Mean Dietary Diversity Score Research Articles

Nutritional Status and Socio-Economic Profile of Farm Women in Aspirational Districts of Tamil Nadu

Aim: “Women in agriculture” is a widely discussed arena but nutrition of women in agriculture is yet to be explored thoroughly. The current paper focuses on farm women in aspirational districts. These are the districts identified by NITI Aayog which are the poorly performing in a state in various developmental dimensions. Hence, the current paper aims at understanding the nutritional status and socio- economic profile of farm women in these districts assuming their higher vulnerability to malnutrition.
 Study Design: Survey design was used for the current study.
 Place and Duration of Study: The study was conducted in Tamil Nadu from 2018 -2022 as part of PhD research work, affiliated to National Dairy Research Institute.
 Methods: Virudhunagar and Ramanathapuram are the two districts identified as aspirational districts in Tamil Nadu. From each district, two blocks were randomly selected. Two villages were selected from each block randomly and 10 farm women from households having at least 2 milch animals and cultivating for atleast on crop season were selected from each village purposively. Hence a total of 8 villages and 180 farm women of reproductive age (18-49yrs) were included in the sample. Mean dietary diversity Score and Body Mass Index were taken as indicators for nutritional status of farm women.
 Results: It was found that a 49.44% of the farm women had only 4 food groups in the last 24 hours followed by 28.89 percent with 5 to 6 food groups and 21.67 percent with 7 to 10 food groups. Only 41.67 percent of the respondents had BMI in the normal range. Around 30 percent of the farm women were underweight, 20 percent were overweight and 8 percent of them were obese. The results call for immediate attention and interventions for ensuring nutritional security of farm women in general and aspirational districts in particular.

The predictors of food security and dietary diversity among internally displaced persons’ children (6–59 months) in Bamenda health district, Cameroon

BackgroundMalnutrition remains a major cause of morbidity and mortality amongst children in displaced settings. Nutrition at this stage is crucial for the growth and development of the child. It is estimated that 41 million children under 5 years are obese/overweight, 159 million are stunted and 50 million are wasted worldwide. This study aimed to determine the prevalence and predictors of food insecurity and dietary diversity among internally displaced persons’ children from 6 to 59 months.MethodologyA cross sectional community-based study was conducted on 395 children aged 6–59 months from May 2021-June 2021. A multistage cluster sampling method was used to select the study participants. A validated structured questionnaire was used to collect data on sociodemographic characteristics, food security and dietary diversity. Predictors of food insecurity and dietary diversity were identified using logistic regression. The outputs were presented using adjusted odd ratio (AOR) with 95% confidence interval (CI).ResultsThe study results revealed that the level of household food insecurity was 91.6%, at risk of experiencing hunger (3.3%) and food secure (5.5%). Participants had mean dietary diversity score of 3.6 food groups, 51.6% had a low or inadequate dietary diversity and 48.4% had adequate dietary diversity. Children who were from households with monthly income of $101- $200 US dollars and had been displaced just once were 79% (AOR: 0.21, 95%CI: 0.07–0.60) and 84% (AOR: 0.16, 95%CI: 0.05–0.50) less likely to be food insecure compared to their counterparts respectively. While households with participants who Walked ≥ 10 min to fetch drinking water (AOR: 11.61 95%CI: 2.39–52.08) were more likely food insecure. In addition, household monthly income of ≥ $100 US dollars (AOR: 0.20, 95%CI: 0.07–0.56) had a reduced chance of providing low diversified food. Households that had received social grants (AOR: 2.15, 95%CI: 1.38–3.49) and walked ≥ 10 min to fetch drinking water (AOR: 2.43, 95%CI: 1.48–3.98) had a higher chance of providing low diversified food.ConclusionDietary diversity and household food insecurity was unacceptably low and high respectively among internally displaced children. Policymakers should prioritize strengthening both nutrition sensitive and specific activities that contribute to reduction of food insecurity and consumption of unbalance diet.

