Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Dietary Survey and Urbanization Level
2.3. DDS and Food Variety Scores (FVS) Calculation
2.4. Assessment of Nutrients Adequacy and Inadequacy
2.5. Anthropometric Measures
2.6. Statistical Analysis
3. Results
3.1. General Information
3.2. Association of DDS and FVS with Nutrient Inadequacy
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Urban (n = 724) | Rural (n = 1288) | All (n = 2012) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
MAR ≥ 0.75 | MAR < 0.75 | MAR ≥ 0.75 | MAR < 0.75 | MAR ≥ 0.75 | MAR < 0.75 | |||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |
DDS | 7.3 | 1.3 | 5.8 | 1.6 | 6.3 | 1.4 | 5.1 | 1.6 | 6.7 | 1.5 | 5.3 | 1.6 |
OFVS | 21.5 | 5.9 | 16.1 | 5.6 | 17.0 | 5.9 | 13.1 | 4.8 | 18.9 | 6.3 | 14.0 | 5.2 |
FVS_FV | 8.2 | 3.0 | 5.9 | 2.8 | 7.1 | 3.1 | 5.2 | 2.5 | 7.6 | 3.1 | 5.4 | 2.6 |
FVS_AF | 6.0 | 2.4 | 3.8 | 2.1 | 3.9 | 2.2 | 2.5 | 1.8 | 4.8 | 2.5 | 2.9 | 2.0 |
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Children (3–12 years, n = 1485) | Adolescents (13–17 years, n = 527) | Total (n = 2012) | ||||
---|---|---|---|---|---|---|
Region | ||||||
Urban (n, %) | 499, 33.60 | 225, 42.69 | 724, 35.98 | |||
Rural (n, %) | 986, 66.40 | 302, 57.31 | 1288, 64.02 | |||
p for Chi-square | 0.0002 | |||||
Gender | ||||||
Boys (n, %) | 775, 52.19 | 269, 51.04 | 1044, 51.89 | |||
Girls (n, %) | 710, 47.81 | 258, 48.96 | 968, 48.11 | |||
p for Chi-square | 0.65 | |||||
Anthropometric measures | ||||||
HAZ (mean, SD) | 0.37, 1.40 | −0.11 **, 1.09 | 0.25, 1.35 | |||
BAZ (mean, SD) | 0.13, 1.45 | −0.06 **, 1.13 | 0.08, 1.37 | |||
Wasting (n, %) | 147, 9.90 | 49, 9.30 | 196, 9.74 | |||
Overweight and Obesity (n, %) | 323, 21.75 | 80, 15.18 ** | 403, 20.03 | |||
Dietary diversity and food variety | ||||||
DDS below recommendation (n, %) | 1151, 77.51 | 406. 77.04 | 1557, 77.39 | |||
FVS below recommendation (n, %) | 353, 23.77 | 105, 19.92 | 458, 22.76 | |||
FVS_FV below recommendation (n, %) | 223, 15.02 | 71, 13.47 | 294, 14.61 | |||
DDS (mean, SD) | 6.10, 1.67 | 6.14, 1.67 | 6.11, 1.67 | |||
OFVS (mean, SD) | 16.53, 6.35 | 17.28 *, 6.32 | 16.73, 6.35 | |||
FVS_FV (mean, SD) | 6.51, 3.12 | 6.84 *, 3.07 | 6.60, 3.11 | |||
FVS_AF (mean, SD) | 3.85, 2.41 | 4.21 **, 2.65 | 3.95, 2.48 | |||
NAR | Intake | NAR | Intake | NAR | Intake | |
NAR of nutrient and nutrient intake † | ||||||
