Dietary diversity scores, nutrient intakes and biomarkers vitamin B12, folate and Hb in rural youth from the Pune Maternal Nutrition Study

Hidden hunger is widespread in India. Individual dietary diversity score (IDDS) is a measure of the nutrient adequacy of the diet. The FAO has set guidelines for the measurement of dietary diversity: the IDDS and the minimum dietary diversity score for women (MDD-W) to assess nutritional deficiency, but validation against nutritional biomarkers is required. Using available data among rural youth (17 years) from the Pune Maternal Nutrition Study, the validity of DDS was assessed to measure deficiencies of vitamin B12, folate and Hb. Of the 355 boys and 305 girls, 19 % were classified as underweight, 57 % as vitamin B12 deficient (<150 pmol/l) and 22 % as anaemic (<120/130 g/l). Cereals, legumes and `other-vegetables' were the most frequently consumed foods. More boys than girls consumed milk, flesh, eggs and micronutrient-dense foods. Median IDDS of 4 (interquartile range (IQR) 3-4) and MDD-W of 6 (IQR 5-7) were low. Youth with vitamin B12 deficiency had a higher likelihood of an IDDS = 4 (1 center dot 89; 95 % CI 1 center dot 24, 2 center dot 87) or an MDD-W = 5 (1 center dot 40; 95 % CI 1 center dot 02, 1.94). Youth with anaemia were more likely to have an IDDS = 4 (1.76; 95 % CI 1.01, 3.14) adjusted for socio-economic scores, BMI, energy intake and sex. Folate deficiency was low (3 %) and was not associated with either score. Youth with lowest plasma vitamin B12 and Hb infrequently or never consumed dairy products/non-vegetarian foods. These rural Indian youth were underweight, had low DDS and consumed foods low in good-quality proteins and micronutrients. Associations of DDS with circulating micronutrients indicate that DDS is a valid measure to predict vitamin B12 deficiency and anaemia.

Automated summary

This study revealed widespread nutritional deficiencies among rural youth in India, especially in terms of vitamin B12 and anemia. The youths had low dietary diversity scores, primarily consuming cereals, legumes, and vegetables, with boys consuming more milk, flesh, and nutrient-dense foods compared to girls. Associations between dietary diversity scores and micronutrient deficiencies indicate the validity of using DDS to predict vitamin B12 deficiency and anemia.