Dietary Intake of Infant and Young Children and Assessment of Dietary Adequacy Indicators in a Pastoral Setting, Southern Ethiopia

Abstract

Introduction: Pastoral system is undergoing rapid socioeconomic transformation and livelihood shifts that may facilitate dietary transitions. Understanding the feeding practices and dietary intake is vitally important for designing an intervention program that addresses the nutrition needs of children in pastoral areas where scarcity of dietary information exists. Methods: Community-based study of dietary intake and questionnaire survey was conducted in Borana pastoral system of southern Ethiopia. The study aimed at investigating the dietary intake of under-five children (n=538) and to assess how well dietary diversity score (DDS), milk and meal frequencies estimate the adequacy of nutrient intake under pastoral context. Recipes and ingredients used to prepare the foods were recorded, and the portion size was estimated to calculate the nutrient contents per 100 grams of the food items. Then, nutrient adequacy ratio (NAR) of a given nutrient and mean adequacy ratio (MAR) were calculated. Results: The study showed that children had a low level of DDS (2.7) and meal frequency (2.3), but had satisfactory milk frequency (4.3). About 31.2% of the children had met minimum meal frequency while only a few (11.7%) attained the minimum DDS. Dairy (99.8%) was the most consumed food item followed by cereals (83.6%) and legumes (53.5%). Thus, dairy contributed to a higher percentage (>85%) of calcium, vitamin A and Vitamin B2 requirements. Dairy marketing was found to have significant effects on dietary patterns i.e. has reduced milk frequency but associated with an increased number of meals per day. Overall, inadequate intakes (NAR < 66%) were observed for Vitamins A, B1, C, folic acid, and Iron. Assessment of dietary adequacy indicators showed that DDS had a greater ROC area (0.71) and better prediction of dietary quality than meal (0.62) and milk (0 50) frequencies, but did not differ from the average of milk and meal frequencies (0.64). Discussion: Diets of the study children were much below the WHO standards with dairy and cereals being the major component of child nutrition reflecting a typically low dietary diversity in pastoral areas. As a result, study subjects had insufficient intakes of several nutrients, implying the need for supplementing critical micronutrients. As dairy is the main staple and local commodity its marketing was found to significantly influence the dietary patterns of children. DDS was found to be the best indicator of dietary adequacy while the averaged frequencies of milk and meal also showed a promising result.