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Nutrition and Health (including climate and ecological aspects)

Minimum dietary diversity in Mexico: establishment of cutoff point to predict micronutrients adequacy

European Journal of Clinical Nutrition volume 76, pages 739–745 (2022)Cite this article

Subjects

Abstract

Objective

To establish the cutoff point for a Minimum Dietary Diversity (MDD) that most accurately predicts the Mean Probability Adequacy (MPA) of 11 micronutrients in the Mexican population, and estimate the population prevalence above it.

Subjects and methods

We analyzed a 24 h-recall collected in a sample of 10,087 participants (≥1-year-old) from the 2012 Mexican National Health and Nutrition Survey. Foods were classified into ten food group indicators (FGIs) of the Food Agriculture Organization (FAO). The cutoff points of MDD were established as follows: (1) sum of the number of FGIs in the participant’s diet; (2) micronutrient intake adequacy estimated by the probability approach method of the FAO; (3) Receiver operating characteristic curves generated by age groups to assess the performance of the number FGIs consumed in predicting the MPA.

Results

The cutoff points of MMD established by age groups were: ≥4 FGIs in preschool-aged children (75.94% of sensitivity and 72.55% of specificity); ≥5 FGIs in school-aged children (60.51% of sensitivity and 72.82% of specificity) and adolescents (70.01% of sensitivity and 59.38% of specificity); and six in adults (62.26% of sensitivity and 70.33% of specificity) and elders (66.67% of sensitivity and 73.33% of specificity). Based on these cutoff points, we observed that 75% of the preschool-aged children, ~60% of school-aged children and adolescents, and less than 40% of adults and elders were above the MDD.

Conclusion

This study provides novel insight into the specific MDD cutoff point to predict micronutrient adequacy in the Mexican population.

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Fig. 1: Receiver operating characteristics curves for cutoff points of Minimum Dietary Diversity as predictors of Mean Probability Adequacy by age group among Mexican population aged ≥1-year-old (ENSANUT 2012).

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Funding

This research was funded by Bloomberg Philanthropies.

Author information

Authors and Affiliations

  1. Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655 Colonia Santa María Ahuacatitlán, Cuernavaca, CP, 62100, Mexico

    Sonia Rodríguez-Ramírez, Tania G. Sánchez-Pimienta & Joaquín A. Marrón-Ponce

  2. CONACYT-Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655 Colonia Santa María Ahuacatitlán, Cuernavaca, CP, 62100, Mexico

    Carolina Batis

  3. University of Antioquia, School of Nutrition and Dietetics, UdeA Calle 70 No. 52-21, Medellín, ANT, Colombia

    Gustavo Cediel

Authors
  1. Sonia Rodríguez-Ramírez
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  3. Carolina Batis
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  4. Gustavo Cediel
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  5. Joaquín A. Marrón-Ponce
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Contributions

CB and GC planned the study. SRR prepared the draft of the manuscript. JAMP conducted the analysis of food and micronutrient intake under the supervision of TGSP and SRR. JAMP had primary responsibility for the final content of the manuscript. All authors participated in the revision and the finalization of the manuscript.

Corresponding author

Correspondence to Joaquín A. Marrón-Ponce.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Informed consent from all adults and parents of participants under 18 years old and informed assent for participants between five and 17 years old was obtained before the information was collected. The ENSANUT 2012 protocol was approved by the INSP Research, Ethics, and Biosafety Committees.

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Rodríguez-Ramírez, S., Sánchez-Pimienta, T.G., Batis, C. et al. Minimum dietary diversity in Mexico: establishment of cutoff point to predict micronutrients adequacy. Eur J Clin Nutr 76, 739–745 (2022). https://doi.org/10.1038/s41430-021-01007-z

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