title: Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal.
abstract: OBJECTIVE
  The main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables.
  
  
  METHODS
  A cross-sectional survey was performed during 2008-2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA.
  
  
  METHODS
  Bhaktapur municipality, Nepal.
  
  
  METHODS
  Lactating women (n 500), 17-44 years old, randomly selected.
  
  
  RESULTS
  The mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women's educational level and socio-economic status, and was higher in the winter.
  
  
  CONCLUSIONS
  The low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.
authors.affiliation: 1Oslo and Akershus University College of Applied Sciences,PO Box 4,St. Olavs Plass,0130 Oslo,Norway.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Henjum
authors.affiliation: 1Oslo and Akershus University College of Applied Sciences,PO Box 4,St. Olavs Plass,0130 Oslo,Norway.
authors.forename: Liv Elin
authors.initials: LE
authors.lastname: Torheim
authors.affiliation: 2Department of Nutrition,Harvard School of Public Health,Boston,MA,USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Thorne-Lyman
authors.affiliation: 4Centre for International Health,University of Bergen,Bergen,Norway.
authors.forename: Ram
authors.initials: R
authors.lastname: Chandyo
authors.affiliation: 2Department of Nutrition,Harvard School of Public Health,Boston,MA,USA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.affiliation: 5Department of Child Health,Institute of Medicine,Tribhuvan University,Kathmandu,Nepal.
authors.forename: Prakash S
authors.initials: PS
authors.lastname: Shrestha
authors.affiliation: 4Centre for International Health,University of Bergen,Bergen,Norway.
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena / Q000208:ethnology; D000328:Adult; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D004522:Educational Status; D005260:Female; D006801:Humans; D007774:Lactation / Q000208:ethnology; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D018977:Micronutrients / Q000008:administration & dosage / Q000032:analysis / Q000172:deficiency*; D009390:Nepal / Q000453:epidemiology; D018673:Nutrition Policy; D009749:Nutrition Surveys; D009752:Nutritional Status / Q000208:ethnology; D012275:Oryza / Q000737:chemistry; D010349:Patient Compliance; D015995:Prevalence; D012621:Seasons; D012639:Seeds / Q000737:chemistry; D012959:Socioeconomic Factors; D014504:Urban Health / Q000208:ethnology; D055815:Young Adult
chemical_list: D018977:Micronutrients
keywords: Dietary diversity; Lactating women; Micronutrient adequacy; Peri-urban Nepal
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