Mean Dietary Diversity Score Research Articles

Association between dietary diversity, health and nutritional status of older persons in rural Zambia

Objective: The purpose of the study was to assess the association between dietary diversity, health and nutritional status of older persons aged 50 years and above in Milenge district of Luapula province, Zambia. Design: A cross-sectional, descriptive study was conducted. Subjects and setting: The study was conducted among 135 older persons (≥ 50 years) comprising 67 men and 68 women who were randomly selected from three communities in Milenge district, Luapula province. Outcome measures: Anthropometric measurements (weight and height) were used to determine the prevalence of malnutrition among the respondents by calculating the body mass index (BMI). Food consumption was assessed using a non-quantified food frequency questionnaire and dietary diversity scores were used to determine the adequacy of food intake, while a health questionnaire was used to determine self-perceived health status of the respondents. Results: Based on the WHO BMI classification, 30.4% of older persons were underweight, whilst 8.1% were overweight. There was a significant difference in mean BMI between male and female older persons (p < 0.01). More men had severe underweight, whilst more women were found to be overweight and obese. The mean dietary diversity score (DDS) was 3.6 ± 1.1. Dietary assessment showed that 64.4% of the respondents had dietary diversity scores that were below the mean value, while 35.6% had scores above the mean value. The Spearman rho correlation test revealed a positive correlation (r = 0.184, p = 0.028) between BMI categories and dietary diversity scores. The majority (74%) of respondents reported having at least one health condition including high blood pressure (42.6%), coronary heart disease (8.9%), malaria (24.4%), tuberculosis (35.6%) and pneumonia (24.4%), while only 26% perceived themselves to be healthy. Conclusion: The study revealed a high prevalence of undernutrition and low dietary diversity among older persons. A positive association was found between nutritional status and dietary diversity. Although the majority of the respondents reported having health conditions, there was no relationship between nutrition-related health conditions and dietary diversity.

Assessment of dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi: a cross-sectional study

High rates of pregnancy during adolescence in Malawi compromise the nutritional status of adolescent mothers and their infants. When a pregnant adolescent is malnourished, she is at risk for health complications. Research focusing on the nutritional status of pregnant adolescents in Malawi is minimal. The purpose of this study was to assess dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi. The study included sixty-two pregnant adolescents between 15-19 years old. Data collection included the use of a pre-tested questionnaire, standardized dietary diversity survey and measurements of mid-upper arm circumference (MUAC), height, and hemoglobin. Statistical analysis included descriptive analysis, linear and logistic regression. Mean (SD) age was 17.7 (1.2) years. Mean MUAC was 25.9 (2.0) cm; 31% had MUAC <25 cm. The occurrence of stunting was 19% and 21% were ≤150 cm tall. The mean hemoglobin was 10.37 (1.93) g/dL and 66% were anemic. The mean dietary diversity score was 4.06 (1.18) and 69% did not achieve minimum dietary diversity (score ≥ five.) No participants consumed dairy and only 7% consumed eggs. Eating meat and poultry or dark green leafy vegetables predicted a 1.31g/dL (pvalue = 0.0306) or 1.08 g/dL (p-value =0.0331) increase in hemoglobin levels, respectively (R 2 =0.15). Food taboos during pregnancy were common (35%). Compared to the Malawi National Nutrition Guidelines, 87% were not eating daily from each of the six food groups and 74% were not meeting the recommended meal frequency during pregnancy (three meals and at least one snack/day). Less than 50% consumed foods from legumes/nuts and animal food groups. The majority (63%) did not take antenatal supplements and only 37% consumed ferrous sulfate. Only 52% received advice about nutrition during pregnancy and few (8%) received advice about infant and young child feeding. Girls who received nutrition advice were more likely to take an iron supplement [OR=4.19 (1.82-9.68), p =0.0008] compared to those who did not. As the number of antenatal visits increased, the participants were more likely to take a supplement [OR=11.88 (3.40-41.49) p =0.001]. Interventions for pregnant adolescents in rural Malawi should occur early in pregnancy and include education on dietary diversity, increasing hemoglobin levels, meal frequency, food taboos, antenatal supplements and infant and young child feeding. Keywords: Adolescent nutrition, Pregnant adolescents, Dietary diversity, Food taboos, Hemoglobin Afr. J. Food Agric. Nutr. Dev . 2019; 19(3): 14555-14570

