scholarly journals Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) Data Collection: Validity of the List-Based and Open Recall Methods as Compared to Weighed Food Record

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2039 ◽  
Author(s):  
Giles T. Hanley-Cook ◽  
Ji Yen A. Tung ◽  
Isabela F. Sattamini ◽  
Pamela A. Marinda ◽  
Kong Thong ◽  
...  
Keyword(s):  
Data Collection ◽  
Dietary Diversity ◽  
Weighted Kappa ◽  
Food Group ◽  
Reproductive Age ◽  
Food Groups ◽  
Women Of Reproductive Age ◽  
Group Diversity ◽  
Minimum Dietary Diversity ◽  
Recall Methods

Minimum dietary diversity for women of reproductive age (MDD-W) was validated as a population-level proxy of micronutrient adequacy, with indicator data collection proposed as either list-based or open recall. No study has assessed the validity of these two non-quantitative proxy methods against weighed food records (WFR). We assessed the measurement agreement of list-based and open recall methods as compared to WFR (i.e., reference method of individual quantitative dietary assessment) for achieving MDD-W and an ordinal food group diversity score. Applying a non-inferiority design, data were collected from non-pregnant women of reproductive age in Cambodia (n = 430), Ethiopia (n = 431), and Zambia (n = 476). For the pooled sample (n = 1337), proportions achieving MDD-W from both proxy methods were compared to WFR proportion by McNemar’s chi-square tests, Cohen’s kappa, and receiver operating characteristic (ROC) analysis. Ordinal food group diversity (0–10) was compared by Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients (ICC), and weighted kappa. MDD-W food groups that were most frequently misreported (i.e., type I and II errors) by the proxy methods were determined. Our findings indicate statistically significant differences in proportions achieving MDD-W, ordinal food group diversity scores, and ROC curves between both proxy methods and WFR (p < 0.001). List-based and open recall methods overreported women achieving MDD-W by 16 and 10 percentage points, respectively, as compared to WFR (proportion achieving MDD-W: 30%). ICC values between list-based or open recall and WFR were 0.50 and 0.55, respectively. Simple and weighted kappa values both indicated moderate agreement between list-based or open recall against WFR. Food groups most likely to be misreported using proxy methods were beans and peas, dark green leafy vegetables, vitamin A-rich fruit and vegetables, and other fruits. Our study provides statistical evidence for overreporting of both list-based and open recall methods for assessing prevalence of MDD-W or ordinal food group diversity score in women of reproductive age in low- and middle-income countries. Operationalizing MDD-W through qualitative recall methods should consider potential trade-offs between accuracy and simplicity.

scholarly journals A Social Norms-Based Intervention Improves Dietary Diversity among Women in Rural India: The Reduction in Anemia through Normative Innovations (RANI) Project

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2822
Author(s):  
Sameera A. Talegawkar ◽  
Yichen Jin ◽  
Erica Sedlander ◽  
Rohini Ganjoo ◽  
Satyaranjan Behera ◽  
...  
Keyword(s):  
Social Norms ◽  
Dietary Diversity ◽  
Reproductive Age ◽  
Control Groups ◽  
Women Of Reproductive Age ◽  
Diet Diversity ◽  
Learning Modules ◽  
Food And Agriculture ◽  
And Control ◽  
Minimum Dietary Diversity

Diet diversity has an important role in the prevention and treatment of anemia. Based on formative research in the community and the theory of normative social behavior, we designed an intervention to improve diet diversity among women of reproductive age. Our study, the Reduction in Anemia through Normative Innovations (RANI) Project, investigated the effect of a social norms-based intervention on diet diversity among women of reproductive age. We randomized villages in Odisha, India, into treatment or control arms, with a minimum of one village buffer between them. We assessed exposure to the intervention by frequency of self-reported images seen from the participatory learning modules, videos watched, and number of hemoglobin tests administered. We assessed diet diversity with the Food and Agriculture Organization’s Minimum Dietary Diversity for Women (MDD-W) questionnaire. We used multiple logistic regression to examine the associations between intervention and diet diversity, adjusting for covariates. Compared with baseline, diet diversity score increased in both treatment and control groups. The odds of having a diverse diet was 47% higher in the treatment group. Higher level of exposure to the RANI intervention was associated with a better diet diversity score, indicating that the intervention was effective in improving diet quality.

