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Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women.

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  • Additional Information
    • Author(s):
    • Address:
      Wageningen University, Wageningen, Netherlands.
    • Publication Information:
      Netherlands
    • Abstract:
      Background: The major cause of micronutrient deficiencies is low intake due to monotonous diets, especially among women of childbearing age. The dietary diversity score has been proposed and validated as a good proxy indicator for micronutrient adequacy. However, there are still outstanding methodological questions related to seasonal effects, food intake methods, selection of foods and the cut-off for estimating the prevalence of acceptable nutrient adequacy. This thesis evaluated the performance of a simple dietary diversity score for assessing nutrient adequacy in the diets of rural women in Kenya. Methods: The study was conducted in Mbooni Division, Makueni District, Kenya among non-pregnant, non-lactating women of reproductive age having a child between 2-5 years. Food consumption data was collected by 3 non-consecutive quantitative 24 hr-recalls and a qualitative free-listing 24 hr-recall, in pre-harvest (Period 1, October 2007, n=73) and post-harvest (Period 2, April 2008, n=203) seasons. Dietary diversity scores (DDS) were derived based on 10 and 13 food groups with a minimum intake threshold per food group of 0 and 15 g, respectively. Mean probability of adequacy (MPA) was calculated based on intake of 11 micronutrients. Results: The dietary diversity score (DDS) and mean probability of adequacy (MPA) were significantly but moderately associated in both seasons (r=0.40 and r=0.38 in Period 1 and 2), and the association was independent of season (p=0.45). The DDS from a qualitative 24 hr-recall (DDSql) showed little agreement with the quantitative 24 hr-recall (DDSqn) with a mean difference (DDSqn-DDSql) of -0.51±1.46 (Period 1) and -0.58±1.43 (Period 2), with lower correlations between MPA and DDS for DDSql (r=0.14 and 0.19 in Period 1 and 2, p>0.05) compared to DDSqn (0.40 and 0.54 in Period 1 and 2, p<0.01). The informative food-based scores and the food group-based scores were moderately associated with mean probability of adequacy (r=0.54-0.59 in Period 1; r=0.37-0.45 in Period 2) with higher values for informative food-based scores. The Minimum Dietary Diversity score for Women and mean probability of adequacy were significantly but moderately associated in both seasons (r=0.43-0.58 in Period 1; r=0.24-0.50 in Period 2), but the use of the cutoff of consuming 5 or more food groups as indication of nutrient adequacy resulted in high total misclassifications in both periods. Conclusion: A dietary diversity score can be used as a simple proxy indicator for micronutrient adequacy, independent of season. The dietary diversity score derived from a qualitative free-listing 24 hr-recall formed a poor indicator, needing further refinement to improve its performance. The informative food-based score performs moderately better in predicting nutrient adequacy, but its advantages do not outway those of the food group-based scores, and the latter is therefore preferred. The Minimum Dietary Diversity score for Women, formed a good indicator to predict nutrient adequacy, but using the cutoff of 5 or more food groups resulted in an overestimation of prevalence of adequate intake in our resource poor population.
    • Number of References:
      many ref.
    • Subject Terms:
      Human Nutrition;Rural Development;Tropical Diseases
    • Subject Terms:
    • CABICODES:
      Women (UU500)
      Diet Studies (VV110)
      Rural Health (VV550) (New March 2000)
    • Publication Information:
      Thesis; ISBN:9789462574236
    • Accession Number:
      20153331058
    • Copyright:
      ©2015 CAB International
  • Citations
    • ABNT:
      NGALA, S. A. Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women. 2015. Wageningen University, Wageningen; Netherlands, 2015. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058. Acesso em: 21 set. 2020.
    • AMA:
      Ngala SA. Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women. Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women. 2015:149. Accessed September 21, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058
    • APA:
      Ngala, S. A. (2015). Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women [Wageningen University]. In Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women (p. 149).
    • Chicago/Turabian: Author-Date:
      Ngala, S. A. 2015. “Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women.” Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women. Wageningen; Netherlands: Wageningen University. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058.
    • Harvard:
      Ngala, S. A. (2015) Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women, Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women. Wageningen University. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058 (Accessed: 21 September 2020).
    • Harvard: Australian:
      Ngala, SA 2015, ‘Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women’, Wageningen University, Wageningen; Netherlands, Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women, p. 149, viewed 21 September 2020, .
    • MLA:
      Ngala, S. A. “Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women.” Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women, Wageningen University, 2015, p. 149. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058.
    • Chicago/Turabian: Humanities:
      Ngala, S. A. “Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women.” Evaluation of Dietary Diversity Scores to Assess Nutrient Adequacy among Rural Kenyan Women. Wageningen University, 2015. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058.
    • Vancouver/ICMJE:
      Ngala SA. Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women [Internet]. Evaluation of dietary diversity scores to assess nutrient adequacy among rural Kenyan women. [Wageningen; Netherlands]: Wageningen University; 2015 [cited 2020 Sep 21]. p. 149. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lhh&AN=20153331058