Diet Diversity is Negatively Associated with Stunting among Ethiopian Children 6-35 Months of Age
Tibebu Moges *
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Katherine A. Birks
Micronutrient Initiative, Ottawa, Canada.
Aregash Samuel
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Aweke Kebede
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia
Amha Kebede
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Sara Wuehler
Micronutrient Initiative, Ottawa, Canada.
Dilnesaw Zerfu
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Adinet Abera
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Girma Mengistu
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Biniyam Tesfaye
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Getachew Addis
Ethiopian Health and Nutrition Research Institute, Addis Aabab, Ethiopia.
Jalal Chowdhury
Micronutrient Initiative, Ottawa, Canada.
*Author to whom correspondence should be addressed.
Abstract
Objectives: In 2011, the Ethiopian Demographic and Health Survey reported 44% of children under five years-of-age were stunted (i.e., height-for-age z-score (HAZ) below -2) and 11% were consuming minimum diet diversity (DD), a World Health Organization core indicator for infant and young child feeding. DD has been found to be negatively associated with stunting among children 6-23 months-of-age. Our objective was to determine the association between DD and stunting among Ethiopian children.
Methods: We used nationally and regionally representative data from the 2011 Ethiopian National Food Consumption Survey, weighted for relative population sizes (N=6819 children 6-35 months-of-age). A DD score was calculated for each child by categorizing individual foods consumed in quantities > 5 g in the past 24-hours into the United Nations Children's Fund seven food groups for DD. We used Chi-square to determine in which regions children were consuming minimum DD, defined as ≥4 food groups. We used logistic regression to determine the association between DD and stunting, including all potential socioeconomic, demographic and physiological confounders.
Results: DD was negatively associated with stunting (OR= 0.965, p<0.0001). Nationally, 14.9% of children consumed adequate DD, with highest rates observed in the Addis Ababa (27.7%) and Harari (23.9%) region (p<0.0001).
Conclusions: As with other populations, our Ethiopian findings suggest that increasing DD may be one method of reducing child stunting rates. Due to broad variations in regional dietary consumption in Ethiopia, future research will include more specific validation exercises of DD as a marker of dietary consumption in this population.