我国成人膳食多样化与营养素摄入充足状态的关系

目的以膳食多样化评分(DDS)为评价指标,了解我国18～59岁城乡居民膳食多样化现状,及其与营养素摄入状态的关系。方法利用2002年中国居民营养与健康状况调查中3 d的24 h膳食回顾调查数据,计算膳食多样化总评分(DDS)以及不同食物种类组内DDS,分析与17种营养素摄入充足比(NAR)和平均充足比(MAR)的关系。结果农村地区居民DDS低于城市居民;农村居民膳食中蔬菜多样化分值高于城市,而鱼、蛋、肉、乳及水果DDS较低;我国居民膳食中最易缺失的食物品种是乳制品,其次是水果和鱼类。MAR值随DDS的增加而增加;DDS与MAR显著正相关(r=0.27～0.43),各类食物的组内多样化与MAR亦显著正相关,肉类、蔬菜和豆制品的相关系数分别为0.30、0.25和0.22,肉类食物对MAR的贡献最大。DDS与能量、蛋白质、脂肪、钙、磷、钾、钠、镁、锌、铁、硒、维生素A、E、C、尼克酸、硫胺素、核黄素的NAR以及NAR-N均显著正相关。结论城市居民膳食多样化程度高于农村,我国城乡居民膳食中最易缺少的食物品种是乳制品;膳食多样化与营养素摄入的充足状态显著相关。     

Validation of food variety as an indicator of diet quality assessed with a food frequency questionnaire for Western Mali

OBJECTIVE: To assess the validity of two diet quality indexes-food variety score (FVS) and diet diversity score (DDS) in Western Mali. DESIGN: In two separate studies (A and B), FVS and DDS were derived from a food frequency questionnaire (FFQ) and were compared with the same scores and with measures of nutrient adequacy derived from 2-day weighed records (WR). SETTING: Two rural, adjacent villages in Mali, West Africa. SUBJECTS: In study A (1996), 48 women and 27 men (15-59 y) participated. Study B (1999) included 34 women and 36 men (15-45 y). RESULTS: Spearman's correlation coefficients between FVS from the FFQ and WR for men were 0.5 in study A and 0.4 in study B. The corresponding correlations for DDS were 0.2 and 0.4, respectively. Correlations for women were lower, especially in study B. Classification into quartiles was also best for men. Correlations for the two diet variety scores from the FFQ with nutrient adequacy from the WR in study A were about 0.3 for men, but lower for women. In study B, these correlations were around 0.5 for men, whereas for women there was no association. CONCLUSION: FVS and DDS can be assessed by our FFQ. The two diet variety scores reflect diet quality and are simple tools that can be used for monitoring. The validation study gave better results for men than for women, which has implications for further use of these instruments.     

Dietary diversity within food groups: an indicator of specific nutrient adequacy in Tehranian women

OBJECTIVE: To determine the relationship between dietary diversity within food groups and dietary diversity score and the probability of nutrient adequacy in Tehranian women. DESIGN: Cross-sectional study assessing food intake by two 24-hour recalls questionnaires on two different occasions. Dietary diversity was defined according to diet quality index revised. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes. SETTING: District 13 of Tehran, Iran. SUBJECTS: 286 females aged 18-80 years. RESULTS: Whole grain diversity score mostly correlated with protein and vitamin B2 (r = 0.35, p < 0.05). Fruit diversity score was correlated with vitamin C (r = 0.44, p < 0.05). Dairy diversity score was correlated with calcium intake (r = 0.54, p < 0.05). Meat diversity score was correlated with protein intake (r = 0.34, p < 0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, BMI, education level and job status (model R2 = 0.53). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R(2) = 0.59). Adding the dietary diversity score improved the model fit significantly (model R2 = 0.64). Dairy diversity score had the strongest association with improved nutrient adequacy. CONCLUSION: Dietary diversity score is a useful indicator of specific nutrient adequacy in Tehranian women. However, to determine the adequacy of a specific nutrient, the diversity scores of specific food groups might be taken into account.     

