Table 1 Characteristics of the studies that examined the relationship between dietary diversity and micronutrient adequacy in infants (under 2 years old)
First author (Year) | Country/study design | Sample size/age of infants | Method and duration of food intake assessment | No. of food groups considered/classification of DD | No. and type of micronutrients considered | DD criteria/MDA criteria | Adjusted covariates | Findings |
|---|---|---|---|---|---|---|---|---|
Faber [21] | Africa/cross-sectional | 316/6–24 months | 24-h recall/2 days on different days of the week | 7/Low DD: ≤ 3 groups | 18/Thiamin, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin C, vitamin D, vitamin E, iron, zinc, magnesium, potassium, cupper, and calcium | WHO-UNICEF/WHO | – | High DD was associated with higher micronutrients density including calcium, iron, magnesium, potassium, phosphorus, zinc, riboflavin, niacin and vitamin D (p < 0.05) |
High DD: ≥ 4 groups | ||||||||
Geng [22] | China/cross-sectional | 1072/6–18 months | 24-h and 7-d food recall/24 h | 8/- | 10/Thiamin, riboflavin, niacin, vitamin B6, vitamin B12, vitamin A, vitamin C, iron, zinc, and calcium | WHO/WHO | Age, weight, length, maternal education, mothers BMI and family income | There was significant association between NAR and DDS and FVS individually and when taken together (DDS + FVS) in all micronutrients except for niacin (p < 0.001) |
Jones [23] | Bolivia/cross-sectional | 251/6–23 months | 24 h recall/24 h | 7/6–8 months: | 9/Thiamin, riboflavin, niacin, folate, vitamin C, vitamin A, iron, zinc, and calcium | WHO/- | Child age and sex, diarrhea symptoms in the previous two weeks, maternal height and education level, and household socioeconomic status | The 24 h food group diversity was positively associated with MMDA (p < 0.05) |
0 food groups = 0 | ||||||||
1–2 food groups = 1 | ||||||||
≥ 3 food groups = 2 | ||||||||
9–11 months: | ||||||||
0 food groups = 0 | ||||||||
1–2 food groups = 1 | ||||||||
≥ 3 food groups = 2 | ||||||||
12–23 months: | ||||||||
1 food groups = 0 | ||||||||
2–3 food groups = 1 ≥ 4 food groups = 2 | ||||||||
Khor [24] | Malaysian/cross-sectional | 119/6–23 months | 24 h food record/2 days on different days of the week | 7/MDD: ≥ 4 food groups | 8/Thiamin, riboflavin, niacin, vitamin C, vitamin A, iron, zinc, and calcium | WHO/WHO | Breast-feeding status, minimum meal frequency, introduction of foods and minimum acceptable diet | The MDD had the greatest contribution to MAR [95% CI 3.09, 39.87 (p = 0.000)] |
Mallard [25] | Zambian/cross-sectional | 811/4–6 months | 24-h recall/24 h | 7/DDS: ranged 0–7 | 13/Thiamin, riboflavin, niacin, vitamin B6, vitamin B12, folate, vitamin A, vitamin C, iron, zinc, calcium, magnesium and phosphorus | WHO/- | Baseline hemoglobin concentration, birth weight, sex, HIV exposure, diarrhea, maternal height and education, and household wealth | MMDA was correlated with DD (p < 0.0001) |
Moursi [26] | Madagascar/cross-sectional | 702/6–23 months | 24 h recall/24 h | 7 and 8/DDS: | 9/vitamin A, thiamin, riboflavin, vitamin B6, folate, vitamin C, calcium, iron, and zinc | -/ FAO-WHO | Child age, breast-feeding status, number of children, and nutritional status of child | DDS were strongly and positively associated with the MMDA (p < 0.05) |
0–8 for 8 food groups | ||||||||
0–7 for 7 food groups after excluding the fats and oils group | ||||||||
(a food group was counted only if at least 10 g was consumed) | ||||||||
Wondafrash [27] | Ethiopia/cross-sectional | 632/6–12 months | 24 h recall/2 d | 7/Good DD: ≥ 4 food groups | 8/Vitamins A and C, thiamin, riboflavin, niacin, iron, calcium, and zinc | WHO/WHO | Socioeconomic index, child age, maternal age and schooling, diarrhea, cough, fever, sex and height-for-age Z -score | DDS was associated with the MMDA (p < 0·0001). A DDS of ≤ 2 food groups was the best predictor of ‘low’ MMDA |