scholarly journals Depression among women of reproductive age in rural Bangladesh is linked to food security, diets and nutrition

2020 ◽  
Vol 23 (4) ◽  
pp. 660-673 ◽  
Author(s):  
Thalia M Sparling ◽  
Jillian L Waid ◽  
Amanda S Wendt ◽  
Sabine Gabrysch
Keyword(s):  
Dietary Diversity ◽  
Reproductive Age ◽  
Food Groups ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Middle Income ◽  
Dominance Analysis ◽  
Food And Nutrition Security ◽  
Nutrition Security ◽  
Food And Nutrition

AbstractObjective:To quantify the relationship between screening positive for depression and several indicators of the food and nutrition environment in Bangladesh.Design:We used cross-sectional data from the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial in Bangladesh to examine the association of depression in non-peripartum (NPW) and peripartum women (PW) with food and nutrition security using multivariable logistic regression and dominance analysis.Setting:Rural north-eastern Bangladesh.Participants:Women of reproductive age.Results:Of 2599 women, 40 % were pregnant or up to 1 year postpartum, while 60 % were not peripartum. Overall, 20 % of women screened positive for major depression. In the dominance analysis, indicators of food and nutrition security were among the strongest explanatory factors of depression. Food insecurity (HFIAS) and poor household food consumption (FCS) were associated with more than double the odds of depression (HFIAS: NPW OR = 2·74 and PW OR = 3·22; FCS: NPW OR = 2·38 and PW OR = 2·44). Low dietary diversity (<5 food groups) was associated with approximately double the odds of depression in NPW (OR = 1·80) and PW (OR = 1·99). Consumption of dairy, eggs, fish, vitamin A-rich and vitamin C-rich foods was associated with reduced odds of depression. Anaemia was not associated with depression. Low BMI (<18·5 kg/m2) was also associated with depression (NPW: OR = 1·40).Conclusions:Depression among women in Bangladesh was associated with many aspects of food and nutrition security, also after controlling for socio-economic factors. Further investigation into the direction of causality and interventions to improve diets and reduce depression among women in low- and middle-income countries are urgently needed.

scholarly journals The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Food Group ◽  
Limited Information ◽  
Food Groups ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Nutritional Status Of Children ◽  
Minimum Dietary Diversity

Abstract Background Undernutrition poses a serious health challenge in developing countries. Tanzania has the highest undernutrition burdens in East and Southern Africa. Poor infant and young child feeding practices including consumption of undiversified diet are the main cause for undernutrition. There is limited information regarding the association between dietary diversity and undernutrition in Tanzania. The objective of this paper was to examine to what extent the dietary diversity is associated with undernutrition of children of 6 to 23 months in Tanzania.Methods This is a secondary data analysis from data collected by the Tanzania Demographic and Health Survey of 2015-2016. Stunting, wasting and underweight were calculated from Z-scores based on 2006 WHO standards. A dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, a Minimum Dietary Diversity (MDD) indicator was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the odds ratios of becoming undernourished.Results A total of 2,960 children were enrolled in this study. The majority (73.9%) of children did not reach the recommended Minimum Dietary Diversity (MDD). The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food group consumed increased. Children who did not received an MDD diet had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal source foods has been found to be associated with reduced stunting among children.Conclusion Consumption of a diverse diet was associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals Minimum dietary diversity among women of reproductive age in urban Burkina Faso

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Estefania Custodio ◽  
Francois Kayikatire ◽  
Sonia Fortin ◽  
Anne‐Claire Thomas ◽  
Yves Kameli ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Dietary Diversity ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Minimum Dietary Diversity

scholarly journals The Relationship Between Dietary Diversity Among Women of Reproductive Age and Agricultural Diversity in Rural Tanzania

