Scientific Publication

Defining a dichotomous indicator for population-level assessment of dietary diversity among pregnant adolescent girls and women: A secondary analysis of quantitative 24-h recalls from rural settings in Bangladesh, Burkina Faso, India, and Nepal

author(s) Verger, Eric O - Eymard-Duvernay, Sabrina - Bahya-Batinda, Dang - Hanley-Cook, Giles T - Argaw, Alemayehu - Becquey, Elodie - Diop, Loty - Gelli, Aulo - Harris-Fry, Helen - Kachwaha, Shivani - Kim, Sunny S - Nguyen, Phuong Hong - Saville, Naomi M - Tran, Lan Mai - Zagré, Rock R - Landais, Edwige - Savy, Mathilde - Martin-Prevel, Yves - Lachat, Carl
from International Food Policy Research Institute (IFPRI)
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themes
regions
  • Southern Asia
  • Asia
  • World
  • Western Africa
  • Sub-Saharan Africa
  • Africa
citation

Verger, Eric O et al., 'Defining a dichotomous indicator for population-level assessment of dietary diversity among pregnant adolescent girls and women: A secondary analysis of quantitative 24-h recalls from rural settings in Bangladesh, Burkina Faso, India, and Nepal', Current Developments in Nutrition, vol. 8(1):102053, p. 102053, Elsevier BV, 2024

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Abstract

Background The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements. Objective This study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15–49 y in LMICs. Methods We used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60. Results In the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%). Conclusions The WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15–49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.

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