Validation of selected 2021 infant and young child feeding indicators for appropriate complementary feeding in relation to dietary adequacy and anthropometric status

@#Introduction: With the new set of 2021 infant and young child feeding (IYCF) indicators released by WHO and UNICEF, there is a need for its validation in the Philippine setting. The study evaluated the validity of cut-off points used for minimum dietary diversity and minimum feeding frequency in terms of micronutrient and energy intake adequacy, respectively, and minimum acceptable diet (MAD) in relation to anthropometric status. Methods: The study covered 8360 infants and young children aged 6-23.9 months with complete information on IYCF, anthropometric measurements, maternal information, and household characteristics from the 2018-2019 Expanded National Nutrition Survey (ENNS). Bivariate and correlation analyses using STATA version 15 (Corp LLC, Texas, USA 2017) were performed to determine the association of specific IYCF indicators: dietary diversity and feeding frequency with nutrient and energy intake adequacy, and MAD with anthropometric status. Sensitivity and specificity analyses were performed to evaluate the accuracy of dietary diversity score (DDS) and feeding frequency in identifying children with adequate nutrient and energy intakes, respectively. Results: Significant associations were found between DDS and micronutrient adequacy, and between feeding frequency and energy intake adequacy, regardless of breastfeeding status. A DDS of 5 and 6 and feeding frequency of 4-5 and 8 maximised sensitivity and specificity in identifying breastfed and non-breastfed children meeting 100% nutrient and energy adequacy, respectively. Conclusion: The selected 2021 complementary feeding indicators are practical guidelines to reflect dietary adequacy, but may not capture the entire process related to nutritional outcomes, especially stunting.

Marcadores de consumo alimentar e diversidade alimentar mínima em diferentes métodos de introdução alimentar: um ensaio clínico randomizado / Food consumption markers and minimum dietary diversity in different complementary feeding methods: a randomized clinical trial

Objetivo: Avaliar os marcadores de consumo alimentar e a diversidade alimentar mínima em lactentes de 12 meses de vida expostos a diferentes métodos de introdução alimentar. Métodos: Ensaio clínico randomizado com pares mãe-lactente submetidos à intervenção sobre introdução alimentar em três métodos: Método tradicional (MT), Baby-led Introduction to SolidS (BLISS) e misto (combinação das duas técnicas). Os marcadores de consumo alimentar foram avaliados por questionário online aos 12 meses com base nos alimentos consumidos no dia anterior, utilizando os marcadores de consumo alimentar para menores de 2 anos do Sistema de Vigilância Alimentar e Nutricional. O estudo foi aprovado no comitê de ética. Resultados: Aos 12 meses foram avaliadas 136 crianças: 45 alocadas no MT, 48 no BLISS e 43 no misto. Os alimentos com maior prevalência de consumo foram: leite materno103 (75,7%), frutas, legumes e verduras 122 (89,7%), carnes ou ovos 135 (99,3%), feijão 115 (84,6%), cereais ou tubérculos 135 (99,3%). Alimentos ultraprocessados que estiveram presentes na dieta dos lactentes foram hambúrguer ou salsichas 3 (2,2%), bebidas açucaradas 2 (1,5%), macarrão instantâneo 4 (2,9%) e biscoito recheado 2 (1,5%).Não foram encontradas diferenças entre os métodos de introdução da alimentação complementar. A diversidade alimentar mínima esteve presente na alimentação de 22 lactentes (16,2%), sendo: 6 (13,3%) no MT, 8 (16,7%) no BLISS e 8 (18,6%) no misto (p=0,793). Conclusão: Leite materno,frutas, legumes e verduras, carne, feijão e arroz estiveram presentes na alimentação da maioria dos lactentes; no entanto, a prevalência de diversidade alimentar mínima foi baixa.O consumo de alimentos ultraprocessados também esteve presente na alimentação dos lactentes. Registro Brasileiro de Ensaios Clínicos (ReBEC) identificação RBR-229scm.

