Dietary Diversity is Associated With Maternal Anemia and Key Prenatal Outcomes in a Prospective Cohort Study of Rural Ethiopia

Introduction:

Nutrient intake, food choices, and dietary diversity are the key determinants of nutritional status and associated health outcomes in human beings. When people eat a variety of foods, they are more likely to meet their needs for a wide range of essential nutrients. Yet for many poor people across the globe, dietary diversity is very low, and the daily diet is dominated by one main staple food. Poorly diversified monotonous foods, originating from plant sources are typical characteristics of the diets most peoples in low income countries, particularly the in sub-Saharan Africa.

Dietary diversity is a measure of the number of individual foods or food groups consumed in a given time period. Particularly, the Individual Dietary Diversity Score (IDDS) is a useful proxy measure of the nutritional quality of an individual's diet and a reflection of nutrient adequacy. It can be triangulated with other food-related information to contribute towards providing a holistic picture of the food and nutrition status of an individual and can be used as a simple and quick indicator of the micronutrient adequacy of a diet.

Maternal and child under-nutrition is considered as the underlying cause of 3•5 million annual deaths, and responsible for the overall increase in disease burden of the low and middle-income countries. As child health and pregnancy outcomes are largely influenced by maternal dietary practices, in nutritionally deprived populations, maternal nutrition is identified as a strong predictor of poor pregnancy outcomes including low birth weight (LBW), still birth and pre-term deliveries. Furthermore, not only the nutritional status, but also anthropometric, biochemical, behavioral and other characteristics of the mother has also been strongly associated with pregnancy and pregnancy outcomes.

Anemia during pregnancy is among the leading maternal nutritional problem associated with a number of poor pregnancy outcomes. Globally, over 42% of pregnant women were identified as anemic and nearly 60% of this anemia is assumed to be due to iron deficiency in non-malarias areas, and 50% in malaria areas.(16). The prevalence, complications, severity and associated risks of anemia among pregnant and lactating mothers in the low and middle income countries are alarmingly high.