Prevalence and determinants of inadequate dietary diversity among 5–9 years old children in Bangladesh: findings from a nationally representative cross-sectional survey
Shahnaz Sharmin, Md Mokbul Hossain, Fahmida Akter, Abu Ahmed Shamim, Sakib Rahman, Kaosar Afsana, Dipak Kumar Mitra, Wameq Azfar Raza, Deepika Chaudhery, Malay Kanti MridhaObjectives
To assess the inadequate dietary diversity (IDD) and factors associated with it among 5–9 years old children in Bangladesh.
Design
The study was based on cross-sectional data from the second wave of a longitudinal food security and nutrition surveillance in 2023.
Setting
Data were collected from 90 clusters (64 rural, 16 non-slum urban and 10 slums) in all 8 administrative divisions of Bangladesh.
Participants
A total of 5764 (2850 boys and 2914 girls) children were included in the study. Information was collected from their mothers.
Outcome measures
The primary outcome measure was IDD. Dietary data were collected using a list-based (24 food categories) recall method, which was further grouped into 10 food groups. IDD was defined as consumption of fewer than 5 food groups out of 10.
Results
More than half of the children (52.7%) had IDD (<5 recommended food groups), with slightly higher prevalence among boys (55.0%) than girls (53.2%). Poor parental education (e.g., grade 0–4 (adjusted prevalence ratio (APR): 1.22 for mother, 1.15 for father), grade 5–9 (APR: 1.16 for mother)), unimproved sanitation (APR: 1.07), mild food insecurity (APR: 1.09), severe food insecurity (APR: 1.12) and lower household wealth (APR: 1.19 for the poorest, 1.18 for the poorer), increased the prevalence of IDD. However, children aged 8–9 years (APR: 0.94) and being overweight or obese (APR: 0.82) had a decreased prevalence of IDD compared with their counterparts.
Conclusions
To address IDD among children, multisectoral interventions should be targeted linking improving household wealth and sanitation, reducing food insecurity and advancing parental education.