Methods of Measuring Dietary Diversity Lalita Bhattacharjee Agnieszka Balcerzak Aklima Parvin Nutritionists Training on Comparative Review of the Nutrition Situation and Policies in Selected Countries and with particular reference to Bangladesh 27 March to 6 April 2014

Foods differ in terms of nutrients they deliver to our organism, and we need to consume a bit from each of the food groups to make sure we cover our nutritional needs.

Grouping foods in a functional food groups is the first step to talk about dietary diversity

Overview of the Methodology Food security assessments have been standardized For dietary assessment there is no one “correct” method Recent Fanta II/FAO have proposed and validated 8 options:  6 group (restricted and unrestricted)  9 groups (restricted and unrestricted)  13 groups (restricted and unrestricted)  21 groups (restricted and unrestricted)

Data Collection Dietary recall Limitations: – Incorrect recall (respondent biases) – Investigator error – Time consuming interview – Relays largely on the cognitive abilities and memory of the respondent – Annoying for the respondent Practical Exercise 3: Use of dietary diversity in food security and nutrition surveillance – Jillian L. Waid

FoodQuantity(g) Breakfast (7AM) Rice parboiled180 Gourd(bottle )125 Potato100 Bengal gram15 Spices10 Oils Soybean10 Lunch : 1pm, Rice parboiled180 Khalshe fish40 Red amaranth/lal shak125 Bengal gram (split)/cholar dal15 Spices10 Oils Soybean10 Evening snacks 4PM Peas dried /split30 Rice (Puffed)50 Dinner : 8 pm, Rice parboiled150 Indian spinach/pui shak125 Gourd (Bottle)125 Bengal gram (split)20 Spices10 Oils Soybean10

16 Food groups Question Number Food groupQuestion Number Food group 1.CEREALS9.FLESH MEATS 2.WHITE POOTS AND TUBERS10.EGGS 3. VITAMIN A RICH VEGETABLES AND TUBERS 11.FISH AND SEAFOOD 4. DARK GREEN LEAFY VEGETABLES 12.LEGUMES, NUTS AND SEEDS 5.OTHER VEGETABLES13.MILK AND MILK PRODUCTS 6.VITAMIN A RICH FRUITS14.OILS AND FATS 7.OTHER FRUITS15.SWEETS 8.ORGAN MEAT16. SPICES, CONDIMENTS, BEVERAGES

Scoring Practical Exercise 3: Use of dietary diversity in food security and nutrition surveillance – Jillian L. Waid HDDSWDDS 9-groupWDDS 13-groupIYCF DD QFood GroupQ Q Q 1.Cereals1,2Starchy staples1,2Starchy staples1,2Starchy staples 2.White tubers & roots4Dark green leafy vegetables 4 3,4,5Vegetables3,6Vitamin A rich fruits & vegetables 3Vitamin A rich vegetables 3,4,6Vitamin A rich fruits & vegetables 5,7Other fruits & vegetables 6Vitamin A rich fruits 5,7Other fruits & vegetables 5Other vegetables 6,7Fruits7Other fruits 8,9Meat8Organ meat8 11Fish and other sea food 9,11Meat and fish9,11Meat and fish8,9,11Flesh foods 10Egg10Egg10Egg10Egg 12Legumes, nuts & seeds12Legumes, nuts & seeds 12Legumes, nuts & seeds 12Legumes, nuts & seeds 13Dairy13Dairy13Dairy13Dairy 14Oils & fats 15Sweets 16Condiments & beverages

Methods for Data Analysis Cut-offs: Not universally defined – FANTA 2: less than 5 (out of 9 or 13 groups) inadequate Programmatically: – Goal to raise the mean overall to the mean of the top third of respondents

HDDS Calculation  Step 1: Assign 1 if the food group/item consumed; 0 not consumed. Sum all the scores for various food groups. Sum will be between  Step 2: The average HDDS for the sample population Sum HDDS Total no. of households Setting HDDS Threshold: Option 1: From a baseline survey take the HDDS for the richest income tercile (33%) Option 2: From a baseline survey take HDDS of the upper tercile of diet diversity (33%)

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