Determinants of dietary adequacy among school age children in Guraghe Zone, Southern Ethiopia

Dietary diversity (DD) is a validated proxy indicator of micronutrient adequacy among different age groups including infants, children and women. This study assessed level of dietary adequacy and its associated factors among school age children in Guraghe Zone, Ethiopia. Survey was conducted among 769 children aged 6 to 12 years of with their care givers using multistage sampling method. Data were collected by using structured questionnaire containing the ten food groups for minimum dietary diversity for women and other parts. Adequate dietary diversity was categorized those children who consume at least five food groups. Bivariate and multivariable binary logistic regression with odds ratios (95% CI) was computed. Overall 769 children were included in the study, with a mean age of 8 years. The mean dietary diversity score was 4.9 (±1.42). About 444 (58.3%) had an inadequate dietary diversity. Those children from extended family size had 1.3 times to have inadequate DD level (AOR=1.3). Children from female headed households, did not attend formal education had 1.3 and 1.4 times higher odds of having an inadequate DD level (AOR=1.3 and 1.4). Similarly, children living with uneducated caregiver had six fold more likely to have an adequate DD level (AOR=6.7). The dietary diversity of children in the study area was below average. Household head, caregiver’s educational status, occupation of the household head, father/female headed household and family size were found to be associated with DD score. There should be awareness creation through existing Health extension platform and back yard vegetation should be improved.

Impact of Oral Health Status on Future Dietary Intake and Dietary Quality in Older Adults in Northern Ireland: A Longitudinal Analysis (P18-080-19)

ObjectivesEvidence linking oral health status with dietary intake and quality in older adults is inconsistent and limited by few prospective studies conducted to date. This study investigated whether oral health status, defined as number of natural teeth and prosthodontic rehabilitation, had an impact on future dietary intake and dietary quality in older Northern Irish (NI) men. MethodsThis study involved older men [n = 1096, mean = 63.5(2.9) years] from the Prospective Epidemiological Study of Myocardial Infarction (PRIME). A dental examination was undertaken at baseline (2001–2006) and oral health status was defined as: 21–28 teeth without dentures (n = 453), 21–28 teeth with dentures (n = 111), 1–20 teeth without dentures (n = 99), 1–20 teeth with dentures (n = 354), and edentate with dentures (n = 79). A food frequency questionnaire administered in 2015 derived intakes of major food groups and diet quality scores were characterised by the Dietary Diversity Score (DDS) and Mediterranean Diet Score (MDS). Associations between oral health status, food intake and diet quality scores were assessed using regression models adjusted for potential confounders including, age, socio-economic status, smoking and alcohol. ResultsIn fully adjusted models, the mean dietary intake of fruit, vegetables and nuts significantly differed between oral health status groups. In comparison to edentate men with dentures, the mean fruit intake was significantly higher in each dentate group: 21–28 teeth without dentures (P = 0.001), 21–28 teeth with dentures (P = 0.001), 1–20 teeth without dentures (P = 0.04), and 1–20 teeth with dentures (P = 0.03). The mean DDS was significantly higher amongst men with 21–28 teeth without dentures, compared to those with 1–20 teeth without dentures (P = 0.001), 1–20 teeth with dentures (P < 0.001), and edentate with dentures (P < 0.001), and mean MDS results were similar. Compared to men with 21–28 teeth without dentures, edentate men with dentures were 64% less likely to achieve the dietary guideline of 2 portions/day (P = 0.01). ConclusionsA greater number of natural teeth was associated with a higher future intake of fruit, vegetables and nuts, as well as higher dietary quality scores, in older NI men. Interventions should optimise retaining natural teeth to help improve dietary intake and quality in older adults. Funding SourcesDepartment of Economy funded PhD.