Objective: To evaluate food consumption markers and minimum dietary diversity in 12-month-old infants exposed to different methods of food introduction. Methods: A randomized clinical trial with mother-infant pairs undergoing intervention on food introduction in three methods: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), and mixed (combination of the two techniques). Food consumption markers were evaluated by an online questionnaire at 12 months based on food consumed the previous day, using food consumption markers for children under 2 years of the Food and Nutrition Surveillance System. The study was approved by the ethics committee. Results: At 12 months, 136 children were evaluated: 45 allocated to PLW, 48 to BLISS, and 43 to mixed. The foods with the highest prevalence of consumption were breast milk 103 (75.7%), vegetables 122 (89.7%), meat 135 (99.3%), beans 115 (84.6%), rice, potatoes, or yam 135 (99.3%). Ultra-processed foods were present in the diet of infants, including hamburgers or sausages 3 (2.2%), sweetened beverages 2 (1.5%), instant noodles 4 (2.9%), and sandwich cookies 2 (1.5 %). No differences were found between the methods of introducing complementary feeding. The minimum dietary diversity was present in the diet of 22 infants (16.2%), being: 6 (13.3%) in the PLW, 8 (16.7%) in the BLISS, and 8 (18.6%) in the mixed (p=0.793). Conclusion: Breast milk, vegetables, meat, beans, and rice were present in the diet of most infants; however, the prevalence of minimal dietary diversity was low. The consumption of ultra-processed foods was also present in the diet of infants. Brazilian Registry of Clinical Trials (ReBEC) identification RBR-229scm.

Análisis de la diversidad dietética en mujeres embarazadas del sureste de México

Objetivo: Describir la diversidad dietética (DD) de un grupo de mujeres embarazadas del municipio de Mérida, Yucatán. Métodos: Se aplicó un cuestionario socioeconómico y tres recordatorios de 24 horas (R-24) en días no consecutivos a 83 mujeres embarazadas. La DD se evaluó a nivel individual de acuerdo a la puntuación Mínima de Diversidad Dietética para la Mujer (MDD-W). Se consideró una DD alta cuando se consumieron ≥5 grupos de alimentos y DD baja cuando el consumo fue <5. Se analizaron las diferencias en el consumo de los grupos de alimentos de acuerdo al nivel de DD mediante pruebas de Chi2. Resultados: La edad promedio de la muestra fue de 27,6 años (±5,2), con una edad gestacional promedio de 23 semanas (±8,3). La media de la DD fue de 4,9 (±1,5) grupos de alimentos. El 39% de la muestra tuvo una DD baja. Las mujeres con DD baja consumieron en menor frecuencia alimentos cárnicos, huevos, vegetales de hoja verde oscuro, frutas y verduras ricas en vitamina A, otras verduras y otras frutas (P= <0,05). La proporción de mujeres con DD baja fue mayor durante los fines de semana (49% vs 68%, Chi2= 7,89, P= 0,005). Conclusiones: La media de la DD obtenida en esta muestra indica una DD baja. Las mujeres en este estudio presentaron un bajo consumo de alimentos ricos en vitaminas mientras que los alimentos ricos en energía y proteína de origen animal presentan un consumo alto.

Objective: To describe the dietary diversity (DD) in a sample of pregnant women from Merida, Yucatan. Methods: We applied a socioeconomic questionnaire and three 24-h dietary recalls, on non-consecutive days, to 83 pregnant women residing in Merida, Yucatan. DD was assessed according to the Minimum Dietary Diversity score for Women (MDD-W). A high DD was considered when a consumption ≥5 food groups occurred, while a consumption <5 groups was considered as a low DD. We analyze the differences in the consumption of food groups according to the level of DD. Chi square test were applied to assess DD. Results: The mean age of participants was 27.6 years (±5.2) and the average gestational age was 23 weeks (±8.3). The mean DD was 4.9 (±1.5) food groups and 39% of the sample had a low DD. Women with low DD consumed less frequently meat foods, eggs, dark green leafy vegetables, fruits and vegetables rich in vitamin A, other vegetables and other fruits (P<=0.05). Low DD was more frequently registered during weekend days (49% vs 68%, P= 0.005). Conclusions: The sample had low DD. Women who participated in this study had a low consumption of foods rich in micronutrients while foods rich in energy and protein of animal origin had a high consumption.

