BACKGROUND: Ethiopia is reported to have one of the highest prevalence of underweight among lactating mothers in Africa. In our study setting, the nutritional report from the district health office showed a high number of underweight lactating mothers and recurrent malnutrition problems. However, the determinants of underweight among lactating mothers were not well understood in our study setting. The study aimed to assess the determinants of underweight among lactating mothers in public health facilities of Siraro District, Southern Ethiopia.
METHODS: Unmatched case control study was conducted among 390 (130 cases and 260 controls) lactating mothers in public health facilities of Siraro District from April 30 to May 30/2022. Cases were lactating mothers with BMI < 18.5 kg/m2 and controls were mothers whose BMI was ≥ 18.5 kg/m2. To identify the determinants of underweight, bivariate and multivariable binary logistic regression analysis were carried out. The final model was interpreted using adjusted odds ratio (AOR), along with a 95% confidence interval (CI). Significance was declared at p-value < 0.05.
RESULTS: Multivariable logistic regression analysis revealed that having; antenatal care visits [AOR = 0.43, 95% CI (0.26,0.72)], latrine availability [AOR = 0.50,95% CI (0.27,0.93)], poor food consumption score [AOR = 5.40, 95% CI (3.15,9.27)], inadequate dietary diversity score [AOR = 1.66, 95% CI (1.20,2.78)], medium [AOR = 3.34, 95% CI (1.52,7.33)] and poor wealth index [AOR = 6.32, 95%CI(3.12,12.81)] were significantly associated with being underweight among lactating mothers.
CONCLUSIONS: Antenatal care visits, latrine availability, poor food consumption scores, inadequate dietary diversity score, medium and poor wealth index were the determinants of underweight. A multi-sectoral approach focusing on latrine construction, economic empowerment and food diversification, as well as ongoing awareness creation, is essential to increase the nutritional status of lactating mothers and break the vicious cycle of malnutrition.

BACKGROUND: Dietary diversity refers to the consumption of a variety of foods or food groups over a given reference period, which is crucial for improving nutrition and overall health. This longitudinal study aimed to investigate the association between dietary diversity and anthropometric indices in community-dwelling older adults living in Tehran in 2017 and 2021.
METHODS: The current study was conducted on 368 older adults [204 (55.4%) women and 164 (44.6%) men] over 60 years of age living in Tehran, who were selected by a systematic cluster sampling method at two-time points, 2017 and 2021. Anthropometric measures (weight, height, hip circumference, and waist circumference) were assessed with standard methods. The participants\' dietary intake was assessed by completing two non-consecutive 24-hour recalls, and dietary diversity score (DDS) was calculated based on Kant\'s method. Statistical analysis was performed using R software by the mixed effect model method.
RESULTS: The mean DDS of the participants in 2017 (5.07 ± 1.20) was higher than that in 2021 (4.94 ± 1.09) (p < 0.05). DDS and dairy diversity score decreased significantly over time. After adjusting for confounders, there was an inverse relationship between the DDS and Body Mass Index (BMI) (B = -0.22; SE = 0.09), but the interaction effect of year × DDS (B = 0.19; SE = 0.10) was not significant (p = 0.06). However, there was a positive relationship between the DDS and A Body Shape Index (ABSI) (B = 0.00; p = 0.022), after adjusting for confounders, this relationship was no longer significant. Additionally, the interaction effect of year and DDS on the ABSI was not significant.
CONCLUSIONS: The dietary intake and dietary diversity of older adult residents of Tehran declined dramatically with age, and a higher DDS was associated with improved anthropometric indices. DDS had an inverse relationship with general obesity in the studied participants, and the passage of time did not affect this relationship. The DDS can be used as a predictive index and is a powerful tool for investigating changes in nutritional status in longitudinal studies of old age. However, longer-duration studies are needed to obtain more conclusive results.