Maternal dietary diversity and micronutrient adequacy during pregnancy and related factors in East Gojjam Zone, Northwest Ethiopia, 2016

BackgroundMonotonous and less diversified diets are associated with micronutrient deficiency. Evidence on maternal dietary intakes during pregnancy is essential to achieve the 2025 global nutrition target and reduce maternal and child mortalities. This study assessed pregnant women’s dietary diversity and identified factors associated with inadequate dietary diversity in East Gojjam Zone.MethodsWe conducted a community-based cross-sectional study between April and June 2016. Eight hundred thirty-four pregnant women were randomly sampled. The Women Dietary Diversity Score tool developed by the Food and Agricultural Organization (FAO) and Food and Nutrition Technical Assistance (FANTA) was used. Data were entered into EpiData with double entry verification, and analysis was done using IBM SPSS version 20. Level of significance was set to P < 0.05 with 95% confidence interval (CI) to identify the independent factors associated with inadequate dietary diversity.ResultsThe mean (±SD) dietary diversity score was 3.68 (±2.10). Inadequate dietary diversity was prevalent in 55% [95% CI (52.3–59.3%)] of pregnant women, or indirectly micronutrient was inadequate in more than half of the pregnant women. Commonly consumed dietary groups were legumes, nuts, and seeds (85.5%) followed by starchy staples (64.7%). Inadequate dietary diversity was higher among non-educated [Adjusted Odds Ratio (AOR) = 7.30, 95% CI (2.35–22.68)] compared to college and above completed women. Wealth index had significant association with dietary diversity, in which women in the poorest [AOR = 8.83, 95% CI, (1.60–48.61)], poorer [AOR = 6.34, 95% CI (1.16–34.65)], poor [AOR = 8.46, 95% CI (1.56–45.70)], and richer [AOR = 6.57, 95% CI (2.16–20.01)] had higher odds of inadequate dietary diversity. Those who had not received dietary counseling had three folds [AOR = 3.31, 95% CI (1.49–7.35)] of inadequate dietary diversity compared to their counterparts. Less likelihood of inadequate dietary diversity was among women with an increased meal frequency [AOR = 0.53, 95% CI (0.38–0.74)].ConclusionConsumption of less diversified food during pregnancy is common in the study area. Adequacy of micronutrients is insufficient for more than half of the studied pregnant women. We conclude that being non-educated affects pregnant women to depend on less diversified diet. Providing dietary counseling during pregnancy can improve nutritional practice for pregnant women.

Participatory farm diversification and nutrition education increase dietary diversity in Western Kenya.

Our study assessed the effectiveness of a community‐based participatory approach in increasing micronutrient adequacy of diets of women and young children through agricultural activities and nutrition education in Vihiga County, Western Kenya. Outcome indicators include the mean dietary diversity score (DDS), the percentage of women and children reaching minimum dietary diversity (MDD), and micronutrient adequacy (mean adequacy ratio). The project consisted of(a) a diagnostic survey covering agrobiodiversity and nutrition, (b) participatory development of activities to improve nutrition, (c) a baseline survey covering dietary intakes, (d) participatory implementation of the developed activities, and (e) an endline survey covering dietary intakes. The diagnostic survey was conducted in 10 sublocations of Vihiga County, which were pair‐matched and split into five intervention and five control sublocations. The intervention sublocations developed activities towards improving nutrition. Before implementation, a baseline survey collected the dietary intake data of 330 women–child pairs in the intervention and control sublocations. To support the activities, communities received agriculture and nutrition training. After 1 year of implementation, an endline survey collected dietary intake data from 444 women–child pairs in the intervention and control sublocations. Impact was assessed using the difference‐in‐difference technique. Highly significant positive impacts on children's mean DDS (treatment effect = 0.7, p < 0.001) and on the share of children reaching MDD (treatment effect = 0.2, p < 0.001) were shown. Higher dietary diversity can be explained by the development of subsistence and income‐generating pathways and increased nutrition knowledge. Participatory farm diversification and nutrition education were shown to significantly increase dietary diversity of young children in Western Kenya.