Impact of food aid on food variety and dietary diversity of an elderly community in Sharpeville, South Africa

Objective  The objective of this paper was to discuss the impact of a two-year food aid intervention programme on dietary diversity and adequacy of an elderly community. This project was undertaken amongst the elderly (n=300), voluntarily attending a day care centre in Sharpeville, South Africa. In a baseline study (2004) in this community the dietary diversity scoring (DDS) method revealed low dietary diversity (3.41) and food variety (4.77) scores (FVS), and a trend that higher scores resulted in a better mean nutrient adequacy ratio. An intervention study, implemented in 2005, aimed to improve the dietary diversity of this elderly community by providing breakfast and lunch five days a week at the care centre. The impact of this food aid was investigated by comparing the DDS, FVS and nutrient adequacy ratios (NAR) before and after the intervention. Methods  The methods included socio-demographic, health, food frequency questionnaire (FFQ), 24 hour-recall (24h-recall), anthropometric and biochemical measurements in 107 elderly people who regularly attended the care centre since 2004. Results  At baseline, the majority of respondents (n=82, 55.1%) were classified with low DDS utilizing 0–3 food groups compared to after the intervention, where 98.1% (n=105) was classified with a high dietary diversity utilizing all nine nutritious food groups. The mean individual DDS of 3.41 that improved to 8.5 after the intervention further supported this. The mean adequacy ratio (MAR) showed a statistically significant improvement from baseline (0.77±0.48) to 1.02±0.66 after the intervention, indicating improvement of the adequacy of the overall diet to meet the daily requirements for this elderly community. Conclusions  The results of this study represent the first demonstration that food aid proved to be an effective short term nutrition intervention that improved the level of dietary diversity. Other food-based approaches or nutrition education activities should be implemented simultaneously to improve self-sufficiency in such a community for long-term effectiveness in terms of nutrient inadequacy and dietary diversity.     

Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China

This study aimed to evaluate the status of dietary diversity and nutrient intake among Han and Dongxiang smallholder farmers in poor rural areas of northwest China. In this cross-sectional study, dietary intake was assessed in 499 smallholder farmers aged 18–75 years from two nationally designated impoverished counties in Gansu Province, China, using three consecutive 24 h dietary recalls. The dietary diversity score (DDS) and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (range from 1 to 9) in participants was relatively low (3.81 ± 1.01). Consumption of grains was excessive, while consumption of vegetables, fruits, meat, beans, eggs, fish, and dairy was inadequate. The NAR values were higher in Han Chinese, with the exceptions of vitamin C, potassium, pyridoxine, and selenium (p < 0.05). For each nutrient, the high DDS group had a higher mean NAR (p < 0.05), except for pyridoxine. High household monthly income, being Han Chinese, high DDS, and being aged over 45 years were positively associated with mean adequacy ratio (MAR) of 14 micronutrients evaluated. Lack of dietary diversity and insufficient intake of essential micronutrients are public health concerns in northwest China. Nutrition education and other proper methods to address these issues are needed.     

Dietary diversity and adequacy of women caregivers in a peri-urban informal settlement in South Africa

Objective

Simple measures reflecting dietary quality are preferred for assessment of dietary intakes in low-income communities, e.g. dietary diversity that reflects a healthy, varied, nutritious diet, associated with nutrient adequacy. A strong association between household income and food access suggests dietary diversity assessment as one of the indicators of household food security. The aim of this study was to assess the food security situation of black women in an informal settlement by exploring their food access capabilities through dietary diversity measures and the coping strategies they employ to cope with poverty and hunger.

Methods

A randomly selected sample of black women living in an informal settlement completed a pretested socio-demographic questionnaire (socio-economic circumstances) and validated questionnaires (1-wk quantified food frequency questionnaire: diversity measures; 24-h recall: nutrient intake; Cornell Hunger Scale: coping strategies). Food variety scores and food group diversity scores were calculated from frequency analyses for all foods and food groups. Nutrient adequacy ratios for various nutrients and the mean adequacy ratio for their diet were calculated. Relationships between dietary diversity and nutritional adequacy were investigated with Pearson correlations. Food variety score cut points were tested for sensitivity and specificity against nutritional adequacy.

Results

Intakes were deficient for all nutrients except carbohydrates. Individual mean ± SD nutrient adequacy ratios ranging between 0.15 ± 0.18 and 0.95 ± 0.19 confirmed the poor dietary quality. Zero to 40 individual foods were consumed, but the mean ± SD food variety score was only 3.17 ± 1.21, indicating low food diversity, as did the low dietary diversity score (2.82 ± 0.99) using 0 to 6 food groups.

Conclusions

Limited food access and food variety in poor households resulted in inadequate nutrient intakes (low nutrient adequacy ratios), confirmed by poor dietary diversity (food variety score and food group diversity score). Dietary diversity assessment can successfully replace traditional dietary assessment tools in poverty-stricken or low-income communities where quick assessments are often required to assess the greatest need.     

