxy indicator of food security status. Social, physical, economic and biological factors, among others, may impact positively or negatively on the dietary diversity of a population. The aim of this study was to explore the food and dietary diversity in Malava and Lurambi sub-Counties of Kakamega County during COVID-19 pandemic. A descriptive survey design was used for data collection. The sample size was 200 households. A questionnaire that was designed and developed using KoBo Collect and synchronized to Open Data Kit (ODK) server was used to collect data. Data was analyzed using Statistical Package for Social Sciences Version 26.0 to generate descriptive and inferential statistical data. Independent t-test statistics for mean differences was used to determine differences in Household Dietary Diversity Scores (HDDS) between Lurambi and Malava sub-Counties. The study results showed that grains and grain products and all other starchy foods recorded the highest HDDS (100%), followed by dark green leafy vegetables (90.1%) and fruits (46.7%). Foods with the lowest HDDS were meat and meat products (16.5%) and other vegetables (19.7%). Lurambi sub-County had a higher dietary diversity score during COVID-19 pandemic as compared to Malava sub-County. The HDDS scores showed that the dietary diversity for Lurambi sub-County was 3.8 and that of Malava sub-County was 3.2. The T-test results were significant at p= 0.02, &lt;0.05 at 95% CI. However, both sub-Counties had overall, a low HDDS as they did not reach the recommended dietary diversity of consuming foods from at least five food groups. Consequently, the overall low HDDS in both sub-Counties could imply that households did not have access to nutritious food during the COVID-19 pandemic. The study concluded that during COVID-19 pandemic, households in Kakamega had low HDDS and hence, establishing strategies for enhancing dietary diversity to improve food access during and beyond any pandemic was key. Key words: Dietary diversity, COVID-19, household food access, food security

The Prevalence and Determinants of Child Hunger and Its Associations with Early Childhood Nutritional Status among Urban Poverty Households during COVID-19 Pandemic in Petaling District, Malaysia: An Exploratory Cross-Sectional Survey.

Child hunger was prevalent during the COVID-19 pandemic, but the extent, determinants, and impact on pre-school children aged 6 months to 7 years old from Malaysian urban poor households are still unknown. This exploratory cross-sectional study was performed between July 2020 and January 2021 at the Lembah Subang People Housing Project, Petaling. The households' food security status was assessed using the previously validated Radimer/Cornell questionnaire, and the children's anthropometric measurements were taken. Food diversity score was assessed using the World Health Organization Infant and Young Children Feeding (under-2 children) or Food and Agriculture Organization Women's Dietary Diversity (2-year-old-and-above children) systems. Overall, 106 households were recruited. The prevalence of child hunger is 58.4% (95% CI: 50.0, 67.4). Significant differences were found in breastfeeding and sugar-sweetened beverage consumption between under-2 and ≥2-year-old children. There were no significant differences between child hunger and other food-insecure groups in weight-for-age, height-for-age, and weight-for-height z-scores. Only a higher dietary diversity score was significantly protective against child hunger after adjusting for maternal age, paternal employment status, and the number of household children (ORadjusted: 0.637 (95% CI: 0.443, 0.916), p = 0.015)). Proactive strategies are warranted to reduce child hunger during the COVID-19 pandemic by improving childhood dietary diversity.

Dietary diversity and overweight are associated with high intrinsic capacity among Chinese urban older adults (2020−2021)

Background and objectivesThe associations of intrinsic capacity (IC) with dietary diversity and body mass index (BMI) remain unclear in older adults. This study aimed to examine the associations of dietary diversity and BMI on high IC. MethodsThe cross-sectional study used data from the Fujian Prospective Aging Cohort, which included 1972 individuals aged 60–98 from 2020 to 2021. The dietary diversity score (DDS) was constructed with eight food varieties, and consuming ≥five varieties of food daily was considered a high DDS. BMI was grouped into underweight, normal weight, overweight, and obesity according to the Chinese guidelines. High IC was defined as ≥three unimpaired domains of cognition, locomotion, sensory, vitality, and psychology. ResultsMultivariate logistic regression analysis was used to assess the separate association of high DDS and BMI groups with high IC. Compared with low DDS, high DDS had a positive association with high IC (OR = 1.42, 95 % CI = 1.16–1.74). Compared with normal weight, underweight was inversely related to high IC (OR = 0.18, 95 % CI = 0.09–0.36), overweight was positively related to high IC (OR = 1.65, 95 % CI = 1.33–2.06), while no significant association was observed between obesity and high IC. The restricted cubic spline model exhibited an inverted U-shaped nonlinear curve of BMI and high IC and identified an optimal BMI of 25.7 kg/m2 for high IC. ConclusionsHigh DDS is a protective factor of high IC in older adults. Overweight had the most protective association with high IC among the four BMI subgroups. Individuals with overweight and higher dietary diversity had higher IC.

Dietary Diversity and Inflammatory Diet Associated with All-Cause Mortality and Incidence and Mortality of Type 2 Diabetes: Two Prospective Cohort Studies.

