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 3.5 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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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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