Dietary Diversity within Food Groups: An Indicator of Specific Nutrient Adequacy in Tehranian Women

Objective: To determine the relationship between dietary diversity within food groups and dietary diversity score and the probability of nutrient adequacy in Tehranian women.

Design: Cross-sectional study assessing food intake by two 24-hour recalls questionnaires on two different occasions. Dietary diversity was defined according to diet quality index revised. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes.

Setting: District 13 of Tehran, Iran.

Subjects: 286 females aged 18–80 years.

Results: Whole grain diversity score mostly correlated with protein and vitamin B₂ (r = 0.35, p < 0.05). Fruit diversity score was correlated with vitamin C (r = 0.44, p < 0.05). Dairy diversity score was correlated with calcium intake (r = 0.54, p < 0.05). Meat diversity score was correlated with protein intake (r = 0.34, p < 0.05). Most subjects failed to meet vitamin B₆, zinc, magnesium, calcium, copper, and vitamin B₁₂ adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, BMI, education level and job status (model R² = 0.53). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R² = 0.59). Adding the dietary diversity score improved the model fit significantly (model R² = 0.64). Dairy diversity score had the strongest association with improved nutrient adequacy.

Conclusion: Dietary diversity score is a useful indicator of specific nutrient adequacy in Tehranian women. However, to determine the adequacy of a specific nutrient, the diversity scores of specific food groups might be taken into account.     

Which dietary diversity indicator is best to assess micronutrient adequacy in children 1 to 9 y?

ObjectivesThe aim of this study was to determine the best dietary diversity indicator to measure dietary diversity and micronutrient adequacy in children.MethodsA national representative cross-sectional survey of children ages 1 to 9 y (N = 2,200) was undertaken in all ethnic groups in South Africa. A 24-h recall was done with the mother or caregiver of each child. A dietary diversity score (DDS), the number of food groups consumed at least once in a period of 24 h, was calculated for each child in accordance with 6-, 9-, 13-, and 21-food group (G) indicators and compared with a mean adequacy ratio (MAR). The nutrient adequacy ratio (NAR) was calculated for 11 micronutrients by comparing the distributions of estimated intakes with the Estimated Average Requirements for that micronutrient. The MAR was the average of all NARs. Correlations were done between MAR and DDS and sensitivity and specificity calculated for each group indicator.ResultsPearson’s correlations between food group indicators and MAR indicate that r values were all highly significant (P < 0.0001). There were no consistent or large differences found between the different group indicators although G13 and G21 appeared to be marginally better. Sensitivity and specificity values in the current study lay between DDS of 3 and 5, suggesting one of these as the best indication of (low) micronutrient adequacy.ConclusionsOverall results seem to indicate that any of the four G indicators can be used in dietary assessment studies on children, with G13 and G21 being marginally better. A cut-off DDS of 4 and 5, respectively, appear best.     

Dietary diversity score in adolescents - a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study

The purpose of this study was to determine dietary diversity and its relation to dietary adequacy in 10-18 year-old adolescents of district 13 of Tehran during the period 1999-2001. After excluding for over and under reporters, dietary intake assessment was conducted on 304, 10-18 year old individuals, participants of Tehran Lipid and Glucose Study. A dietary diversity score was calculated as part of the pyramid serving database that is categorized into 23 broad food groups. Each of the 5 broad food categories received a maximum diversity score of 2 of the 10 possible score points. To be counted as a "consumer " for any of the food groups categories, a respondent needed to consume one-half serving, as defined by Food Guide Pyramid quantity criteria, at any time during a 2-day survey period. The nutrient adequacy ratio for a given nutrient is the ratio of a subject's intake to the current recommended allowance for the subject's sex and age category. Weight and height were measured and BMI was calculated. Student's t-test was used to compare the means. Those variables which had normal distribution were tested by Pearson correlation coefficient and the others were tested by the Spearman correlation coefficient. Mean +/-SD of dietary diversity score (DDS) was 6.25 +/- 1.08 (range 0-10). The maximum and minimum scores of dietary diversity were related to the fruit (1.46+/-0.61) and bread-grain (0.95+/-0.27) groups, respectively. Significant positive correlation was observed between DDS and the mean adequacy ratio (MAR) (r =0.42, P <0.001). Fifty percent of people had DDS >or = 6. In people with a DDS of six or over, BMI was higher (19.81 +/- 4.08vs18.95+/- 3.30 Kg/m(2), P<0.01) than others. There was a significant and positive correlation between DDS and most of the nutrient adequacy ratios (NARs). It is concluded that DDS is an appropriate method to evaluate nutrient intake adequacy in this group of adolescents.     