Dietary diversity and micronutrients adequacy among the women of reproductive age at St. Martin’s island in Bangladesh

Minimum dietary diversity for women, an important dimension of diet quality, has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), women of reproductive age (WRA) particularly are at high risk of inadequate micronutrient intake resulting from poor diversified diets. Therefore, the present study aimed to assess dietary diversity and micronutrients adequacy in the diets of WRA of St. Martin’s island, along with their socio-economic determinants. A cross-sectional study was conducted on a representative sample of 201 WRA living at St. Martin’s island. Utilizing the Estimated Average Requirement (EAR) cut-point approach, the adequacy of micronutrient intake was evaluated from observed 24-h recall dietary data. The recent guideline of FAO was employed to evaluate Minimum Dietary Diversity for Women (MDD-W). Binary logistic regression and multiple linear regression analyses were performed to identify socio-economic determinants of MDD-W and micronutrients adequacy. The mean (SD) dietary diversity score was 4.25 (1.17) and about 40.3% of the participants met the MDD-W cut-off. Starchy staples (100%), meat/poultry/fish (87%), and other vegetables (79%) were consumed more frequently, while, the least reported food groups were dairy (2%), nuts and seeds (11%), and vitamin A-rich fruits and vegetables (11%). Except for Niacin, intake of all micronutrients was inadequate, with an inadequacy prevalence of 36–100%. Educational level, and decision-making role of women were significantly related to their dietary diversity. On the other hand, age, decision-making role, and MDD-W were important determinants of micronutrient adequacy. In conclusion, the WRA of St. Martin's island consumed neither a sufficient amount of micronutrients nor an adequate diversity of foods. In addition, several socio-economic components are linked with dietary diversity and micronutrient adequacy. Therefore, attention is needed to decide on the best strategies to improve the quality of diet and dietary diversity for WRA in this setting.

English

This study describes the influence of chemotherapy on patients' eating habits in the context of resource-limited countries. This is a descriptive and analytical cross-sectional study of patients who have been prescribed chemotherapy and followed throughout this treatment at the Yalgado Ouedraogo University Hospital. We collected data on the initial eating habits and dietary coping strategies during chemotherapy during medical oncology consultations. One hundred and two patients were collected, aged 49.19 years on average. We compared the food consumption and dietary diversity scores before and during chemotherapy, the usual diet of our patients is local cereals and tubers accompanied by vegetables and animal proteins. During chemotherapy, 81.4% of patients experienced both quantitative and qualitative taste and olfactory changes. The mean food consumption score was 58.5 before and 57.5 during chemotherapy (p = 0.005). The mean dietary diversity score during chemotherapy is 5.27 versus 4.9 before chemotherapy (p < 0.0001). During chemotherapy, 50 patients had fewer meals, and 20 had increased their dietary intake. Making nutritionists and dieticians available to cancer patients would improve their food experience during chemotherapy. Key words: Cancer, nutrition, chemotherapy, diet.

Dietary patterns in Uganda and their influencing factors: A critical review

Improving the understanding of dietary patterns and underlying factors remains crucial in designing nutritional interventions and policy making. This review sought to provide a holistic picture of the studies covering dietary patterns in Uganda and the associated factors so as to identify gaps in existing literature and provide a basis for nutrition-sensitive interventions. A literature search for publications dating from March 2010 to 2021 was done using the terms dietary diversity, nutrient intake, food consumption and food choices in Uganda. Studies covering populations above 6 months of age, male and female, with exception of diseased populations, were screened. Because of the variability in the methodologies for assessment of dietary intake and dietary diversity, meta-analysis was not conducted. A total of 17,728 articles were found and 25 studies met the inclusion criteria. Nine of the 25 studies reported on dietary diversity indicators and their associated factors. The literature shows that diets in Uganda are mainly composed of starchy staples, especially cereals, roots, tubers and bananas, with legumes constituting the main protein source. The diets are characterized by low consumption of fruits and vegetables as well as animal protein sources. The share of food expenditure allocated to the different food groups corresponded to information on consumption for the different groups. Studies revealed that household food expenditure was higher among urban households, an observation attributable to their high reliance on food purchases to meet food requirements. The share of household expenditure on cereals and staples was reported to decrease with increasing wealth quantile and was lower among urban households. An opposite trend was reported for animal protein sources. Across the different studies, the mean dietary diversity score was above three (3). Nonetheless, intake of micronutrients and the mean dietary energy consumption (DEC) were reported to be lower than the daily recommended values. Given the lack of uniformity in the indicators across the different studies and differences in methodologies especially for dietary diversity scores, the existing research is inadequate for establishing quantitative evidence on the trends in dietary patterns and diversity, gender and age group differences in relation to dietary patterns. There is a need for high-quality, nation-wide research using validated tools and methodologies to measure dietary patterns and trends and explore the relation to gender and age groups. Key words: Food consumption, Food choices, Dietary Patterns, Uganda, Dietary diversity

The Effectiveness of a Web-Based Application for a Balanced Diet and Healthy Weight Among Indonesian Pregnant Women: Randomized Controlled Trial.

