Dietary Diversity and Its Relationship With Nutritional Status Among Adolescents and Adults in Rural India

Abstract

Summary. Dietary diversity is associated with household or individual food availability and intake of nutrients from different food groups and is an important component of nutritional outcome. This study examined the Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) of three dietary diversity indices and their relationship with the nutritional status of adolescents and adults in rural regions of two states in India, Wardha district in Maharashtra and Koraput district in Odisha, in 2014. Individual dietary diversity was calculated using 24-hour diet recall (FS 24hr ) data and household dietary diversity was measured with food frequency data using Berry's index (DDI) and food scores (FS FFQ ). The nutritional status of individuals was assessed using anthropometric indices. The diets in both locations were cereal dominated. It was observed that 51% of adolescent boys and 27% of adolescent girls had 'thinness' and stunting. The prevalence of undernutrition was higher among adult women (48%) than adult men (36%). The mean diversity indices were FS 24hr of 8, DDI of 89-90 and FS FFQ of 64-66 in the two locations. The FS 24hr was found to be positively correlated with the NAR of all nutrients while DDI and FS FFQ were correlated with seven and six nutrients, respectively. The DDI and FS 24hr showed an association with MAR if the two locations were combined together. Sensitivity and specificity analysis showed that FS 24hr gave more true positives than false positives and the area under the Receiver Operating Characteristic curve was 0.68, implying that this measure truly differentiates individuals having low dietary diversity with low MAR from those with low dietary diversity and a high MAR. All three measures of dietary diversity showed a linear association with the nutritional outcomes of adults, while in the adolescent group only DDI showed a relationship. It is concluded that 24-hour diet recall is a good measure for studying the relationship between dietary diversity and nutritional status in adults.

Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?

“…Dietary diversity over a three day period (as in this present study) will undoubtedly be higher than that observed during one day, which might be another reason for the higher DDS in our study. Worldwide there is also a large variety of DDS and FVS values reported among studies, which again appears to be due to differences in how the parameters used have been defined and calculated [ 8 , 9 , 19 ]. These differences include variations in definitions of the food groups (e.g., the number and make up of food groups used, or the use of food codes or even food ingredients in some studies), applying thresholds of intake for each food group, and different methods for extracting diversity and variety data, such as using one 24-h recall period versus three or seven 24-h recall periods, or even food frequency questionnaires (FFQ).…”

“…Several studies in Asia have reported that dietary diversity can be a valuable indicator to predict macronutrient or micronutrient adequacy for children [ 7 , 8 , 9 ]. The latest study in India (among adolescents) found that the nutrient adequacy ratio (NAR) of most micronutrients studied increased with the dietary diversity score (DDS), allowing them to conclude that nutrient adequacy was positively associated with high dietary diversity [ 8 ]. In a study conducted in the Philippines, DDS was found to be both significantly correlated to the mean probability of adequate nutrient intake (MPA) and to the intake of most micronutrients.…”

Association of meal and snack patterns with micronutrient intakes among Greek children and adolescents: data from the Hellenic National Nutrition and Health Survey

“…Mean adequacy ratio (MAR) was calculated as an overall measure of nutrient adequacy of the different meal and snack patterns . Recommended Daily Allowance and Adequacy Intake (when the formers were not available) cut‐offs, as proposed by the ΙΟΜ, were used to compute for the nutrient adequacy ratio (NAR).…”

Prevalensi dan Faktor yang Berhubungan dengan Terjadinya Beban Gizi Ganda pada Keluarga di Indonesia

“…Hal tersebut dapat berpengaruh terhadap metabolisme tubuh dan akhinya berdampak pada terjadinya status gizi kurang pada individu. 31,32 Namun, disisi lain, penelitian yang dilakukan di Afrika Utara menunjukkan bahwa tidak ada korelasi yang signifikan antara usia ibu dan kejadian beban gizi ganda pada keluarga. 33 Hasil analisis menunjukkan bahwa jumlah anak juga berhubungan dengan terjadinya beban gizi ganda pada keluarga.…”