Dietary diversity score as an indicator of micronutrient intake in Filipino children and adolescents

Abstract

Background and objectives: The study objective was to assess if Dietary diversity score (DDS) based on counting 10 food groups consumed can be used as an indicator of adequacy of micronutrient intake in Filipino children and adolescents.

Methods and study design: Dietary data of 7448 Filipinos age 3 to 18 years old included in the National Nutrition Survey in 2013 were used to assess the adequacy of intake of iron, vitamin A, vitamin C, thiamin, riboflavin and niacin. Nutrient adequacy ratio (NAR) for each micronutrient was computed and these were used to calculate the mean adequacy ratio (MAR) for each individual. Linear association for MAR and the different scores of DDS was verified using Pearson's correlation. Sensitivity and specificity were analyzed through the receiver operating characteristics curve to determine the DDS cut-off point that can be used to ascertain adequacy of micronutrient intake.

Results: The mean DDS is 6 and the mean MAR is 0.69. There was significant positive correlation between MARs and NARs (p<0.0001), as well as between MAR and DDS (r=0.29; p<0.0001). A DDS of 6 showed the highest sensitivity (74.2%) and specificity (44.6%) for achieving MAR of 0.5, while a DDS of 7 had the highest sensitivity (54.9%) and specificity (67.6%) in achieving MAR of 0.75.

Conclusions: DDS is significantly correlated with micronutrient intake and a score of 6 or 7 can be used as a cutoff in screening for those with possible dietary micronutrient inadequacy in Filipino children and adolescents.