Original Article
European Journal of Clinical Nutrition (2009) 63, 199–208; doi:10.1038/sj.ejcn.1602927; published online 31 October 2007
Dietary diversity scores can be improved through the use of portion requirements: an analysis in young Filipino children
Contributors: MCD, LSA, BMP conceived the study. MCD, LSA planned the analysis. MCD carried out analysis and drafted the article. MCD, BMP, LSA, participated in critical revision of the article. YKT assisted with technical aspects and quality checks on the analysis.
M C Daniels1, L S Adair1,2, B M Popkin1,2 and Y K Truong3
- 1Department of Nutrition, University of North Carolina at Chapel Hill, NC, USA
- 2Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA
- 3Department of Biostatistics, University of North Carolina at Chapel Hill, NC, USA
Correspondence: Dr MC Daniels, Department of Nutrition, University of North Carolina at Chapel Hill, University Square CB#8120, 123 West Franklin Street, Chapel Hill, NC 27516, USA. E-mail: mchris@email.unc.edu
Received 3 July 2006; Revised 21 August 2007; Accepted 28 August 2007; Published online 31 October 2007.
Abstract
Objectives:
Early childhood malnutrition is a pressing international concern which dietary diversity scores (summary scores of food groups in the diet) may be helpful in addressing. We explored three current research needs surrounding diversity scores: the impact of portion size on score function, the relationship of scores to nutrient adequacy and density and the ability of scores to function as screening tools.
Subjects/Methods:
1810 children, age 24 months. Cross sectional study of a birth cohort.
Results:
We evaluated two nine food group dietary diversity scores based on 0 and 10 g minimum food group requirements for their relationship to nutrient adequacy and nutrient density. Both scores were significantly correlated with nutrient adequacy and density and predicted statistically significant increases (P<0.05) in the probability of adequacy for all nutrients. However, correlations and predicted increases were somewhat larger for the 10 g score. We also considered the sensitivity and specificity of each score for detecting low and high nutrient adequacy in the population. The 10 g cutoff improved score ability to predict low nutrient adequacy, and reduced the misclassification of subjects for all comparisons.
Conclusions:
This research suggests that the score without portion requirements reflects dietary adequacy, but when feasible, further refinement of diversity scores is desirable through the application of minimum portion requirements.
Keywords:
dietary quality, nutrient adequacy, nutrient density, dietary diversity, Philippines, complementary feeding
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