Dietary diversity practice and associated factors among adolescent girls in Dembia district, northwest Ethiopia, 2017

Dietary diversity and associated factors among children aged 6-23 months attending a public health hospital in Awi zone, Ethiopia, 2023

Background

Inadequate dietary diversity among children aged 6-23 months remains a public problem in Ethiopia. Adequate dietary diversity is crucial for children to meet their nutritional demands and promote healthy growth and development in infancy and young childhood.

Objective

The study aimed to assess dietary diversity and associated factors among children aged 6-23 months in Awi Zone, Ethiopia, 2023.

Methods

The study was conducted among children aged 6-23 months in Awi Zone, Amhara, Ethiopia, from August to September 2023. A community-based cross-sectional study design was conducted. A simple random sampling approach followed by face-to-face interview data collection techniques was used. To ascertain minimum dietary diversity, a 24 h food recall method comprising eight food item questionnaires was used. A statistical association was found between dependent and independent variables using the adjusted odds ratio with 95% confidence intervals and a p-value of ≤0.05.

Result

This study found that only 192 (47.6%) children aged 6-23-month old had adequate dietary diversity. In this study, variables such as maternal education [AOR 2.36, 95% CI (1.297, 3.957)], birth interval [AOR 2.85, 95% CI (1.45, 4.25)], and food insecurity [AOR = 2.23, 95% CI (1.626, 3.1)] were strongly significant variables for the minimum dietary diversity of the child.

Conclusion and recommendations

The proportion of the minimum dietary diversity was relatively low. Mother's educational status, low birth intervals, and food insecurity were significant predictors of minimum dietary diversity. The stakeholders, including the Ministry of Health, regional health offices, and agricultural sectors, prioritize enhancing child nutrition through targeted food-based approaches. Developing and implementing comprehensive intervention programs to improve children's minimum dietary diversity (MDD) should be a central focus. Professionals should strengthen nutrition education to promote optimal MDD practices.

Dietary diversity and its associated factors among adolescent girls in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Even though fragmented and inconsistent findings have been reported in Ethiopia, adolescence is a period of rapid growth following infancy and is severely affected by micronutrient deficiencies, food insecurity, and poor-quality diets. Therefore, the aim of this meta-analysis was to estimate the pooled prevalence of dietary diversity and its associated factors among adolescent girls in Ethiopia.

METHODS

International databases such as EMBASE, Hinari, Scopus, PubMed, Google Scholar, and direct Google searches were systematically used to search for articles and reports. The Newcastle-Ottawa Scale, modified as appropriate, was used for cross-sectional studies to assess the quality of the included articles and reports. A Microsoft Excel sheet was used for data extraction and then exported into STATA version 17 for further analysis. The pooled prevalence of dietary diversity was estimated using a random effects meta-analysis approach. Egger's and Begg's tests were employed to evaluate publication bias.

RESULTS

The pooled prevalence of minimum dietary diversity among adolescent girls in Ethiopia was 43% (95% CI: 30, 56) with significant heterogeneity (I2 = 99.2%, p = 0.00). Urban residence (OR: 2.46), mother being a government employee (OR: 2.31), attending a private school (OR: 6.24), adolescent having formal maternal education (OR: 4.49), adolescent having formal paternal education (OR: 3.26), father being a government employee (OR: 3.50), father being a merchant employee (OR: 2.51), middle family wealth index (OR: 1.76), household food security (OR: 3.96), receiving nutrition counseling (OR: 2.46), and higher meal frequency (OR: 7.35) were significantly associated with minimum dietary diversity.

CONCLUSION

The pooled prevalence of dietary diversity among adolescent girls was low. Factors significantly associated with achieving minimum dietary diversity included urban residence, higher parental education and employment in government, private school attendance, household wealth, food security, receiving nutrition counseling, and higher meal frequency. These findings emphasize the need to improve dietary diversity among rural adolescent girls and food insecure households. Establishing nutrition counseling services could enhance understanding and skills related to a varied diet.

Factors associated with inadequate dietary diversity among adolescent girls in Hurumu Woreda High School, Oromia Region, Southwest Ethiopia

Background

Inadequate diet among adolescent girls leads to anatomical and physiological disturbances which will contribute to the vicious intergenerational cycle of malnutrition. However, only a few studies are available in Ethiopia on dietary diversity among adolescent girls who are attending school.

Objective

The objective of this study is to assess factors associated with inadequate dietary diversity among high school adolescent girls in Hurumu Woreda, Southwest Ethiopia, 2022.