2019 ◽  
Vol 41 (1) ◽  
pp. 50-60 ◽  
Author(s):  
Alexandra L. Bellows ◽  
Chelsey R. Canavan ◽  
Mia M. Blakstad ◽  
Dominic Mosha ◽  
Ramadhani A. Noor ◽  
...  
Keyword(s):  
Crop Production ◽  
Dietary Diversity ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Food Groups ◽  
Women Of Reproductive Age ◽  
Dietary Diversity Score ◽  
Agricultural Diversification ◽  
Rural Tanzania ◽  
The Relationship

Background: Agriculture can influence diets through consumption of home-produced foods or increased purchasing power derived from sale of agricultural commodities. Objective: This article explores cross-sectional relationships between agricultural diversification and dietary diversity (a proxy for micronutrient adequacy) among women of reproductive age in rural Tanzania. Methods: Dietary diversity was measured using the women’s minimum dietary diversity score indicator. Data were analyzed from the baseline survey of a cluster randomized control trial in Rufiji, Tanzania. One woman of reproductive age was randomly surveyed from each eligible household, totaling 1006 individuals. Generalized linear mixed-effects models were used to estimate the relationship between agricultural indicators and dietary diversity. Results: Median dietary diversity score for women was 3.00 (interquartile range: 2-3). Approximately 73% of households grew at least 1 crop in the previous year. Women’s dietary diversity score was positively associated with cropping diversity ( P for trend = .04), ownership of livestock (adjusted coefficient: 0.30; 95% confidence interval [CI]: 0.08-0.44; P = .005), cash crop production (adjusted coefficient: 0.22; 95% CI: 0.03-0.41; P = .02), and production of pulses (adjusted coefficient: 0.50; 95% CI: 0.27-0.74; P < .0001) and other vegetables (adjusted coefficient: 0.64; 95% CI: 0.11-1.17; P = .02). Conclusions: Average dietary diversity is well below the recommended 5 food groups per day, a widely used indicator of micronutrient adequacy. Since the majority of households participate in agriculture, the efforts to promote agricultural diversification and/or specialization and sale of agricultural goods may positively influence dietary diversity and associated health and nutrition outcomes.

scholarly journals Seasonal Fluctuations in MDD-W and Nutrient Dense Food Group Intakes of Women's Diets in Rural Zambia and Malawi (P10-137-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Gina Kennedy ◽  
Molly Ahern
Keyword(s):  
Dietary Diversity ◽  
Panel Study ◽  
Food Group ◽  
Reproductive Age ◽  
Leafy Vegetables ◽  
Cold Weather ◽  
Small Fish ◽  
Food Groups ◽  
Seasonal Fluctuations ◽  
Rural Zambia

Abstract Objectives To study seasonal variation in minimum dietary diversity of women (MDD-W) and food group intake for women of reproductive age (WRA) living in rural Zambia and Malawi where the effect of seasonal agricultural production and seasonal food availability on dietary diversity is likely to be high. Methods 200 WRA living in Chitipa District, Malawi (n = 100) and Luwingu District, Zambia (n = 100) provided informed consent and were enrolled in a panel study. Households with at least one woman between age 15–49 were randomly selected. A dietary diversity questionnaire was administered every-other month for six rounds, from September 2017 to July 2018. MDD-W was calculated as the proportion of women consuming five or more out of ten food groups. Percent of women consuming each food group by round was also calculated. Chi square was used to test the difference in MDD-W across rounds. Results There was significant seasonal difference in the percentage of women achieving MDD-W. Lowest and highest proportion of WRA meeting MDD-W was 18% and 79% in Malawi (P < 0.05) and 28% and 70% in Zambia (P < 0.05). MDD-W followed expected variation, peaking in the season of greatest food abundance and lowering during the “lean” season. The food groups grains and tubers, dark green leafy vegetables and other vegetables dominate women's diets. Small fish species are the most commonly consumed flesh food, although availability and consumption decrease seasonally due to cold weather and annual fish bans. Vitamin-A rich fruits and vegetables, other fruit, and nuts and seeds are highly seasonal. Dairy and eggs are rarely consumed. Conclusions Significant seasonal fluctuations in the proportion of WRA achieving MDD-W exist. This has implications for project monitoring and evaluation. Periods of abundance and scarcity for nutritionally important food groups were demonstrated. Attention should be given to improved nutrition-sensitive processing, storage and access to nutrient dense food groups affected by seasonal fluctuations. Funding Sources Research was funded by the International Fund for Agricultural Development (IFAD) with project partners McGill University, WorldFish, Bioversity International, Self Help Africa, University of Zambia, SPRODETA and the LUANAR and by the CGIAR research program on Agriculture for Nutrition and Health.

