@article{discovery10184758, year = {2024}, title = {Defining a Dichotomous Indicator for Population-Level Assessment of Dietary Diversity Among Pregnant Adolescent Girls and Women: A Secondary Analysis of Quantitative 24-h Recalls from Rural Settings in Bangladesh, Burkina Faso, India, and Nepal}, journal = {Current Developments in Nutrition}, note = {{\copyright} 2023 The Authors. Published by Elsevier Inc. on behalf of American Society for Nutrition. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).}, publisher = {Elsevier BV}, number = {1}, volume = {8}, month = {January}, keywords = {Dietary diversity, indicator, micronutrient adequacy, minimum dietary diversity for women, pregnant, resource-poor settings}, abstract = {BACKGROUND: The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements. OBJECTIVE: This study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15-49 y in LMICs. METHODS: We used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of {\ensuremath{>}}0.60. RESULTS: In the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of {\ensuremath{>}}0.60 was 9.6\%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62\%), very good specificity (81\%), and percentage of correctly classified individuals (79\%). CONCLUSIONS: The WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.}, issn = {2475-2991}, url = {https://doi.org/10.1016/j.cdnut.2023.102053}, author = {Verger, EO and Eymard-Duvernay, S and Bahya-Batinda, D and Hanley-Cook, GT and Argaw, A and Becquey, E and Diop, L and Gelli, A and Harris-Fry, H and Kachwaha, S and Kim, SS and Nguyen, PH and Saville, NM and Tran, LM and Zagr{\'e}, RR and Landais, E and Savy, M and Martin-Prevel, Y and Lachat, C} }