学龄期儿童膳食多样化与微量营养素摄入量的关联性分析

目的 探究学龄期儿童膳食多样化与微量营养素摄入量的关系,为指导儿童科学饮食促进儿童健康提供科学依据。方法 课题组于2009年在江苏省射阳县建立关于儿童生长发育研究的出生队列,选取随访的442名6~7岁儿童作为研究对象。采用24 h膳食回顾调查评估儿童膳食状况,根据《中国食物成分表》估算微量营养素的摄入量并计算儿童膳食多样化评分(DDS和DDS₁₀)和食物多样性评分(FVS);同时评估儿童体格发育指标,应用多变量回归模型分析膳食多样化和微量营养素摄入量与儿童肥胖的关系。结果 研究地区儿童膳食微量营养素摄入量低于该年龄组的中国居民膳食营养素参考摄入量。三种儿童膳食多样化评分均值低于国内其他研究(DDS:6.69±1.59; DDS₁₀:4.94±1.51;FVS:16.79±7.53)。儿童膳食多样化评分与大部分微量营养素摄入状况均呈显著性正相关 (DDS:β=0.14~1.28; DDS₁₀:β=0.17~1.58 ; FVS:β=0.04~0.25,P<0.05),但膳食多样化评分与儿童肥胖无显著相关性(P>0.05)。结论 膳食多样化评分能从一定程度反映儿童微量营养素摄入的状况。倡导饮食多样化的膳食模式对促进儿童健康成长具有重要意义。     

Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys

Simple indicators reflecting diet quality for young children are needed both for programs and in some research contexts. Measures of dietary diversity are relatively simple and were shown to be associated with nutrient adequacy and nutritional status. However, dietary diversity also tends to increase with income and wealth; thus, the association between dietary diversity and child nutrition may be confounded by socioeconomic factors. We used data from 11 recent Demographic and Health Surveys (DHS) to examine the association between dietary diversity and height-for-age Z-scores (HAZ) for children 6-23 mo old, while controlling for household wealth/welfare and several other potentially confounding factors. Bivariate associations between dietary diversity and HAZ were observed in 9 of the 11 countries. Dietary diversity remained significant as a main effect in 7 countries in multivariate models, and interacted significantly with other factors (e.g., child age, breast-feeding status, urban/rural location) in 3 of the 4 remaining countries. Thus, dietary diversity was significantly associated with HAZ, either as a main effect or in an interaction, in all but one of the countries analyzed. These findings suggest that there is an association between child dietary diversity and nutritional status that is independent of socioeconomic factors, and that dietary diversity may indeed reflect diet quality. Before dietary diversity can be recommended for widespread use as an indicator of diet quality, additional research is required to confirm and clarify relations between various dietary diversity indicators and nutrient intake, adequacy, and density, for children with differing dietary patterns.     

农村留守儿童膳食多样化评价及其影响因素分析

  目的  评价学龄期留守儿童的膳食多样化得分及其影响因素,为指导留守儿童合理膳食提供参考依据。  方法  2019年8月对2009年在江苏射阳建立的儿童出生队列中501名9~10岁儿童进行调查,问卷询问儿童留守情况与其他基本信息,24 h膳食回顾法收集膳食资料。根据联合国粮食与农业组织(Food and Agriculture Organization, FAO)的标准计算膳食多样化得分(dietary diversity score, DDS₁₀和DDS)和食物多样性得分(food variety score, FVS);测量儿童的体格发育指标并评估肥胖情况,应用多变量回归分析留守情况与膳食多样化得分关系及影响因素。  结果  留守儿童的比例为40.9%,3种膳食多样化得分(DDS₁₀、DDS、FVS)分别为(5.69±1.31)(6.55±1.44)(13.48±4.23)分,均低于非留守儿童(5.99±1.29,6.79±1.40,14.15±4.22)分,留守儿童与非留守儿童的DDS₁₀评分差异有统计学意义(P=0.01)。广义线性模型回归结果显示,性别、被动吸烟、家庭教育水平、家庭年收入、留守情况与膳食多样化得分相关均有统计学意义(P值均 < 0.05)。  结论  留守儿童的膳食多样化程度较低,膳食多样化与儿童性别、被动吸烟、家庭教育水平和家庭年收入等有关。应注重留守儿童膳食多样化,改善儿童饮食。     

