Dietary Patterns and Risk of Micronutrient Deficiencies: their Implication for Nutritional Intervention in Ethiopia

Abstract

Background: Dietary patterns are the quantities, proportions, variety or combinations of different foods and beverages in diets, and the frequency with which they are habitually consumed. In Ethiopia, information on the dietary patterns and association of the proxies of dietary adequacy and quality with nutritional outcomes is scarce. The aims of this paper were to assess the interactions between dietary patterns, nutritional adequacy, nutritional quality and the risk of micronutrient deficiencies, and to highlight their implications in nutritional interventions. Methods: A community based cross-sectional study was carried out in North Shewa zone of Amhara Regional State, central Ethiopia from December 2014 to February 2015. Multistage sampling techniques were employed to recruit participants and 640 subjects involved in the study. Data were collected using structured and seven-day recall questionnaires. Chi-Square test, Kruskal-Walis test, Spearman correlation, multiple linear and multinomial regression models were used for inferential analyses. Results: The main dietary patterns included cereals, vegetables and legumes. Animal Source Foods (ASF) was consumed by 35.4% of participants. The median (range) of Food Variety Score (FVS) and Diet Diversity Score (DDS) were 16 (8-25) and 3.43 (1.14-5.57), respectively. About 28 % of subjects were malnourished. FVS had a positive correlation with DDS (r=0.502, p<0.001) and Body Mass Index (BMI) (r=0.145, p<0.001). DDS had also a positive correlation with BMI (r= 0.19, p<0.001). Family size and educational status were identified as determinant factors for FVS, but the later had a significant influence on DDS. The risks of vitamin A and iron deficiencies were 60.3% and 86.3%, respectively. The consumption of food groups rich in vitamin A and haem iron were significantly different across FVS and DDS (p<0.05). Conclusions: Dietary inadequacy, poor nutritional quality and high risk of micronutrient deficiencies were identified. These underlined the implications of nutritional interventions in central Ethiopia. Keywords: dietary patterns; micronutrients; FVS; DDS; BMI; Ethiopia Abbreviations: ASF – Animal Source Foods; BMI – Body Mass Index; DDS – Diet Diversity Score; FVS – Food Variety Score; LL – Lower Limit; OR - Odds Ratio; UL – Upper Limit; UNICEF – United Nations Children’s Fund; WHO – World Health Organization