Background and Objectives: Anaemia is one of the most common forms of malnutrition globally, with most anaemia cases related to micronutrient deficiency. Diets with higher dietary diversity scores (DDS) are usually nutritionally diverse and could positively impact micronutrient status, including haemoglobin (Hb) concentration improvement. The study aimed to determine DDS and its association with the Hb concentration of Boarding and Day adolescent Senior High School students in Ghana. Materials and Methods: A semi-structured and three 24 h dietary recalls were used to obtain the participants\' demographic and diet intake data, respectively. Hb concentration was assessed using a validated portable haemoglobinometer. DDS was evaluated using the Minimum Dietary Diversity for Women (MDD-W) approach. Results: A significant difference in the DDS between Boarding and Day students existed. Only 22% of the Boarding students had adequate dietary diversity, whereas 64% of the Day students had adequate dietary diversity. A significantly smaller proportion of the Boarding students consumed nuts and seeds, dairy, flesh foods, eggs, vitamin A-rich vegetables and fruits, other vegetables, and other fruits compared to Day students (p < 0.05, all). No significant difference (p = 0.925) in mean (±SD) Hb concentrations between Boarding (11.9 ± 1.1 g/dL) and Day (11.9 ± 1.1 g/dL) students was found. Additionally, no significant correlation between mean DDS and Hb concentration (p = 0.997) was recorded. Using Hb < 12 g/dL as the determination of anaemia, 55.1% Boarding and 57.8% Day students had anaemia. Conclusions: Low dietary diversity in Boarding students highlighted inadequate nutrition provided by school meals. Strategies to increase meal diversity should be prioritised by stakeholders in Ghana\'s educational sector.

BACKGROUND: School-age is a dynamic period of growth and development, leading to good health and a productive adult life. Adequate dietary intake provides essential nutrients for growth, health and cognition. However, the practices of adequate nutrition is still not a matter of course for schoolchildren in many countries. The aim of this study was to identify associated factors of dietary diversity among students in public primary school in the Central Plateau Region.
METHODS: Multi-stage sampling was used to select schoolchildren. A semi-structured questionnaire was used to collect information\'s of food consumption at home and at school using a 24-h dietary recall method. Binary logistic regression was used to identify variables associated with students\' dietary diversity scores (DDS) with statistical significance at p < 0.05, after performing Chi-square test of independence to identify candidates variables at p < 0.25.
RESULTS: The study involved 560 pupils aged 6 to 14 older, including 52.9% girls and 47.9% boys. Dietary diversity was divided into three classes: low (DDS ≤ 4), medium (DDS = 5) and high (DDS ≥ 6). Thus, 13.4% of students have a low DDS and average in 48.9%, versus 37.7% high. Students in Ganzourgou were twice as likely to have a low DDS (AOR = 2.01, 95% CI:1.00-4.04) compared to those in Oubritenga. Household drinking water source, pupil status and father\'s occupation were significantly associated with pupils\' dietary intake.
CONCLUSIONS: Primary schoolchildren don\'t have good dietary practices in the Plateau Central Region. Promoting dietary diversification in households and balanced meals in school canteens would be necessary to improve the DDS of schoolchildren.
BACKGROUND: Clinical Trial Number: 2022_33_/MS/MESRSI/CERS of 02/14/2022.

