The document discusses gaps in knowledge around the nexus between dietary diversity, agriculture, and nutrition. It notes that while dietary diversity scores are good indicators, they need further refinement. There is also a need to determine if local diets can fulfill all nutrient requirements and more information is required on alternatives before promoting them. The document also highlights limitations of dietary diversity scores and presents examples of developing food-based dietary guidelines in Kenya based on locally available foods. It raises questions around whether non-traditional, underutilized wild foods could help and identifies gaps in composition data and understanding bioavailability for such foods.

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. • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Thank you
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