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  • Original Article
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Dietary diversity scores can be improved through the use of portion requirements: an analysis in young Filipino children

European Journal of Clinical Nutrition volume 63, pages 199–208 (2009)Cite this article

Abstract

Objectives:

Early childhood malnutrition is a pressing international concern which dietary diversity scores (summary scores of food groups in the diet) may be helpful in addressing. We explored three current research needs surrounding diversity scores: the impact of portion size on score function, the relationship of scores to nutrient adequacy and density and the ability of scores to function as screening tools.

Subjects/Methods:

1810 children, age 24 months. Cross sectional study of a birth cohort.

Results:

We evaluated two nine food group dietary diversity scores based on 0 and 10 g minimum food group requirements for their relationship to nutrient adequacy and nutrient density. Both scores were significantly correlated with nutrient adequacy and density and predicted statistically significant increases (P<0.05) in the probability of adequacy for all nutrients. However, correlations and predicted increases were somewhat larger for the 10 g score. We also considered the sensitivity and specificity of each score for detecting low and high nutrient adequacy in the population. The 10 g cutoff improved score ability to predict low nutrient adequacy, and reduced the misclassification of subjects for all comparisons.

Conclusions:

This research suggests that the score without portion requirements reflects dietary adequacy, but when feasible, further refinement of diversity scores is desirable through the application of minimum portion requirements.

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Acknowledgements

The Cebu Longitudinal Health and Nutrition Survey is a collaborative project with the Office of Population Studies of the University of San Carlos, Philippines. We thank Gina Kennedy at FAO for her assistance in obtaining and applying protocol guidelines and Litlit Duazo from the Office of Population Studies, San Carlos University, Philippines for her assistance with compiling changes in the food composition tables. In addition we express our thanks to Anna Jennings for assistance in SES data preparation, and Darren Dahly for development of the urbanization index. Supported by Grants from NIH: 5-T32-DK07686, RO1-TW05596, RO1-HD38700.

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Authors and Affiliations

  1. Department of Nutrition, University of North Carolina at Chapel Hill, NC, USA

    M C Daniels, L S Adair & B M Popkin

  2. Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA

    L S Adair & B M Popkin

  3. Department of Biostatistics, University of North Carolina at Chapel Hill, NC, USA

    Y K Truong

Authors
  1. M C Daniels
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  2. L S Adair
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  3. B M Popkin
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  4. Y K Truong
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Corresponding author

Correspondence to M C Daniels.

Additional information

Contributors: MCD, LSA, BMP conceived the study. MCD, LSA planned the analysis. MCD carried out analysis and drafted the article. MCD, BMP, LSA, participated in critical revision of the article. YKT assisted with technical aspects and quality checks on the analysis.

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Daniels, M., Adair, L., Popkin, B. et al. Dietary diversity scores can be improved through the use of portion requirements: an analysis in young Filipino children. Eur J Clin Nutr 63, 199–208 (2009). https://doi.org/10.1038/sj.ejcn.1602927

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