A higher dietary diversity score (DDS) and a lower energy-adjusted dietary inflammatory index (E-DII) may be associated with lower risks of type 2 diabetes (T2D) and mortality. This cohort study aimed to investigate the associations of DDS and E-DII with all-cause mortality, incidence of T2D, and mortality of T2D, as well as the joint effects of these two dietary factors. A total of 181,360 participants without all types of diabetes at baseline from the UK Biobank and 42,139 participants from the US NHANES were included. Cox proportional hazards models were used to assess the associations of DDS and E-DII with outcomes. In the UK Biobank data, 8338 deaths, 3416 incident T2D cases, and 353 T2D deaths occurred during a median follow-up of 12.5 years. In the US NHANES data, 6803 all-cause deaths and 248 T2D-specific deaths were recorded during a median follow-up of 9.6 years. We observed that higher DDS and lower E-DII were significantly associated with lower risks of total mortality and incident T2D. Compared with low DDS, the hazard ratios (HRs) and 95% confidence intervals (CIs) of high DDS were 0.69 (0.64, 0.74) for all-cause mortality, 0.79 (0.70, 0.88) for incident T2D in the UK Biobank, and 0.69 (0.61, 0.78) for all-cause mortality in the US NHANES. Compared with participants in tertile 3 of E-DII, those in tertile 1 had a lower risk of overall death [HR 0.86 (95% CI: 0.81, 0.91) in UK Biobank; 0.83 (0.77, 0.88) in US NHANES] and incident T2D [0.86 (0.79, 0.94)] in UK Biobank. No evidence was observed of the interactive effects of DDS and E-DII on either all-cause mortality or the incidence and mortality of T2D. There was no significant association found between any exposure and T2D mortality in this study. In conclusion, our results revealed that higher DDS and lower E-DII were associated with both total mortality and incident T2D in UK and US adults.

Nutritional knowledge of mothers, children’s food consumption, and stunting prevalence: a study of indigenous community in Kasepuhan of Ciptagelar and Sinar Resmi, West Java, Indonesia

Background: The indigenous community of Kasepuhan of Ciptagelar lives in villages that still hold the local traditions firmly. In contrast, the indigenous community of Kasepuhan of Sinar Resmi geographically live in more open villages, so they can easily interact with people from other villages. Culture contributes social values to food consumption and nutritional status. Methods: This cross-sectional study was conducted on the two indigenous communities from January 2015 until June 2016. The study involved selecting samples using stratified random sampling. The total sample was as many as 200 households. Results: The study found that 70.3% of mothers in Kasepuhan of Ciptagelar and 48.6% in Kasepuhan of Sinar Resmi have low nutritional knowledge (score &lt;60). The households living in both Kasepuhans had high dietary consumption diversity. However, a household in Ciptagelar had a higher dietary diversity score (6.4±1.4) than in Sinar Resmi (5.7±2.0) (p=0.032). The foods taboo for pregnant mothers were meatballs, Reundeu leaves, durian, pineapple, and Ambon banana. The foods taboo for children under five were meat, chicken feet, chicken tail, chicken liver, chicken gizzard, and seafish. The stunting prevalence of children in Ciptagelar was 44.3%, while Sukaresmi was 22.9%. Conclusions: Based on those findings, the mother’s nutritional knowledge in Kasepuhan of Sinar Resmi was better than in Kasepuhan of Ciptagelar. The diversity of household food consumption in Kasepuhan of Ciptagelar was higher. However, there was a possibility that the nutritional intake of children in Kasepuhan of Ciptagelar was lower. Consequently, the stunting prevalence was higher in Kasepuhan of Ciptagelar than in the Kasepuhan of Sinar Resmi.

Dietary diversity of women from soybean and non-soybean farming households in rural Zambia

IntroductionSoybean farming in Zambia is promoted to increase farm productivity and diversification away from maize, and improve cash income and livelihoods for farmers. However, the impact of soybean farming on women's dietary intake is not clear. This study compares the dietary diversity of women from soybean (S) and non-soybean (NS) farming households as a pathway to understanding policy efficacy.MethodsA cross-sectional survey involving 268 women of reproductive age from 401 rural households was conducted in two soybean-producing districts of Central Province, Zambia. Data from a qualitative 7-day food frequency questionnaire (FFQ) was used to calculate dietary diversity scores (DDS), women's dietary diversity scores (WDDS-10) and assess dietary patterns. Information on household sociodemographic and agricultural characteristics was used to explore determinants of dietary diversity.ResultsResults show there were no significant differences in the mean DDS (S: 10.3 ± 2.4; NS:10.3 ± 2.6) and WDDS-10 (S:6.27 ± 1.55; NS:6.27 ± 1.57) of women from soybean and non-soybean farming households. Both cohorts had similar dietary patterns, plant-based food groups with additional fats and oils. Agricultural diversity was not associated with dietary diversity. Household wealth status was the most important determinant of dietary diversity, as women from wealthier households were more likely to have higher DDS (β = 0.262, 95% CI = 0.26 to 0.70, P &amp;lt; 0.001) and WDDS-10 (β = 0.222, 95% CI = 0.08 to 0.37, P &amp;lt; 0.003) compared to those from poorer households. Women from households that spent more on food had a higher DDS (β = 0.182, 95% CI = 0.002 to 0.07), but not WDDS-10 (β = 0.120, 95% CI = −0.01 to 0.03); for every additional dollar spent on food in the past 7 days, the DDS increased by 0.18. Meanwhile, soyabean farming was not statistically associated with higher wealth.ConclusionsPolicymakers and promoters of agricultural diversification and nutrition-sensitive agriculture need to consider how women can benefit directly or indirectly from soybean farming or other interventions aimed at smallholder farmers.