Dietary Diversity and Nutritional Status of Urban Primary School Children from Iran and India

Abstract

Introduction: Nutritional status of children is influenced by diet. Better dietary diversity helps ensure adequate intake of essential nutrients especially for growing school going children. The aim of this study was to assess the effect of dietary scores and nutritional status of urban Iranian and Indian school children. Methods: The present study examined dietary diversity, weight-forage (WA) and height-forage (HA) and weightfor-height weight-forage z-scores and nutritional status of 4570 children aged 6-9 years, including 2234 Iranian (1016 boys, 1218 girls) and 2336 Indian (1240 boys, 1096 girls) attending primary schools residing in Mumbai and Ahwaz, Iran, from low and middle income categories. Dietary diversity scores were assessed based on frequency of consumption of individual food items categorized into 11 individual food groups. Results: Total dietary diversity scores were significantly higher for Indian children who had normal weight or who were overweight (F=32.197, p=0.000) and lowest for underweight children. Similar trends were observed for the children from Iran (F=9.345, p=0.000). Total food group scores increased with better height status of the children. In both countries, severely and moderately stunted children had lower total mean scores than those who had normal and above average height. Wasting was also associated with lower total mean scores. Analysis of data for individual food groups showed that increasing weight was associated with higher scores for almost all food groups in India. In Iran, mean scores for vegetables, beverages, sweets and fats increased with increasing weight. Heights for age z-scores were positively associated with a mean score for pulses in countries and dairy products, beverages and fats. Higher BMI was associated with higher scores for cereals, fruits, vegetables, dairy products, mixed dishes, beverages, sweets and fats.

Intestinal helminth infections and dietary diversity score predict nutritional status of urban schoolchildren from southern Ethiopia

“…Low child DDS (≤4) in the current study was significantly associated with stunting status [AOR (95% CI) = 2.3 (1.2, 4.7)] suggesting that a diet habitually low in micronutrients may have contributed to stunting in the current study. DDS is a recommended qualitative indicator of micronutrient adequacy of a diet [27,45] and has been shown to predict growth of children in other studies [14,46,47]. On the other hand, DDS was not independently associated with wasting status; a similar finding to previous studies that reported DDS was associated with stunting, but not with wasting [14,46,47].…”

“…DDS is a recommended qualitative indicator of micronutrient adequacy of a diet [27,45] and has been shown to predict growth of children in other studies [14,46,47]. On the other hand, DDS was not independently associated with wasting status; a similar finding to previous studies that reported DDS was associated with stunting, but not with wasting [14,46,47]. DDS may not necessarily reflect variation in energy intake of children as a child may have optimal energy intake from a monotonous starch based diet with low diversity.…”

“…Studies showed dietary factors like low meal frequency [13], consumption of less diverse diet [14], inadequate intake of carbohydrates [15] and household food insecurity [15] are important determinants of nutritional status in schoolchildren. Recurrent childhood illnesses like diarrhea, respiratory infections and intestinal parasites also contribute to malnutrition through decreased food intake, impaired nutrient absorption, direct losses and stimulation of the immune system that diverts energy and nutrients from structural and physiological functions [16,17].…”

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

“…Much research has been done on the methods used to measure diet quality, resulting in the development of several indices (Savy et al, 2005). A 24-hour diet recall method was recommended by the FAO (FAO, 2013), while Hooshmand and Udipi (2013) used food frequency to measure dietary diversity. Food frequency helps to assess the habitual dietary pattern, which is useful to understand the relationship between diet and chronic diseases (FAO, 2004).…”

“…the frequency of consumption (daily, twice or three times a week, once a week, fortnightly and occasionally) by a household for the different food groups for a reference period of the preceding one month. The following consumption scores were given: daily: 7; twice or three times a week: 3; once a week: 1; fortnightly: 0.5; monthly: 0.25; and occasionally: 0 (following Hooshmand & Udipi, 2013). The scores were added to obtain the food diversity score for the household.…”