Use of variety/diversity scores for diet quality measurement: relation with nutritional status of women in a rural area in Burkina Faso

Objectives: To develop scores for food variety and diversity to assess the overall dietary quality in an African rural area; and to study their relationship with the nutritional status of women of childbearing age. Design: Cross-sectional. Setting: Sahelian rural area in the North-East Burkina Faso (West Africa). Subjects: A total of 691 mothers with children below the age of 5 y, selected at random in 30 villages. Methods: A qualitative recall of women's food consumption during the previous 24 h made it possible to calculate a food variety score (FVS=count of food items consumed) and a dietary diversity score (DDS=count of food groups, among 14 groups). These scores were then divided into terciles. Body mass index (BMI), mid-upper arm circumference (MUAC) and body fat percentage (BFP) were used to determine the women's nutritional status. Results: The overall dietary quality was poor: mean FVS (s.d.)=8.3 (2.9) food items; mean DDS=5.1 (1.7) food groups. A clear relationship was shown between both FVS and DDS (in terciles) and most nutritional indices. Women with a FVS in the lowest tercile had a mean BMI of 20.1, while those in the highest tercile had a BMI of 20.9 (P=0.009). Those in the lowest tercile of DDS had a 22.8% prevalence of underweight vs 9.8% in the highest tercile (P<0.0001). The latter relationship remained significant even when the subjects' sociodemographic and economic characteristics were accounted for. Conclusion: Dietary scores measured at the individual level are good proxies for overall dietary quality of women living in a poor rural African area. These scores were also shown to be linked with the nutritional status of women. Financing: IRD financed the study with the assistance of UNICEF for the purchase of anthropometric equipment. The first author received a research allowance from the French Ministry of Research through the doctoral school 393 of Pierre and Marie Curie University (Paris VI).