Dietary species richness as a measure of food biodiversity and nutritional quality of diets.

Biodiversity is key for human and environmental health. Available dietary and ecological indicators are not designed to assess the intricate relationship between food biodiversity and diet quality. We applied biodiversity indicators to dietary intake data from and assessed associations with diet quality of women and young children. Data from 24-hour diet recalls (55% in the wet season) of n = 6,226 participants (34% women) in rural areas from seven low- and middle-income countries were analyzed. Mean adequacies of vitamin A, vitamin C, folate, calcium, iron, and zinc and diet diversity score (DDS) were used to assess diet quality. Associations of biodiversity indicators with nutrient adequacy were quantified using multilevel models, receiver operating characteristic curves, and test sensitivity and specificity. A total of 234 different species were consumed, of which <30% were consumed in more than one country. Nine species were consumed in all countries and provided, on average, 61% of total energy intake and a significant contribution of micronutrients in the wet season. Compared with Simpson's index of diversity and functional diversity, species richness (SR) showed stronger associations and better diagnostic properties with micronutrient adequacy. For every additional species consumed, dietary nutrient adequacy increased by 0.03 (P < 0.001). Diets with higher nutrient adequacy were mostly obtained when both SR and DDS were maximal. Adding SR to the minimum cutoff for minimum diet diversity improved the ability to detect diets with higher micronutrient adequacy in women but not in children. Dietary SR is recommended as the most appropriate measure of food biodiversity in diets.

Combining market and nonmarket food sources provides rural households with more options to achieve better diets in Southern Benin.

This study examines the relative contributions to dietary diversity of the diversity of plant and domesticated animal species which rural households produce or collect, i.e., nonmarket food sources, versus the diversity of foods purchased in markets. Although opinions differ in the literature as to their relative importance, clarifying how different sources of food contribute to the dietary diversity of rural households in the developing world is important to inform policies and interventions to improve their food security and dietary quality. This case study was carried out among a random sample of 654 rural households in southern Benin during two seasons: when food is plentiful after harvest; and when food is scarcer between harvests. We collected data on crops, wild plants, and domesticated animals utilized by households, the number of markets they visited, and the diet of a mother in the household, with a structured 24-hour food frequency questionnaire. We hypothesize that the number of markets visited is an indicator of the diversity of foods available in the markets they have access to, and thus shows the contribution of markets as food sources. Results support this hypothesis and show that households that produced more plant and domesticated animal species and those that visited more markets had more diversified diets. Obtaining diverse foods from multiple sources provides households with more options to achieve better diets. These results suggest a need for a more holistic approach that recognizes the complementarities between market and nonmarket sources of foods. This approach should build on the diversity of species rural households already utilize, and on the ways they interact with markets. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01320-w.

Dietary Diversity Predicts the Adequacy of Micronutrient Intake in 6- to 23-Month-Old Children Regardless of the Season in Rural Southern Benin.

BACKGROUND: The Infants and Young Children Dietary Diversity Score (IYC-DDS-7) has been validated to assess dietary quality in children. However, its applicability to predict the adequacy of micronutrient intake remains a challenge in all contexts. DESIGN AND METHODS: A 24-hour dietary recall assessment was conducted on a sample of 628 children aged 6 to 23 months in the plenty season (PS) as well as in the lean season (LS). The IYC-DDS-7 was calculated based on 7 food groups, whereas the mean micronutrient density adequacy (MMDA) for 11 micronutrients. The ß regression models were used to assess the relationship between IYC-DDS and MMDA and differences in nutrient intake between the 2 seasons. A receiver-operating characteristic curve analysis was also performed to determine IYC-DDS-7 cutoff levels that maximized sensitivity and specificity in assessing dietary quality and predicting MMDA below- or above-selected cutoff levels. RESULTS: Participating children's MMDA was 56.9% ± 12.8% versus 61.9% ± 8.6% and IYC-DDS-7 was 3.43 ± 1.5 versus 3.77 ± 1.0 in the PS and LS. The IYC-DDS-7 had a positive correlation with MMDA, irrespective of the season. For a 1-unit increase in IYC-DDS-7, MMDA increased by a mean of 10.7% (CI, 8.3%-13.1%; P < .001). The minimum threshold of the 4 food groups corresponded to a sensitivity of 76% and 61% and a specificity of 75% and 70% for the prediction of inadequate diet in the PS and LS, respectively. CONCLUSIONS: The IYC-DDS-7 predicted MMDA, regardless of seasons for infants and young children. The IYC-DDS-7 cutoff of 4 groups performed well in classifying children with low-diet quality.

Urbanisation, nutrition transition and cardiometabolic risk: the Benin study.

A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural-urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.

On-Farm Diversity and Market Participation Are Positively Associated with Dietary Diversity of Rural Mothers in Southern Benin, West Africa.