Methods

An institution-based cross-sectional study was conducted among 374 high school adolescent girls from 3 May 2022 to 12 June 2022 and selected by using simple random sampling techniques. Data were collected through face-to-face interviews using structured questionnaires. Epi-data version 4.6.0 was used to enter the data, which were then exported to SPSS version 26 for analysis. Simple binary and multivariable logistic regressions were performed to identify factors associated with inadequate dietary diversity.

Results

In this study, the magnitude of inadequate dietary diversity among adolescent girls was 62.6% [95% CI: 57.5-66.5]. Living with more than five family members (AOR = 1.8, 95% CI: 1.16-3.44), consumption of sweet foods/beverages (AOR = 2.2, 95% CI: 1.07-3.41), poor nutritional knowledge (AOR = 2.5, 95% CI: 1.48-3.89), and poor household wealth tercile (AOR = 2.8, 95% CI: 1.44-5.12) were significantly associated with inadequate dietary diversity.

Conclusion

Living with more than five family members, poor household wealth status, consumption of sweet foods/beverages, family size, and poor nutritional knowledge were factors significantly associated with inadequate dietary diversity. Hence, nutrition education, the use of family planning methods, and securing income-generating activities should be implemented.

Dietary patterns in relation with nutritional outcomes and associated factors among adolescents: implications for context-specific dietary intervention for the Agrarian Community, Northwest Ethiopia

Introduction

Dietary pattern analysis allows us to characterize the dietary intakes of individuals rather than nutrient intake data and strongly predicts disease risks. The relationship between food intake and adolescents' nutritional health is not well understood yet. Therefore, this study aimed to generate evidence for context-specific dietary intervention for adolescents.

Objective

This study aimed to determine dietary patterns and their relationship with nutritional outcomes and identify the contributing factors among adolescents in the Agrarian Community of Northwest Ethiopia.

Methods

A cross-sectional survey was conducted among 622 randomly selected adolescents. Dietary data were collected over a 1-week recall period using the Food Frequency Questionnaire (FFQ). After testing the basic assumptions, an exploratory factor analysis was conducted to determine the dietary patterns. Anthropometric data on weight and height were collected to determine the nutritional status using WHO Anthroplus 2010 software. A chi-square test was conducted to evaluate the effect of different dietary patterns on nutritional outcomes. A multivariable binary logistic regression model was used to identify factors affecting the dietary patterns of adolescents.

Result

Three types of dietary patterns, namely, traditional, mixed, and animal-source foods with traditional alcoholic beverage consumption were identified. These dietary patterns explain 58.64% of the variance in adolescent diet in the study setting. The burden of stunting was 15.12% vs. 11.21, 19.40% vs. 6.94, and 8.36% vs.17.97% among adolescents with lower traditional, mixed, and higher animal sources with alcoholic dietary pattern consumption habits, respectively (value of p <0.05). Adolescents who resided in low-land agroecology (AOR = 2.44; 95% CL: 1.24, 4.81) and had access to animal-source foods (AOR = 1.64; 95% CI: 1.04, 2.60) were associated with lower consumption of traditional dietary patterns. Similarly, adolescents who resided in low-land (AOR = 1.80; 95% CI: 1.18, 2.74) had formal education (AOR = 2.38; 95% CI: 1.35, 4.19) and had poor nutrition knowledge (AOR = 2.83; 95% CL: 1.55, 5.19) were associated with lower consumption of mixed dietary patterns. Moreover, adolescents residing in the high-land (AOR = 2.50; 95% CI: 1.37, 4.56) and being female (AOR =1.87; 95% CI: 1.27, 2.74) were significant factors associated with lower consumption of animal-sourced foods with traditional alcoholic beverage consumption patterns.

Conclusion

Multidimensional modifiable factors were explored that could be targeted for public health interventions for the identified dietary patterns. Integrated and multifaceted dietary intervention approaches are needed to promote healthy diets and discourage the consumption of unhealthy diets to reduce undernutrition in the study area and similar settings.

Dietary diversity and associated factors among school-aged children and adolescents in Lokossa district of southern Benin: a cross-sectional study

OBJECTIVE

The main objective of this study was to assess the prevalence of dietary diversity and associated factors.

DESIGN

Cross-sectional study.

SETTING

Lokossa district, southern Benin.

PARTICIPANTS

A survey conducted in a probabilistic sample of 612 students (345 boys and 267 girls), aged 8-17 years old from 26 primary schools. Dietary Diversity Scores were calculated by summing the number of food groups consumed by the schoolchildren and adolescents over a 24-hour recall period. Adequate dietary diversity can be assigned to a consumption that is greater than or equal to five food groups, and inadequate dietary diversity can be assigned to a consumption that is lower than five food groups. Descriptive statistics such as frequency, mean and SD were computed. Statistical analysis was performed on the data to determine which variables were associated with dietary diversity as well as the results of the adjusted OR with a 95% CI. A p<0.05 was considered statistically significant.