Pregnant women have self-declared that they have difficulties in estimating nutrient intakes. The Nutrition Information System for Indonesian Pregnant Women (SISFORNUTRIMIL) application was created as a dietary assessment and calorie-counting tool to guide pregnant women to eat the right portion sizes for each meal. The study aimed to examine the effectiveness of the SISFORNUTRIMIL application in helping users achieve a balanced diet and healthy maternal weight gain in comparison to nonusers in Indonesia. First-pregnancy women in the second trimester aged 19-30 years (N=112) participated in the randomized controlled trial. Recruited women who were eligible and consented to participate in the study were allocated into the intervention group, or application user (n=56), and the control group, or application nonuser (n=56). The intervention recommended that pregnant women consume at least 5 food groups and calculate a recommended average portion size for 12 weeks. Both groups were self-monitored and recorded their intake in food records for 3 days every week. The dietary diversity consumed, macro- and micronutrient intake, and maternal weight gain were assessed pre- and postintervention. Data were collected three times during the intervention. Diversity food consumption was measured by the Minimum Dietary Diversity for Women of reproductive age. Furthermore, the Indonesian recommended dietary allowances were used to refer to and validate appropriate energy and nutrient amounts. Independent sample t test was used to compare differences between the intervention and control groups. The mean dietary diversity score for the application user group (7.79, SD 1.20) was significantly greater than for the application nonuser group (7.02, SD 1.39; adjusted mean difference 0.77, 95% CI 0.28-1.25; d=0.28; P=.005). Macro- and micronutrient intake was significantly more in accordance with the dietary recommendations for the user group compared to the control group, including an energy daily intake of 156.88 kcal (95% CI 114.52-199.23; d=-1.39; P=.002), 102.43 g of carbohydrates (95% CI -125.2 to -79.60; d=-1.68; P=.02), 14.33 g of protein (95% CI 11.40-17.25; d=1.86; P<.001), and 10.96 g of fat (95% CI -13.71 to -8.20; d=-1.49; P<.001). Furthermore, there was a significantly higher intake of daily vitamins and minerals in the intervention group than in the control group. Other results showed that maternal weight gain in the intervention group was in accordance with the parameters of healthy weight gain. Recording food intake using the application was significantly effective in improving the dietary diversity consumed, improving adequate energy and nutrient intake, and producing healthy maternal weight during pregnancy. ISRCTN Registry ISRCTN42690828; https://www.isrctn.com/ISRCTN42690828.

Dietary Diversity, Household Food Insecurity and Stunting among Children Aged 12 to 59 Months in N'Djamena-Chad.

Household food insecurity is increasingly recognized as a global health problem, particularly in sub-Saharan Africa. This study aimed to contextualize the associations between household food insecurity, dietary diversity and stunting in N'Djamena. This study is a community-based cross-sectional study, and the SMART (Standardized Monitoring and Assessment of Relief and Transitions) methodology was used to calculate the sample size. A total of 881 households were selected for the survey. A 24-h recall evaluated the dietary diversity score (DDS), the Household Food Insecurity Access Scale (HFIAS) made it possible to assess household food insecurity (HFI), and stunting among children aged 12 to 59 months was assessed by anthropometric measurements. Logistic regression was constructed to determine the association between household food insecurity, dietary diversity, and stunting. The study was conducted from January to March 2022. The prevalence of severe food insecurity was 16.6%, and that of stunting was 25.3%. The mean DDS was 6.5 ± 1.6. Severe food insecurity (OR 2.505, CI: 1.670-3.756) was significantly associated with stunting. The association between DDS and stunting was not significant. This study's prevalence of household food insecurity and stunting was very high. Household food insecurity and household size were significantly associated with stunting.

Dietary Diversity and Nutritional Status of Adolescents in Rural Ghana.