Dietary diversity and its determinants among Khasi and Garo indigenous women (15 to 49 years) in Meghalaya, northeast India

2021 ◽  
pp. 026010602110166
Author(s):  
Melari Shisha Nongrum ◽  
Lukas Pawera ◽  
Bhogtoram Mawroh
Keyword(s):  
Local Food ◽  
Dietary Diversity ◽  
Indigenous Women ◽  
Reproductive Age ◽  
Leafy Vegetables ◽  
Food Plants ◽  
Inverse Association ◽  
Food Groups ◽  
The Mean ◽  
Minimum Dietary Diversity

Background: Despite generally high agrobiodiversity, the Khasi and Garo indigenous people in Meghalaya have poor nutritional status among children and women. Aim: To assess the dietary diversity of the Khasi and Garo indigenous women of reproductive age in Meghalaya, while examining the associated factors that affect it and to map the diversity of local food plants. Methods: A dietary survey was conducted through 24-hour recall with 276 women from 28 villages of Meghalaya. The mapping of local food plants was conducted through key informant interviews and focus group discussions in the same villages. Results: The mean minimum dietary diversity for women is 4.22 (SD ±1.26); with one-third (37%) of the women attaining a minimum dietary diversity of five or more food groups in a day. There were significant differences in the dietary diversity among the indigenous groups, the Garo community attaining higher minimum dietary diversity for women. There was also an inverse association between the number of land uses and dietary diversity. The mean number of food plants (including crop varieties) found in each village is 203 (SD±45.7). Conclusions: There is potential to enhance dietary diversity through diversifying lesser consumed crops such as vitamin A-rich vegetables and fruits, nuts, seeds and green leafy vegetables in existing land holdings. Also, proper management and access to the commons will provide a sustainable resource base for diet and food security, enhance dietary diversity and bridge the hidden hunger among children and women.

scholarly journals Assessing Dietary Diversity in Pregnant Women: Relative Validity of the List-Based and Open Recall Methods

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Phuong Hong Nguyen ◽  
Yves Martin-Prevel ◽  
Mourad Moursi ◽  
Lan Mai Tran ◽  
Purnima Menon ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Dietary Diversity ◽  
Intraclass Correlation ◽  
Roc Curves ◽  
Food Group ◽  
Rank Test ◽  
Kappa Statistics ◽  
Specific Work ◽  
Food Groups ◽  
Recall Methods

