International Food Policy Research Institute, Washington, DC.
FHI 360, Washington, DC.
J Nutr. 2018 May 1;148(5):790-797. doi: 10.1093/jn/nxy045.
The Minimum Dietary Diversity for Women (MDD-W) indicator based on a 10-food group women dietary diversity score (WDDS-10) has been validated to assess dietary quality in nonpregnant women. Little is known about its applicability in pregnant women, and specifically pregnant adolescent girls with higher nutrient requirements.
This study aimed to 1) compare the adequacy of micronutrient intakes between pregnant adolescent girls and women, 2) examine the performance of WDDS-10 in predicting the mean probability of adequacy (MPA) of 11 micronutrients, and 3) assess how well the MDD-W cutoff of 5 groups performed in pregnant adolescent girls and women.
We used data from a 2015 household survey in Bangladesh (n = 600). Nutrient intakes were estimated with a multiple-pass 24-h recall and WDDS-10 was assessed through the use of a list-based method. Multiple linear regression models adjusted for geographical clustering assessed the association between WDDS-10 and MPA. Sensitivity and specificity analysis assessed the accuracy of MDD-W in correctly classifying individuals into high (MPA >0.6) or low MPA.
Dietary intakes of pregnant adolescent girls and women were similar in energy intake, WDDS-10 (5.1 ± 1.4), MPA (0.40 ± 0.12), and micronutrient intakes. Probabilities of adequacy were ∼0.30 for riboflavin, vitamin B-12, calcium, and zinc; 0.12-0.15 for folate; 0.16-0.19 for vitamin A; and extremely low for iron at 0.01. The WDDS-10 was significantly associated with MPA in both groups and predicted MPA equally well at population level (SD of residuals 0.11 for both). Use of the 5-food groups cutoff for MDD-W to classify individuals' diets into MPA >0.6, however, resulted in a low correct classification (∼40%). A cutoff of 6 food groups markedly improved correct classification.
The WDDS-10 predicted MPA equally well for pregnant adolescent girls and women at population level. The MDD-W indicator performed poorly in classifying individuals with MPA >0.6.
基于十种食物的妇女饮食多样性得分（WDDS-10）的最低饮食多样性女性指标（MDD-W）已被验证用于评估非孕妇的饮食质量。但对于孕妇，特别是营养需求较高的孕妇青少年，其适用性知之甚少。
本研究旨在 1）比较孕妇青少年与妇女微量营养素摄入量的充足程度，2）检验 WDDS-10 预测 11 种微量营养素平均充足概率（MPA）的表现，3）评估 MDD-W 五分位切点在孕妇青少年和妇女中的表现。
我们使用了 2015 年孟加拉国一项家庭调查的数据（n=600）。采用多次通过 24 小时回忆法估计营养素摄入量，并采用基于清单的方法评估 WDDS-10。调整地理聚类的多元线性回归模型评估了 WDDS-10 与 MPA 之间的关联。敏感性和特异性分析评估了 MDD-W 正确分类高（MPA>0.6）或低 MPA 个体的准确性。
孕妇青少年和妇女的能量摄入量、WDDS-10（5.1±1.4）、MPA（0.40±0.12）和微量营养素摄入量相似。核黄素、维生素 B-12、钙和锌的充足概率约为 0.30；叶酸为 0.12-0.15；维生素 A 为 0.16-0.19；铁的充足概率极低，为 0.01。WDDS-10 在两组中均与 MPA 显著相关，在人群水平上预测 MPA 的能力相当（残差标准差均为 0.11）。然而，使用 MDD-W 的五分位切点将个体的饮食分类为 MPA>0.6，正确分类的比例较低（约 40%）。六分位切点则明显提高了正确分类的比例。
WDDS-10 在人群水平上对孕妇青少年和妇女的 MPA 预测能力相当。MDD-W 指标在对 MPA>0.6 的个体进行分类时表现不佳。