OBJECTIVE: Our study aimed to investigate the association of dietary diversity score (DDS), as reflected by five dietary categories, with biological age acceleration.
METHODS: A cross-sectional study.
METHODS: This study included 88,039 individuals from the UK Biobank.
METHODS: Biological age (BA) was assessed using Klemerae-Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age represents the age acceleration (AgeAccel), termed as \"KDMAccel\" and \"PhenoAgeAccel\". AgeAccel > 0 indicates faster aging. Generalized linear regression models were performed to assess the associations of DDS with AgeAccel. Similar analyses were performed for the five dietary categories.
RESULTS: After adjusting for multiple variables, DDS was inversely associated with KDMAccel (βHigh vs Low= -0.403, 95%CI: -0.492 to -0.314, P < 0.001) and PhenoAgeAccel (βHigh vs Low= -0.545, 95%CI: -0.641 to -0.450, P < 0.001). Each 1-point increment in the DDS was associated with a 4.4% lower risk of KDMAccel and a 5.6% lower risk of PhenoAgeAccel. The restricted cubic spline plots demonstrated a non-linear dose-response association between DDS and the risk of AgeAccel. The consumption of grains (βKDMAccel = -0.252, βPhenoAgeAccel = -0.197), vegetables (βKDMAccel = -0.044, βPhenoAgeAccel = -0.077) and fruits (βKDMAccel = -0.179, βPhenoAgeAccel = -0.219) was inversely associated with the two AgeAccel, while meat and protein alternatives (βKDMAccel = 0.091, βPhenoAgeAccel = 0.054) had a positive association (All P < 0.001). Stratified analysis revealed stronger accelerated aging effects in males, smokers, and drinkers. A strengthening trend in the association between DDS and AgeAccel as TDI quartiles increased was noted.
CONCLUSIONS: This study suggested that food consumption plays a role in aging process, and adherence to a higher diversity dietary is associated with the slowing down of the aging process.

Little is known about the independent and joint effects of the energy-adjusted dietary inflammatory index (E-DII) and dietary diversity score (DDS) on sarcopenia and its components (low muscle mass, low muscle strength, and low physical performance). A total of 155,669 UK Biobank participants with ≥1 (maximum 5) 24 h dietary assessments were included in this cross-sectional analysis. We used logistic regression models to investigate the associations of E-DII and DDS with sarcopenia and its three components. We further examined the joint effects of E-DII and DDS on sarcopenia and its components using additive and multiplicative interaction analyses. We observed that lower E-DII and higher DDS were associated with lower odds of sarcopenia and its components. There were significant joint associations of E-DII and DDS with sarcopenia and low physical performance (p-interaction < 0.05) on the multiplicative interactive scale. Our study suggests that lower dietary inflammatory potential and higher dietary diversity might be important protective factors against sarcopenia and its components. More cases of sarcopenia and low physical performance might be preventable by adherence to a more anti-inflammatory diet combined with a higher dietary diversity.

BACKGROUND: Malnutrition is a worldwide problem that impacts every country, affecting one in three individuals, including Ghana. According to estimates from the Food and Agriculture Organization (FAO), 690 million people were undernourished globally in 2019. Malnutrition is no exception in rural cocoa communities in Ghana. The expansion of cocoa is causing food insecurity and low dietary diversity in most cocoa-growing areas. There is little information on the food security status and dietary diversity among male-headed and female-headed cocoa households in the Juaboso-Bia cocoa landscape. Thus, this study sought to explore the dietary diversity distribution, food security status, sources of staple food, food unavailability periods, food production status, themes contributing to low dietary diversity and food insecurity, and perception of the impact of cocoa expansion on crop diversification among male-headed and female-headed cocoa households in the study area.
METHODS: Both quantitative and qualitative research methods were employed to address the research questions. The study collected 200 semi-structured questionnaire data and 14 in-depth interview data from cocoa household heads in the Juaboso-Bia landscape. The survey data was cleaned and analysis, such as household dietary diversity status, food security status, and binary logistic regression were performed in the Statistical Package for Social Scientists (SPSS). The in-depth interviews were analyzed using thematic analysis.
RESULTS: Through this study, it was revealed that 62.8% of the male-headed cocoa households had medium to high dietary diversity compared to their female counterparts 39.3%. About 47.9% of the male-headed households were food secure than the female-headed households (29.1%). Moreover, the months that both male and female-headed households recalled facing severe food unavailability were July and June. In addition, climate change/variability, unavailable lands, poverty, large household size, and gender stereotypes were themes promoting low dietary diversity and food insecurity among male and female-headed households. Furthermore, sex, total household income, and cropland conversion to cocoa were the variables influencing household heads\' perception of the impact of cocoa expansion on crop diversification.
CONCLUSIONS: The study showed that the male-headed cocoa households had high dietary diversity and were food secure than the female-headed cocoa households, lending credence to the conceptual framework applied in this study. There is a significant relationship between household head gender and food security status. Therefore, this study recommends the following interventions to improve dietary diversity and food security among male and female-headed cocoa households: raise awareness about the need for diverse diets and provide practical information on how to incorporate a greater variety of food groups into their daily meals; and promote gender equity and inclusivity in food security interventions. Future research could investigate how gender mainstreaming policies in agriculture have helped empower and improve the food security of female-headed households in Ghana.