Dietary Diversity Was Positively Associated with Psychological Resilience among Elders: A Population-Based Study.

The association between dietary diversity (DD) and psychological resilience among older people is an underdeveloped area of research. This cross-sectional study explored the associations of DD with psychological resilience among 8571 community-based elderly individuals. The intake frequencies of food groups were collected, and dietary diversity was assessed based on the mean DD score. Psychological resilience was assessed using a simplified resilience score (SRS). Data were analyzed using multiple linear regression and logistic regression models. Poor DD was significantly associated with psychological resilience, with a β (95% CI) of −0.94 (−1.07, −0.81) for the SRS (p < 0.01) and an odds ratio (95% CI) of 1.83 (1.66, 2.01) for low SRS status. The interaction effects of age with DD were observed for the SRS (p < 0.001) and low SRS status (p < 0.001). Based on separate analyses by age group, the association of a low SRS with poor DD was more prominent in the younger elderly than the oldest old, with OR (95% CI) 2.32 (1.96, 2.74) and 1.61 (1.43, 1.82), respectively. Compared with younger participants with good DD, the risk of a low SRS was greater for younger participants with poor DD, the oldest old with good DD, and the oldest old with poor DD, with OR (95% CI) 2.39 (2.02, 2.81), 1.28 (1.09, 1.51), and 2.03 (1.72, 2.39), respectively. The greatest contribution to DD was from a high consumption of vegetables, fruits, and nuts. Our study suggested that poor DD was associated with a low psychological resilience among the Chinese elderly, especially the younger elderly. These findings suggest that augmentation of DD might promote psychological resilience.

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

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

Socio-economic patterning of food consumption and dietary diversity among Indian children: evidence from NFHS-4

Background/ObjectivesMost interventions to foster child growth and development in India focus on improving food quality and quantity. We aimed to assess the pattern in food consumption and dietary diversity by socioeconomic status (SES) among Indian children.Subjects/MethodsThe most recent nationally representative, cross-sectional data from the National Family Health Survey (NFHS-4, 2015–16) was used for analysis of 73,852–74,038 children aged 6–23 months. Consumption of 21 food items, seven food groups, and adequately diversified dietary intake (ADDI) was collected through mother’s 24-h dietary recall. Logistic regression models were conducted to assess the association between household wealth and maternal education with food consumption and ADDI, after controlling for covariates.ResultsOverall, the mean dietary diversity score was low (2.26; 95% CI:2.24–2.27) and the prevalence of ADDI was only 23%. Both household wealth and maternal education were significantly associated with ADDI (OR:1.28; 95% CI:1.18–1.38 and OR:1.75; 95% CI:1.63–1.90, respectively), but the SES gradient was not particularly strong. Furthermore, the associations between SES and consumption of individual food items and food groups were not consistent. Maternal education was more strongly associated with consumption of essential food items and all food groups, but household wealth was found to have significant influence on intake of dairy group only.ConclusionsInterventions designed to improve food consumption and diversified dietary intake among Indian children need to be universal in their targeting given the overall high prevalence of inadequate dietary diversity and the relatively small differentials by SES.

WHAT INFLUENCES CHILD DIETARY DIVERSITY? EMPIRICAL EVIDENCE FROM SINDA DISTRICT OF EASTERN ZAMBIA

It is well documented in various studies carried out in Sub-Saharan Africa that dietary diversity is a major chal- lenge for most households. This is true even in places that are known to produce a wide variety of food. Therefore, the pur- pose of this study was to determine the levels of child dietary diversity and to understand the factors that influence child di- etary diversity. The study empirically established that child dietary diversity in Sinda district of Eastern Zambia was low, with a mean dietary diversity score of 3.6. The factors sig- nificantly influencing child dietary diversity were found to be the mothers’ education, age of child, ownership of livestock and participation in nutrition trainings. It is recommended to invest in strategies that will promote maternal education, di- versification of crops and livestock rearing and the scaling up of nutrition trainings based on a multi-sectoral approach.

