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Article Dans Une Revue Current Developments in Nutrition Année : 2017

Development of a dichotomous indicator for population-level assessment of dietary diversity in women of reproductive age

Doris Wiesmann
  • Fonction : Auteur
Terri J Ballard
  • Fonction : Auteur
Megan Deitchler
  • Fonction : Auteur
Gina Kennedy
  • Fonction : Auteur
Anna Lartey
Warren Tk Lee
  • Fonction : Auteur
Mourad Moursi
  • Fonction : Auteur

Résumé

Background: Dietary diversity is a key element of diet quality, but diets of women of reproductive age (WRA; aged 15–49 y) in resource-poor settings are often deficient in a range of micronutrients. Previous work showed associations between simple food-group diversity indicators (FGIs) and micronutrient adequacy among WRA. For operational and advocacy purposes, however, there is strong demand for a dichotomous indicator reflecting an acceptable level of dietary diversity. Objective: The aim of the study was to develop a dichotomous indicator of dietary diversity in WRA. Methods: We performed a secondary analysis of 9 data sets containing quantitative dietary data from WRA in resource-poor settings (total n = 4166). From the raw dietary data, we calculated an individual “mean probability of adequacy” (MPA) across 11 micronutrients. Several candidate FGIs were constructed. Indicator performance in predicting an MPA >0.60 was assessed within each data set by using receiver-operating characteristic analysis and sensitivity and specificity analysis at various FGI cutoffs. The analysis was performed separately for nonpregnant and nonlactating (NPNL) women and for lactating women. Results: We identified 2 “best candidate” dichotomous indicators on the basis of 9- or 10-point food-group scores (FGI-9 and FGI-10) with a cutoff of ≥5 food groups. Both were significantly correlated to MPA in each site (P < 0.001). Areas under the curve were moderate, ranging from 0.62 to 0.82 among NPNL women and from 0.56 to 0.90 among lactating women. Comparisons of results slightly favored FGI-10 for all women. Conclusions: When resource-intensive dietary methods are not feasible, a simple dichotomous indicator based on a cutoff of ≥5 of 10 defined food groups reflects “minimum dietary diversity for women of reproductive age.” According to the conclusions of a consensus meeting of experts, this indicator is well suited for population-level assessment, advocacy, and possibly also for tracking of change in dietary diversity across time.
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Dates et versions

hal-01913832 , version 1 (06-11-2018)

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Yves Martin-Prevel, Mary Arimond, Pauline Allemand, Doris Wiesmann, Terri J Ballard, et al.. Development of a dichotomous indicator for population-level assessment of dietary diversity in women of reproductive age. Current Developments in Nutrition, 2017, 1 (12), pp.cdn.117.001701. ⟨10.3945/cdn.117.001701⟩. ⟨hal-01913832⟩
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