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

The major cause of the high prevalence of micronutrient deficiencies among women in low and middle income countries, is low intake due to monotonous diets. Due to costly and time consuming food intake assessment methods, there is generally lack of information on women’s diet quality and nutrition.

Resource poor settings need data collection tools which are cheap, simple and easy to use in largely illiterate populations, yet give valid and accurate results. The dietary diversity score being a count of food groups consumed has gained interest as a simple tool that can be used in such settings to collect data in large surveys.
The main objective of this project was to evaluate the dietary diversity score as a simple tool to asses (micro)nutrient adequacy of diets of rural Kenyan women of reproductive age. Food consumption data were collected through repeated 24-hour recalls among women of reproductive age having a child between 2-5 years, living in Eastern Kenya. Data were collected in two seasons. Results indicate that,  in an area with low to moderate seasonality, despite dietary diversity changing with season, it is still a good proxy for nutrient adequacy irrespective of season. The free-listing qualitative 24-hour recall makes a poor indicator of nutrient adequacy, requiring validation for use in large surveys in poor resource settings. Although an informative food based score is a moderate predictor of nutrient adequacy, its advantages  do not out way advantages of food group based scores.  Of the two, the food group based score is therefore preferred.
Our study, to the authors knowledge is the first to evaluate the ability of Minimum Dietary Diversity score for Women, to predict nutrient adequacy. Minimum Dietary Diversity score for Women formed a good indicator for  predicting nutrient adequacy in our study settings. However, Minimum Dietary Diversity score for Women using a cut off of dietary diversity score of ≥5, does not meet the acceptable mean probability of nutrient adequacy of >0.6 in our resource poor population. 

More research: International maternal and child nutrition