Effects of multiannual, seasonal unconditional cash transfers on food security and dietary diversity in rural Burkina Faso: the Moderate Acute Malnutrition Out (MAM'Out) cluster-randomized controlled trial.

To evaluate the impact of multiannual, seasonal unconditional cash transfers (UCT) provided within the Moderate Acute Malnutrition Out (MAM'Out) research project on households' food security and children's and caregivers' dietary diversity. A two-arm cluster-randomized controlled trial with sixteen villages in the intervention group and sixteen others in the control group. A monthly allowance of 10 000 XOF was transferred to caregivers of eligible children via a personal mobile phone account from July to November 2013 and 2014. Tapoa province in the eastern region of Burkina Faso. Data on household food access (monthly adequate household food provisioning (MAHFP); household food insecurity access scale (HFIAS)) and maternal and child dietary diversity were analysed for 1143 households, 1219 caregivers of reproductive age (15-49 years) and 1247 under-5 children from both intervention and control groups. The mean women dietary diversity score in intervention caregivers and the mean dietary diversity score (DDS) in intervention children with inadequate minimum DDS at baseline were respectively 7 % (95 % CI 2, 11 %; P = 0·002) and 17 % (95 % CI 11, 23 %; P <0·001) higher compared with the control group. However, no difference was found in the intervention effect on household food security measured with HFIAS (relative risk = 1·03; 95 % CI 0·92, 1·15; P = 0·565) and MAHFP (relative risk = 0·98; 95 % CI 0·96, 1·01; P = 0·426). Multiannual, seasonalUCT increased dietary diversity in children and their caregivers. They can be recommended in actions aiming to improve maternal and child diet diversity.

Dietary Diversity and Associated Factors among HIV Positive Adult Patients Attending Public Health Facilities in Motta Town, East Gojjam Zone, Northwest Ethiopia, 2017

Introduction. Dietary diversity is defined as the amount of different food groups or foods that are consumed over a specific reference time. The human immune deficiency virus problem remains one of the main public health challenges, especially in low and middle income countries. Nutrition has been linked to both the transmission of human immune deficiency virus and poor outcomes related to human immune deficiency virus. Objective. To assess dietary diversity and associated factors among human immune deficiency virus positive adult patients in Motta administrative town, Northwest Ethiopia, 2017. Methods. A facility based cross-sectional study design was conducted on 410 study participants selected using a stratified sampling technique with proportional allocation. The data were collected using semi-structured and pretested questionnaire. Data were entered into Epi-Data version 3.1 and analysis was performed using SPSS version 20. Descriptive statistics were used to describe the number and percentage of the study variables. The bivariate and multivariable logistic regression analyses were done to identify the independent factors associated with dietary diversity among adult human immune virus (HIV) positive patients. Result. A total of 410 study participants were included in the analysis. Of the total, 121 (29.5%) of adult HIV positive respondents consumed diversified diet with the mean dietary diversity score of 3.2 (SD±1.88). The predominant food item consumed during the study periods was starchy staples (96.1%) and legumes (81.7%). Having means of communication cell phone (mobile phone) [(AOR= 2.13 (1.16, 3.60)], media exposure status in the household [(AOR =1.95 (1.22, 3.11)] and nutrition counselling [(AOR =2.17 (1.09, 4.67)] were significant factors associated with dietary diversified feeding at 95% CI. Conclusion. The study revealed that low dietary diversity score was significant nutritional problem among HIV positive adults in Motta town health facilities. Having mobile cell phone, media exposure status and nutritional counseling were significantly associated with dietary diversity score. Therefore efforts should be strengthened to improve the counseling service at each health institution and encourage the patients to use media for the source of information.

