title: Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls.
abstract: OBJECTIVE
  In low-income settings, dietary diversity scores (DDSs) often predict the micronutrient adequacy of diets, but little is known about whether they predict levels of biochemical indicators of micronutrient status.
  
  
  METHODS
  In 2010, we studied two samples of non-pregnant 14- to 19-year-old girls in central Mozambique, the first in January-February ('hunger season'; n = 227) and the second in May-June (harvest season; n = 223). In this paper, we examined whether a low Women's Dietary Diversity Score (WDDS) predicts a low concentration of haemoglobin, serum ferritin, zinc, and folate, and plasma retinol in adolescent Mozambican girls. We constructed three scores: WDDS based on 24-h recalls, WDDS15g based on 24-h recall and employing a 15 g limit, and 7dWDDS based on 7-day food frequency questionnaires. Logistic regression models, stratified by season, were used to estimate the odds of having a low concentration of a status indicator (≤25th percentile of the season-specific distribution or cut-off from the literature) in those with a low score compared to those with a higher score.
  
  
  RESULTS
  In January-February, after adjusting for confounders, a low (≤3) WDDS and a low (≤5) 7dWDDS were each associated with higher odds of having low serum zinc compared to having a higher score, regardless of which of the two types of cut-offs for serum zinc was used. These associations were not present in May-June.
  
  
  CONCLUSIONS
  Our data from Mozambique suggest that dietary diversity is associated with serum zinc, but this association seems to be limited to the hunger season.
authors: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland. liisa.korkalo@helsinki.fi.
authors: Liisa
authors: L
authors: Korkalo
authors: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
authors: Maijaliisa
authors: M
authors: Erkkola
authors: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
authors: Arja E
authors: AE
authors: Heinonen
authors: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
authors: Riitta
authors: R
authors: Freese
authors: Food Security and Nutrition Association (ANSA), Maputo, Mozambique.
authors: Kerry
authors: K
authors: Selvester
authors: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
authors: Marja
authors: M
authors: Mutanen
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D011939:Mental Recall; D018977:Micronutrients / Q000008:administration & dosage*; D009073:Mozambique; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D014801:Vitamin A / Q000097:blood; D055815:Young Adult; D015032:Zinc / Q000097:blood
chemical_list: D006454:Hemoglobins; D018977:Micronutrients; D014801:Vitamin A; D005293:Ferritins; D005492:Folic Acid; D015032:Zinc
keywords: Adolescent girl; Dietary diversity score; Micronutrient; Mozambique; Nutritional status; Sub-Saharan Africa