The rapid biological and physical changes during adolescence require adequate nutrient intake. This study assessed dietary diversity and nutritional status of adolescents living in selected rural areas in Ghana. In this cross-sectional study, 137 young adolescents, aged 10 to 14 years were recruited. Structured questionnaire was used to collect data on sociodemographic, household size and food intake practices. A multiple past 24-hour recall was used to estimate the micronutrients intake. Haemoglobin and anthropometry data were assessed. Dietary diversity score was assessed with 10 food groups described by Food and Agricultural Organization. Descriptive, chi-square, binary regression and partial correlation were used in the data analysis. The prevalence of underweight was 5.5%, overweight 5.8% and anaemia 29.9%. The mean dietary diversity score was 3.8 ± 0.8 and about 84.7% of participants had inadequate dietary diversity. Proportions of adolescents who consumed from the different food groups over a 24-hour period were: grains, white roots and tubers, plantain (100%); pulses (10.2%); nuts and seeds (34.1%); dairy (8%); meat, poultry and fish (86.9%); eggs (7.3%); dark green leafy vegetables (29.9%); other vitamin-A rich fruits and vegetables (2.2%); other vegetables (81%); other fruits (7.3%). Dietary diversity scores were positively and significantly correlated with intake of micronutrient, with correlation coefficients of .169, .186, .191, .173 and .175 for vitamin A, niacin, vitamin B6, iron and zinc, respectively. Meal skipping (AOR = 12.2, P < .001, 95% CI: 3.6-41.7) and snacking (AOR = 5.0, P = .007, 95% CI:1.6-16.7) increased odds of inadequate dietary diversity. The high prevalence of inadequate dietary diversity was positively related to meal skipping and snacking among adolescents. Dietary diversity score was significantly related to the intake of vitamin A, niacin, vitamin B6, iron and zinc. The prevalence of anaemia among our study participants is of public health concern. Adolescents should be encouraged both at home and school to eat from diverse food groups to promote adequate intake of micronutrients.

Study of the dietary and anthropometric profile and identification of determining factors in adolescents at school in the Khemisset region of Morocco.

The nutritional status and dietary diversity of adolescents play a crucial role in their growth, development, and overall health. The aim of this study is to assess the nutritional status and determine the dietary diversity score in urban and rural school settings among Moroccan adolescents. We conducted a descriptive cross-sectional study in public schools in Khemisset in the municipality of Sidi Allal El Bahraoui, Morocco. We used a questionnaire to collect sociodemographic data and a 24- hour dietary recall to calculate the dietary diversity score. This study included 215 students. The mean BMI was 21.06 ± 0.23 kg/m2, with 60.8% of students having a normal BMI, 24.5% being underweight, 11.8% overweight, and 2.8% obese. The mean dietary diversity score was 5.672±0.956, with 21% having a low dietary diversity score, 12% having a high score, and 67% having a moderate score. Factors associated with nutritional status were place of residence, type of delivery, and age, while the dietary diversity score was associated with school level and BMI of adolescents. The data from the study show that the diet of adolescents in the Khemisset region of Morocco is moderately diversified. In addition, the prevalence of underweight and overweight was worrying, underlining the need for multiple strategic interventions to improve the health status of adolescents.

Determinants of minimum dietary diversity of lactating mothers in rural northern region of Bangladesh: A community-based cross-sectional study

BackgroundBreastfeeding requires additional diversified foods for the nutritional requirements of mothers and children, especially in preventing micronutrient deficiencies. The minimum dietary diversity for women (MDD-W) is a proxy indicator of micronutrient adequacy for women. ObjectivesThis study aimed to identify the determinants associated with MDD in lactating women. MethodsA community-based cross-sectional study was conducted among lactating mothers having at least one live birth in last three years from two districts of Bangladesh between 31st May 2021 and 9th June 2021. Dietary and socio-demographic information was obtained using a single 24-h recall and socio-economic status questionnaires. MDD was defined as at least four food groups consumed in the last 24 hours. In binary logistic regression, adjusted models were used to assess the relationship between MDD and socio-economic factors. ResultsThe mean Dietary Diversity Score (DDS) was 3.9 ± 1.2. The MDD was met by 29.7% of women. Respondent's ages 20–24 years [Adjusted Odds Ratio (AOR) = 0.5; 95% CI: 0.3–0.9], 25–34 years [AOR = 0.5; 95% CI: 0.3–0.8], and 35–49 years [AOR = 0.5; 95% CI: 0.2–0.9], husband's academic qualifications more than 12 years [AOR = 1.9; 95% CI: 1.0–3.7], family income more than 15000 BDT per month [AOR = 2.3; 95% CI: 1.2–4.3], and husband's profession as a day labor [AOR = 0.5; 95% CI: 0.3–0.7] were significant factors to have MDD. ConclusionsDDS and MDD were very poor among the mothers, whereas women's age, husband's education, and the family's monthly income were independent determinants of MDD. Special interventions may be needed to improve MDD.

Food quality and nutritional status of school-going adolescents in the province of El Jadida in Morocco.