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

Background/context: Dietary diversity (DD) is universally recognized as a key component of healthy diets. Healthy diet is one of the most important determinants that can influence nutritional status of women of reproductive age.&#x0D; Materials and Methods: This cross sectional study was conducted in Shitpara village of Sreepur Upazila under Gazipur district during February to June 2013 to assess the dietary diversity and nutritional status of women of reproductive age. Convenient sampling technique was adopted to select 181 women. Interview schedule &amp; checklist used as research instrument.&#x0D; Results: The mean(+/-s.d.)age of the respondents was 27.45+/-9.38 years, 133(80%) of them were married and 176(97.2%) are literate. Mean family size was 5.34+/- 2.386 persons and mean family income was 9611.05 Taka per month. Among 133 married women, 68(51%) have 2 or less than two children. Their mean(+/-s.d.) dietary diversity score was 5.13+/- 1.19 and majority 149(82%) of them having medium dietary diversity tercile (4-6). All of them ate carbohydrate types of food, 174(96.1%) protein rich foods &amp; 83(45.9%) vit.A rich vegetables &amp; fruits. Their mean BMI was 22.35 +/- 3.71 kg/ m2. Majority 118 (65%) of them having normal BMI and 22(12%) are under weight. Only 6(3%) of them are obese. Thoughdietary diversity was medium (4-6); relationship between dietary diversity and nutritional status could not be established.&#x0D; Conclusion:The qualitative measurement of dietary diversity is not sufficient enough to identify women at risk of under- or over nutrition.&#x0D; J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 36-40

Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia.

BackgroundThis study examines socio-economic determinants of food consumption patterns amongst women of reproductive age and children aged 6–59 months from urban poor settlements of Lusaka and their implications for nutritional status. Particular emphasis was placed on the role of fish in their diets and nutritional status.MethodsA cross-sectional survey design was applied, in which 714 mother-child dyads, with children aged 6–59 months were enrolled. A three-stage randomized cluster sampling approach was applied.ResultsThe mean dietary diversity score among children aged 6–23 and 24–59 months was 2.98 (±1.27) and 3.478 (±1.07), respectively. In children aged 6–23 months, there was a significant difference in their nutritional status, based on fish consumption (χ2 = 10.979, df = 2, p = 0.004). Children from poorer households consumed mostly small fish (Kapenta). The quantity of fish consumed by children was significantly associated with stunting in both age groups, odds ratio = 0.947 (95% CI: 0.896, 1.000) for children aged 6–23 months and odds ratio = 1.038 (95% CI: 1.006, 1.072) for children aged 24–59 months old. Other significant risk factors for stunting in children aged 6–23 months were the child’s age, mother’s body mass index, access to treated water and child morbidity. Child’s age, mother’s educational level and wealth status were determinants of dietary diversity in children aged 6–59 months as shown by the Poisson regression.ConclusionNutritional status of children aged 6–23 months is associated with fish consumption, with children consuming fish less likely to be stunted. Small fish (Kapenta) is an animal-source food that is particularly important in the diet of children in urban poor households in Zambia and contributes to better nutritional outcomes. As all small fish stem from capture fisheries, sustainable one health environmental integration, monitoring and management strategies are desirable.

Nutritional status and dietary diversity of orphan and non \u2013 orphan children under five years: a comparative study in the Brong Ahafo region of Ghana

