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      Dietary diversity and nutritional adequacy among married Filipino immigrant women: The Filipino Women’s Diet and Health Study (FiLWHEL)

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          Abstract

          Background

          Migration has an influence on health behavior and food intake. Dietary variety is a key component to high-quality diets because a single food item does not contain a variety of nutrients and may not reflect nutritional adequacy. We aimed to compare the dietary diversity scores (DDS), food variety scores (FVS), and nutrient adequacy levels of married Filipino immigrant women in Korea to those of Korean women.

          Methods

          We matched the data of 474 participants aged 20-57 years from the Filipino Women’s Diet and Health Study (FiLWHEL) by age category with those of married Korean women randomly selected from the Korea National Health and Nutrition Examination Survey (KNHANES). Dietary information in FiLWHEL and KNHANES were assessed through the 24-hour recall method. We calculated the DDS by summing the number of eleven food groups consumed (DDS 10 g if they consumed at least 10 g/day; DDS all if they consumed any amount) and the FVS by counting the number of food items consumed. For nutrient adequacy, we calculated the probability of adequacy (PA) and intake below the estimated average requirement (EAR).

          Results

          Filipino women had a lower DDS and FVS in comparison to Korean women. The means (±SDs) of DDS 10 g, DDS all, and FVS for Filipino women versus Korean women were 6.0 (±1.6) versus 6.8 (±1.5) ( p < 0.001), 6.7 (±1.7) versus 7.9 (±1.4) ( p < 0.001) and 9.2 (±3.3) versus 14.7 (±4.9) ( p < 0.001), respectively. When we compared each food group, the intakes of fish, other seafood, legumes/seeds/nuts, eggs, vegetables, and fruits were lower for Filipino women than for Korean women. The mean probability of adequacy (MPA) of nutrient intake of the nine selected nutrients was lower for Filipino women in comparison to Korean women. The mean (±SD) was 0.55 (±0.28) versus 0.66 (±0.26), respectively.

          Conclusions

          Our findings showed that married Filipino immigrant women in Korea had lower dietary variety scores in comparison to Korean women. This was reflected in their nutritional adequacy. Nutrition education focusing on the promotion of eating a variety of foods may be needed for Filipino immigrant women in Korea.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-5233-z) contains supplementary material, which is available to authorized users.

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          Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy?

          NP Steyn, JH Nel, G Nantel … (2006)
          To assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children. Secondary data analyses were undertaken with nationally representative data of 1-8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated. The children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7-8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the 'other group' (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity. Either FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.
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            Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement

            Carl Lachat, Dana Hawwash, Marga Ocké … (2016)
            Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.
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              Assessing the prevalence of nutrient inadequacy.

              Alicia Carriquiry (1999)
              To describe an approach for assessing the prevalence of nutrient inadequacy in a group, using daily intake data and the new Estimated Average Requirement (EAR). Observing the proportion of individuals in a group whose usual intake of a nutrient is below their requirement for the nutrient is not possible in general. We argue that this proportion can be well approximated in many cases by counting, instead, the number of individuals in the group whose intakes are below the EAR for the nutrient. This is a methodological paper, and thus emphasis is not on analysing specific data sets. For illustration of one of the statistical methods presented herein, we have used the 1989-91 Continuing Survey on Food Intakes by Individuals. We show that the EAR and a reliable estimate of the usual intake distribution in the group of interest can be used to assess the proportion of individuals in the group whose usual intakes are not meeting their requirements. This approach, while simple, does not perform well in every case. For example, it cannot be used on energy, since intakes and requirements for energy are highly correlated. Similarly, iron in menstruating women presents some difficulties, due to the fact that the distribution of iron requirements in this group is known to be skewed. The apparently intractable problem of assessing the proportion of individuals in a group whose usual intakes of a nutrient are not meeting their requirements can be solved by comparing usual intakes to the EAR for the nutrient, as long as some conditions are met. These are: (1) intakes and requirements for the nutrient must be independent, (2) the distribution of requirements must be approximately symmetric around its mean, the EAR, and (3) the variance of the distribution of requirements should be smaller than the variance of the usual intake distribution.
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                Author and article information

                Contributors
                Grace P. Abris: grace110601@gmail.com
                Na-Hui Kim: nhkim0119@gmail.com
                Sherlyn Mae P. Provido: shee801@gmail.com
                Sangmo Hong: smhong@hallym.or.kr
                Sung Hoon Yu: physicianyu@daum.net
                Chang Beom Lee: lekang@hanyang.ac.kr
                Jung Eun Lee:
                ORCID: http://orcid.org/0000-0003-1141-878X
                jungelee@snu.ac.kr
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 15 March 2018
                Publication date PMC-release: 15 March 2018
                Publication date Collection: 2018
                Volume: 18
                Electronic Location Identifier: 359
                Affiliations
                [1 ]ISNI 0000 0001 0729 3748, GRID grid.412670.6, Department of Food and Nutrition, , Sookmyung Women’s University, ; Cheongpa-ro 47-gil 100, Yongsan-gu, Seoul, 04310 Korea
                [2 ]ISNI 0000 0004 1790 2596, GRID grid.488450.5, Division of Endocrinology, Department of Internal Medicine, , Hallym University Dongtan Sacred Heart Hospital, ; 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, Seoul, 18450 Korea
                [3 ]ISNI 0000 0004 0647 3212, GRID grid.412145.7, Division of Endocrinology and Metabolism, Department of Internal Medicine, , Hanyang University Guri Hospital, Hanyang University College of Medicine, ; 153 Gyeongchun-ro, Guri, 11923 Korea
                [4 ]ISNI 0000 0004 0470 5905, GRID grid.31501.36, Department of Food and Nutrition, College of Human Ecology, Research Institute of Human Ecology, , Seoul National University, ; 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 Korea
                Author information
                http://orcid.org/0000-0003-1141-878X
                Article
                Publisher ID: 5233
                DOI: 10.1186/s12889-018-5233-z
                PMC ID: 5856319
                PubMed ID: 29544458
                SO-VID: 29037118-b7a0-4dee-ae75-d01343b4c83b
                Copyright © © The Author(s). 2018
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 20 May 2017
                Date accepted : 28 February 2018
                Funding
                Funded by: Hanmi Pharmaceutical
                Award ID: 201300000001270
                Award Recipient :
                Funded by: Chong Kun Dang Pharm. Seoul, Korea
                Award ID: 201600000000225
                Award Recipient :
                Funded by: Multicultural Human Ecology Center at the Research Institute of Human Ecology, Seoul National University
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                ScienceOpen disciplines: Public health
                Keywords: food variety,migrants’ health,adequate nutrition
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: food variety, migrants’ health, adequate nutrition

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