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      Minimum Dietary Diversity Score and Associated Factors among Pregnant Women at Alamata General Hospital, Raya Azebo Zone, Tigray Region, Ethiopia

      research-article
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      Journal of Nutrition and Metabolism
      Hindawi

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          Abstract

          Background

          Consumption of diversified food during pregnancy found very important and critical to determine healthy pregnancy outcome. Low dietary diversity has a major adverse effect on mothers, fetus, and life of new born. Dietary diversity is still low in low-resourced countries. Therefore, this study aims to determine prevalence of minimum dietary diversity score (MDDS) and associated factors among pregnant women.

          Methods

          Facility-based cross-sectional study was conducted from April to May, 2017, in Alamata General Hospital (AGH). Data were collected using a pretested and structured self-interview questionnaire. A systematic sampling technique was used to select study participants. Binary logistic regression and odds ratio with 95% confidence interval (CI) were carried out to see the association between variables and the outcomes.

          Results

          From a survey of 412 participants, 61.2% had high MDDS and 38.8% had low MDDS. Multivariate analysis revealed that being government employees (AOR = 4.87, CI: 1.70–13.95), merchant (AOR = 4.67, CI: 1.81–12.05), secured food (AOR = 3.85, CI: 2.12–6.97), and eating three meals and above (AOR = 2.66, CI: 1.47–4.82) were significantly associated with high MDDS among pregnant women.

          Conclusions

          In our study, minimum dietary diversity shows small increment from previous study. Screening and special emphases should be given by a health-care provider on women diet during antenatal follow-up at health-care settings.

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          Most cited references23

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          Food consumption trends and drivers

          A picture of food consumption (availability) trends and projections to 2050, both globally and for different regions of the world, along with the drivers largely responsible for these observed consumption trends are the subject of this review. Throughout the world, major shifts in dietary patterns are occurring, even in the consumption of basic staples towards more diversified diets. Accompanying these changes in food consumption at a global and regional level have been considerable health consequences. Populations in those countries undergoing rapid transition are experiencing nutritional transition. The diverse nature of this transition may be the result of differences in socio-demographic factors and other consumer characteristics. Among other factors including urbanization and food industry marketing, the policies of trade liberalization over the past two decades have implications for health by virtue of being a factor in facilitating the ‘nutrition transition’ that is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Future food policies must consider both agricultural and health sectors, thereby enabling the development of coherent and sustainable policies that will ultimately benefit agriculture, human health and the environment.
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            Operationalizing dietary diversity: a review of measurement issues and research priorities.

            Dietary diversity (DD) is universally recognized as a key component of healthy diets. There is still, however, a lack of consensus on how to measure and operationalize DD. This article reviews published literature on DD, with a focus on the conceptual and operational issues related to its measurement in developing countries. Findings from studies of the association between DD and individual nutrient adequacy, child growth and/or household socioeconomic factors are summarized. DD is usually measured using a simple count of foods or food groups over a given reference period, but a number of different groupings, classification systems and reference periods have been used. This limits comparability and generalizability of findings. The few studies that have validated DD against nutrient adequacy in developing countries confirm the well-documented positive association observed in developed countries. A consistent positive association between dietary diversity and child growth is also found in a number of countries. Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security. The nutritional contribution of animal foods to nutrient adequacy is indisputable, but the independent role of animal foods relative to overall dietary quality for child growth and nutrition remains poorly understood. DD is clearly a promising measurement tool, but additional research is required to improve and harmonize measurement approaches and indicators. Validation studies are also needed to test the usefulness of DD indicators for various purposes and in different contexts.
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              Maternal nutrition and fetal development.

              Nutrition is the major intrauterine environmental factor that alters expression of the fetal genome and may have lifelong consequences. This phenomenon, termed "fetal programming," has led to the recent theory of "fetal origins of adult disease." Namely, alterations in fetal nutrition and endocrine status may result in developmental adaptations that permanently change the structure, physiology, and metabolism of the offspring, thereby predisposing individuals to metabolic, endocrine, and cardiovascular diseases in adult life. Animal studies show that both maternal undernutrition and overnutrition reduce placental-fetal blood flows and stunt fetal growth. Impaired placental syntheses of nitric oxide (a major vasodilator and angiogenesis factor) and polyamines (key regulators of DNA and protein synthesis) may provide a unified explanation for intrauterine growth retardation in response to the 2 extremes of nutritional problems with the same pregnancy outcome. There is growing evidence that maternal nutritional status can alter the epigenetic state (stable alterations of gene expression through DNA methylation and histone modifications) of the fetal genome. This may provide a molecular mechanism for the impact of maternal nutrition on both fetal programming and genomic imprinting. Promoting optimal nutrition will not only ensure optimal fetal development, but will also reduce the risk of chronic diseases in adults.
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                Author and article information

                Contributors
                Journal
                J Nutr Metab
                J Nutr Metab
                JNME
                Journal of Nutrition and Metabolism
                Hindawi
                2090-0724
                2090-0732
                2019
                2 May 2019
                : 2019
                : 8314359
                Affiliations
                College of Health Sciences, School of Nursing and Midwifery, Salale University, Fitche, Ethiopia
                Author notes

                Academic Editor: H. K. Biesalski

                Author information
                http://orcid.org/0000-0001-8922-1827
                Article
                10.1155/2019/8314359
                6525861
                31192011
                903d2b4f-e815-4108-98a6-b16fb26bcad9
                Copyright © 2019 Kemal Jemal and Mukemil Awol.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 September 2018
                : 26 February 2019
                : 26 March 2019
                Funding
                Funded by: Woldia University
                Categories
                Research Article

                Nutrition & Dietetics
                Nutrition & Dietetics

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