An absolutely fascinating paper from FANTA (Food and Nutrition Technical Assistance) reports the outcome of a study of Dietary Diversity as a Measure of Women’s Diet Quality in Resource-Poor Areas: Results from Rural Bangladesh Site. I’ve only read the Executive Summary, I confess, but the take-home messages are clear.
Our results from rural Bangladesh indicate that micronutrient intakes were very inadequate indeed. We note that intakes were inadequate for all micronutrients, not just those that are the usual focus of public health interventions (iron/folate during pregnancy, vitamin A, and iodine). The major deficits identified here will not be alleviated by programs narrowly focused on one or several micronutrients.
How then can those deficits be alleviated?
The study developed a range of indicators of dietary diversity and dietary quality, based on women’s recollections of what they had eaten during the previous 24 hours and assessing how well that delivered each of 11 micronutrients. Even for women who were getting far less than the recommended amounts, those who ate a more diverse diet nevertheless got more micronutrients, and this was independent of the total amount of food they ate.
Although other food groups were eaten in small quantities, they provided substantial proportions of the folate, vitamin A, vitamin C, and calcium in the diet, and all of the vitamin B12 (because this last is found only in animal-source foods). The most nutritionally important of these other food groups, in roughly descending order of importance in the diet, were dark green leafy vegetables; fish; nuts and seeds; dairy; “other†vegetables; vitamin C-rich vegetables; eggs; and vitamin C-rich fruits.
These analyses showed that the increases in nutrient intakes and adequacy that accompany increases in diversity result both from increased total intakes (reflected in energy intakes) and from increases in the nutrient density of the diet.
Dark green leafy vegetables, fish, nuts and seeds; these are not terribly difficult things to grow and make available at a very local level. The health benefits are immense, and because of the effects of maternal nutrition on the growth and development of their children would be felt for years. But how many governments, how many aid agencies and charities, how many projects, are actually pushing dietary diversity as a solution to malnutrition?