Low dietary diversity is a predictor of child stunting in rural Bangladesh

• Published in: European journal of clinical nutrition Vol. 64; no. 12; pp. 1393 - 1398
• Main Authors: Rah, J.H, Akhter, N, Semba, R.D, De Pee, S, Bloem, M.W, Campbell, A.A, Moench-Pfanner, R, Sun, K, Badham, J, Kraemer, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2010; Nature Publishing Group
• Subjects: 692/699/1702/295; 692/699/2743/1530; 692/700/1720; Adequacy; age; Anthropometry; Bangladesh - epidemiology; Biodiversity; Biological and medical sciences; breast feeding; Child development; child nutrition; Child Nutritional Physiological Phenomena; Child, Preschool; Children; Clinical Nutrition; Confidence intervals; Diarrhea; Diet; dietary diversity score; Epidemiology; Feeding. Feeding behavior; Female; Food; Food - economics; Food groups; food intake; Fundamental and applied biological sciences. Psychology; Growth Disorders - epidemiology; growth retardation; human diseases; Humans; Infant; infant nutrition; infants; Internal Medicine; Logistic Models; Low income areas; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Multivariate Analysis; Nutrient deficiency; Nutrient status; Nutrition; nutritional adequacy; Nutritional Status; Odds Ratio; original-article; Poverty; prediction; preschool children; Public Health; Regression analysis; Regression models; Rural areas; Rural Population; socioeconomic status; Socioeconomics; Statistical analysis; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Bangladesh; Asia; under-five; nutritional status; Bangladesh; stunting; complementary food; dietary diversity; Human; Rural environment; Prediction; Metabolic diseases; Growth retardation; Feeding; Diet; Child; Nutritional status; Food
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2010.171

Background/Objectives: Dietary diversity is associated with overall quality and nutrient adequacy of the diet in low-income countries. We determined the association between dietary diversity and stunting among children aged 6–59 months in rural Bangladesh. Subjects/Methods: In total, 165 111 under-fives who participated in the National Surveillance Project in 2003–2005 were included in the analysis. Dietary diversity score (DDS) was constructed through the summation of the number of days each of the nine food groups was consumed in the previous week. The association between stunting and DDS was determined adjusting for confounders using logistic regression models. All analyses were performed separately for children aged 6–11, 12–23 and 24–59 months. Results: One-half of the children were stunted. In multivariate analyses, compared with low DDS, high dietary diversity was associated with a 15, 26 and 31% reduced odds of being stunted among children aged 6–11, 12–23 and 24–59 months, respectively, after adjusting for all potential confounders (odds ratio (OR)=0.85, 95% confidence interval (CI): 0.76–0.94; OR=0.74, 95% CI: 0.69–0.79; OR=0.69, 95% CI: 0.66–0.73). In all groups, children who were still breastfed were more likely to have limited diversity (OR=1.88, 95% CI: 1.32–2.67; OR=1.71, 95% CI: 1.52–1.92; OR=1.15, 95% CI: 1.11–1.19). Those having diarrhea in the past week and coming from families with low socioeconomic status were more likely to have decreased diversity (P<0.05). Conclusions: Reduced dietary diversity is a strong predictor of stunting in rural Bangladesh. The inclusion of a variety of food groups into complementary foods may be essential to improve child nutritional status.