Dietary diversity and variety scores represent tools for measuring the overall quality of diets. In children, they are good indicators of their nutritional status and growth. The aim of this study was to assess the consumption and eating habits as well as the lifestyle of Moroccan adolescents attending school in the city of El Jadida. A sample of 463 children of both sexes, aged 9 to 17, attending four schools in the city of El Jadida was studied. Eating habits and information on socioeconomic level are assessed using questionnaires and weight and height were measured on participants. According to the dietary diversity score (DDS) classes, 2.4% of the children surveyed were with low DDS, 55.7% moderate and 41.9%, with high DDS. The mean DDS was 5.67 ± 1.03 in underweight children and 5.53 ± 1.5 in those with overweight (obesity included) and the food variety scores (DVS) were of 12.94±3.24 food items and 10.81±3.25 in the 2 groups respectively. In addition, data analyzes show that children from parents with a low level of education had higher averages of DDS and DVS (DDS: 5.54 ± 0.84; SVA: 10.65 ± 2.32) compared to those of parents with medium education level (DDS: 5.31±0.96; DVS: 9.72±2.62) or high level (DDS: 5.17±0.93; DVS: 9.36 ±2.42). In addition, children from parents of high economic level had a lower averages of DDS and DVS (DDS: 5.24 ± 0.88; DVS: 8.84 ± 2.10) compared to those of parents of low economic level (DDS: 5.36±1.00; DVS: 10.14±2.85). The sugary products were consumed by 56.3% of underweiht children, 75% of normal-weight children and 67% of overweight children (including obese). The estimated total energy intake (TEI) was higher than the Recommended Daily Allowances (RDA) in underweight 2933 Kcal/d and in overweight (including obese) children 3061.75 Kcal/d, while the mean daily intakes of folate, calcium, iron, potassium and zinc were lower than the (RDA). The food groups consumed by the majority of children were cereals (98.5%), fruits and vegetables (87.7%), and sweet products (69.8%) while oilseed products and fat were less consumed (9.7% and 7.8% respectively). The study data show that the adolescents diet were moderately diverse, little varied and poor in certainnutrients essential for their nutritional status and growth. The study draws attention to the need for parents to be aware ofthe benefits of improving the diet quality and weight status of adolescents.

Food provision in early childhood development centres in Harare, Zimbabwe

&#x0D; &#x0D; &#x0D; &#x0D; Background. Poor nutrition practices result in malnutrition, a public health concern that affects a third of children globally. In Zimbabwe, ~27.6% of children under-5 years old are stunted. Some of these children spend long hours in early childhood development centres (ECDCs). Children can receive half to two-thirds of their daily food intake while in care, making ECDCs an ideal entry point to influence child nutrition positively. There are no specific nutrition guidelines for ECDCs in Zimbabwe.&#x0D; Objective. The study aimed to investigate food provision at ECDCs of the Northern-Central District of Harare.Methods. A descriptive, cross-sectional study with an analytical component was conducted in 15 ECDCs. Fifteen ECD managers (ECDMs) and 14 food handlers (FHs) were included in the study. An observational checklist allowed recording of food preparation and hygiene practices. The Dietary Diversity Score (DDS) of the menu was calculated using the Food and Agriculture Organisation (FAO) 9-group DDS sheet.Results. Inadequate food storage facilities and food handling practices were observed. Staff had minimal nutrition-related training. Staff displayed a positive attitude towards their role in providing healthy meals. Barriers to serving healthy meals were inadequate funds, children’s food preferences, unrealistic parental expectations, and external factors. The mean DDS score for menus was 2.8. Meals consisted mainly of starchy items, legumes and meat, and lacked fruit and dairy items.Conclusion. National guidelines can improve children’s dietary intake while in day care. In alignment with Sustainable Development Goals 2 and 3, food provision at ECDCs should be a priority.&#x0D; &#x0D; &#x0D; &#x0D;

Food consumption and dietary diversity associated with breastfeeding mod of children aged 6-23 months in Ouagadougou, Burkina Faso

Background. To provide the essential needs that the body requires, it is necessary to consume a variety of foods. In Burkina Faso, little information is available on the diversity of food consumed by children in major’s urban centers. Aim. The objective of this study was to assess the dietary diversity of children aged from 6 to 23 months and the associated determinants. Methods. The study consisted in the analysis of food data through a cross-sectional survey. Sphinx V5, IBM SPSS Statistics 20.0 and XLSTAT 2016 software were used for data entry and processing. Results. The majority of mothers (50.16%) were between 26 and 35 years old and 95.31% lived with a partner. In total, 41.26% of women had secondary education levels while 44.66% were housewives. Breastfed children largely consumed cereals (95.31%), legumins (83.01%) and fruits (77.67%). Non-breastfed children also consumed mainly cereals (92.86%), legumins (85.71%) and fruits (75%). Minimum dietary diversity was achieved by 100% of non-breastfed children with a Mean Dietary Diversity Score (MDDS) of 5.75 groups versus 81.86% for breastfed children with MDDS of 4.45 food groups. The minimum acceptable diet was reached by 73.73% of breastfed children versus 92.85% for non-breastfed children. The analysis of factors associated with dietary diversity showed a correlation with the mothers’ education levels, the mothers’ occupation, the children’s gender, the number of daily meals and the consumption of some food groups. Conclusion. The food diversity indicators were generally satisfactory.

