Food variety, socioeconomic status and nutritional status in urban and rural areas in Koutiala (Mali)

Objectives: To compare dietary diversity scores measured over a 1-day and a 3-day period, and to assess their relationships with socio-economic characteristics and the nutritional status of rural African women. Design: A qualitative dietary recall allowed calculation of a dietary diversity score (DDS; number of food groups consumed out of a total of nine). Body mass index (BMI) and body fat percentage (BFP) were used to assess the nutritional status of women. Setting and subjects: A representative sample of 550 mothers in north-east Burkina Faso. Results: The DDS increased from 3.5 to 4.4 when calculated from a 1-day or a 3-day recall (P , 0.0001), although for the latter the DDS was affected by memory bias. The DDS calculated from a 1-day recall was higher when a market day occurred during the recall period. Both scores were linked to the sociodemographic and economic characteristics of the women. Women in the lowest DDS tertile calculated from the 1-day recall had a mean BMI of 20.5 kg m 22 and 17.7% of them were underweight, versus 21.6 kg m 22 and 3.5% for those in the highest tertile (P ¼ 0.0003 and 0.0007, respectively). The DDS calculated from the 1-day recall was also linked to mean BFP; all these links remained significant after adjustment for confounders. For the 3-day period, no such relationships were found to be significant after adjustment. Conclusion: The DDS calculated from a 1-day dietary recall was sufficient to predict the women's nutritional status. In such a context attention should be paid to market days.

Section: Discussionsupporting

confidence: 84%

Measuring dietary diversity in rural Burkina Faso: comparison of a 1-day and a 3-day dietary recall

Savy

Martin‐Prével

Traissac

et al. 2007

“…Our findings suggested adequate dietary diversity to be the indicator most strongly associated with better nutrition outcomes during this period. Other studies that have used a variety of indicators aimed at capturing food variety or dietary diversity have come to similar conclusions about the importance of the diversity of young children's diets (10,12,35,37,(39)(40)(41) . Building on these previous studies, and using nationally representative data, our analysis also showed a clear association between dietary diversity and , did not achieve MDD; , achieved MDD) among children aged 6-23 months, 2007 Bangladesh Demographic and Health Survey.…”

Section: Discussionmentioning

confidence: 92%

“…Using Demographic and Health Survey (DHS) data from these regions, chronic undernutrition was found to be significantly associated with dietary diversity (37) . Significant and positive associations between dietary diversity and nutritional status among young children have also been found in smaller-scale studies in rural Bangladesh (38) , rural Burkina Faso (12) , Kenya (39) , Mexico (40) and Mali (41) , and in a review in Africa (35) .The relationships between the newly established WHOrecommended IYCF indicators with nutritional outcomes have not been previously examined using national-level data from Bangladesh. The present research applied the newly established indicators to nationally representative data, to study and illustrate the associations between IYCF practices and growth in Bangladeshi children.…”