RESULTS

The proportion of schoolchildren and adolescents with inadequate dietary diversity was 25.8% (95% CI 15.1% to 40.5%). Schoolchildren and adolescents living in rural areas, having low household socioeconomic status, eating breakfast less than 5 days per week and no eating school meals were significantly associated with inadequate dietary diversity.

CONCLUSIONS

The results of this study revealed that the diet among schoolchildren and adolescents lacked diversity and is associated with socioeconomic status, rural living, eating breakfast and school meals. Public health interventions, such as school meal programmes in rural and isolated areas, in association with poverty-reducing programmes and nutrition education, are recommended to improve the quality of diet and limit the consequences of poor diet diversity.

Dietary diversity practice and associated factors among adolescents in Ethiopia, systematic review and meta-analysis

BACKGROUND

Adolescence (10-19 years) is a critical life period for growth and health. An increase in dietary diversity in the food is related to improved nutrient adequacy of the diet. However, studies conducted on dietary diversity practice among adolescents showed non-conclusive and inconsistent findings on the magnitude of the problem. Likewise, there was no meta-analysis conducted in the study area. Hence, this systematic review and meta-analysis were conducted to estimate the pooled prevalence of good dietary diversity practice and its associated factors among adolescents in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. All articles were systematically searched by Google Scholar, PubMed, Hinari, Cochrane Library, Global Health and CINAHL. Meta-analysis was conducted by using STATA 14 software. Forest plots were used to present the pooled prevalence of good dietary diversity practices. A random effect model was used to compute the pooled prevalence; while subgroup analysis was performed to identify the possible source of heterogeneity. Publication bias was assessed by the begg's and egger's test. Moreover, the associated factor of dietary diversity practices was observed.

RESULTS

This review involved 7 studies, and 3,950 participants. The pooled prevalence of good dietary diversity practice among adolescents in Ethiopia was 39.24% (95% CI: 30.82, 47.66). Mothers with formal education [AOR = 1.98, (95% CI: 1.65, 2.36)], fathers with formal education [AOR = 2.30, (95% CI: 1.81, 2.93)], Medium wealth index [AOR = 2.75, (95% CI: 1.96, 3.86)] and urban residence [AOR = 2.88, (95% CI: 1.59, 5.22)] were positively associated with good dietary diversity practice.

CONCLUSIONS

The pooled prevalence of good dietary diversity practices among adolescents is low. Being urban residents, the medium wealth quintile, mothers' educational status and fathers' educational status were independent factors of good dietary diversity practice among adolescents. Therefore, focused nutritional interventions should be given to rural residents and adolescents from low economic status.

Diet quality of preparatory school students in Awi Zone, Ethiopia: a cross-sectional study

OBJECTIVE

The study aimed to assess diet quality and associated factors among preparatory school students in Awi Zone, Ethiopia.

DESIGN

A school-based cross-sectional study design was used in this study.

SETTING

The study was carried out in Awi Zone, Amhara Region, Ethiopia.

PARTICIPANTS

A total of 834 preparatory school students participated in the study.

OUTCOME MEASURES

Diet quality was the outcome variable, and it was computed using the dietary diversity score, food variety score and consumption of animal-source foods. Students with high dietary diversity scores, appropriate animal-source food consumption and adequate food variety scores were labelled as having good-quality diets. Data were collected using a pretested structured self-administered questionnaire. Bivariate and multivariable logistic regressions were employed to analyse the data. Variables with p≤0.2 in the bivariate logistic regression analysis were included in the multivariable logistic regression model. Multivariable logistic regression analysis was done to determine the strength of the association. Statistical significance was determined at p value less than 0.05.

RESULTS

Only 24.7% (95% CI: 21.7%, 27.7%) of preparatory school students had good-quality diets. Being female (adjusted OR (AOR)=2.88, 95% CI: 2.0, 4.1), residing in an urban setting (AOR=1.90, 95% CI: 1.1, 3.2), having an educated mother (AOR=1.78, 95% CI: 1.1, 2.7), having pocket money (AOR=1.83, 95% CI: 1.2, 2.6) and nutrition information (AOR=1.90, 95% CI: 1.2, 3.1), and family monthly income >8000 Ethiopian birrs (AOR=3.90, 95% CI: 2.2, 7.1) were factors significantly associated with having good-quality diet.

