DIETARY DIVERSITY, DIET QUALITY AND NUTRIENT ADEQUACY OF DIETS OF WOMEN OF REPRODUCTIVE AGE IN SOUTH EAST NIGERIA

Abstract

Malnutrition remains a public health problem among women of reproductive age in developing countries. The quality of diets is known to be related to dietary diversity and favorable nutritional status. Diet in developing world is predominantly starchy staples with few animal products. Information on dietary intakes, patterns and diet quality for women across Nigeria are limited. This study was conducted to assess Dietary Diversity (DD), Diet Quality (DQ) and Nutrient Adequacy (NA) of diets of Women of Reproductive Age (WRA) in South East Nigeria (SEN). This study was a descriptive cross-sectional design with four-stage sampling technique used to select 1,200 WRA from three of the five States in SEN. Three Local Government Areas (LGA) were randomly selected from the three senatorial districts in each state. From the nine LGA, 36 rural and 18 urban communities were randomly picked from which the respondents were selected using systematic random sampling method. A pre-tested semi-structured interviewer-administered questionnaire was used to collect data on demographic and socio-economic characteristics. Two non-consecutive 24-hour diet recall, weight and height measurements were conducted. Dietary diversity was determined using a 14 food-group dietary diversity tool and the overall score was categorised as follows: low, 1-4; average, 5-9; high, 10-14. Diet quality was determined using diet quality index-international scale (DQI-I) comprising of: ‗Variety‘ (20%), ‗Adequacy‘ (40%), ‗Moderation‘ (30%), and ‗Overall-Balance‘ (10%). Twenty-four-hour dietary recall was analysed using adapted Total Dietary Assessment (TDA) Software. Nutrient Adequacy Ratio (NAR) was derived for energy and 11 nutrients by dividing the nutrient intake of each woman by her recommended Dietary Allowance (RDA). Data were analysed using descriptive statistics, ANOVA, t-test, and Pearson‘s correlation at p=0.05 level of significance. Mean age of WRA was 28.2±5.6 years and BMI was 26.8±4.8 kg/m2. Most (96.3%) WRA were married, 41.7% were traders while, 54.9% completed secondary school education. About 39.3% of the women were overweight while 21.5% and 0.8% were obese and underweight, respectively. Overall, Dietary Diversity Score (DDS) was 7.0±1.8 and 7.6% had low, 84.6% had average, and iii 7.8% had high scores. The DDS in the three States were similar, however, significantly higher in the urban (7.0±2.5) than rural (6.9±2.4) sector. Overall, DQ was 58.8±8.1, the total variety (9.5±3.1) and overall-balance (2.0±1.8) component was poor, adequacy (23.8±4.7) was average and moderation (25.0±3.7) was high in the study area. There was no significant difference between DQ in the urban (59.3±7.4) and rural (58.3±7.5) communities. Nutrient Adequacy Ratio for energy (80.5%), protein (83.0%), iron (39.2%) and zinc (72.7%) was adequate in the region while NAR for calcium (3.8%) and vitamin C (16.9%) was inadequate. There was a significant correlation between dietary diversity and diet quality (r=0.48, p< 0.05). The Dietary Diversity Score and Diet Quality indicate average diversity and quality in dietary intake. Nutrient adequacy ratio however, suggested excess intake of energy and protein which may predispose to obesity and its associated complications. Nutrition education and dietary diversification among women of reproductive age are recommended in South East Nigeria.