TY  - JOUR
JF  - Current Developments in Nutrition
PB  - Elsevier BV
ID  - discovery10184758
N1  - © 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/).
Y1  - 2024/01//
IS  - 1
TI  - 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
AV  - public
SN  - 2475-2991
UR  - https://doi.org/10.1016/j.cdnut.2023.102053
A1  - Verger, EO
A1  - Eymard-Duvernay, S
A1  - Bahya-Batinda, D
A1  - Hanley-Cook, GT
A1  - Argaw, A
A1  - Becquey, E
A1  - Diop, L
A1  - Gelli, A
A1  - Harris-Fry, H
A1  - Kachwaha, S
A1  - Kim, SS
A1  - Nguyen, PH
A1  - Saville, NM
A1  - Tran, LM
A1  - Zagré, RR
A1  - Landais, E
A1  - Savy, M
A1  - Martin-Prevel, Y
A1  - Lachat, C
N2  - 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 >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 >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.
VL  - 8
KW  - Dietary diversity
KW  -  indicator
KW  -  micronutrient adequacy
KW  -  minimum dietary diversity for women
KW  -  pregnant
KW  -  resource-poor settings
ER  -