The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pediatrics
Abstract
Background: Undernutrition poses a serious health challenge in developing countries and Tanzania has the
highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have
been identified as the main causes for undernutrition. As dietary diversity is a major requirement if children are to
get all essential nutrients, it can thus be used as one of the core indicators when assessing feeding practices and
nutrition of children. Therefore, adequate information on the association between dietary diversity and undernutrition
to identify potential strategies for the prevention of undernutrition is critical. Here we examined to what extent dietary
diversity is associated with undernutrition among children of 6 to 23 months in Tanzania.
Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015–2016, we carried out
secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores of
Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. A composite
dietary diversity score was created by summing the number of food groups eaten the previous day as reported for
each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven
was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques
were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight.
Results: A total of 2960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and
underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach
the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A
containing fruits and vegetables (65%). The remaining food groups were reported to be consumed by a much lower
proportion of children, including eggs (7%), meat and fish (36%), milk and dairy products (22%), as well as legumes and
nuts (35%), and other vegetables (21%). Consumption of a diverse diet was significantly associated with a reduction of
stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was
found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a
significantly higher likelihood of being stunted (AOR = 1.37, 95% CI; 1.13–1.65) and underweight (AOR = 1.49, 95% CI;
1.15–1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be
associated with reduced stunting among children.
Conclusion: Consumption of a diverse diet is associated with a reduction in undernutrition among children of
6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the
energy and nutritional demands of children should be considered in Tanzania.
Description
Research Article
Keywords
Dietary diversity, Complementary feeding, Undernutrition, Pediatric, Infants-young children, Tanzania