Use of variety/diversity scores for diet quality measurement: relation with nutritional status of women in a rural area in Burkina Faso

OBJECTIVES: To develop scores for food variety and diversity to assess the overall dietary quality in an African rural area; and to study their relationship with the nutritional status of women of childbearing age. DESIGN: Cross-sectional. SETTING: Sahelian rural area in the North-East Burkina Faso (West Africa). SUBJECTS: A total of 691 mothers with children below the age of 5 y, selected at random in 30 villages. METHODS: A qualitative recall of women's food consumption during the previous 24 h made it possible to calculate a food variety score (FVS = count of food items consumed) and a dietary diversity score (DDS = count of food groups, among 14 groups). These scores were then divided into terciles. Body mass index (BMI), mid-upper arm circumference (MUAC) and body fat percentage (BFP) were used to determine the women's nutritional status. RESULTS: The overall dietary quality was poor: mean FVS (s.d.) = 8.3 (2.9) food items; mean DDS = 5.1 (1.7) food groups. A clear relationship was shown between both FVS and DDS (in terciles) and most nutritional indices. Women with a FVS in the lowest tercile had a mean BMI of 20.1, while those in the highest tercile had a BMI of 20.9 (P = 0.009). Those in the lowest tercile of DDS had a 22.8% prevalence of underweight vs 9.8% in the highest tercile (P < 0.0001). The latter relationship remained significant even when the subjects' sociodemographic and economic characteristics were accounted for. CONCLUSION: Dietary scores measured at the individual level are good proxies for overall dietary quality of women living in a poor rural African area. These scores were also shown to be linked with the nutritional status of women. FINANCING: IRD financed the study with the assistance of UNICEF for the purchase of anthropometric equipment. The first author received a research allowance from the French Ministry of Research through the doctoral school 393 of Pierre and Marie Curie University (Paris VI).     

Zinc status and dietary quality of type 2 diabetic patients: implication of physical activity level

The purpose of this study was to analyze the relationships among zinc status, diet quality, glycemic control and self-rated physical activity level of type 2 diabetic patients. Dietary intakes for two non-consecutive days were measured by 24-hour recall method for seventy-six diabetic patients. Fasting blood glucose and HbA1c were measured for the assessment of glycemic control. We evaluated the extent of dietary adequacy by the percentage of subjects with a dietary intake of a nutrient less than the estimated average requirement(EAR), the dietary diversity score(DDS) and the dietary variety score(DVS). Zinc status was assessed from serum levels and urinary excretion. Dietary inadequacy was serious for five nutrients: riboflavin, calcium, thiamin, zinc and vitamin C. Dietary intakes from the meat, fish, and egg food groups and the milk food group were below the recommended level. We found that subjects with high levels of physical activities had significantly higher DVS and serum zinc levels compared to others (p<0.05). Fasting blood glucose levels and HbA1c were not significantly different across self-reported physical activity levels. Therefore, we suggest that maintaining physical activity at or above a moderate level is beneficial to improving dietary quality and zinc status.     

Evaluation of nutrient intake and diet quality of gastric cancer patients in Korea

This study was conducted to identify dietary factors that may affect the occurrence of gastric cancer in Koreans. Preoperative daily nutrition intake and diet quality of patients diagnosed with gastric cancer were evaluated. Collected data were comparatively analyzed by gender. The results were then used to prepare basic materials to aid in the creation of a desirable postoperative nutrition management program. The subjects of this study were 812 patients (562 men and 250 women) who were diagnosed with gastric cancer and admitted for surgery at Soonchunhyang University Hospital between January 2003 and December 2010. Nutrition intake and diet quality were evaluated by the 24-hr recall method, the nutrient adequacy ratio, mean adequacy ratio (MAR), nutrient density (ND), index of nutritional quality (INQ), dietary variety score (DVS), and dietary diversity score (DDS). The rate of skipping meals and eating fast, alcohol consumption, and smoking were significantly higher in males than those in females. The levels of energy, protein, fat, carbohydrate, phosphorous, sodium, potassium, vitamin B₁, vitamin B₂, niacin, and cholesterol consumption were significantly higher in males than those in females. Intake of fiber, zinc, vitamin A, retinol, carotene, folic acid were significantly higher in females than those in males. MAR in males was significantly higher (0.83) than that in females (0.79). INQ values were higher in females for zinc, vitamin A, vitamin B₂, vitamin B₆, and folic acid than those in males. The average DVS was 17.63 for females and 13.19 for males. The average DDS was 3.68 and the male''s average score was 3.44, whereas the female''s average score was 3.92. In conclusion, males had more dietary habit problems and poor nutritional balance than those of females. Our findings suggest that proper nutritional management and adequate dietary education for the primary prevention of gastric cancer should be emphasized in men.     

