Dietary diversity scores can be improved through the use of portion requirements: an analysis in young Filipino children.
OBJECTIVE
Early childhood malnutrition is a pressing international concern which dietary diversity scores (summary scores of food groups in the diet) may be helpful in addressing. We explored three current research needs surrounding diversity scores: the impact of portion size on score function, the relationship of scores to nutrient adequacy and density and the ability of scores to function as screening tools.


METHODS
1810 children, age 24 months. Cross sectional study of a birth cohort.


RESULTS
We evaluated two nine food group dietary diversity scores based on 0 and 10 g minimum food group requirements for their relationship to nutrient adequacy and nutrient density. Both scores were significantly correlated with nutrient adequacy and density and predicted statistically significant increases (P<0.05) in the probability of adequacy for all nutrients. However, correlations and predicted increases were somewhat larger for the 10 g score. We also considered the sensitivity and specificity of each score for detecting low and high nutrient adequacy in the population. The 10 g cutoff improved score ability to predict low nutrient adequacy, and reduced the misclassification of subjects for all comparisons.


CONCLUSIONS
This research suggests that the score without portion requirements reflects dietary adequacy, but when feasible, further refinement of diversity scores is desirable through the application of minimum portion requirements.
Daniels
M C
MC
Department of Nutrition, University of North Carolina at Chapel Hill, NC 27516, USA. mchris@email.unc.edu
Adair
L S
LS
Popkin
B M
BM
Truong
Y K
YK
D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data; D015930:Diet Records; D004034:Diet Surveys; D006801:Humans; D016014:Linear Models; D044342:Malnutrition / Q000175:diagnosis / Q000517:prevention & control*; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D010679:Philippines; D012372:ROC Curve; D012680:Sensitivity and Specificity