Food Variety and Dietary Diversity Scores in Children: Are they Good Indicators of Dietary Adequacy?

Stellenbosch University, Johannesburg, Gauteng, South Africa
Public Health Nutrition (Impact Factor: 2.68). 08/2006; 9(5):644-50. DOI: 10.1079/PHN2005912
Source: PubMed


To assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children.
Secondary data analyses were undertaken with nationally representative data of 1-8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated.
The children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7-8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the 'other group' (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity.
Either FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

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    • "Several studies have shown the validity of this type of index (i.e., food consumption score and household dietary diversity score), finding them to be significantly correlated with caloric intake and nutrient adequacy (Rathnayake, Madushani, & Silva, 2012; Ruel, 2003). The nutrition literature has found that increases in this dietary diversity measure are associated with socio-economic status and household food security; adequate micronutrient density of complementary foods for infants and young children; and macro-and micronutrient adequacy of the diet for non-breastfed children, adolescents, and adults (Foote, Murphy, Wilkens, Basiotis, & Carlson, 2004; Hatloy, Halland, Diarra, & Oshaug, 2000; Kennedy, Pedro, Seghieri, Nantel, & Brouwer, 2007; Steyn, Nell, Nantel, Kennedy, & Labadarios, 2006). "

    Full-text · Chapter · Jan 2016
    • "Diets with greater variety of foods or food groups are associated with greater energy and nutrient intake (Kant 2004; Rose et al. 2002; Tarini et al. 1999). Dietary diversity has also been positively linked with the three pillars of food security (availability, access and utilization) based on the results of empirical studies (Bernal and Lorenzana 2003; Styen et al. 2006; Hillbrunner and Egan 2008). Therefore, understanding household dietary diversity may be an alternative and easier pathway to assess household level food security (Taruvinga et al. 2013; Thorne-Lyman et al. 2010, Headey and Ecker 2013). "
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    ABSTRACT: The level of diversity in household diets is an indirect measure of diet quality and the extent to which nutritional needs of households are being met. There is also a positive relationship between dietary diversity and the three pillars of food security, viz., availability, access and utilization. In the light of these statements, the paper reports on the patterns of food consumption and dietary diversity in 12 selected villages of eastern India with a view to understanding the heterogeneity in food habits, quality of diet intake and the socio-economic and demographic determinants of the dietary diversity in the region. There was significant disparity across the villages in terms of budgetary shares and intake levels of different food items. The level of heterogeneity in food intake was also reflected in the estimates of dietary diversity across villages. Multiple regression analysis on the determinants of dietary diversity showed that larger households with better-educated male heads and higher purchasing power fared well on dietary diversity scores. Access to the Public Distribution System (PDS) also contributed to enhancement of dietary diversity through an indirect route, as PDS beneficiaries are better able to afford diverse food items. In contrast, low social status in the form of affiliation to scheduled castes/scheduled tribes (SC/ST) diminished diversity scores. From a policy perspective, it is therefore important to focus interventions on improving dietary diversity and nutrition security with proper understanding of the socio-economic setting of the target area and its population.
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    • "In addition a review of developing country studies confirmed the positive strong association between diet diversity, nutrient adequacy and energy availability, suggesting that diet diversity could be a useful indicator of food security (Ruel 2004). A study in South Africa demonstrated a high correlation between mean adequacy ratio (MAR) of nutrients and dietary diversity scores (Steyn et al. 2005). An association between dietary diversity and nutrient adequacyhas been indicated (Arimond et al. 2010). "
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    ABSTRACT: We explore how diet diversity differs with agricultural seasons and between households within pastoral and agro-pastoral livelihood systems, using variety of foods consumed as a less complex proxy indicator of food insecurity than benchmark indicators like anthropometry and serum nutrients. The study was in the central part of the rangelands in Uganda. Seventy nine households were monitored for three seasons, and eight food groups consumed during a 24 hour diet recall period used to create a household diet diversity score (HDDS). Mean HDDS was 3.2, varied significantly with gender, age, livelihood system and season (p < .001, F = 15.04), but not with household size or household head's education level. Agro-pastoralists exhibited lower mean diet diversity than pastoralists (p < .01, F = 7.84) and among agro-pastoralists, households headed by persons over 65 years were most vulnerable (mean HDDS 2.1). This exploratory study raises issues requiring further investigation to inform policies on nutrition security in the two communities.
    Full-text · Article · Jun 2015 · Ecology of Food and Nutrition
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