UNASSIGNED: Tuberculosis (TB) is a major public health problem that affects millions of people worldwide. Malnutrition is a common complication of TB and can worsen the disease outcome. The purpose of this study was to investigate the dietary and nutritional status, as well as the dietary structure, of TB patients in Hulunbuir City, Inner Mongolia, China. Additionally, the study aimed to analyze the factors that influence the nutritional status in order to provide a theoretical foundation for the prevention and treatment of TB and related issues.
UNASSIGNED: A cross-sectional study was conducted on 334 randomly selected TB patients from Hulunbuir City Second Hospital. A questionnaire survey was administered to collect information on demographic characteristics, dietary habits, and food intake. Nutritional status was assessed by body mass index (BMI). Dietary diversity score (DDS) was calculated based on the number of food groups consumed in the previous 24 hours. Statistical analysis was performed using SPSS 20.0 software. Descriptive statistics employed rates and composition ratios, and categorical data was represented using frequencies and percentages. The chi-square test was used to analyze the association between nutritional status and other variables, with a significance level set at α=0.05. Multivariable ordinal logistic regression analysis was performed to identify the independent factors affecting the nutritional status of TB patients.
UNASSIGNED: The univariate analysis revealed statistically significant differences (P < 0.05) in the nutritional status (as measured by BMI) among tuberculosis patients, considering ethnicity, educational level, smoking, meat-based diet, vegetable consumption, and DDS grading. No statistically significant differences were found regarding gender, age, marital status, occupation, sleep duration, alcohol consumption, and consumption of rice and flour dishes. Statistically significant variables from the univariate analysis were included in a multivariable ordinal logistic regression analysis model. The findings highlighted that educational level (high school or below), smoking, meat-based diet, DDS scores of 1-3, and a primarily vegetable-based diet had independent effects on the nutritional status of tuberculosis patients (all P < 0.05). No significant difference was found in nutritional status between the Han ethnic group and other ethnicities.
UNASSIGNED: The study revealed that the dietary and nutritional status of TB patients in Hulunbuir City was suboptimal and influenced by several factors. Smoking, meat-based diet, and low dietary diversity score were the primary risk factors for malnutrition among TB patients. The study suggests that nutritional education and intervention programs should be implemented for TB patients to improve their dietary quality and nutritional status.

BACKGROUND: Preeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia.
METHODS: This study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants\' usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs).
RESULTS: The mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001).
CONCLUSIONS: Our findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

BACKGROUND: Food security is a function of food access and dietary diversity. Older age is a period when adequate and diverse dietary intake is a challenge. This study aimed to investigate the association between food security on the one hand and dietary diversity and socioeconomic factors on the other hand among the free-living older people in the city of Tehran.
METHODS: In this cross-sectional study, 583 older people, aged 60-80 years living in Tehran city, were selected through the systematic cluster sampling method. Food security was determined by the United States Household Food Security Survey Module (US-HFSSM (.Socioeconomic status (SES) and two 24-h recalls were obtained. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied.
RESULTS: The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of older people were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. FI with mild hunger was associated with household income (OR = 2.744, 95% CI = 1.100-6.846), while FI with severe hunger was associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051-0.424).
CONCLUSIONS: Overall, socio-economic status and demographic characteristics were the predictors of FI among older people. The findings can have implication in design and targeting of interventions directed at older people.