CONCLUSION

The majority of the preparatory school students had poor-quality diets. These findings highlight the necessity of nutrition education that considers the sociodemographic characteristics of the students and their families. Implementing income-generating interventions for low-income households was also recommended by the findings.

Dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto sub city, Addis Ababa, Ethiopia, 2021

BACKGROUND

Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. However, the evidence revealed the variation and unrelated data on the prevalence of dietary diversity and lack of including all adolescent age and community groups in Ethiopia. Hence, this study assessed dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto Sub-city, Addis Ababa Ethiopia, 2021.

METHODS

A community-based cross-sectional study was conducted among 475 adolescent girls at Nifas Silk Laphto sub-city, Addis Ababa Ethiopia from July 1 to 30, 2021. Multistage cluster sampling was employed to select adolescent girls. Pretested questionnaires were used to collect the data. The data were checked for completeness and entered by Epidata version 3.1 and cleaned and analyzed by SPSS version 21.0. A multivariable binary logistic regression model was fitted to identify factors associated with dietary diversity scores. The degree of association was assessed using an odds ratio with a 95% confidence interval and variables with p-value ≤ 0.05 were considered significant.

RESULT

The mean and the standard deviation of dietary diversity scores were 4.70 and 1.21 respectively. The proportion of low dietary diversity scores among adolescent girls was 77.2%. Adolescent girls' age, meal frequency, wealth index of household, and food insecurity were significant determinants of dietary diversity score.

CONCLUSION

The magnitude of low dietary diversity scores was significantly higher in the study area. Adolescent girls', meal frequency, wealth index, and food security status were predictors of dietary diversity score. School-based nutrition education and counseling and designing strategies for improving household food security programs are crucial.

Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study

Background

Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally.

Objective

The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia.

Methods

A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant.

Results

The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18).

Conclusion

The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

Stunting and thinness in school-attending adolescents in Addis Ababa

BACKGROUND

Adolescent population Global Diet Quality Score (GDQS) is uncommon in low-income settings. Though Global Diet Quality Score is a good measure of dietary diversity, it has not been used in assessing nutritional outcomes among adolescents. Therefore, the aim of this study is to assess school-attending adolescents stunting and thinness status and associations with global diet quality scores in Addis Ababa.

METHODS

A school-based cross-sectional study was conducted among school-attending adolescents in the age group of 10-14 years in urban settings in Ethiopia. A multi-stage stratified random sampling procedure was used to select schools and students. A total of 1200 adolescents were included in the study. Binary and Multinomial logistic regression analyses were used to determine the predictors of stunting and thinness respectively.

RESULTS

The proportion of school-attending adolescents stunting was 8.17% (95% CI: 6.74%,9.85%) and their thinness status 12.66% (95% CI: 10.89%, 14.67%). The overall mean GDQS food groups for Seven days period consumed were 19.99 + 2.81 SD. Male adolescents were 1.95 times more likely to be stunted compared to female adolescents (1.95; 95%CI: 1.11,3.39). Frequent consumption of low-fat dairy increased the risk of thinness, while frequent consumption of citrus fruits and white root tubers decreased the risk of school-attending adolescents' thinness.

CONCLUSION

The proportion of thin or stunted adolescents attending school was high still, about 1 in 10. Stunting and thinness have no association with the overall GDQS. Nutritional interventions need to consider frequent consumption of citrus fruits, low-fat dairy, and white roots and tubers in school adolescents' nutritional programs. Further studies should validate the GDQS for stunting and thinness of school adolescents.

Dietary intake and its associated factors among in-school adolescents in Ghana

Introduction

Early-life nutrition related experiences may fuel the emergence of obesity and type 2 diabetes in adolescence. The adoption of unhealthy dietary practices early in life is an indicator of adverse cardiometabolic health in adulthood. In-school adolescents’ dietary practices in Ghana have not been explored extensively despite increasing levels of obesity in adolescents. This study sought to examine dietary practices, socio-demographic disparities and the factors influencing dietary choices among in-school adolescents in Ghana.

Methods

A school-based, cross-sectional study was conducted in the Central region of Ghana in 2017. Using multistage sampling procedures, a total of 1,311 in-school adolescents were selected for the study. A modified version of the generic Global School Health Survey questionnaire on dietary practices was adapted and used for data collection. Percentage and frequency counts were used to report on the dietary practices, while Chi-square was used to determine socio-demographic variations in the dietary practices. Binary logistic regression was used to compute the influence of socio-demographic characteristics of respondents on the prevalence of healthy dietary behavior among in-school adolescents.

