title: Low dietary diversity is a predictor of child stunting in rural Bangladesh.
abstract: OBJECTIVE
  Dietary diversity is associated with overall quality and nutrient adequacy of the diet in low-income countries. We determined the association between dietary diversity and stunting among children aged 6-59 months in rural Bangladesh.
  
  
  METHODS
  In total, 165 111 under-fives who participated in the National Surveillance Project in 2003-2005 were included in the analysis. Dietary diversity score (DDS) was constructed through the summation of the number of days each of the nine food groups was consumed in the previous week. The association between stunting and DDS was determined adjusting for confounders using logistic regression models. All analyses were performed separately for children aged 6-11, 12-23 and 24-59 months.
  
  
  RESULTS
  One-half of the children were stunted. In multivariate analyses, compared with low DDS, high dietary diversity was associated with a 15, 26 and 31% reduced odds of being stunted among children aged 6-11, 12-23 and 24-59 months, respectively, after adjusting for all potential confounders (odds ratio (OR)=0.85, 95% confidence interval (CI): 0.76-0.94; OR=0.74, 95% CI: 0.69-0.79; OR=0.69, 95% CI: 0.66-0.73). In all groups, children who were still breastfed were more likely to have limited diversity (OR=1.88, 95% CI: 1.32-2.67; OR=1.71, 95% CI: 1.52-1.92; OR=1.15, 95% CI: 1.11-1.19). Those having diarrhea in the past week and coming from families with low socioeconomic status were more likely to have decreased diversity (P<0.05).
  
  
  CONCLUSIONS
  Reduced dietary diversity is a strong predictor of stunting in rural Bangladesh. The inclusion of a variety of food groups into complementary foods may be essential to improve child nutritional status.
authors.affiliation: SIGHT AND LIFE, Wurmisweg 576, Basel, Switzerland. Jee-Hyun.Rah@dsm.com
authors.forename: J H
authors.initials: JH
authors.lastname: Rah
authors.forename: N
authors.initials: N
authors.lastname: Akhter
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: S
authors.initials: S
authors.lastname: de Pee
authors.forename: M W
authors.initials: MW
authors.lastname: Bloem
authors.forename: A A
authors.initials: AA
authors.lastname: Campbell
authors.forename: R
authors.initials: R
authors.lastname: Moench-Pfanner
authors.forename: K
authors.initials: K
authors.lastname: Sun
authors.forename: J
authors.initials: J
authors.lastname: Badham
authors.forename: K
authors.initials: K
authors.lastname: Kraemer
mesh_terms: D000886:Anthropometry; D001459:Bangladesh / Q000453:epidemiology; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005502:Food / Q000191:economics; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D016017:Odds Ratio; D011203:Poverty; D012424:Rural Population