BackgroundUndernutrition in children under 5 years is a major risk factor to child deaths and is related to impaired cognitive development and lower school performance. Underprivileged children such as orphans are at particularly high risk of undernutrition. Little is however known about the nutritional status and dietary diversity of orphan children in Ghana. This study therefore compared the nutritional status and dietary diversity of orphan and non- orphan children.MethodsAn analytical cross – sectional study design was used. Two hundred and forty-six children (123 non- orphan and 123 orphans) were sampled from households (non - orphans) and four orphanages (orphans). Maternal / caregiver and child socio-demographic characteristics and dietary diversity of children was assessed with a semi – structured questionnaire. We measured anthropometric characteristics of children. Stunting, wasting and underweight in children was classified using Height – for – age Z – scores (HAZ), Weight – for – height Z – scores (WHZ) and Weight – for – age Z – scores (WAZ) respectively. Bivariate and multivariate analyses were used to compare the nutritional status and dietary diversity of orphan and non- orphan children.ResultsMajority of the children were male (52.4%). The prevalence of stunting, wasting and underweight was 17.9, 5.3 and 7.7% respectively for all children. There was no difference in the prevalence of stunting (17.1% vs 18.7%) (p = 0. 74), wasting (4.9% vs 5.7%) (p = 0.78) and underweight (7.3% vs 8.1%) (p = 0.81) among non – orphans and orphans. There was also no difference in mean HAZ (p = 0.52), WHZ (p = 0.27) and WAZ (p = 0.12) of non- orphan and orphan children. However, orphans had higher mean dietary diversity score (p < 0.001) and minimum dietary diversity (p < 0.001) than non – orphans. After controlling for potential confounders, non – orphans were 7.491 times more likely to have a low dietary diversity [AOR = 7.491; 95% CI (1.851–30.320); p = 0.005] compared to orphans.ConclusionPresent study data show no significant difference in the anthropometric status of orphan and non – orphan children. Orphans were more likely to receive a diversified diet than non – orphans.

Do Chinese Preschool Children Eat a Sufficiently Diverse Diet? A Cross-Sectional Study in China.

Background: This study aimed to comprehensively evaluate dietary diversity and its associated factors in Chinese preschoolers and explore whether the daily food consumption of children with different dietary diversity-associated characteristics met recommended dietary amounts. Methods: A cross-sectional study covering seven cities and two villages was conducted and included 697 preschool children aged 3–7 years old. Dietary diversity score (DDS) and DDS 10 were calculated based on 24-h dietary recall. The food-intake differences among children with different DDS 10 predictors were examined. Results: The mean DDS and DDS 10 in Chinese preschool children were 7.4 ± 1.5 (ranged from 3 to 9) and 7.0 ± 3 (ranged from 3 to 9) respectively. Positive predictors of dietary diversity included residing in an urban environment, a higher household expenditure on children’s food, and a higher frequency of eating outside. Food-intake differences existed among the predictors. Conclusions: Education and intervention should be strengthened to improve the dietary diversity of preschool children, especially in rural areas. The overall dietary pattern of children requires attention, which means not only increasing dietary diversity but also avoiding an unbalanced diet.

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years.

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit intake decreased in women from their 70s. Twelve-year longitudinal data showed dietary diversity declined in women in their 60s. In terms of food intake, fruit, milk and dairy intake decreased in both sexes in their 50s and 60s; such declines would lower dietary diversity.

Dietary diversity and nutrient intake adequacy among women in Iwo local government area, Osun State Nigeria

