Exploring Differences in Dietary Diversity and Micronutrient Adequacy between Costa Rican and Mexican Adolescents

Abstract

Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.

Keywords: Latin American countries; adolescents; micronutrient probability of adequacy; minimum dietary diversity.

Figure 1

Percentage of specificity and sensitivity for diverse MPA values by 10 MDD cut-off points. (Panel A): CR adolescents, (Panel B): MX adolescents. ¹ Specificity: identifies nutritionally appropriate diets as adequate. ² Sensitivity: identifies nutritionally inappropriate diets as inadequate. MDD: Minimum Dietary Diversity; MPA: Mean Probability of Adequacy.

Figure 2

Methodological diagram showing characteristics of the Mexican and Costa Rican studies. MDD: minimum dietary diversity; ROC: receiver-operating characteristic; DD: diet diversity.

Figure 3

Percentage of Costa Rican and Mexican adolescents with consumption lower than 15 g for each of the ten food groups. F&V: fruits and vegetables. * Food groups with significant differences between countries (chi-square test, p < 0.05).

Figure 4

Percentage of adolescents whose consumption of the different food groups was less than 15 g. (Panel A): Data set by sex, (Panel B): data set by area of residence. F&V: fruits and vegetables. * Food groups with significant differences between categories of sex and area of residence (chi-square test, p < 0.05).

Figure 5

Probability of Adequacy (PA) for each nutrient and Mean Probability of Adequacy (MPA) by country. * Nutrients with significant differences between countries, determined using the Wilcoxon test (p < 0.05).