European Journal of Nutrition & Food Safety

Objectives: Determining that dietary diversity can be used as indicator of micronutrient adequacy irrespective of season, we examined seasonal variations in dietary diversity, nutrient adequacy, and their association among Kenyan women (reproductive age).

Methods: Repeated non-consecutive 24hr-recalls data collected during pre-harvest (period 1, Oct 2007, n=73), post-harvest (period 2, April 2008, n=203) and pre-harvest (period 3, Oct 2008, n=192) seasons. We constructed dietary diversity scores (DDS) based on 13 food groups, minimum intake of 15 g and calculated mean probability of adequacy (MPA) for 11 micronutrients. Correlations / regression analysis tested association between DDS and MPA and effects of season. Sensitivity/specificity analysis detected cut-off values of DDS indicating low nutrient adequacy.

Results: DDS ranged from 4.5±1.2 period 1 to 3.2±1.3 period 3, indicating low diverse diet, based on starchy staples, without consumption of organ meat and fish. MPA ranged from 0.36±0.07 period 1 to 0.11±0.08 period 3.  DDS and MPA were significantly associated in all seasons, the strength of association varied slightly per season, being stronger in the post/pre-harvest periods 2 and 3. DDS cut-off of 4 (MPA≤40%) periods 1 and 2, and DDS cut-off of 3 (MPA≤20%) period 3, maximized sensitivity/specificity detecting low adequacy.

Conclusions: DDS can be used as a simple indicator for micronutrient adequacy, but strength of association and cut-off level of DDS indicating inadequacy is moderated by season.