ABSTRACT Background The Minimum Dietary Diversity for Women (MMD-W) was validated as a proxy of micronutrient adequacy for nonpregnant women, with proposed data collection being either a list-based or a qualitative open recall method. Few studies have compared the performance of these 2 methods. Objectives We compared performance in predicting micronutrient adequacy of food group indicators (FGIs) measured by the list-based and the quantitative open recall methods using varying quantity cut-offs. We also examined the agreement between list-based and open recall FGIs. Methods Data were collected in Bangladesh (n = 600 pregnant women) and India (n = 655). The performance of different indicators to predict micronutrient adequacy was compared using receiver operating characteristic (ROC) analysis. Correlations between list-based and open recall FGIs were calculated using Spearman's rank test; agreement was assessed by the intraclass correlation coefficient (ICC) and kappa statistics. Food groups that were most often misreported by the list-based method were identified. Results There were no statistically significant differences in ROC curves between list-based and open recall FGIs in either country. In Bangladesh, correlations between list-based and open recall FGIs varied between 0.6 and 0.8; ICC values were 0.43–0.75; kappa values were 0.51–0.53 when using a cut-off of any quantity or 15 g for open recall, but were lower (k = 0.24) with the cut-off of 1 portion. In India, these values were lower: ∼0.4 for correlation, 0.32–0.37 for ICCs, and 0.17–0.22 for kappas. Food groups most susceptible to misreporting using the list-based method were beans/peas in Bangladesh and other vegetables in India. Conclusions Our study provides initial support for the use of list-based questionnaires in assessing food group diversity or prevalence of MDD-W in pregnant women. Additional and context-specific work may be required to understand the potential of simple methodologies to assess consumption of specific food groups. This trial was registered at clinicaltrials.gov as NCT02745249 (Bangladesh) and NCT03378141 (India).

scholarly journals Standard Minimum Dietary Diversity Indicators for Women or Infants and Young Children Are Good Predictors of Adequate Micronutrient Intakes in 24–59-Month-Old Children and Their Nonpregnant Nonbreastfeeding Mothers in Rural Burkina Faso

2020 ◽  
Author(s):  
Loty Diop ◽  
Elodie Becquey ◽  
Zuzanna Turowska ◽  
Lieven Huybregts ◽  
Marie T Ruel ◽  
...  
Keyword(s):  
Low Income ◽  
Dietary Diversity ◽  
Rank Correlation ◽  
Reproductive Age ◽  
Physiological Status ◽  
Spearman Rank Correlation ◽  
Women Of Reproductive Age ◽  
Spearman Rank ◽  
Proxy Indicators ◽  
Minimum Dietary Diversity

ABSTRACT Background Simple proxy indicators are needed to assess and monitor micronutrient intake adequacy of vulnerable populations. Standard dichotomous indicators exist for nonpregnant women of reproductive age and 6–23-mo-old children in low-income countries, but not for 24–59-mo-old children or pregnant or breastfeeding women. Objectives This study aimed to evaluate the performance of 2 standard food group scores (FGSs) and related dichotomous indicators to predict micronutrient adequacy of the diet of rural Burkinabe 24–59-mo-old children and women of reproductive age by physiological status. Methods A 24-h recall survey was conducted at dry season among 1066 pairs of children and caregivers. Micronutrient adequacy was evaluated by the mean probability of adequacy (MPA) of intake over 11 micronutrients. Proxy indicators were FGS-10 [10 food groups based on the FAO/FHI360 minimum dietary diversity for women (MDD-W) guidelines] and related MDD-W (FGS-10 ≥5); and FGS-7 [7 groups based on the WHO infant and young child (IYC) feeding MDD guidelines] and related MDD-IYC (FGS-7 ≥4). Results FGS-10 and FGS-7 were similar across children and women (∼3 groups). FGS-10 performed better than FGS-7 to predict MPA in children (Spearman rank correlation = 0.59 compared with 0.50) and women of all 3 physiological statuses (Spearman rank correlation = 0.53–0.55 compared with 0.42–0.52). MDD-W and MDD-IYC performed well in predicting MPA &gt;0.75 in children and MPA &gt;0.6 in nonpregnant nonbreastfeeding (NPNB) women, but a 4-group cutoff for FGS-10 allowed a better balance between sensitivity, specificity, and proportion of correct classification. MPA levels for pregnant and breastfeeding women were too low to assess best cutoff points. Conclusions MDD-IYC or an adapted MDD-W (FGS-10 ≥4 instead of FGS-10 ≥5) can be extended to 24–59-mo-old children and NPNB women in similar-diet settings. The inadequacy of micronutrient intakes in pregnant and breastfeeding women warrants urgent action. Micronutrient adequacy predictors should be validated in populations where a higher proportion of these women do meet dietary requirements.

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