inge d. brouwer, wageningen university "the dietary diversity, agriculture and nutrition...
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Science Forum 2013 (www.scienceforum13.org) Breakout Session 3 - DIET DIVERSIFICATIONTRANSCRIPT
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The dietary diversity, agriculture and nutrition nexus:
what are the gaps in knowledge
CGIAR Science Forum 2013: Breakout session 3: dietary diversification
Inge D. Brouwer, Division of Human Nutrition, Wageningen University
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• Dietary diversity
score is a good
indicator but needs
refinement
• Can local diets fulfill
all nutrient
requirements?
• More information on
alternatives needed
before promoting
them
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Overview Dietary Diversity scores
Individual dietary diversity
Household dietary diversity
Associated with increase in household per capita daily caloric availability from staples and non-staples
- Household dietary diversity score- Food consumption score
Associated with increase in energy intake and probability of adequacy of micronutrients
- Individual Dietary Diversity Score- Minimum Dietary Diversity - Minimum Meal Frequency
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Increasing dietary diversity is associated with
probability of adequacy of 11 micronutrients
0.3
0.35
0.4
0.45
0.5
0.55
0.6
0.65
0.7
3 4 5 6 7 8
food group score
mea
n p
rob
abil
ity
of
adeq
uac
y
FGI-6
FGI-6R
FGI-9
FGI-9R
FGI-13
FGI-13R
FGI-21
FGI-21R
DietaryDiversity Score
Partial correlation DietaryDiversity Score
Partial correlation
Adjusted for total energy intake Adjusted for total energy intake
FGI-6 0.25* FGI-6R 0.48*
FGI-9 0.33* FGI-9R 0.48 *
FGI-13 0.27* FGI-13R 0.38 *
FGI-21 0.32* FGI-21R 0.41 *
Kennedy et al,
2009
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Limitations of dietary diversity scores
� No cut-off point indicating low or high DDS
� Data on study populations generally low in DDS and MPA
� No consensus on number of food groups to be used in calculating DDS
Post-harvest season
Pre-harvest season
MPA 0.39 (± 0.09) 0.09 (± 0.07)
DDS 4.1 (± 1.2) 3.2 (± 1.3)
Partial correlation MPA - DDS
0.36 0.43
Association of dietary diversity and mean
probability of adequacy in women in 2
seasons, Mbooni District, Kenya
Ngala et al, 2013 (unpublished)
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Development of food base dietary guidelines
based on locally available, acceptable and
affordable foods
� Linear programming: way to select food-based
recommendations to determine & to promote optimized diet to
fulfill energy and nutrient intakes based on local food habits
� Identification of problem nutrients
� Optifood
● Local food habits
● Constraints
Foods consumed, portion
sizes, frequency, food
composition values
Energy requirements, RNIs
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Food Based Dietary guidelines for women
in reproductive age, KenyaFood groups # of daily serves/week*
Average(50th)
Optimized diet
Added fats 5 5 + cooking fat (7)
Added sugars 7 7
Dairy products 5 5 + cow milk (7)
Fruits 2 2
Grains & grain products 14 16
Legumes, nuts & seeds 5 5 + beans dry red (5)
Miscellaneous 5 5
Starchy roots & other starchy
plant foods 2 2
Vegetables 14 18 + Sukuma Wiki (7)
Snack 5 7
Starchy Staple 19 23Akter et al, 2013 (unpublished)
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Food Based Dietary guidelines for women
in reproductive age, Kenya
0
10
20
30
40
50
60
70
80
90
100
110
Food
Energy
Protein Fat Calcium Folate Vit A Iron Zinc
Worst-case scenario Best-case scenario
% R
NI
Partial problem nutrientsAbsolute problem nutrients
Akter et al, 2013 (unpublished)
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Can non or under-utilized, wild foods be an
alternative solution?
� Quality of food composition tables
● Varieties/species
● Nutrient values
● Retention during processing
� Bioavailability
0
0,5
1
1,5
2
2,5
3
3,5
4
Beta
caro
tene
(mg/1
00g)
Betacarotene retention during
storage of fresh and cooked
Sukuma Wiki
Raw
sukuma
Wiki
Cooked
sukuma
Wiki
Mueni et al, 2004 (unpublished)
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Can non or under utilized, wild foods be an
alternative solution?
� Quality of food composition tables
● Varieties/species
● Nutrient values
● Retention during processing
� Bioavailability?
� Sufficient availability?
• Children 12-59 months, Kenya• MM=maize porridge, 4.1 mg iron/meal
• MA=maize/amaranth porridge, 23 mg iron/meal
• MM+=maize porridge with MNP, 6.6 mg iron/meal, 2.5 mg as NaFeEDTA
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Discussion points
� Dietary diversity is a good indicator for effect of agriculture interventions on composition of diet and adequacy of intake
● Need for more refinement of dietary diversity scores
� Improvement of diet with locally available foods may not fulfill all nutrient requirements (Fe, Ca, Zn)
� In search for alternatives, there is need for
● Improved food composition tables (varieties, species, retention during processing)
● Information on bioavailability of nutrients
● Agriculture-sensitive nutrition
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Thank you
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