Verger Eric O, Eymard-Duvernay Sabrina, Bahya-Batinda Dang, Hanley-Cook Giles T, Argaw Alemayehu, Becquey Elodie, Diop Loty, Gelli Aulo, Harris-Fry Helen, Kachwaha Shivani, Kim Sunny S, Nguyen Phuong Hong, Saville Naomi M, Tran Lan Mai, Zagré Rock R, Landais Edwige, Savy Mathilde, Martin-Prevel Yves, Lachat Carl
MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France.
Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
Curr Dev Nutr. 2023 Nov 30;8(1):102053. doi: 10.1016/j.cdnut.2023.102053. eCollection 2024 Jan.
The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements.
This study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15-49 y in LMICs.
We used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60.
In the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%).
The WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.
育龄妇女最低饮食多样性（MDD-W）指标已被验证可作为低收入和中等收入国家（LMICs）非孕妇微量营养素充足程度的替代指标。实际上，当时尚无足够数据在面临更高微量营养素需求的孕妇中验证该指标。
本研究旨在从用于构建MDD-W的10个食物组中验证一个最低食物组消费阈值，用作LMICs中15 - 49岁孕妇更高微量营养素充足程度的人群水平指标。
我们使用了来自4个LMICs（孟加拉国、布基纳法索、印度和尼泊尔）6项调查的二次定量24小时回顾数据（总计 = 4909）。我们计算了10食物组的妇女饮食多样性得分（WDDS-10），并计算了11种微量营养素的充足平均概率（MPA）。采用线性回归模型评估WDDS-10与MPA之间的关联。使用敏感性、特异性和正确分类个体的比例来评估MDD-W在预测MPA>0.60时的表现。
在汇总样本中，WDDS-10和MPA的中位数（四分位间距）分别为3（1）和0.20（0.34），而MPA>0.60的孕妇比例为9.6%。在每项调查中，WDDS-10与MPA均呈显著正相关。尽管不同调查中可接受的食物组消费阈值在4至6个食物组之间有所不同，但5个食物组的阈值在汇总样本中表现最佳，敏感性良好（62%），特异性非常好（81%），正确分类个体的百分比为（79%）。
WDDS-10是LMICs中15 - 49岁孕妇饮食微量营养素充足程度的良好预测指标。此外，MDD-W指标中5个或更多食物组的阈值可能适用于所有育龄妇女，无论其生理状态如何。