Effect of Prenatal Dietary Pattern on Maternal Anemia and Low Birth Weight in Rural Areas of Kanpur

Background: In India, the dietary pattern of women from low socioeconomic status are almost same during pre-pregnant, pregnant and lactating periods. Additional foods are required to improve weight gain in pregnancy and birth weight of infants. Aim & Objective: To identify the impact of prenatal dietary pattern on maternal anemia and low birth weight in rural areas of Kanpur Nagar. Methods: This study was a cross sectional study conducted amongst mothers who recently delivered (RDW) in rural blocks of District Kanpur Nagar. Data was collected by interviewing study subjects using a semi-structured interview schedule after applying multistage random sampling technique. Results: Out of 102 women studied, 39.2% women had consumed >90 IFA tablets, 49.1% of mothers had practiced MMF and 47.1% of women practiced MDD during their prenatal period and 40.1% babies of current pregnancy were born as LBW. IFA consumption during pregnancy was significantly associated with maternal anemia. MMF during pregnancy was significantly associated with LBW. Conclusions: In our study it was found that IFA consumption, MMF and MDD during antenatal is a key preventive measure to reduce anemia status in pregnant females and birth weight of baby during prenatal period.

Dietary diversity as a sustainable approach towards micronutrient Deficiencies in India

The silent epidemic of micronutrient deficiencies (MNDs) continues to be a major public health challenge in the developing world, including India. The prevalence of iron, iodine, zinc, vitamin A and folate deficiencies is alarmingly high worldwide. India is additionally facing a high prevalence of vitamin D and B12 deficiencies. To combat the hidden epidemic of MNDs, various governments around the world have mostly relied on supplementation or fortification-based interventions. India launched salt iodization programme in 1962 and vitamin A and iron-folate supplementation programmes in 1970. Yet, even after decades of these programmes, MNDs are still widespread in the country. Due to slow progress in alleviating the burden of most MNDs, the Government of India aims to scale up fortification-based intervention programmes. However, there are safety and effectiveness concerns with such approaches. Hence, overdependence on supplementation and fortification alone may be counterproductive. Instead, food based dietary diversification approach can be the way forward. In this article, we list the common MNDs in India, evaluate major policy interventions, discuss concerns pertaining to fortification and suggest the need for a concurrent food-based approach, in particular dietary diversification, as a long-term and sustainable strategy to address population-based MNDs.

Diversidad alimentaria en habitantes de tres provincias de Perú durante la COVID-19 y factores asociados

RESUMEN Objetivo: Evaluar la diversidad alimentaria entre los habitantes de las provincias de Lima, Arequipa y Sullana de Perú durante el tiempo de aislamiento debido a la COVID-19 y explorar los factores asociados. Métodos: Estudio transversal en el que se aplicó cuestionarios electrónicos a los encuestados entre la última semana de junio y primera semana de julio de 2020. Todas las ciudades se encontraban en cuarentena al momento de realizar el estudio. Evaluamos la diversidad dietética utilizando el Puntaje de Diversidad Dietética del Hogar (HDDS, siglas en inglés). Se recolecto información en un total de 672 hogares, después del control de calidad en gabinete y previo al análisis estadístico se analizaron los datos de 600 hogares: 281 en Lima, 212 en Arequipa y 107 en Sullana; el total de participantes fueron 2.570 residentes de las tres ciudades de Perú. Resultados: El grupo de cereales tuvo el 96,5% de consumo, las misceláneas el 77,7%, los aceites y grasas el 74,7%, y los pescados y mariscos el 52,3%. Tener mayores ingresos económicos se asoció con un HDDS significativamente más alto en comparación con aquellos que tienen menores ingresos (p<0,01). Los habitantes de Sullana tienen el puntaje de diversidad alimentaria más bajo (HDDS= 7,82), seguido por Arequipa (HDDS= 10,19) y Lima (HDDS= 10,93). Conclusiones: Las personas con menor nivel educativo, con menores ingresos económicos y residentes en Sullana tenían un Puntaje de Diversidad Dietética del Hogar más bajo.

