Adaptation and validation of a dietary diversity questionnaire to predict nutrient adequacy in children aged 24 to 59 months in Iran: national food and nutrition surveillance.

IF 3.6 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH BMC Public Health Pub Date : 2025-02-12 DOI:10.1186/s12889-025-21772-x
Hamid Rasekhi, Zahra Yari, Bahareh Nikooyeh, Tirang R Neyestani, Delaram Ghodsi, Samira Rabiei, Samira Ebrahimof, Maryam Amini
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Abstract

Background: Dietary Diversity Score (DDS), as a proxy for nutritional adequacy, can be used as a useful tool to assess diet quality, especially in children, due to its low cost and ease of use in comprehensive studies. This study aimed to develop a questionnaire to estimate dietary diversity and also assess the validity of DDS as an indicator of nutritional status among children aged 24 to 59 months in Iran.

Methods: In addition to the Dietary Diversity Questionnaire (DDQ), which was designed based on the Food and Agriculture Organization (FAO) protocols, two non-consecutive 24-hour dietary recalls were completed for 471 children aged 24-59 months, recruited using random cluster sampling. Nutrient Adequacy Ratio (NAR) for energy, protein, and micronutrients, and the Mean Nutrient Adequacy Ratio (MAR) were calculated. Serum retinol concentration was assayed using High Performance Liquid Chromatography (HPLC). Children's weights and heights were measured and Height for Age (HAZ), Weight for Age (WAZ), Weight for Height (WHZ), and BMI for Age (BAZ) Z-scores were calculated according to World Health Organization (WHO) criteria in 2006. Pearson correlation analysis was performed to analyze the correlation between DDS and NARs, MAR, anthropometric indicators, and serum retinol.

Results: The mean age of the children was 42.5 ± 0.47 months. The average DDS was 5.19 ± 0.06. DDS showed a positive association with the NAR of energy, protein, and all micronutrients (p < 0.05) except for vitamin K. There was a positive and significant correlation between DDS and MAR (r = 0.271; p < 0.001). In addition, DDS showed a direct, weaker but statistically significant, correlation with serum retinol concentration (r = 0.104; p = 0.026). No significant relationship was found between DDS and children's growth indicators.

Conclusions: The designed DDQ can be a valuable tool for examining the adequacy of nutritional intake in Iranian children.

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调整和验证膳食多样性问卷,以预测伊朗24至59个月儿童的营养充足性:国家食品和营养监测。
背景:膳食多样性评分(Dietary Diversity Score, DDS)作为营养充足性的代表,由于其成本低且易于在综合研究中使用,可以作为评估饮食质量的有用工具,特别是在儿童中。本研究旨在编制一份问卷,以估计饮食多样性,并评估DDS作为伊朗24至59个月儿童营养状况指标的有效性。方法:采用随机整群抽样的方法,对471名24-59月龄儿童进行两次非连续的24小时饮食回顾,并根据粮农组织(FAO)方案设计膳食多样性问卷(DDQ)。计算能量、蛋白质和微量营养素的营养充足比(NAR)和平均营养充足比(MAR)。采用高效液相色谱法测定血清视黄醇浓度。测量儿童体重和身高,并根据2006年世界卫生组织(WHO)标准计算年龄身高(HAZ)、年龄体重(WAZ)、身高体重(WHZ)和年龄BMI (BAZ) z分数。采用Pearson相关分析分析DDS与NARs、MAR、人体测量指标、血清视黄醇的相关性。结果:患儿平均年龄为42.5±0.47个月。平均DDS为5.19±0.06。DDS与能量、蛋白质和所有微量营养素的NAR呈正相关(p结论:设计的DDQ可以成为检查伊朗儿童营养摄入充足性的有价值的工具。
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来源期刊
BMC Public Health
BMC Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
4.40%
发文量
2108
审稿时长
1 months
期刊介绍: BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.
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