The Johns Hopkins Bloomberg School of Public Health Center for Human Nutrition, Baltimore, MD.
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC.
J Nutr. 2018 Jan 1;148(1):131-139. doi: 10.1093/jn/nxx011.
Dietary diversity scores and dichotomous indicators derived from them are widely used to assess dietary quality, and specific scoring methods have been recommended for women and 6- to 23-mo-old children. However, there is no specific score recommended for older children and the effect of seasonal dietary changes on score performance is not well documented.
We assessed performance of 2 recommended dietary diversity scores as indicators of dietary quality over 3 seasons.
We conducted 7 repeat 24-h dietary recalls among 4- to 8-y-old rural Zambian children (n = 200) over 6 mo. Dietary diversity was assessed using a 7-food group score for assessing infant and young child feeding (DDS-IYCF) and a 10-food group score for use among women of reproductive age (DDS-W). Micronutrient intake adequacy was described by mean probability of adequacy (MPA) over 11 micronutrients. Longitudinal models were fit to test the association between each score and MPA overall and by season. Receiver operating characteristic (ROC) curves were used to describe indicator performance of each score.
Mean ± SE scores were 4.11 ± 0.03 for DDS-IYCF and 4.39 ± 0.03 for DDS-W. Both scores varied by season, but DDS-W better reflected seasonal dietary changes. Across seasons, MPA increased 1-6 percentage points/unit increase in DDS-IYCF or 1-10 percentage points for DDS-W (P < 0.05). Score performance as a predictor of MPA > 0.75 was moderate, with area under the ROC curve values by season ranging from 0.63 to 0.77 for DDS-IYCF and from 0.66 to 0.72 for DDS-W.
DDS-W performed better than DDS-IYCF in characterizing seasonal variability and micronutrient adequacy among rural Zambian children.
饮食多样性评分和由此衍生的二分指标被广泛用于评估饮食质量，并且已经为女性和 6 至 23 月龄儿童推荐了特定的评分方法。然而，对于年龄较大的儿童，没有推荐特定的评分，并且关于季节性饮食变化对评分表现的影响的记录并不多。
我们评估了 2 种推荐的饮食多样性评分在 3 个季节作为饮食质量指标的表现。
我们在 6 个月的时间里，对 4 至 8 岁的赞比亚农村儿童（n=200）进行了 7 次重复 24 小时饮食回忆。使用评估婴幼儿喂养的 7 种食物组评分（DDS-IYCF）和 10 种食物组评分（适用于育龄妇女的 DDS-W）来评估饮食多样性。通过 11 种微量营养素的平均充足率（MPA）来描述微量营养素摄入的充足性。使用纵向模型来测试每个评分与 MPA 的总体和季节之间的关联。使用受试者工作特征（ROC）曲线来描述每个评分的指标表现。
DDS-IYCF 的平均得分±标准误差为 4.11±0.03，DDS-W 的平均得分±标准误差为 4.39±0.03。这两个评分都因季节而异，但 DDS-W 更好地反映了季节性饮食变化。在各个季节，DDS-IYCF 每增加 1-6 个百分点/单位或 DDS-W 每增加 1-10 个百分点，MPA 就会增加 1-6 个百分点（P<0.05）。作为 MPA>0.75 的预测指标，评分的表现为中等，每个季节的 ROC 曲线下面积值在 DDS-IYCF 为 0.63 至 0.77，在 DDS-W 为 0.66 至 0.72。
DDS-W 在描述赞比亚农村儿童的季节性变化和微量营养素充足性方面优于 DDS-IYCF。