Results

The study revealed the prevalence of healthy dietary practices (49.9%, n = 654) among in-school adolescents in the region. The study also found increased frequency in consumption of soft drinks (93%, n = 1220) and toffees/sweets (90%, n = 1183) among in-school adolescents. However, low intake of breakfast (57%, n = 749) was observed among the adolescents. Significant disparities were observed in relation to gender, age, parental communication, academic performance and geographical location in the dietary practices of in-school adolescents. Furthermore, gender (OR = 1.36, P = 0.007), academic performance (OR = 2.19, P = 0.001) and geographical location (OR = 1.79, P = 0.001) were found to be significantly associated with dietary practices among in-school adolescents in the region.

Conclusions

There was low consumption of fruits and vegetables among adolescents. Fruits and vegetables consumption was associated with gender, academic performance and geographical location, and these may be a reflection that knowledge on healthy food choices and availability are important factors influencing dietary choices among in-school adolescents. School health policy interventions aimed at improving nutritional status among adolescents and enhanced fruit and vegetable consumption in the country should take into account the potential benefit of increasing availability of fruits and vegetables in schools, while reducing access to sweets and soft drinks in the schools and communities.

Dietary diversity score and associated factors among high school adolescent girls in a selected school of Yeka Sub-city, Addis Ababa

Introduction:

Adequate dietary intake is critical for modification of eating behavior and provides nutrients required for growth particularly among adolescents. The evidence revealed the variation and unrelated data on the prevalence of dietary diversity among adolescent girls in Ethiopia.

Objective:

To assess the magnitude of dietary diversity and associated factors among high school adolescent girls at the selected school of Yeka Sub-city, Addis Ababa, Ethiopia 2021.

Methods:

A cross-sectional study was conducted in high schools of the Yeka sub-city. Self-administered questionnaires were used to collect data. Data were analyzed using SPSS and the characteristics of the study participants were reported using descriptive statistics. A logistic regression model was fitted to identify factors associated with dietary diversity.

Result:

The mean score of dietary diversity was 4.9 ± 1.47 with a response rate of 97.2% among a proposed number of participants. The dietary diversity score is high in 56.7% and low among 43.3% of adolescents. Stayed a long time on social media (adjusted odds ratio = 2.6), school type (adjusted odds ratio = 6.5), educational status of mother (adjusted odds ratio = 8.7), consuming more sweet food (adjusted odds ratio = 3.6), occupation of the mother (adjusted odds ratio = 2.3), household security (adjusted odds ratio = 2.3), and fear of obese/worried about shape (adjusted odds ratio = 5.0) were statistically associated with low dietary diversity score.

Conclusion:

The finding of the study revealed that the magnitude of low dietary diversity among adolescent girls was found to be high. Long time social media usage, school type, educational status of the mother, consuming more sweet food, occupation of mother, household food security, and fear of obese/worried about shape were statistically associated with dietary diversity score.

Indigenous vegetables: a sustainable approach to improve micronutrient adequacy in Tanzanian women of childbearing age

BACKGROUND/OBJECTIVES

Increasing dietary diversity is a viable strategy for addressing micronutrient malnutrition in women of childbearing age (WCA) from low-income countries. Recently, it has been demonstrated that some indigenous vegetables (IV) with high nutrient density may help to ameliorate micronutrient's intake. The Minimum Dietary Diversity index for Women (MDD-W) could be considered as a proxy to describe one important dimension of women's diet quality. This cross-sectional study aimed at exploring aspects contributing to micronutrients adequacy in Tanzanian WCA, with a focus on IV consumption and other socio-demographic factors.

SUBJECTS/METHODS

Data collection was conducted among urban and peri-urban women in Arusha city, Tanzania. Socio-demographic factors were collected using a structured interview. Information on IV consumption and MDD-W calculation were obtained using a 24-h recall.

RESULTS

One-hundred and forty-one women aged 14-49 years were interviewed. Sixteen per cent of the sample consumed at least one portion of IV/day. The total median MDD-W was 4.0 (IQR. 3.0-5.0) and it was adequate in the 44% of the sample. Women who consumed IV had MDD-W 0.66 points (95% CI: 0.02-1.30, p = 0.046) higher than those who did not; consuming IV had an odds ratio of more than three times concerning women not consuming IV (OR: 3.30, 95% CI: 1.24-8.81, p = 0.017).

CONCLUSIONS

The IV consumption is positively associated with micronutrient adequacy and its absence from the diet can be an indicator of micronutrient deficiencies in vulnerable people such as WCA. For that reason, this study suggests that IV consumption may improve micronutrient deficiency in WCA.