Dietary Diversity May Play A Mediatory Role on the Association between Household Food Insecurity and Nutritional Status among Children Aged 24-59 Months

Abstract

Background: Consuming scarce and poorly diversified diet, along with inadequate breastfeeding, contribute seriously to the complete scope of child undernutrition like stunting, wasting, underweight and micronutrient deficiency. Objective: To determine the association between dietary diversity score (DDS) and nutritional status among children aged 24 to 59 months in Haromaya district, Ethiopia. Methods: Children aged 24-59 months (N= 453) were enrolled in this cross-sectional study with a representative sample of households selected by a multistage sampling procedure in Haromaya district. Anthropometry and 24hr dietary recall were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. Structural equation modeling was applied to test the mediatory effect of DDS on the relationship between household food insecurity (HFI) and child nutritional status. Results: The mean DDS was 3.62 (SD 1.09), and 50% of the children indicated poor and average DDS with only 20% children in very good DDS. By logistic regression analysis and after adjusting for the confounding factors, poor DDS was highly significant predictor of wasting, stunting and underweight (AOR = 4.09, C.I = 1.31 - 12.76, p = .01), (AOR = 2.28, C.I = 1.11 - 4.69, p = .03) and (AOR = 2.48, C.I = 1.17 - 5.24, p = .02) respectively. HFI had a significant direct effect on wasting though no significant indirect effect on wasting through mediation variable, DDS, (β1 reduced from 0.06 (S.E. = 0.027, p < .05) to 0.05 (S.E. = 0.028, p > .05). Conclusion: Poor DDS was a predictor of wasting, stunting and underweight. Additionally, DDS had a role in the association between HFI and nutritional status.