ABSTRACT Objective: To evaluate dietary diversity among the inhabitants of the Peruvian provinces of Lima, Arequipa and Sullana during the time of isolation due to COVID-19 and to explore the associated factors. Methods: Cross-sectional study in which electronic questionnaires were applied to respondents between the last week of June and the first week of July 2020. All cities were in quarantine at the time of the study. We assessed dietary diversity using the Household Dietary Diversity Score (HDDS). Information was collected from a total of 672 households, after quality control and prior to statistical analysis, data from 600 households were analyzed: 281 from Lima, 212 from Arequipa and 107 from Sullana, representing 2,570 residents of the three Peruvian cities. Results: The group of cereals had 96.5% of consumption, miscellaneous 77.7%, oils and fats 74.7%, and fish and shellfish 52.3%. Having higher economic income was associated with a significantly higher HDDS compared to those with lower income (p<0.01). The inhabitants of Sullana have the lowest dietary diversity score (HDDS= 7.82), followed by Arequipa (HDDS= 10.19) and Lima (HDDS= 10.93). Conclusions: People with a lower educational level, with lower economic income and residents of Sullana had a lower Household Dietary Diversity Score.

Assessment of Infant and Young Child Feeding Practices among Mothers of Paniya Tribal Children Aged 0–23 Months in Gudalur Block, Nilgiris District

Optimal infant and young child feeding practices(IYCFPs), despite being emphasized since 2003, are yet to be met in India. This study assessed these practices and their association with various factors among mothers of children aged 0–23 months in Paniya tribes in Nilgiris, Tamil Nadu. About 89.1% of the infants below six months were timely breastfed and 77.9% of them were exclusively breastfed, respectively. Complementary food was introduced to 25% of infants aged six to eight months. About 27.8% of them received a diverse diet. About 91.7% of them were fed egg and/or flesh food and 37% of them were fed vegetables and fruits. Illiterate mothers and mothers who had a vaginal delivery fed the infant optimally. The adherence to these practices was found to decrease gradually with an increase in the infant’s age. The prevalence of IYCFP is higher in the study population compared to the corresponding indicators for the district according to the National Family Health Survey‑5.

Association of household food security and dietary diversity of mother-child pairs in the Philippines

@#Introduction: The majority of Filipino households experience food insecurity. Mothers and children are among the population groups suffering from poor diet quality. This study aimed to determine the extent of the association of household food security (HFS) to mothers’ and children’s dietary diversity score (DDS), and to identify the significant factors associated with meeting the DDS of these vulnerable groups. Methods: The study was a cross-sectional, population-based study utilising secondary data from the 2015 Updating Survey. From a total of 6,692 mother-child pairs, the association between HFS and meeting the DDS of mothers and children, as well as the potential predictors for meeting the DDS were tested using descriptive and logistic regression analyses. Results: The findings showed that HFS was significantly associated with meeting the DDS of mothers and children aged 6-36 months (p<0.001). The proportion of meeting the DDS among mothers and children was significantly higher in food-secure than in food-insecure households (20.7% vs. 14.4%). Furthermore, meeting the DDS decreased with increasing levels of food insecurity. Household food security status, education background, employment, child’s age, and wealth status were significantly associated with meeting the DDS. Conclusion: This study showed the extent of how food security was associated with meeting the DDS of mothers, children, and mother-child pairs, and the factors associated with meeting the DDS. Results can be used to strengthen the formulation of appropriate, evidence-based policies to address household food insecurity and low DDS among mothers and young children.

Association of Dietary Diversity with Growth and Development of Children in Multi-ethnic Rural Areas of Sichuan Province / 中国医学科学院学报