Gender and age group differences in nutrition intake and dietary quality of Korean adults eating alone: based on Korean National Health and Nutrition Examination Survey Data, 2013–2016

BACKGROUND/OBJECTIVESThis study investigated gender and age differences in nutrient intake and dietary quality of people eating alone.SUBJECTS/METHODSFrom Korean National Health and Nutrition Examination Survey 2013–2016 data, 2,305 adults aged 20 years and older that ate meals alone were included in this study. Their energy and nutrients intakes, as well as their nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) were analyzed. Food group consumption pattern, dietary variety score (DVS), dietary diversity score (DDS) were also analyzed. All data were compared among gender and age groups.RESULTSMen consumed more energy and nutrients than women, except for vitamin C, and the NARs showed similar gender differences. The INQs of 4 nutrients (calcium, vitamin A, vitamin C, and riboflavin) were lower than 1.0 in men, whereas only the calcium INQ was lower than 1.0 in women. Men had a lower DDS (3.6) than women (3.9) (P < 0.001) and had more ‘undesirable’ food group consumption patterns than women (P < 0.001). The intakes of calcium, vitamin A, and vitamin C were relatively low in the young-aged group (INQs less than 1.0). In the old-aged group, the MAR level was relatively low, and the INQs of calcium, riboflavin, and niacin were below 1.0. The old-aged group consumed more menu items, but their DVS was the lowest.CONCLUSIONSCompared to women, the dietary quality and food diversity among men were poorer. There were poorer quality and diversity patterns in the young-aged group compared to those of the older groups. An overall low intake of nutrients and the low nutrient density of meals were the main dietary problems among the old-aged group who eat alone. Therefore, men, particularly young- and old-aged, need to be prioritized in nutritional policies directed toward those who eat alone.     

Food variety and dietary diversity as indicators of the dietary adequacy and health status of an elderly population in Sharpeville, South Africa

This cross-sectional, analytical study was a comprehensive health assessment focusing on dietary quality of 170 randomly selected elderly respondents in Sharpeville, South Africa. The methods included a sociodemographic, health food frequency questionnaire, 24h-recall questionnaires, and anthropometric and biochemical measurements. The low mean +/- standard deviation (SD) dietary diversity score (3.41 +/- 1.34) and food variety score (4.77 +/- 2.2) compared with poverty parameters confirmed household food insecurity in this community. Although three (n = 99, 58.6%) or two (n = 49, 28.9%) daily meals were mostly consumed, these were mainly carbohydrate-based and nutrient-deficient. The cereal group (2.01 +/- 0.81) had the highest mean food variety score +/- SD, followed by dairy (0.62 +/- 0.53) and flesh foods (0.40 +/- 0.53). When a mean adequacy ratio of 70% was used as a cut-off point for nutrient adequacy, it was found that the food variety score must be eight or higher and the dietary variety score must be at least six. These indicators thus have a high ability to identify those respondents with an inadequate diet but lower ability to identify those respondents with a nutritionally adequate diet. The data further showed a trend that with a higher food variety and dietary diversity, a better mean adequacy ratio is reached for this low-income group of elderly subjects. In conclusion, the results showed that food variety and dietary diversity scores give a fairly good assessment of the adequacy of the diet, and scoring dietary diversity is a significant, yet simple tool to identify elderly persons at risk of food and nutrition insecurity.     

Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings

Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from large household surveys, to serve as proxy indicators of micronutrient adequacy for population-level assessment. We used 5 existing data sets (from Burkina Faso, Mali, Mozambique, Bangladesh, and the Philippines) with repeat 24-h recalls to construct 8 candidate food group diversity indicators (FGI) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. FGI varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between intakes and requirements across a range of micronutrients in each site. All 8 FGI were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver-operating characteristic analysis showed moderate predictive strength for the best choice indicators, which varied by site. Simple FGI hold promise as proxy indicators of micronutrient adequacy.     

Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results

Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the “Latin American Health and Nutrition Study (ELANS)”, a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.     

Food variety and dietary diversity scores to understand the food-intake pattern among selected Malaysian households

Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0-7 and 0-6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.