Energy | 0.83, 0.18 | 1533.21, 558.42 | 0.77 **, 0.20 | 2049.58 **, 755.70 | 0.81, 0.19 | 1668.50, 656.54 |
Vitamin A | 0.66, 0.32 | 434.36, 495.44 | 0.59 **, 0.31 | 600.71 **, 1365.02 | 0.64, 0.32 | 477.93, 820.87 |
Thiamine | 0.65, 0.24 | 0.64, 0.34 | 0.60 **, 0.22 | 0.85 **, 0.37 | 0.64, 0.23 | 0.70, 0.36 |
Riboflavin | 0.66, 0.26 | 0.65, 0.38 | 0.59 **, 0.23 | 0.82 **, 0.45 | 0.64, 0.25 | 0.69, 0.40 |
Vitamin C | 0.67, 0.30 | 54.69, 45.58 | 0.65, 0.29 | 79.23 **, 94.82 | 0.67, 0.30 | 61.11, 63.25 |
Calcium | 0.36, 0.22 | 333.06, 231.11 | 0.40 **, 0.22 | 430.06 **, 258.23 | 0.37, 0.22 | 358.47, 242.23 |
Iron | 0.90, 0.16 | 14.81, 8.89 | 0.89, 0.16 | 20.05 **, 11.18 | 0.90, 0.16 | 16.18, 9.82 |
Zinc | 0.89, 0.17 | 7.55, 3.42 | 0.87, 0.18 | 10.19 **, 4.22 | 0.89, 0.17 | 8.24, 3.83 |
Selenium | 0.75, 0.25 | 33.76, 20.68 | 0.69 **, 0.25 | 45.85 **, 25.60 | 0.74, 0.25 | 36.92, 22.70 |
α-vitamin E | 0.73, 0.29 | 8.26, 6.58 | 0.64 **, 0.31 | 11.13 **, 9.87 | 0.71, 0.30 | 9.01, 7.68 |
Niacin | 0.84, 0.21 | 10.33, 5.43 | 0.84, 0.21 | 14.68 **, 8.03 | 0.84, 0.21 | 11.47, 6.50 |
Phosphorus | 0.97, 0.10 | 697.98, 312.14 | 0.95 *, 0.12 | 935.39 **, 367.00 | 0.96, 0.11 | 760.17, 343.56 |
Sodium | 0.97, 0.14 | 4.37, 3.36 | 0.97, 0.15 | 6.10 **,8.02 | 0.97, 0.14 | 4.82, 5.07 |
Magnesium | 0.84, 0.19 | 203.20, 91.22 | 0.78 **, 0.20 | 278.78 **, 127.80 | 0.83, 0.19 | 223.00, 107.32 |
Potassium | 0.80, 0.21 | 1.35, 0.70 | 0.75 **, 0.21 | 1.82 **, 1.01 | 0.79, 0.21 | 1.47, 0.82 |
MAR (mean, SD) | 0.76, 0.15 | 0.73 *, 0.15 | 0.75, 0.15 |
DDS | OFVS | FVS_FV | FVS_AF | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Low (<5) | Medium (5–6) | High (≥7) | Low (<13) | Medium (13–19) | High (≥19) | Low (<5) | Medium (5–7) | High (≥8) | Low (<3) | Medium (3–4) | High (≥5) | |||||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |
NAR | ||||||||||||||||||||||||
Energy | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.8 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.7 a | 0.2 | 0.7 b | 0.2 | 0.8 c | 0.2 |
Vitamin A | 0.4 a | 0.3 | 0.6 b | 0.3 | 0.7 c | 0.3 | 0.5 a | 0.4 | 0.6 b | 0.3 | 0.8 c | 0.3 | 0.5 a | 0.3 | 0.6 b | 0.3 | 0.8 c | 0.3 | 0.3 a | 0.3 | 0.5 b | 0.3 | 0.7 c | 0.3 |
Thiamine | 0.5 a | 0.2 | 0.6 b | 0.2 | 0.7 c | 0.2 | 0.6 a | 0.2 | 0.6 b | 0.2 | 0.7 c | 0.2 | 0.6 a | 0.2 | 0.6 b | 0.2 | 0.7 c | 0.2 | 0.5 a | 0.2 | 0.5 b | 0.2 | 0.7 c | 0.2 |
Riboflavin | 0.4 a | 0.2 | 0.6 b | 0.2 | 0.8 c | 0.2 | 0.5 a | 0.2 | 0.6 b | 0.2 | 0.8 c | 0.2 | 0.5 a | 0.2 | 0.6 b | 0.2 | 0.8 c | 0.2 | 0.3 a | 0.2 | 0.4 b | 0.2 | 0.7 c | 0.2 |