Objective To understand the growth and dietary diversity status of children in multi-ethnic areas of Sichuan province,and to explore the associations of dietary diversity with growth and development indicators. Methods Children of 18-36 months old and their primary caregivers were selected with multi-stage cluster random sampling method from rural areas of Han,Tibetan,and Yi ethnic groups in Sichuan province. The sociodemographic information of children and their caregivers was collected using self-designed questionnaire.The dietary diversity score(DDS)was calculated according to the criteria in the Guidelines for Measuring Household and Individual Dietary Diversity released by the Food and Agriculture Organization of the United Nations.The body height(length)and body weight of each child were measured by standard equipment for anthropological measurement,and the height for age Z score(HAZ),weight for age Z score(WAZ),and weight for height Z score(WHZ) were calculated.Multivariate linear regression was performed to analyze the relationship between dietary diversity and growth indicators of children. Results A total of 1092 children were enrolled in this study,and the prevalence of stunting(HAZ<-2),underweight(WAZ<-2),and wasting(WHZ<-2)was 21.1%,4.9%,and 2.5%,respectively.The children had the mean DDS of 4.8±1.7,and 45.3% of children had poor dietary diversity(DDS≤4).The children of Han ethnic group(5.8±1.4)had higher DDS than those of Tibetan ethnic group(4.9±1.6)and Yi ethnic group(3.9±1.6)(P<0.001).The results of multivariate linear regression indicated that DDS was positively correlated with HAZ(β=0.206,95%CI=0.158-0.254,P<0.001)after adjustment of sex,age,birth weight,preterm birth,and parental body height.After further adjustment of family fixed assets,ethnic group,caregiver's type,and caregiver's education background,the correlation between DDS and HAZ remained significant(β=0.077,95%CI=0.026-0.128, P=0.003). Conclusions The children in the multi-ethnic rural areas of Sichuan province showed troublesome growth and development status and low dietary diversity,which were conspicuously different between ethnic groups,especially in the rural areas of Yi ethnic group.The dietary diversity was positively associated with HAZ.It is recommended to carry out nutrition and health education according to the local dietary characteristics and thus improve the growth and development of children in multi-ethnic rural areas in Sichuan.

Association between dietary pattern and cognitive function of elderly in Tianjin / 上海预防医学

ObjectiveTo determine the association of dietary diversity and dietary pattern with cognitive function in elderly in community. MethodsA cross-sectional study was conducted to randomly select 143 elderly people over 65 years old in Wangdingdi Community of Tianjin. Self-designed questionnaire was used and then dietary diversity index was calculated. Wechsler Adult Intelligence Scale-Chinese Revised （WAIS-RC） was used to measure intelligence quotient （IQ） to assess cognitive function. Factor analysis and multivariate linear regression model were used to extract dietary patterns and determine the association of dietary diversity index and dietary patterns with cognitive function， respectively. ResultsFactor analysis revealed four dietary patterns， which were meat and cereal dietary pattern， fish and poultry milk dietary pattern， bean vegetable dietary pattern， and egg dietary pattern. Multivariate linear regression showed that egg dietary pattern was significantly associated with performance IQ （P<0.05）， suggesting that egg dietary pattern may have a protective effect on IQ of the elderly. There was no significant association between dietary diversity and cognitive function in the elderly （P>0.05）. ConclusionEgg dietary pattern may protect cognitive function in the elderly. Therefore， the elderly should increase the intake of eggs in daily diet.

Environmental enteric dysfunction, soil transmitted helminthiasis and stunting among 36- to 59-month-old children in Quezon Province, Philippines

@#Introduction: Environmental enteric dysfunction (EED) is relevant in public health as it is a potential cause of child stunting. In the Philippines, stunting affects 33.4% of children in 2015. As of date, no local studies on EED exist. This study primarily aimed to determine the prevalence of EED, soil transmitted helminthiasis (STH) and stunting; and their relationships. Methods: A cross-sectional study was conducted among 120 children aged 36-59 months old in Quezon Province, Philippines. EED was assessed via glucose hydrogen breath test with a cut-off of >20 ppm over baseline by 90 minutes suggestive of small intestinal bacterial overgrowth (SIBO), a biomarker of EED. Kato Katz Technique was used to determine STH. Stunting was determined using the 2006 World Health Organization Child Growth Standards. Descriptive and correlation analyses of data were done at 10% level of significance. The study received approval from the National Ethics Committee of PCHRD-DOST, Philippines. Results: Data on expired hydrogen level of <20ppm were documented. The prevalence of STH among children were 38.1% for Ascaris lumbricodes, 15.3% for Trichuris trichiura, and 1.7% for hookworm infections. A high rate of stunting at 40.0% was observed. There was a significant positive association between stunting and the presence of Ascaris (p=0.01). Conclusion: There was no case of EED detected in the study. The severity of stunting was high at 40.0%. Among the STH, the prevalence of 38.1% children having Ascaris lumbricodes was alarming in terms of morbidity control. Nutrition interventions including WASH practices and the use of anthelminthic drugs need to be intensified to address stunting and STH.

