Dietary diversity is associated with child nutritional status: Evidence from 11 Demographic and Health Surveys
Dietary diversity is associated with child nutritional status: Evidence from 11 Demographic and Health Surveys
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DOI：
10.1093/jn/134.10.2579
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发表时间：
2004-10-01
影响因子：
4.2
通讯作者：
Ruel, MT
中科院分区：
文献类型：
--
作者：
Arimond, M;Ruel, MT
项目和某些研究背景都需要反映幼儿饮食质量的简单指标。膳食多样性的测量相对简单，并且被证明与营养充足性和营养状况相关。然而，饮食多样性也往往随着收入和财富的增加而增加；因此，膳食多样性与儿童营养之间的关联可能会受到社会经济因素的影响。我们使用最近 11 项人口与健康调查 (DHS) 的数据来研究 6-23 个月大儿童的饮食多样性与年龄别身高 Z 分数 (HAZ) 之间的关联，同时控制家庭财富/福利和其他几个潜在的混杂因素。在 11 个国家中的 9 个国家中观察到饮食多样性与 HAZ 之间的双变量关联。在多变量模型中，饮食多样性作为 7 个国家的主要影响仍然显着，并且在其余 4 个国家中的 3 个国家中，饮食多样性与其他因素（例如儿童年龄、母乳喂养状况、城市/农村地点）存在显着相互作用。因此，在所分析的所有国家中，除了一个国家外，饮食多样性与 HAZ 显着相关，无论是作为主要影响还是相互作用。这些发现表明，儿童饮食多样性与营养状况之间存在关联，且独立于社会经济因素，并且饮食多样性确实可能反映饮食质量。在膳食多样性被推荐广泛用作膳食质量指标之前，需要进行额外的研究来确认和澄清不同膳食模式儿童的各种膳食多样性指标与营养摄入量、充足性和密度之间的关系。
Simple indicators reflecting diet quality for young children are needed both for programs and in some research contexts. Measures of dietary diversity are relatively simple and were shown to be associated with nutrient adequacy and nutritional status. However, dietary diversity also tends to increase with income and wealth; thus, the association between dietary diversity and child nutrition may be confounded by socioeconomic factors. We used data from 11 recent Demographic and Health Surveys (DHS) to examine the association between dietary diversity and height-for-age Z-scores (HAZ) for children 6-23 mo old, while controlling for household wealth/ welfare and several other potentially confounding factors. Bivariate associations between dietary diversity and HAZ were observed in 9 of the 11 countries. Dietary diversity remained significant as a main effect in 7 countries in multivariate models, and interacted significantly with other factors (e.g., child age, breast-feeding status, urban/ rural location) in 3 of the 4 remaining countries. Thus, dietary diversity was significantly associated with HAZ, either as a main effect or in an interaction, in all but one of the countries analyzed. These findings suggest that there is an association between child dietary diversity and nutritional status that is independent of socioeconomic factors, and that dietary diversity may indeed reflect diet quality. Before dietary diversity can be recommended for widespread use as an indicator of diet quality, additional research is required to confirm and clarify relations between various dietary diversity indicators and nutrient intake, adequacy, and density, for children with differing dietary patterns.