Vitamin C | 0.5 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.3 | 0.6 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.3 | 0.5 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.2 | 0.5 a | 0.3 | 0.6 b | 0.3 | 0.7 c | 0.3 |
Calcium | 0.2 a | 0.2 | 0.3 b | 0.2 | 0.5 c | 0.2 | 0.3 a | 0.2 | 0.3 b | 0.2 | 0.5 c | 0.2 | 0.3 a | 0.2 | 0.3 b | 0.2 | 0.5 c | 0.2 | 0.2 a | 0.2 | 0.3 b | 0.2 | 0.4 c | 0.2 |
Iron | 0.8 a | 0.2 | 0.9 b | 0.2 | 1.0 c | 0.1 | 0.8 a | 0.2 | 0.9 b | 0.2 | 1.0 c | 0.1 | 0.8 a | 0.2 | 0.9 b | 0.2 | 1.0 c | 0.1 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.1 |
Zinc | 0.8 a | 0.2 | 0.9 b | 0.2 | 0.9 c | 0.1 | 0.8 a | 0.2 | 0.9 b | 0.2 | 1.0 c | 0.1 | 0.8 a | 0.2 | 0.9 b | 0.2 | 0.9 c | 0.1 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.1 |
Selenium | 0.5 a | 0.3 | 0.7 b | 0.2 | 0.9 c | 0.2 | 0.6 a | 0.3 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.6 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.2 | 0.5 a | 0.3 | 0.6 b | 0.3 | 0.8 c | 0.2 |
α-vitamin E | 0.6 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.3 | 0.6 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.3 | 0.6 a | 0.3 | 0.7 b | 0.3 | 0.8 c | 0.3 | 0.5 a | 0.4 | 0.5 b | 0.3 | 0.7 c | 0.3 |
Niacin | 0.7 a | 0.3 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.8 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.8 | 0.2 a | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.6 a | 0.2 | 0.7 b | 0.3 | 0.9 c | 0.2 |
Phosphorus | 0.9 a | 0.2 | 1.0 b | 0.1 | 1.0 c | 0.0 | 0.9 a | 0.2 | 1.0 b | 0.1 | 1.0 c | 0.0 | 0.9 a | 0.2 | 1.0 b | 0.1 | 1.0 c | 0.1 | 0.8 a | 0.2 | 0.9 b | 0.2 | 1.0 c | 0.1 |
Sodium | 0.9 a | 0.2 | 1.0 a | 0.1 | 1.0 b | 0.1 | 1.0 a | 0.2 | 1.0 a | 0.1 | 1.0 b | 0.1 | 1.0 a | 0.2 | 1.0 a | 0.1 | 1.0 b | 0.1 | 0.9 a | 0.3 | 1.0 a | 0.2 | 1.0 b | 0.1 |
Magnesium | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.8 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.8 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.8 c | 0.2 |
Potassium | 0.6 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.7 a | 0.2 | 0.8 b | 0.2 | 0.9 c | 0.2 | 0.6 a | 0.2 | 0.7 b | 0.2 | 0.8 c | 0.2 |
MAR ‖ | 0.6 a | 0.2 | 0.7 b | 0.2 | 0.8 c | 0.1 | 0.6 a | 0.2 | 0.7 b | 0.2 | 0.8 c | 0.1 | 0.6 a | 0.2 | 0.7 b | 0.2 | 0.8 c | 0.1 | 0.6 a | 0.2 | 0.6 b | 0.2 | 0.8 c | 0.1 |