Dietary diversity and nutritional status of 2 to 5 years old children in households with and without home gardens in selected districts in Siem Reap province, Cambodia

@#Introduction: There is a high prevalence of malnutrition in Cambodia during the past 10 years. One of the programmes implemented to secure household food security in order to alleviate malnutrition was home gardening. This study aimed to compare the nutritional status of 2 to 5 years old children in households with and without home gardens. Methods: Twenty-five households with home gardens and 60 households without home gardens were sampled. Results: The households sampled had a mixed type of home garden with three to five crop varieties occupying 20 to 200 square meters area. The purpose of the garden was to increase vegetable consumption and produce additional income. Results showed that 72% and 65% of the children resided in households with and without home gardens, respectively. Majority had medium dietary diversity score, i.e. consumed four to five different food groups per day. Except for stunting, higher prevalences of undernutrition (32%) and wasting (8%) were observed among children residing in households with home gardens compared to children in households without home gardens. Conclusion: There were no associations for dietary diversity score and nutritional status of children from households with and without home gardens. Among the sociodemographic and economic factors, age, sex, family size, and vegetable consumption were significantly associated with dietary diversity score and nutritional status of the children.

Dietary diversity score and its association with anemia status among selected nonpregnant women in Pasay City, Philippines

Background and Objective@#Iron deficiency anemia, the most common type of anemia, is a disease of public health significance that leads to negative economic and health implications. Dietary diversity is one of the recommended strategies in combating micronutrient deficiency such as anemia and may be measured through Dietary Diversity Score (DDS). The study aimed to determine whether DDS is associated with anemia status among nonpregnant women of reproductive age (WRA) in Pasay City, Philippines. Specifically, the study aimed to determine the: (1) prevalence of anemia, (2) mean DDS, and (3) association between DDS and anemia status among the study population. @*Methodology@#The study was analytic and cross-sectional that included 121 nonpregnant WRA who were selected using stratified random sampling with proportional allocation. Data collection methods included anthropometric assessment, hemoglobin determination, and 24-hour food recall as basis for calculating the dietary diversity score. @*Results and Conclusion@#Results of the study found that the prevalence of anemia was 21.49% and mean DDS was 4.46 (between low and moderate DDS). A statistical association was found between DDS and anemia status (p<0.001) such that the odds of having anemia was 25.47 times higher among women with low DDS compared to women with moderate/high DDS. Therefore, nutrition education and promotion awareness is needed on dietary diversity to prevent anemia among women of reproductive age.

Rural and Urban Differences in Household Food Insecurity and Diet Diversity of Preschool Children (PSC) in Occidental Mindoro

@#Objective. Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a great impact on household food security and dietary diversity. The relationship between the human environment and other factors threatens different domains of food systems resulting in food security. The objective of this study is to determine significant differences between the prevalence of household food security and diet diversity between urban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake of preschool children between rural and urban communities Methods. This study utilized a comparative, cross-sectional, analytic study design in order to determine the prevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the food security status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversity of diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participate in this study. Ratio and proportion using the point and interval estimate were used to determine the prevalence in different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the two areas under study. Results. Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while the prevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant difference in the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile, the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97% to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant difference in prevalence of low dietary diversity score among preschool children between rural and urban communities (p=0.0107). Conclusion. There were significant differences in terms of household food insecurity and less diverse diet between two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize these vulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fish was observed in the diet of preschool children for both communities however, higher prevalence of less dietary diversity was detected among rural communities.