Dietary diversity is associated with nutrient adequacy, blood biomarkers and anthropometric status among preschool children in poor ethnic minority area of Northwest China.

This study aimed to evaluate the status of dietary diversity, nutrient adequacy, blood biomarkers of nutrients, and anthropometric status, as well as to determine the predictors of dietary diversity score (DDS) and mean adequacy ratio (MAR) among preschool children in poor ethnic minority areas of northwest China. A total of 578 healthy preschool children aged 3-6 from 17 kindergartens were selected to assess dietary intake, anthropometric status (height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-height z-score (WHZ), and blood biomarkers. DDS and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (ranging from 1 to 9) was relatively low (4.67 ± 1.56). Most participants consumed starchy staples, but few participants consumed organ meat. DDS was associated with serum potassium, serum iron, WAZ, HAZ, all NARs, and MAR (all p < 0.05). Living in urban areas (β = 0.158), higher household wealth (β = 0.116), and more caregivers' nutritional knowledge (β = 0.022) were positively associated with DDS (all p < 0.01), while living in urban areas (β = 0.031), higher education of caregivers (β = 0.0.027), and higher DDS (β = 0.049) were positively associated with MAR (all p < 0.01). In conclusion, dietary diversity was associated with nutrient adequacy and other health outcomes. Nutritional education and poverty alleviation are integral to improving the nutritional status of preschool children.

Food addiction, orthorexia nervosa and dietary diversity among Bangladeshi university students: a large online survey during the COVID-19 pandemic

PurposeMaladaptive eating behaviors like food addiction (FA) are common among students, and orthorexia nervosa (ON) is being evaluated as a new condition among eating disorders (EDs). Moreover, dietary diversity (DD) is recognized as an important component of a healthy diet. Thus, the current study sought to examine the prevalence of ON and FA as well as the factors associated with ON, FA, and DD among university students in Bangladesh during the COVID-19 pandemic.MethodsFour-thousand-and-seventy-six students were recruited and completed an online survey consisting of the Bratman Orthorexia test, the modified Yale Food Addiction Scale, and a questionnaire based on the Food and Agriculture Organizations’ guidelines. Inferential statistics, bivariate and multivariable linear regression were used for analyzing data.ResultsON and FA were observed in 1.7% and 7.5% of participants, respectively, with 43.8% exhibiting Health Fanatic eating attitude. The mean DD score was 5.96 (SD = 1.56). Students with ON consumed more legumes, nuts, seeds, and vegetables including dark green leafy vegetables whereas students with FA consumed more organ meats and eggs. Students who were older-aged, married, formerly smoked, had fitness goals, and had guilty feelings about violating food rules were more likely to have ON, whereas those who were female, were married, actively smoked, and were overweight and obese were more likely to have FA.ConclusionsThe findings suggest that students from Bangladesh are at risk of FA, and less so for ON. These entities and low DD deserve more research attention in Bangladesh to increase awareness and ensure appropriate interventions.

Dietary Diversity, Micronutrient Adequacy and Bone Status during Pregnancy: A Study in Urban China from 2019 to 2020.