mentioning

confidence: 99%

Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data

Zongrone

Winskell

Menon³

2012

103

Objective: To determine the association between indicators of infant and young child feeding (IYCF) and anthropometric measures of nutritional status among children aged 0-23 months in a nationally representative data set. Design: Data from the 2007 Bangladesh Demographic and Health Survey were used. Analyses were conducted using multiple linear regression and logistic regression analyses adjusted for the complex survey design of the survey, controlling for child, maternal and household characteristics, and including regional dummy variables. Setting: Bangladesh. Subjects: Pairs (n 2096) of last born infants and their mothers. Results: Exclusive breast-feeding under 6 months of age was associated with higher weight-for-height Z-score (effect size (ES) 5 0?29; P , 0?05). Appropriate complementary feeding in children aged 6-8 months was associated with higher height-for-age Z-score (HAZ; ES 5 0?63; P , 0?01) and higher weight-for-age Z-score (WAZ; ES 5 0?30; P , 0?05). Higher dietary diversity index (DDI) was associated with higher HAZ (ES 5 0?08; P , 0?01 for every 1 point higher DDI) and higher WAZ (ES 5 0?04; P , 0?05). Children who achieved minimum diet diversity had higher HAZ (ES 5 0?20; P , 0?05). Logistic regression models confirmed that exclusive breast-feeding was protective against wasting and DDI was protective against stunting and underweight. Conclusions: Our results highlight the importance of IYCF practices as determinants of child growth outcomes in this context, and reinforce the need for interventions that address the spectrum of IYCF practices, from exclusive breast-feeding to age-appropriate complementary feeding, especially diet diversity, in efforts to improve nutrition of infants and young children. Keywords Infant and young child feeding Exclusive breast-feeding Dietary diversity Nutrition BangladeshGlobally, childhood undernutrition is one of the most important public health challenges. When considering all causes of under-5s mortality worldwide, it is estimated that 35 % of these deaths are attributable to malnutrition (1) . The critical 'window of opportunity' for child growth is in the first 2 years of life; recent analyses have found that the effect of growth faltering during this period is more severe than previously thought (2) . In this critical period for the growth of children under 2 years of age, it is essential to ensure proper nutrition. According to the UNICEF conceptual framework for child nutrition (3) , both dietary intake and health care are critical determinants of child undernutrition.Aspects of infant and young child feeding (IYCF) that are important in the first 2 years of life include: early initiation of breast-feeding; exclusive breast-feeding for the first 6 months of life; adequate, timely and appropriate complementary feeding from 6 to 24 months of age; continued breast-feeding after the introduction of complementary foods; adequate dietary diversity in complementary foods; and adequate frequency of meals. A large body of research was conducted over alm...

“…Urban residents and participants in the highest SES tertile reported a significantly more diversified and micronutrient-adequate diet than rural residents or participants in the lowest SES tertile. Previous reviews document a strong relationship between dietary diversity and socio-economic characteristics (36)(37)(38) . Hatloy et al (2000) documented that socio-economic factors are important determinants for dietary diversity in urban and rural areas (36) .…”

Section: Discussionmentioning

confidence: 99%

“…Previous reviews document a strong relationship between dietary diversity and socio-economic characteristics (36)(37)(38) . Hatloy et al (2000) documented that socio-economic factors are important determinants for dietary diversity in urban and rural areas (36) . It has been reported that dietary diversity increases as income increases (38) .…”

Section: Discussionmentioning

confidence: 99%

Dietary quality indices vary with sociodemographic variables and anthropometric status among Mexican adults: a cross-sectional study. Results from the 2006 National Health and Nutrition Survey

Ponce

Rodríguez‐Ramírez

Mundo‐Rosas

et al. 2013

Objective: To evaluate the dietary quality of Mexican adults' diet, we constructed three dietary quality indices: a cardioprotective index (CPI), a micronutrient adequacy index (MAI) and a dietary diversity index (DDI). Design: Data were derived from the 2006 National Health and Nutrition Survey, which is a national survey representative of the Mexican population with a stratified, multistage, probabilistic sample design. Dietary intake was assessed from an FFQ with 101 different foods and daily nutrient intakes were computed. The CPI evaluated compliance with seven WHO recommendations for the prevention of CVD, the MAI evaluated the intake of six micronutrients based on the estimated average requirements from the US Institute of Medicine and the DDI was constructed based on the consumption of thirty different food groups. Settings: Mexico. Subjects: Mexican adults aged 19-59 years old. Results: We evaluated the diet of 15 675 males and females. Adjusted means and adjusted proportions by age and sex were computed to predict adherence to dietary recommendations. Rural inhabitants, those living in the South and those from the lowest socio-economic status reported a significantly higher CPI (4?5 (SE 0?08), 4?3 (SE 0?08) and 4?2 (SE 0?09), respectively; P , 0?05), but a significantly lower MAI and DDI, compared with urban inhabitants, those from the North and those of upper socio-economic status (P , 0?05). Conclusions:The constructed diet quality indices identify nutrients and foods whose recommended intakes are not adequately consumed by the population. Given the epidemiological and nutritional transition that Mexico is experiencing, the CPI is the most relevant index and its components should be considered in Mexican dietary guidelines as well as in any food and nutrition programmes developed.