Rural and Urban Differences in Household Food Insecurity and Diet Diversity of Preschool Children (PSC) in Occidental Mindoro

Objective@#Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a great impact on household food security and dietary diversity. The relationship between the human environment and other factors threatens different domains of food systems resulting in food security. The objective of this study is to determine significant differences between the prevalence of household food security and diet diversity between urban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake of preschool children between rural and urban communities @*Methods@#This study utilized a comparative, cross-sectional, analytic study design in order to determine the prevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the food security status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversity of diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participate in this study. Ratio and proportion using the point and interval estimate were used to determine the prevalence in different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the two areas under study. @* Results@#Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while the prevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant difference in the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile, the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97% to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant difference in prevalence of low dietary diversity score among preschool children between rural and urban communities (p=0.0107). @*Conclusion@#There were significant differences in terms of household food insecurity and less diverse diet between two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize these vulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fish was observed in the diet of preschool children for both communities however, higher prevalence of less dietary diversity was detected among rural communities.

Dietary diversity, vitamin D intake and childhood stunting: a case-control study in Bantul, Indonesia

@#Introduction: Stunting is known to be a major public health problem among Indonesian children. We aimed to examine the association between dietary diversity and vitamin D intake with stunting in children aged 6-23 months. Methods: This case-control study was conducted in Bantul District, Yogyakarta Special Region, Indonesia. A total of 79 subjects aged 6-23 months were selected for each case and control group based on their stunting status. We assessed potential explanatory variables at the child, parental, household, and community levels. Results: Factors which were significantly associated with stunting included young children aged 1823 months (adjusted OR = 3.84; 95% CI: 1.17-12.26), birth length ≥48 cm (adjusted OR = 0.36; 95% CI: 0.16-0.83), inadequate intake of vitamin D (adjusted OR = 5.18; 95% CI: 1.03-26.02), and diversified diet (adjusted OR = 0.17; 95% CI: 0.03-0.92). Other variables such as household economic status, living residency, history of exclusive breastfeeding, and infectious diseases, as well as intakes of energy and protein were not significantly related to stunting. Conclusion: Minimum dietary diversity, vitamin D intake from complementary foods, and birth length were associated with stunting status among children. Therefore, it is crucial to focus on stunting prevention programmes in the first two years of life, or even since the preconception period.

Identification of dietary diversity associated with stunting in Indonesia

@#Introduction: Stunting has become one of the world’s most discussed health topics. Dietary diversity takes on an important role in increasing the nutrition fulfilment of young children aged 6–59 months for their optimal growth. This study aims to understand the association between dietary diversity and stunting in children aged 6–59 months old in Babakan Madang subdistrict, Bogor district of West Java, Indonesia. Methods: This study used a cross-sectional design and was conducted in May 2019 in Babakan Madang subdistrict. The subjects chosen for this study were 200 children aged 6–59 months, and they were selected using the probabilityproportional-to-size sampling technique. Individual dietary diversity was assessed by minimum dietary diversity with the consumption of four or more food groups out of the total seven groups. Data were analysed using descriptive statistics and chi-square test. Results: Poor dietary diversity was significantly related with stunting (p=0.023; OR=2.182; 95% CI: 1.152–4.134). In addition, age <2 years was a significant protective factor against stunting (p=0.011; OR=0.445; 95% CI: 0.246– 0.806). Conclusion: The risk of stunting in children can be reduced by providing a variety of foods in their diets, which includes at least four food groups a day. There is a need to increase awareness among the population about appropriate nutrition through dietary education.

Maternal Anthropometry and Dietary Diversity Associated with Birth Weight in Maternity Hospitals in Abidjan (Côte d’Ivoire)