DDS | OFVS | FVS_FV | FVS_AF | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Β | SE | p | Β | SE | p | Β | SE | p | Β | SE | p | |
NAR | ||||||||||||
Vitamin A | 0.054 | 0.005 | <0.0001 | 0.013 | 0.001 | <0.0001 | 0.032 | 0.002 | <0.0001 | 0.040 | 0.003 | <0.0001 |
Thiamine | 0.011 | 0.003 | 0.000 | 0.003 | 0.001 | <0.0001 | 0.010 | 0.002 | <0.0001 | 0.010 | 0.002 | <0.0001 |
Riboflavin | 0.062 | 0.003 | <0.0001 | 0.014 | 0.001 | <0.0001 | 0.022 | 0.001 | <0.0001 | 0.043 | 0.002 | <0.0001 |
Vitamin C | 0.040 | 0.004 | <0.0001 | 0.014 | 0.001 | <0.0001 | 0.040 | 0.002 | <0.0001 | 0.017 | 0.003 | <0.0001 |
Niacin | 0.031 | 0.003 | <0.0001 | 0.006 | 0.000 | <0.0001 | 0.011 | 0.001 | <0.0001 | 0.030 | 0.002 | <0.0001 |
α-vitamin E | 0.013 | 0.004 | 0.001 | 0.003 | 0.001 | 0.002 | 0.007 | 0.002 | 0.001 | 0.009 | 0.003 | 0.002 |
Calcium | 0.043 | 0.003 | <0.0001 | 0.009 | 0.001 | <0.0001 | 0.010 | 0.001 | <0.0001 | 0.026 | 0.002 | <0.0001 |
Iron | 0.017 | 0.002 | <0.0001 | 0.004 | 0.000 | <0.0001 | 0.008 | 0.000 | <0.0001 | 0.009 | 0.001 | <0.0001 |
Zinc | 0.023 | 0.002 | <0.0001 | 0.004 | 0.001 | <0.0001 | 0.008 | 0.001 | <0.0001 | 0.018 | 0.001 | <0.0001 |
Selenium | 0.048 | 0.001 | <0.0001 | 0.011 | 0.001 | <0.0001 | 0.009 | 0.002 | <0.0001 | 0.032 | 0.002 | <0.0001 |
Phosphorus | 0.016 | 0.001 | <0.0001 | 0.003 | 0.000 | <0.0001 | 0.004 | 0.000 | <0.0001 | 0.007 | 0.001 | <0.0001 |
Sodium | 0.000 | 0.002 | 0.754 | −0.001 | 0.001 | 0.061 | −0.003 | 0.001 | 0.018 | 0.001 | 0.002 | 0.375 |
Magnesium | 0.015 | 0.002 | <0.0001 | 0.004 | 0.000 | <0.0001 | 0.009 | 0.001 | <0.0001 | 0.004 | 0.002 | 0.024 |
Potassium | 0.036 | 0.003 | <0.0001 | 0.009 | 0.001 | <0.0001 | 0.017 | 0.001 | <0.0001 | 0.018 | 0.002 | <0.0001 |
MAR | 0.029 | 0.002 | <0.0001 | 0.007 | 0.000 | <0.0001 | 0.013 | 0.001 | <0.0001 | 0.019 | 0.001 | <0.0001 |
DDS (Ref.: low, <5) | OFVS (Ref.: low, <13) | FVS_FV (Ref.: low, <5) | FVS_AF (Ref.: low, <3) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Medium (5–6) | High (≥7) | Medium (13–19) | High (≥19) | Medium (5–7) | High (≥8) | Medium (3–4) | High (≥5) | |||||||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
Inadequacy of micronutrient | ||||||||||||||||
Vitamin A | 0.7 | 0.5, 0.9 | 0.4 | 0.3, 0.6 | 0.9 | 0.7, 1.1 | 0.5 | 0.4, 0.6 | 0.6 | 0.5, 0.7 | 0.3 | 0.2, 0.4 | 0.5 | 0.4, 0.7 | 0.3 | 0.2, 0.4 |
