Dietary diversity and social determinants of nutrition among late adolescent girls in rural Pakistan
The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low‐ and middle‐income countries. We aimed to identify and quantify the relations...
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| Vydáno v: | Maternal and child nutrition Ročník 18; číslo 1; s. e13265 - n/a |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
John Wiley & Sons, Inc
01.01.2022
John Wiley and Sons Inc Wiley |
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| ISSN: | 1740-8695, 1740-8709, 1740-8709 |
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| Abstract | The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low‐ and middle‐income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15–18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10‐item scale to 24‐h dietary recall data collected three times per participant. To examine the associations between the SDN‐related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster‐randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1–7; n = 1170]), and the minimum cut‐off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6–15.6%). Consumption of starches was reported in all recalls, but micronutrient‐rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. |
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| AbstractList | The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low‐ and middle‐income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15–18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10‐item scale to 24‐h dietary recall data collected three times per participant. To examine the associations between the SDN‐related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster‐randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1–7; n = 1170]), and the minimum cut‐off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6–15.6%). Consumption of starches was reported in all recalls, but micronutrient‐rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15–18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per participant. To examine the associations between the SDN-related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster-randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1–7; n = 1170]), and the minimum cut-off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6–15.6%). Consumption of starches was reported in all recalls, but micronutrient-rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low‐ and middle‐income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15–18.9 years ( n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10‐item scale to 24‐h dietary recall data collected three times per participant. To examine the associations between the SDN‐related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster‐randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1–7; n = 1170]), and the minimum cut‐off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6–15.6%). Consumption of starches was reported in all recalls, but micronutrient‐rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS ( P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. Abstract The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low‐ and middle‐income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15–18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10‐item scale to 24‐h dietary recall data collected three times per participant. To examine the associations between the SDN‐related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster‐randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1–7; n = 1170]), and the minimum cut‐off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6–15.6%). Consumption of starches was reported in all recalls, but micronutrient‐rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15-18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per participant. To examine the associations between the SDN-related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster-randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1-7; n = 1170]), and the minimum cut-off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6-15.6%). Consumption of starches was reported in all recalls, but micronutrient-rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements.The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15-18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per participant. To examine the associations between the SDN-related explanatory variables and DDS, we generated a hierarchical, causal model using mixed effects linear regression to account for the cluster-randomized trial design. Using all data, diets lacked diversity (DDS mean ± SD: 3.35 ± 1.03 [range: 1-7; n = 1170]), and the minimum cut-off for dietary diversity was infrequently achieved (13.5%; 95% CI: 11.6-15.6%). Consumption of starches was reported in all recalls, but micronutrient-rich food consumption was less common. Of the SDN considered, wealth quintile had the strongest association with DDS (P < 0.0001). The diets of the sampled Pakistani adolescent girls were insufficient to meet micronutrient requirements. Poverty was the most important predictor of a diet lacking in diversity, indicating limited purchasing power or access to nutritious foods. Dietary diversification and nutrition education strategies alone are unlikely to lead to improved diets without steps to tackle this barrier, for example, through fortification of staple foods and provision of supplements. |
| Author | Ahmed, Imran Cousens, Simon Baxter, Jo‐Anna B. Sellen, Daniel W. Wasan, Yaqub Islam, Muhammad Soofi, Sajid B. Bhutta, Zulfiqar A. |
| AuthorAffiliation | 4 Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine London UK 6 Department of Anthropology University of Toronto Toronto Ontario Canada 3 Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan 5 Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada 2 Department of Nutritional Sciences University of Toronto Toronto Ontario Canada 1 Centre for Global Child Health Hospital for Sick Children Toronto Ontario Canada |
| AuthorAffiliation_xml | – name: 4 Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine London UK – name: 3 Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan – name: 5 Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada – name: 1 Centre for Global Child Health Hospital for Sick Children Toronto Ontario Canada – name: 6 Department of Anthropology University of Toronto Toronto Ontario Canada – name: 2 Department of Nutritional Sciences University of Toronto Toronto Ontario Canada |
| Author_xml | – sequence: 1 givenname: Jo‐Anna B. orcidid: 0000-0002-4718-0382 surname: Baxter fullname: Baxter, Jo‐Anna B. organization: University of Toronto – sequence: 2 givenname: Yaqub surname: Wasan fullname: Wasan, Yaqub organization: Aga Khan University – sequence: 3 givenname: Muhammad surname: Islam fullname: Islam, Muhammad organization: Hospital for Sick Children – sequence: 4 givenname: Simon surname: Cousens fullname: Cousens, Simon organization: London School of Hygiene and Tropical Medicine – sequence: 5 givenname: Sajid B. orcidid: 0000-0003-4192-8406 surname: Soofi fullname: Soofi, Sajid B. organization: Aga Khan University – sequence: 6 givenname: Imran surname: Ahmed fullname: Ahmed, Imran organization: Aga Khan University – sequence: 7 givenname: Daniel W. surname: Sellen fullname: Sellen, Daniel W. organization: University of Toronto – sequence: 8 givenname: Zulfiqar A. surname: Bhutta fullname: Bhutta, Zulfiqar A. email: zulfiqar.bhutta@aku.edu organization: University of Toronto |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34467621$$D View this record in MEDLINE/PubMed |
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| Copyright | 2021 The Authors. published by John Wiley & Sons Ltd. 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Keywords | malnutrition social determinants of health Pakistan micronutrients diet adolescent girls food intake |
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| References | 2021; 5 2002; 56 1997; 26 2015; 33 2018; 81 1998 2008 2016; 387 2010; 140 2013; 382 2015; 80 2018; 1416 2017; 357 2017; 1393 2021; 13 2019; 40 2000 2018a; 15 2019; 23 2018b; 15 2014; 59 2020b 2018 2020a 2017 2016 2015 2014 2018; 72 2021; 397 2013 2019; 393 2014; 9 2012; 379 2018; 10 2018; 14 e_1_2_10_23_1 e_1_2_10_24_1 e_1_2_10_20_1 United Nations (e_1_2_10_35_1) 2015 Government of Pakistan, UK Aid, & UNICEF Pakistan (e_1_2_10_22_1) 2018 e_1_2_10_3_1 e_1_2_10_6_1 e_1_2_10_16_1 e_1_2_10_39_1 e_1_2_10_5_1 e_1_2_10_17_1 e_1_2_10_38_1 e_1_2_10_8_1 e_1_2_10_37_1 e_1_2_10_7_1 e_1_2_10_36_1 e_1_2_10_12_1 e_1_2_10_9_1 e_1_2_10_13_1 e_1_2_10_10_1 Aga Khan University (e_1_2_10_2_1) 2013 e_1_2_10_11_1 e_1_2_10_32_1 e_1_2_10_31_1 Global Alliance for Improved Nutrition (e_1_2_10_18_1) 2018 e_1_2_10_30_1 Global Alliance for Improved Nutrition (e_1_2_10_19_1) 2017 Commission on Social Determinants of Health (e_1_2_10_14_1) 2008 FAO (e_1_2_10_15_1) 2016 UNICEF (e_1_2_10_33_1) 1998 Akhtar R. (e_1_2_10_4_1) 2014 UNICEF Pakistan (e_1_2_10_34_1) 2018 e_1_2_10_29_1 e_1_2_10_27_1 Government of Pakistan (e_1_2_10_21_1) 2020 e_1_2_10_28_1 e_1_2_10_25_1 e_1_2_10_26_1 |
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| Title | Dietary diversity and social determinants of nutrition among late adolescent girls in rural Pakistan |
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