Aims: Birth weight is a powerful predictor of infant growth and survival and depends on the fetal growth environment, which is influenced by maternal nutritional status. However, the association between maternal anthropometric and nutritional factors and birth weight is not well characterized in Côte d'Ivoire. The objective of this study was to determine the maternal anthropometric and nutritional characteristics associated with birth weight. Study Design: This was a retrospective study. Place and Duration of Study: This study was done in maternity hospitals of three municipalities in Abidjan, Côte d'Ivoire, from 1st October to 30 November 2018. Methodology: It consisted in collecting birth data from 146 newborns born from a monofetal pregnancy, whose mothers aged 20 to 42 had participated in a previous survey. Also, the relationship between birth weight, maternal anthropometry and maternal nutrition factors has been studied. Univariate, bivariate and multivariate data analysis was done using SPSS version 25 software. Results: The results indicate mean birth weight of 3118.48±515.39 g and 7.6% and 5.5% respectively of low and excessive birth weight. In a multivariate linear regression, the mean birth weight of newborns of women with medium and high dietary diversity score was higher than those newborn of women with low dietary diversity score (AOR=0.386, 95% confidence interval (CI): 0.072-0.699; p=0.017 and AOR=0.233, 95% CI: 0.016-0.450; p=0.036). Similarly, women with gestational weight gain greater than 7 kg and high stature (>1.55 cm) gave birth to heavier children (AOR=0.551, 95% CI: 0.346-0.756; p=0.000 and AOR=0.633, 95% CI: 0.207-1.059; p=0.004, respectively). Conclusion: Although it revealed the presence of low and excess birth weight, this study has shown that maternal anthropometry and dietary diversity score were associated with birth weight of the baby.

Are household food security, nutrient adequacy, and childhood nutrition clustered together? A cross-sectional study in Bankura, West Bengal

Background: Research on different measures of food security and their interrelation in order to identify vulnerable households are scarce in India. Objectives: The objective was to assess household food security (HHFS), nutrient adequacy, dietary diversity, and nutritional status of under-five children along with their interrelation in the slums of Bankura Municipality, West Bengal. Methods: A cross-sectional study was conducted during 2016–2017 among 240 households using two-stage 30-cluster random sampling. Information regarding socioeconomic characteristics, availability, and utilization of different poverty alleviation schemes was collected. HHFS was assessed by a validated HHFS scale-short form in Bengali and nutrient adequacy with 24-h recall method. The eldest under-five child in the family was measured for anthropometry using standard procedure and for dietary diversity with the Individual Dietary Diversity Score. Results: Overall, 74 (29.1%) households had “food security,” whereas 102 (44.3%) and 64 (26.6%) had, respectively, low and very low food security. Among 190 under-five children, 63 (35.3%) had single and 50 (25.5%) had multiple anthropometric failures. Overall, 89 (36.1%) households were deficient for both energy and protein and 111 (47.6%) had deficiency of either of these two. Indicators on the utilization of different poverty alleviation schemes were associated with low/very low food security. A “Composite Index of Food Scarcity” comprising of HHFS, nutrient adequacy, and dietary diversity was proposed which was found to have dose–response relationship with grades of anthropometric failure of under-five children. Conclusions: An index comprising of three indicators might help identify the vulnerable households in relation to food security more effectively than a single indicator.

Dietary diversity among women of reproductive age (15-49 years): implication for folate deficiency in Mbarara district, Uganda

Background: Understanding dietary diversity of women of reproductive age (WRA) is vital for better nutritional interventions of their health and that of unborn. Most diets consumed are macronutrient dense which leads to micronutrient deficiencies like neural tube defects (NTDs).Thirty three babies were born with NTDs at Mbarara Regional Referral Hospital during 2016 and 2017 for reasons among which is folate deficiency. Folate can be derived cheaply from green vegetable consumption before antenatal visits. The study’s objective was to assess dietary diversity of WRA (15-49 years) living within Mbarara district.Methods: A cross sectional study was conducted for three months using a translated dietary diversity questionnaire from Food and Agricultural Organisation. Applying a 24 h recall method at various intervals of feeding, 402 WRA living within three constituencies of Mbarara district were randomly selected to participate.Results: 70.1% of WRA attained high Individual dietary diversity score (IDDS) of (≥6). 45.1% consumed folate rich plant and animal sources. 4.8%, 8.4%, and 17.6% consumed dark green leafy vegetables, vitamin rich fruits and animal sources respectively. Education, constituency of residence and occupation had a significant association with IDDS of P≤0.05 (0.000, 0.004, 0.030) respectively. WRA who scored IDDS≥6, 58.2% attained at least secondary education, 51.1% lived in urban constituency and 47.5% were working. 30% consumed starchy staple groups, though at 15.8% legumes, nuts and seeds group was most consumed.Conclusions: Low intake of folate rich sources was noted, though many WRA consumed diverse diets therefore, education and employment are suitable interventions