Arimond Mary, Ruel Marie T
Food Consumption and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC 20006, USA.
J Nutr. 2004 Oct;134(10):2579-85. doi: 10.1093/jn/134.10.2579.
Simple indicators reflecting diet quality for young children are needed both for programs and in some research contexts. Measures of dietary diversity are relatively simple and were shown to be associated with nutrient adequacy and nutritional status. However, dietary diversity also tends to increase with income and wealth; thus, the association between dietary diversity and child nutrition may be confounded by socioeconomic factors. We used data from 11 recent Demographic and Health Surveys (DHS) to examine the association between dietary diversity and height-for-age Z-scores (HAZ) for children 6-23 mo old, while controlling for household wealth/welfare and several other potentially confounding factors. Bivariate associations between dietary diversity and HAZ were observed in 9 of the 11 countries. Dietary diversity remained significant as a main effect in 7 countries in multivariate models, and interacted significantly with other factors (e.g., child age, breast-feeding status, urban/rural location) in 3 of the 4 remaining countries. Thus, dietary diversity was significantly associated with HAZ, either as a main effect or in an interaction, in all but one of the countries analyzed. These findings suggest that there is an association between child dietary diversity and nutritional status that is independent of socioeconomic factors, and that dietary diversity may indeed reflect diet quality. Before dietary diversity can be recommended for widespread use as an indicator of diet quality, additional research is required to confirm and clarify relations between various dietary diversity indicators and nutrient intake, adequacy, and density, for children with differing dietary patterns.
无论是在项目中还是在某些研究背景下，都需要有反映幼儿饮食质量的简单指标。饮食多样性的衡量相对简单，并且已被证明与营养充足和营养状况相关。然而，饮食多样性也往往会随着收入和财富的增加而提高；因此，饮食多样性与儿童营养之间的关联可能会受到社会经济因素的混淆。我们使用了最近11次人口与健康调查（DHS）的数据，来研究6至23个月大儿童的饮食多样性与年龄别身高Z评分（HAZ）之间的关联，同时控制家庭财富/福利以及其他几个可能的混杂因素。在11个国家中的9个国家观察到了饮食多样性与HAZ之间的双变量关联。在多变量模型中，饮食多样性在7个国家中作为主要效应仍然显著，并且在其余4个国家中的3个国家中与其他因素（例如儿童年龄、母乳喂养状况、城乡位置）存在显著交互作用。因此，在除一个国家之外的所有分析国家中，饮食多样性无论是作为主要效应还是在交互作用中，都与HAZ显著相关。这些发现表明，儿童饮食多样性与营养状况之间存在独立于社会经济因素的关联，并且饮食多样性可能确实反映了饮食质量。在饮食多样性能够被推荐广泛用作饮食质量指标之前，还需要进行更多研究，以确认并阐明不同饮食模式儿童的各种饮食多样性指标与营养摄入、充足性和密度之间的关系。