Diet quality during reproduction is crucial to maternal and infant health. However, the association between dietary diversity and bone health of pregnant women remains unclear. We aimed to evaluate the dietary quality of Chinese urban gravidas using the dietary diversity score (DDS), and to explore the relationship of the DDS with micronutrient adequacy and bone health. In this cross-sectional study, we analyzed data from 775 pregnant women aged 18 years or older in urban China. Dietary diversity was assessed using the Minimum Dietary Diversity for Women (MDD-W) indicator. A 24-h dietary recall was used to collect diet data and to calculate the MDD-W and the nutrient intake. Bone health was measured using quantitative ultrasound and assessed by the speed of sound (SOS). Pearson's correlation coefficients between the DDS and the nutrient adequacy ratio (NAR) were calculated. A multivariable linear regression model was used to estimate the effect size of the DDS on the SOS. The mean DDS was 6.61 ± 1.53 points and 91.0% of participants reported the consumption of five or more food groups. Women in the diverse diet subgroup (DDS ≥ 7 points) were more likely to consume all kinds of food except starchy staples and had higher NARs. Pearson's correlation coefficients between the DDS and the NAR ranged from 0.161 to 0.484. For participants in the second trimester, those with a diverse diet had a higher SOS. A multivariable linear regression analysis showed that the DDS was positively and significantly associated with the SOS (β = 17.18, 95% CI = 5.97-28.39, p = 0.003), but this was not the case for women in the first and third trimesters. Urban Chinese women had good dietary diversity during pregnancy. A higher dietary diversity was associated with a higher NAR. From the point of view of bone, a diverse diet was positively correlated with better bone status, suggesting the importance of improving diet diversity for pregnant women, especially from mid-pregnancy.

The association between dietary diversity and anthropometric indices of children aged 24-59 months: A cross-sectional study in northern Ghana

The quality of diet has been shown to influence the nutritional status of children and women in some developing contexts. However, studies on the association between diet quality and the nutritional status of children aged 24-59 months are scanty in sub-Saharan Africa. More so, the conclusions from the few studies that are available are inconsistent. The objective of this study was to determine the association between the dietary diversity score (DDS) and the nutritional status of children aged 24-59 months in the Tolon District of Ghana. The study population included 200 child-mother pairs, randomly selected from 2 large rural communities in the Tolon district of Ghana. A single qualitative 24-hour recall (24HR) and semi-structured questionnaires were used to collect children’s data through face-to-face interviews with their mothers/caregivers. Anthropometry measures were used to define wasting (WHZ &lt; -2SD), underweight (WAZ &lt; -2SD) and stunting (HAZ &lt; -2SD). A summated DDS was based on the Food and Agriculture Organization’s 13 food groupings. Multiple linear regression models, adjusting for potential confounding variables (including the child’s age, sex, birth order, sickness, mother’s age, literacy and occupation, paternal age, occupation and household size, wealth and food security) were fitted to analyse the association between DDS and nutritional status (WHZ, WAZ and HAZ). The prevalence rates of stunting, underweight and wasting among the sampled children were 58.3%, 20.3% and 4.2%, respectively. The mean DDS was 6.3 ± 1.2 out of a possible maximum score of 13, with the dietary pattern mostly plant foods with little consumption of animal source foods. There was a significant positive association between DDS and WHZ (β=0.16, P=0.03) and adjusting for potential confounding variables did not change the observed association. The association between DDS and WAZ was significantly positive only after adjusting for confounding variables (β=0.17, P=0.01). Although positive, the association between DDS and HAZ was not statistically significant in both crude (β=0.03, P=0.73) and adjusted (β=0.10, P=0.29) models. The high prevalence of stunting and underweight among the children requires urgent attention from the ministry of health and its development stakeholders. The findings of the present study suggest improvement in dietary diversity may be an effective approach to improving wasting and underweight during the life phase when young children are completely reliant on family meals. Sensitization programmes on dietary diversification need to be strengthened in child-welfare clinics. Intervention programmes such as backyard gardening, small ruminant rearing and income-generation activities may improve access to a diverse diet. Keywords: Dietary diversity, wasting, stunting, underweight, weight-for-height, weight-for-age, height-for-age

Minimum dietary diversity and associated factors among lactating mothers in Haryana, India: a community based cross-sectional study

IntroductionFood adequacy and dietary quality in the lactation period are fundamental for maternal and child health. Lactating mothers are vulnerable to malnutrition because of increased physiological demand, monotonous diet, lactogenesis process, and increased nutrient requirements. The micronutrient adequacy especially among women is not ensured in Indian diet. The dual course of gender bias and poverty, along with lack of knowledge about diet quality are significant impediments in maintaining minimum dietary diversity among Indian women. The study aimed to assess the prevalence of minimum dietary diversity and associated factors among lactating women.MethodologyA community-based cross-sectional study was conducted among 1236 lactating women through a multistage sampling procedure in Haryana state, India. Data were collected in Computer-assisted personal interviewing (CAPI) using a pretested structured interview schedule. Minimum Dietary Diversity for Women by Food and Agriculture Organization (FAO) was used to calculate the minimum dietary diversity.ResultsThe mean dietary diversity score among lactating women from the ten food groups was 6.35 ± 2.57 and the prevalence of minimum dietary diversity was 77.1%. The complete model revealed that both individual and household factors can explain the variation in dietary diversity intake. Furthermore, the result of model 2 explained that women aged 31 to 35 years (AOR 5.92,95% (1.87–18.77), graduation and above qualified women (AOR 1.98, 95% (0.96–4.09) and lactating women with high knowledge on nutrition (AOR 2.00, 95% (1.34–4.57) were the significant factors promoting minimum dietary diversity.ConclusionThree-fourths of the lactating women reached adequate minimum dietary diversity. Younger age, low educational level, and poor nutritional knowledge were significant constraints to achieving minimum dietary diversity. Further improvement in the minimum dietary diversity among lactating women is very much required. It is also advised that exiting platforms dispersing awareness on nutrition should be supported and strengthened.