OBJECTIVE: The objective of this study is to test the extent to which, under different opportunities for market participation, the diversity of plant species rural households grow or collect (on-farm diversity), and the variety of foods mothers purchase (market diversity) are associated with their dietary diversity. METHODS: Rural households from three districts in southern Benin were interviewed during dry (n = 472) and wet (n = 482) seasons between 2011 and 2012. Villages within districts and their households were selected randomly according to market accessibility, with a mother selected from each household. Information on on-farm diversity was collected using a semi-structured questionnaire. Market diversity was obtained through a 7-day food frequency questionnaire that elicited if foods were purchased. Dietary diversity was derived from a quantitative 24-hour food recall. A system of three simultaneous equations via a Generalized Methods of Moments was estimated to address potential endogeneity between dietary diversity and on-farm diversity and market diversity. RESULTS: Results show rich on-farm diversity with more than 65 different edible plant species grown or collected by households. More than 70% of foods consumed by mothers were purchased in 55 market places. More than 50% of mothers met minimum dietary diversity with at least 5 food groups consumed. Diagnostic tests indicated the existence of endogeneity. Econometric results showed that on-farm and market diversities were positively associated with mothers' dietary diversity (p < 0.05) once market opportunities, seasonality and other socioeconomic factors were controlled for. CONCLUSION: Results provide evidence of a positive relationship between on-farm diversity and dietary diversity among participant mothers. They demonstrate the important contribution of market diversity to their dietary diversity. Links among these three facets of diversity suggest that production for self-consumption and food purchases complement rather than replace each other in their contribution to dietary diversity and thus dietary quality.

[Child malnutrition and maternal overweight in same households in poor urban areas of Benin]. / Malnutrition infantile et surpoids maternel dans des ménages urbains pauvres au Bénin.

The coexistence of child malnutrition and maternal overweight in the same households typifies rapid nutrition transition in developing countries (DCs). It is reportedly less common in Africa than in Latin America or Asia, but the phenomenon is still little documented. The purpose of our study in poor urban neighbourhoods of the capital city of Benin (West Africa) was to assess the magnitude of the overlap of child protein-energy malnutrition (PEM) and maternal overweight within households, and to compare these households with other nutritional phenotypes in terms of socio-economic circumstances and diet quality. Our hypothesis was that both child PEM and maternal overweight could stem from poor socio-economic conditions, including lack of sanitation, and poor diet quality. Food diversity was used as an index of diet quality, or the qualitative dimension of food security. A random sample of 148 households that included a least the biological mother, one child between 6 and 59 months of age and a second one between 5 and 11 years was selected in two poor neighbourhoods of the capital city of Cotonou to assess the prevalence of "double burden" households and of other nutritional phenotypes of households: with PEM only in at least one child; with maternal overweight only; and without PEM or overweight. Body weights and heights of mothers and of the two targeted children were measured. As long as one child had low weight-for-height or height-for-age (z-score <-2.0), the household came under the "PEM" type. In mothers, overweight was defined as body mass index (BMI) > or = 25, obesity > or = 30 and chronic energy deficiency <18.5. We retained 126 households for interviews with mothers on socio-economic circumstances and food diversity. A socio-economic status (SES) score was constructed on the basis of household amenities and maternal education. Food insecurity was based on reported shortage of food in the last year in the household. Based on the frequency of consumption of 13 different food groups in the previous week, a food diversity score was computed. Overall 35.5% of children were malnourished, and school-age children had a worse nutritional status than under-5 children: 41% and 30% PEM (chronic or acute or both), respectively. The rate of maternal overweight was 39.1% including 15.5% of obesity. Child PEM coexisted with maternal overweight or obesity in 16.2% of the households; 27.7% of households had PEM only, 23% overweight only, 20.3% showed no malnutrition or overweight, and 12.8% had an underweight mother. Maternal BMI status was significantly associated with both children's weight-for-height z-score, particularly the elder one. The rate of child malnutrition, particularly wasting, was significantly higher among underweight mothers and lower in overweight mothers . Underweight mothers were merged with mothers with BMI < or = 25 for the remaining analyses. Households with overweight mothers tended to enjoy relatively better socio-economic conditions--higher SES, higher maternal education, less food insecurity, better household sanitation; they also tended to have a more diversified diet. This is in contrast with PEM households. Dual burden households shared several socio-economic features with the PEM households, except for a higher (not significant) SES score. Dual burden households also had the lowest food diversity score of all household types. Logistical regression models revealed that a relatively higher SES level was associated with a higher likelihood of maternal overweight in PEM households, whereas poor household sanitation increased the odds of PEM among maternal overweight households. Food diversity appeared significantly associated with a lower likelihood of dual burden in all types of households. The study highlights the importance of addressing the double burden of malnutrition and overweight even in poor areas of low income countries of West Africa. It suggests that prevention efforts should be aimed at improving diet quality and sanitation in poor urban households.