Validity of The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) in Rural Rwanda

Abstract

This study aimed to examine the validity of the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W), which assesses the micronutrient adequacy of the participants by counting the number of food groups they consumed, in rural Rwanda. We used 54 one-day weighed food records collected from 41 women to calculate Spearman s rank-order correlation coefficient between references of micronutrient adequacy and the MDD-W. Since only a few micronutrients references had a significant correlation with MDD-W scores (r 0.294 to 0.392), we concluded the MDD-W could not work well in our study sites. That was due to these sites food consumption patterns; while micronutrient-dense foods such as meat and dark green leafy vegetables were eaten less (average daily intake was 25.8g and 46.2g, respectively) and they did not practically contribute to micronutrient supply, energy-dense foods such as starchy staple foods were consumed in a large amount (600.5g per day) and supplied a large part of micronutrient intake. Moreover, it was observed that references of many micronutrients increased in proportion to starchy staple foods consumption (r 0.634). The MDD-W was not suitable for micronutrient assessment in our study sites conditions and quantity information should be taken into consideration where food variety is limited. (203 words / about 200 words)

Recommended modification of porridge and mixture to improve nutrient intake in the rural area of Northern Rwanda

“…Contrary to general assumption, yellow plantain and potatoes were the major sources of protein and iron intakes among the participants. Although nonheme iron in roots and tubers has low bio-availability [24], a similar tuber-based dietary pattern was observed in other areas in Rwanda [26].…”

“…Overall, a limited variety of dishes has been observed in rural parts of developing countries [23][24][25]. Previous studies also mentioned that rural Rwandan diets were characterized by poor dietary diversity [4,26]. Table 2 shows that in many eating occasions, households cooked only one dish.…”

“…Mixture is a dish made from boiling some foods together. In many other rural areas in Rwanda, the mixture of different food items in a single pot is a common traditional dish [4,26]. Table 2 shows that for lunch and dinner, all households cooked mixture one or more times in a day, regardless of their SES.…”

Empowering rural service providers to improve nutrition in mountain regions

“…The importance of such interventions has been recently highlighted in low-and middleincome countries (Di Prima et al, 2022). It should be noted that MDD-W is a qualitative indicator of micronutrient adequacy making it unsuitable for measuring adequacy of micronutrients when larger amounts of staple food, for instance, can provide an adequate amount of particular micronutrients (Kano et al, 2017). Furthermore, diversity in consumption and production within a particular food group is not captured by MDD-W, thereby possibly underestimating the increase in the diversity of production and consumption post-intervention compared to their diversity pre-intervention.…”