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In Ethiopia, women’s dietary diversity is low, primarily due to poor food availability and access, both at home and market level. The present study aimed to describe market access using a new definition called market food diversity (MFD) and estimate the impact of MFD, crop and livestock diversity on dietary diversity among women enrolled in the Agriculture to Nutrition (ATONU) trial.
Design
Baseline cross-sectional data collected from November 2016 to January 2017 were used for the analysis. Availability of foods in markets was assessed at the village level and categorized into nine food groups similar to the dietary diversity index for women. Bivariate and multivariate mixed-effects regression analyses were conducted, adjusted for clustering at the village level.
Setting
Chicken-producing farmers in rural Ethiopia.
Participants
Women (n 2117) aged 15–49 years.
Results
Overall, less than 6 % of women met the minimum dietary diversity (≥5 food groups) and the most commonly consumed food groups were staples and legumes. Median MFD was 4 food groups (interquartile range: 2–8). Multivariate models indicated that women’s dietary diversity differed by livestock diversity, food crop diversity and agroecology, with significant interaction effects between agroecology and MFD.
Conclusions
Women’s dietary diversity is poor in Ethiopia. Local markets are variable in food availability across seasons and agroecological zones. The MFD indicator captures this variability, and women who have access to higher MFD in the highland agroecological zone have better dietary diversity. Thus, MFD has the potential to mitigate the effects of environment on women’s dietary diversity.
To develop and validate a context-specific comprehensive knowledge, attitude and practice (KAP) questionnaire for literate mothers on factors affecting micronutrient status of 6–10-year-old children.
Design
Sequential exploratory mixed-methods study using focus group discussions (FGD) and psychometric validation.
Setting
Seven randomly selected villages with >500 households with three to five family members each, in Ghatkesar sub-district, Medchal district, Telangana state, India.
Participants
Literate mothers from middle-income households with at least one child (6–10 years) for FGD (n 44), for testing the internal consistency (n 80) and for test–retest reliability (n 30).
Results
The themes for FGD were diet diversity, micronutrients, cooking and eating practices, national programmes and sunlight exposure. Knowledge among caregivers about sources of micronutrients, deficiency symptoms, cooking/eating practices was low, while attitude towards diet diversity and sunlight was good. Non-availability of fruits and vegetables was a barrier to diet diversity. About 72 % of the questions from the item pool were based on FGD. After content validity, 125 items were selected for the questionnaire which, upon psychometric validation, was reduced to an eighty-eight-item questionnaire with difficulty index of 0·10–0·91, discrimination index of 0·09–0·68, Cronbach’s α of 0·78 (reliability of knowledge and attitude) and 0·50 (practice). A Bland–Altman plot showed good agreement between test and retest scores.
Conclusions
The questionnaire developed and validated using a sequential exploratory mixed-methods approach can be used for assessing KAP on micronutrients and factors affecting consumption of diverse diets in rural Indian households.
To compare the Health Star Rating (HSR) and the nutritional profile of branded and generic packaged foods in Australia.
Design
In-store audits of packaged food products capturing data on HSR and nutritional content to analyse differences between branded and generic foods across ten food categories.
Setting
The audit was conducted in four major supermarket chains across various locations within metropolitan Sydney regions, Australia.
Results
A total of 6269 products were analysed with 57 % of generic products and 28 % of branded products displaying an HSR. The median HSR of branded products was significantly greater than for generic products overall (4·0 v. 3·5, P<0·005) and in six out of ten food categories (P<0·005). However, when branded products could be matched to their generic counterparts for paired comparisons (n 146), no statistical difference was observed in all ten food categories. Branded products that chose to display an HSR had significantly lower saturated fat and Na, but higher fibre contents than branded products not displaying an HSR.
Conclusions
Our data show no difference in the HSR or nutrient profiles of similar branded and generic products that display HSR. Branded products appear to exploit the voluntary nature of the HSR scheme, preferentially displaying an HSR on healthier products compared with their generic counterparts.