Thiamine | 0.7 | 0.5, 1.1 | 0.7 | 0.5, 1.1 | 0.8 | 0.6, 1.1 | 0.7 | 0.5, 0.9 | 0.8 | 0.6, 1.1 | 0.5 | 0.3, 0.7 | 0.8 | 0.5, 1.1 | 0.4 | 0.4, 0.7 |
Riboflavin | 0.3 | 0.2, 0.5 | 0.1 | 0.07, 0.2 | 0.4 | 0.3, 0.5 | 0.1 | 0.1, 0.2 | 0.6 | 0.4, 0.8 | 0.2 | 0.18, 0.3 | 0.2 | 0.1, 0.4 | 0.1 | 0.1, 0.2 |
Vitamin C | 0.7 | 0.5, 0.9 | 0.5 | 0.3, 0.6 | 0.8 | 0.6, 1.0 | 0.5 | 0.4, 0.6 | 0.5 | 0.4, 0.7 | 0.3 | 0.2, 0.3 | 0.8 | 0.6, 1.0 | 0.7 | 0.5, 0.9 |
Calcium | 1.5 | 0.6, 3.8 | 0.6 | 0.2, 1.4 | 0.9 | 0.4, 2.0 | 0.5 | 0.2, 1.0 | 1.1 | 0.5, 2.5 | 0.7 | 0.4, 1.2 | 1.1 | 0.5, 2.4 | 0.3 | 0.2, 0.7 |
Iron | 0.6 | 0.5, 0.9 | 0.3 | 0.2, 0.5 | 0.7 | 0.5, 0.9 | 0.4 | 0.3, 0.5 | 0.9 | 0.7, 1.3 | 0.4 | 0.3, 0.7 | 0.8 | 0.6, 1.2 | 0.5 | 0.3, 0.7 |
Zinc | 0.6 | 0.5, 0.9 | 0.3 | 0.2, 0.5 | 1.0 | 0.7, 1.3 | 0.5 | 0.3, 0.7 | 0.9 | 0.7, 1.2 | 0.4 | 0.3, 0.6 | 0.5 | 0.4, 0.6 | 0.1 | 0.1, 0.2 |
Selenium | 0.7 | 0.5, 0.9 | 0.2 | 0.1, 0.3 | 0.4 | 0.3, 0.5 | 0.3 | 0.2, 0.4 | 0.7 | 0.5, 0.9 | 0.5 | 0.4, 0.7 | 0.4 | 0.3, 0.6 | 0.2 | 0.1, 0.2 |
Niacin | 0.6 | 0.4, 0.8 | 0.3 | 0.3, 0.5 | 0.8 | 0.6, 1.1 | 0.4 | 0.3, 0.6 | 0.7 | 0.6, 1.0 | 0.5 | 0.4, 0.7 | 0.4 | 0.3, 0.5 | 0.2 | 0.1, 0.2 |
Phosphorus | 0.4 | 0.3, 0.6 | 0.1 | 0.1, 0.3 | 0.8 | 0.5, 1.1 | 0.2 | 0.1, 0.4 | 0.6 | 0.4, 0.9 | 0.2 | 0.1, 0.3 | 0.7 | 0.5, 1.1 | 0.2 | 0.1,0.3 |
Magnesium | 0.9 | 0.7, 1.3 | 0.6 | 0.4, 0.8 | 1.1 | 0.8, 1.5 | 0.6 | 0.5, 0.9 | 0.8 | 0.6, 1.0 | 0.5 | 0.4, 0.7 | 1.0 | 0.8,1.4 | 0.8 | 0.6, 1.2 |
OMI | 0.4 | 0.3, 0.6 | 0.2 | 0.1, 0.3 | 0.5 | 0.4, 0.7 | 0.2 | 0.1, 0.3 | 0.5 | 0.4, 0.7 | 0.2 | 0.1, 0.3 | 0.4 | 0.3, 0.5 | 0.2 | 0.1, 0.2 |
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Meng, L.; Wang, Y.; Li, T.; Loo-Bouwman, C.A.v.; Zhang, Y.; Man-Yau Szeto, I. Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy? Nutrients 2018, 10, 1674. https://doi.org/10.3390/nu10111674
Meng L, Wang Y, Li T, Loo-Bouwman CAv, Zhang Y, Man-Yau Szeto I. Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy? Nutrients. 2018; 10(11):1674. https://doi.org/10.3390/nu10111674
Chicago/Turabian StyleMeng, Liping, Yan Wang, Ting Li, Carolien Annika van Loo-Bouwman, Yumei Zhang, and Ignatius Man-Yau Szeto. 2018. "Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?" Nutrients 10, no. 11: 1674. https://doi.org/10.3390/nu10111674
APA StyleMeng, L., Wang, Y., Li, T., Loo-Bouwman, C. A. v., Zhang, Y., & Man-Yau Szeto, I. (2018). Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy? Nutrients, 10(11), 1674. https://doi.org/10.3390/nu10111674