Dietary diversity has been considered a potential 'proxy' indicator to reflect nutrient intake adequacy. The study assessed the Dietary Diversity and Nutrient Intake Adequacy among adult women in Iwo Local Government (LGA) area of Osun State. Apparently healthy 250 adult women (20-59) were the respondents in the study. The anthropometric measurements of the respondents were taken using standard equipment. A 24-hour dietary recall questionnaire was used to assess the food intake of the respondents, which was converted into nutrient intake using adapted Total Dietary Assessment (TDA) software. Dietary Diversity Score (DDS) was created using a 15-food group model. Nutrient intake was evaluated using Nutrient Adequacy Ratio (NAR). Mean adequacy ratio (MAR) was calculated as an indicator of nutrient intake adequacy. Statistical Package for Social Sciences (SPSS) software was used for analysis of the data collected. More than half (56.4%) of the respondents had normal body weight, 15.2% were underweight, 21.2% were overweight and 7.2% were obese. The diet of the respondents consisted of food items mainly from food groups such as cereals, white roots and tubers, vitamin A-rich vegetables, spices, condiments and beverages. Fruits and foods from milk and milk products were the least consumed. The mean DDS was 8.29±1.3, 4.4% of the respondents had high DDS, 94.4% had minimum DDS and 1.2% had low DDS. The MAR was 2.56±0.69, the intake of some nutrients such as carbohydrate, fat, iron, zinc and protein was above the recommended dietary intake and there was inadequate intake for some nutrients such as calcium, vitamin C and potassium among the respondents. Consumption of foods from groups such as meat and meat products, eggs and poultry and fish were found to be significantly related with nutrient intake adequacy as respondents with adequate intake of nutrients consumed more from these food groups. These results indicate that dietary diversity is an indicator of nutrient intake adequacy. Most of the respondents consumed foods from cereals, white roots and tubers, vegetables, legumes, oil and fats, spices and condiments than from other food groups. Keywords: Dietary-diversity, Nutrient, Women, Food-groups, Overweight, Micronutrient, Adequacy, Nigeria

Optimal dietary practices and nutritional knowledge of school adolescent girls in Jimma Town, South West Ethiopia

Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. This study aimed to assess the optimal dietary practices and nutritional knowledge of school adolescent girls in Jimma Zone, South-west Ethiopia. School-based cross-sectional study was conducted among 455 school adolescent girls. Multivariable logistic regression was used to identify independent variables. Majority (61.3%) of students had dietary diversity score less than five and their mean (±SD) dietary diversity score was 4.34 ± 1.41. The majority (55.8%) of adolescent girls had a good knowledge score about nutrition related information which they earned from the school (86.6%). Low dietary diversity of school adolescent girls was positively associated with attending government schools, lack of maternal education and low-economic status. Therefore, both government and non-government organizations need to focus on school and community based nutrition intervention to address the low dietary diversity of school girl adolescents.

Seasonality affects dietary diversity of school-age children in northern Ghana.

Background and objectivesDietary diversity score (DDS) is relatively easy to measure and is shown to be a very useful indicator of the probability of adequate micronutrient intake. Dietary diversity, however, is usually assessed during a single period and little is known about the effect of seasonality on it. This study investigates whether dietary diversity is influenced by seasonality.MethodsTwo cross-sectional surveys were conducted in two different seasons—dry season (October 2010) and rainy season (May 2011) among the same school-age children (SAC) in two rural schools in northern Ghana. The study population consisted of 228 school-age children. A qualitative 24-hour dietary recall was conducted in both seasons. Based on 13 food groups, a score of 1 was given if a child consumed a food item belonging to a particular food group, else 0. Individual scores were aggregated into DDS for each child. Differences in mean DDS between seasons were compared using linear mixed model analysis.ResultsThe dietary pattern of the SAC was commonly plant foods with poor consumption of animal source foods. The mean DDS was significantly higher (P < 0.001) in the rainy season (6.95 ± 0.55) compared to the dry season (6.44 ± 0.55) after adjusting for potential confounders such as age, sex, occupation (household head and mother) and education of household head. The difference in mean DDS between dry and rainy seasons was mainly due to the difference in the consumption of Vitamin A-rich fruits and vegetables between the seasons. While vitamin A-rich fruits (64.0% vs. 0.9%; P < 0.0001) and vitamin A rich dark green leafy vegetables (52.6% vs. 23.3%, P < .0001) were consumed more during the rainy season than the dry season, more children consumed vitamin A-rich deep yellow, orange and red vegetables during the dry season than during the rainy season (73.7% vs. 36.4%, P <0.001).ConclusionSeasonality has an effect on DDS and may affect the quality of dietary intake of SAC; in such a context, it would be useful to measure DDS in different seasons. Since DDS is a proxy indicator of micronutrient intake, the difference in DDS may reflect in seasonal differences in dietary adequacy and further studies are needed to establish this.