ArticleEuropean journal of clinical nutrition2026
Evaluation of a context-specific diet diversity score (DDS) for predicting micronutrient adequacy in 6-10-year-old rural Indian children.
Article in European journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLow diet diversity is the major contributor to micronutrient inadequacy among children, underscoring a need for a rapid assessment tool to assess micronutrient adequacy.
objectiveThis study aimed to (i) develop a context-specific diet diversity score (DDS) tool (ii) evaluate the performance of the DDS scoring system against mean probability of adequacy for 10 micronutrients, 5 biomarkers of micronutrient status and (iii) identify an optimal DDS cut-off by applying minimum portion size threshold to support its potential use as a practical screening tool.
methodsA cross-sectional study was conducted among 6-10-year-old children (n = 76) in two villages of Ghatkesar sub-district, Telangana. Portion sizes of commonly consumed fruits and vegetables were standardized. Data on household demographics, anthropometry, and biomarkers of micronutrient status were collected using a pretested questionnaire and standardized protocols. Three non-consecutive 24-hour-dietary-recalls were obtained using the weighment method. DDS was developed based on the nutrient content of consumed foods; minimum intake thresholds of 0.1 g, 5 g and 10 g was applied while scoring. Mean probability of adequacy (MPA) for 10 micronutrients was estimated using ICMR-EAR values. Correlations of DDS with MPA and biomarkers were examined, and sensitivity and specificity were assessed using ROC curves, considering MPA ≥ 70% as adequate.
resultsThe DDS included 13 food groups. Mean DDS (5 g threshold) was 8.67 ± 1.50 and correlated significantly with MPA (r = 0.58), and hemoglobin (t = 2.07). A DDS-5 g cut-off of ≥10 predicted MPA > 70%, with an AUC of 0.89.
conclusionThe DDS showed good predictive performance for micronutrient adequacy, but requires further field validation before programmatic use.
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