Dietary diversity and associated factors among pregnant women in urban Northern Ghana

Background: Though low dietary diversity during pregnancy results in low nutrient intake and adverse pregnancy outcomes, information on dietary diversity and its associated factors among pregnant women in Ghana particularly Northern Ghana is scanty. This study therefore assessed dietary diversity and associated socio-demographic characteristics among pregnant women in urban Northern Ghana. Methods: An analytical cross-sectional study design was used, involving 273 pregnant women randomly selected from 8 health facilities in Tamale Metropolis and Sagnarigu Municipality. Socio-demographic characteristics of participants were documented using a structured questionnaire. Dietary diversity of participants was assessed using a 24 hour dietary recall method and the dietary diversity score was calculated based on ten food groups. Chi-square test and binary logistic regression analysis were used to identify the factors associated with low dietary diversity. Results: The mean age of the participants was 26.44 ±5.75 years with minimum and maximum ages of 16 and 44 years respectively. About 48% of the women had low dietary diversity. The mean dietary diversity score was 4.87 ± 2.04. Having no education at all [Odds Ratio (OR) = 5.5; 95% CI (2.09 –14.31); p = 0.001] and having only primary education [OR = 3.8; 95% CI (1.21 –12.09); p &lt; 0.022] were significantly associated with low dietary diversity. Conclusion: The study revealed that the prevalence of low dietary diversity is high among pregnant women in urban Northern Ghana. Improving the educational level of women is recommended to improve their dietary diversity.

Micronutrient Status and Select Characteristics of Adolescents: Results From a School Nutrition Program in Bangladesh

ObjectivesTo describe select characteristics of adolescent girls and boys and micronutrient status of adolescent girls at baseline prior to starting a school nutrition intervention. MethodsGirls (n = 2244) and boys (n = 773) in grades 8–9 attending 74 schools participated in a baseline survey including questions on individual and household characteristics, nutrition knowledge and experience and dietary diversity. Venous blood was collected from girls for micronutrient status assessment. Iron status was assessed using inflammation-adjusted serum ferritin. Vitamin A status was based on retinol binding protein. Folate status was defined using serum and red blood cell folate (RBCF). In-school observations of WASH infrastructure resources and drinking water quality testing were conducted. All estimates accounted for clustering. ResultsGirls and boys, respectively, had ever heard of anemia 34% and 27%, iron-folic acid (IFA) tablets 31% and 14%, deworming tablets 84% and 85% and worm infestation 49% and 52%. Reported IFA use in the last month and deworming tablet intake in the last 6 months were 4% and 1% and 81% and 86%, among girls and boys, respectively. Mean dietary diversity score suggested adequacy among girls (5.2) and boys (5.3) with 63%–68% having scores > 5, and 36%–39% consuming rich sources of heme iron. Adolescents perceived the existence of iron in household tubewell (21%–24%), with 5–9% describing the taste, smell, or color of rust in drinking water. The prevalence of micronutrient deficiencies and severity varied: anemia 24.7%, iron deficiency 9.1%, iron deficiency anemia 3.9%, vitamin A deficiency 3.3%, RBCF insufficiency 76.1%, risk of RBCF deficiency 8.9%, RBCF deficiency 2.5%, and serum folate deficiency 9.5%. In schools, 70% met the sustainable development goals (SDG) indicator for basic drinking water service, 59% of all sampled drinking water sources complied with WHO standards for E. coli, 42% met the SDG indicator for basic sanitation service, and 3% met the SDG indicator for basic hygiene service. ConclusionsThe baseline results show variable awareness and coverage of interventions, adequate dietary diversity, micronutrient deficiencies among girls, and room for improvement to achieve SDG basic WASH services and reduce E coli. contamination of drinking water sources in schools. Funding SourcesNutrition International, Ottawa, Canada.