Factors associated with dietary diversity among pregnant women in the western hill region of Nepal: A community based cross-sectional study.

BACKGROUND: Dietary diversity can play an important role in providing essential nutrients for both mother and fetus during pregnancy. This study aimed to assess the factors associated with dietary diversity during pregnancy in the western hill region of Nepal. METHODS: A cross-sectional study of 327 pregnant women was conducted in an urban municipality of Baglung district in the western hill region of Nepal. A semi-structured questionnaire was used to collect information on household demographic and socioeconomic status, food taboos, household food security status, nutrition-related knowledge in pregnancy, and women's empowerment. Women consuming ≥5 of 10 food groups in the past 24 hours were defined as consuming a diverse diet using the Minimum Dietary Diversity Score for Women (MDD-W) tool. Bivariate and multivariate logistic regression was used to estimate crude odds ratio (cOR) and adjusted odds ratios (aOR) and 95% confidence intervals (CIs) to understand factors associated with dietary diversity. RESULTS: Almost 45% (95% CI: 39.6-50.4) of the participants did not consume a diverse diet and the mean dietary diversity score was 4.76 ± 1.23. Multivariable analysis revealed that women with greater empowerment (aOR = 4.3, 95% CI: 1.9-9.9), from wealthier households (aOR = 5.1, 95% CI: 2.7-9.3), joint families (aOR = 2.7, 95% CI: 1.4-5.1), employment (aOR = 2.2, 95% CI: 1.2-4.1), and had adequate nutrition knowledge (aOR: 1.9, 95% CI 1.1-3.4) had higher odds of dietary diversity. CONCLUSION: Along with socioeconomic status, women's empowerment and nutrition knowledge were modifiable risk factors that should be considered as targets for programs to improve women's health during pregnancy.

Implications of Updating the Minimum Dietary Diversity for Children Indicator for Tracking Progress in the Eastern and Southern Africa Region.

Minimum dietary diversity (MDD), a population-level dietary quality indicator, is commonly used across low- and middle-income countries to characterize diets of children aged 6-23 mo. The WHO and UNICEF recently updated the MDD definition from consumption of ≥4 of 7 food groups in the previous 24 h (MDD-7) to ≥5 of 8 food groups (MDD-8), adding a breastmilk group. The implications of this definition change were examined across 14 countries in Eastern and Southern Africa where improving complementary feeding is a policy priority. A lower MDD-8 score was found compared with MDD-7 across all countries; in 3 countries the difference between indicators was >5 percentage points. Country-level variability is driven by differences in breastfeeding rates and dietary diversity score. As countries transition to the new indicator it is important to actively publicize changes and to promote valid interpretation of MDD trends.