Inge D. Brouwer, Wageningen University "The Dietary Diversity, Agriculture and Nutrition Nexus"

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Science Forum 2013 (www.scienceforum13.org)
Breakout Session 3 - DIET DIVERSIFICATION

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Inge D. Brouwer, Wageningen University "The Dietary Diversity, Agriculture and Nutrition Nexus"

  1. 1. The dietary diversity, agriculture and nutrition nexus: what are the gaps in knowledge CGIAR Science Forum 2013: Breakout session 3: dietary diversification Inge D. Brouwer, Division of Human Nutrition, Wageningen University
  2. 2. • Dietary diversity score is a good indicator but needs refinement • Can local diets fulfill all nutrient requirements? • More information on alternatives needed before promoting them
  3. 3. Overview Dietary Diversity scores Individual dietary diversity Household dietary diversity Associated with increase in household per capita daily caloric availability from staples and non-staples - Household dietary diversity score - Food consumption score Associated with increase in energy intake and probability of adequacy of micronutrients - Individual Dietary Diversity Score - Minimum Dietary Diversity - Minimum Meal Frequency
  4. 4. Increasing dietary diversity is associated with probability of adequacy of 11 micronutrients 0.3 0.35 0.4 0.45 0.5 0.55 0.6 0.65 0.7 3 4 5 6 7 8 food group score meanprobabilityofadequacy FGI-6 FGI-6R FGI-9 FGI-9R FGI-13 FGI-13R FGI-21 FGI-21R Dietary Diversity Score Partial correlation Dietary Diversity Score Partial correlation Adjusted for total energy intake Adjusted for total energy intake FGI-6 0.25* FGI-6R 0.48* FGI-9 0.33* FGI-9R 0.48 * FGI-13 0.27* FGI-13R 0.38 * FGI-21 0.32* FGI-21R 0.41 * Kennedy et al, 2009
  5. 5. Limitations of dietary diversity scores No cut-off point indicating low or high DDS Data on study populations generally low in DDS and MPA No consensus on number of food groups to be used in calculating DDS Post- harvest season Pre- harvest season MPA 0.39 (± 0.09) 0.09 (± 0.07) DDS 4.1 (± 1.2) 3.2 (± 1.3) Partial correlation MPA - DDS 0.36 0.43 Association of dietary diversity and mean probability of adequacy in women in 2 seasons, Mbooni District, Kenya Ngala et al, 2013 (unpublished)
  6. 6. Development of food base dietary guidelines based on locally available, acceptable and affordable foods Linear programming: way to select food-based recommendations to determine & to promote optimized diet to fulfill energy and nutrient intakes based on local food habits Identification of problem nutrients Optifood ● Local food habits ● Constraints Foods consumed, portion sizes, frequency, food composition values Energy requirements, RNIs
  7. 7. Food Based Dietary guidelines for women in reproductive age, Kenya Food groups # of daily serves/week* Average (50th) Optimized diet Added fats 5 5 + cooking fat (7) Added sugars 7 7 Dairy products 5 5 + cow milk (7) Fruits 2 2 Grains & grain products 14 16 Legumes, nuts & seeds 5 5 + beans dry red (5) Miscellaneous 5 5 Starchy roots & other starchy plant foods 2 2 Vegetables 14 18 + Sukuma Wiki (7) Snack 5 7 Starchy Staple 19 23 Akter et al, 2013 (unpublished)
  8. 8. Food Based Dietary guidelines for women in reproductive age, Kenya 0 10 20 30 40 50 60 70 80 90 100 110 Food Energy Protein Fat Calcium Folate Vit A Iron Zinc Worst-case scenario Best-case scenario %RNI Partial problem nutrientsAbsolute problem nutrients Akter et al, 2013 (unpublished)
  9. 9. Can non or under-utilized, wild foods be an alternative solution? Quality of food composition tables ● Varieties/species ● Nutrient values ● Retention during processing Bioavailability 0 0,5 1 1,5 2 2,5 3 3,5 4 Betacarotene(mg/100g) Betacarotene retention during storage of fresh and cooked Sukuma Wiki Raw sukuma Wiki Cooked sukuma Wiki Mueni et al, 2004 (unpublished)
  10. 10. Can non or under utilized, wild foods be an alternative solution? Quality of food composition tables ● Varieties/species ● Nutrient values ● Retention during processing Bioavailability? Sufficient availability? • Children 12-59 months, Kenya • MM=maize porridge, 4.1 mg iron/meal • MA=maize/amaranth porridge, 23 mg iron/meal • MM+=maize porridge with MNP, 6.6 mg iron/meal, 2.5 mg as NaFeEDTA
  11. 11. Discussion points Dietary diversity is a good indicator for effect of agriculture interventions on composition of diet and adequacy of intake ● Need for more refinement of dietary diversity scores Improvement of diet with locally available foods may not fulfill all nutrient requirements (Fe, Ca, Zn) In search for alternatives, there is need for ● Improved food composition tables (varieties, species, retention during processing) ● Information on bioavailability of nutrients ● Agriculture-sensitive nutrition
  12. 12. Thank you Text

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