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Objective: To examine the association between nutrient adequacy and dietary diversity, and to assess and compare the determinants for the two constructs in an adult population in rural Mali. Design: Cross-sectional study assessing food intake by a validated 7-day quantitative food frequency questionnaire. Two different dietary diversity indexes were created: food variety score (FVS), a simple count of food items, and diet diversity score (DDS) a count of food groups. Mean adequacy ratio, the mean ratio of intake to recommended intake (each truncated at one) of energy and nine nutrients, was calculated as an indicator of nutrient adequacy. Information on household and individual characteristics, including demography, socioeconomic conditions and food production strategies was obtained using precoded questionnaires. Setting: Bafoulabé district, Kayes region, Western Mali. Subjects: In total, 502 subjects (55% women) aged 15-45 y from 319 different households. Results: Both FVS and DDS had a positive correlation with mean adequacy ratio (MAR). Multivariate analysis (linear regression)showed that the most important factors explaining MAR was the number of milk products, vegetables and green leaves consumed, as well as sex and the number of crops produced in the household. Dietary diversity was associated with socioeconomic status, residence and age. Conclusion: Dietary diversity is useful as an indicator of nutrient adequacy. It is important to examine how various food groups contribute to the nutrient adequacy of the diet in an area. Sponsorship: The Norwegian Research Council and The Strmme Foundation funded the project.

Objective: The purpose of this study was to analyse the associations between the food variety score (FVS), dietary diversity score (DDS) and nutritional status of children, and to assess the associations between FVS, DDS and socioeconomic status (SES) on a household level. The study also assessed urban and rural differences in FVS and DDS. Design: Cross-sectional studies in 1994/95, including a simplified food frequency questionnaire on food items used in the household the previous day. A socio economic score was generated, based on possessions in the households. Weight and height were measured for all children aged 6-59 months in the households, and anthropometric indices were generated. Subjects and setting: Three hundred and twenty-nine urban and 488 rural households with 526 urban and 1789 rural children aged 6-59 months in Koutiala County, Sikasso Region, Mali. Results: Children from urban households with a low FVS or DDS had a doubled risk (OR>2) for being stunted and underweight. Those relations were not found in the rural area. There was an association between SES and both FVS and DDS on the household level in both areas. The FVS and DDS in urban households with the lowest SES were higher than the FVS and DDS among the rural households with the highest SES. Conclusions: Food variety and dietary diversity seem to be associated with nutritional status (weight/age and height/age) of children in heterogeneous communities, as our data from urban areas showed. In rural areas, however, this association could not be shown. Socioeconomic factors seem to be important determinants for FVS and DDS both in urban and rural areas. FVS and DDS are useful variables in assessing the nutritional situation of households, particular in urban areas.

This paper discusses the nutrient composition and the nutritional importance of green leaves and wild gathered foods in an area with surplus food production in Mali. In this West African country, there is little information about the nutrient composition and the nutritional quality of foods in general, and of wild gathered foods in particular. Food frequency was collected in two cross-sectional surveys. Focus group discussions with women in the area were used to collect information about seasonality, availability and preparation of various foods. Selected food samples were collected for chemical analysis of nutrient composition. The food samples of green leaves (Adansonia digitata, Amaranthus viridis, Tamarindus indica, Allium cepa), seeds and flour (Parkia biglobosa) and fruits (Tamarindus indica) were analysed for water, energy, fat, protein, minerals, amino acids and carotenoids. Availability and use of the foods varied with seasons. In the rainy season, wild gathered foods (e.g. A. digitata) were used as much as fresh cultivated foods (e.g., A. viridis and A. cepa). The wild food resources were more frequently used in rural than in urban areas, with A. digitata as the dominating green leaves. Green leaves were rich in energy, protein and minerals (calcium, iron). Leaves of A. viridis were, in particular, rich in beta-carotene (3290 micrograms/100 g). Chemical score in dried green leaves varied from 47 (A. cepa) to 81 (A. digitata), with lysine as the first limiting amino acid. P. biglobosa fermented seeds, with 35% fat and 37% protein were a complementary source of lysine in the diet. Based on the seasonality, the frequency of use and the nutrient contents of selected green leaves and wild gathered foods in Koutiala district, it is concluded that these traditional and locally produced foods are valuable and important nutrient contributors in the diet both in rural and urban areas, but most important in rural areas.

Objective: To assess the validity of two diet quality indexesFfood variety score (FVS) and diet diversity score (DDS) in Western Mali. Design: In two separate studies (A and B), FVS and DDS were derived from a food frequency questionnaire (FFQ) and were compared with the same scores and with measures of nutrient adequacy derived from 2-day weighed records (WR). Setting: Two rural, adjacent villages in Mali, West Africa. Subjects: In study A (1996), 48 women and 27 men (15-59 y) participated. Study B (1999) included 34 women and 36 men (15-45 y). Results: Spearman's correlation coefficients between FVS from the FFQ and WR for men were 0.5 in study A and 0.4 in study B. The corresponding correlations for DDS were 0.2 and 0.4, respectively. Correlations for women were lower, especially in study B. Classification into quartiles was also best for men. Correlations for the two diet variety scores from the FFQ with nutrient adequacy from the WR in study A were about 0.3 for men, but lower for women. In study B, these correlations were around 0.5 for men, whereas for women there was no association. Conclusion: FVS and DDS can be assessed by our FFQ. The two diet variety scores reflect diet quality and are simple tools that can be used for monitoring. The validation study gave better results for men than for women, which has implications for further use of these instruments. Sponsorship: The Norwegian Research Council and The Stromme Foundation funded the project.