scholarly journals How Seasonal Is the Minimum Dietary Diversity for Children Indicator? An Investigation in Three Countries on Three Continents: Senegal, Nepal and Peru

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 570-570
Author(s):  
Andrew Thorne-Lyman ◽  
Helen Kuo ◽  
Angela KC ◽  
Swetha Manohar ◽  
Binod Shrestha ◽  
...  
Keyword(s):  
International Development ◽  
Dietary Diversity ◽  
The United States ◽  
Child Growth ◽  
Dietary Quality ◽  
Food Groups ◽  
Ecological Variability ◽  
Feed The Future ◽  
Minimum Dietary Diversity ◽  
Over Time

Abstract Objectives A diverse diet helps to assure adequate micronutrient intakes and normal child growth and development. The revised minimum dietary diversity (MDD) indicator for children 6–23 months (>5 of 8 food groups) is often used to track dietary quality over time, but the influence of seasonality has not been explored. Methods We identified surveys with MDD data across seasons including national continuous Demographic Health Surveys in Senegal (2012–2017, N = 12,183) and Peru (2004–16, N = 36,044) and the PoSHAN substudy seasonal surveys (covering 3 seasons) in Nepal (2013–2016, N = 1364). MDD prevalence and mean food groups were estimated. In Senegal and Peru, data were disaggregated by rainy/dry season and month. Results In Senegal, MDD prevalence was similar in the rainy (10.8%) and dry (9.6%) seasons. In Nepal, MDD prevalence was stable at 35.1–34.9% from the monsoon of 2013 through the end of 2014, and then increased to 41.7–47.7% from the winter 2014 through monsoon seasons of 2015 and 2016. In Peru, the prevalence of MDD ranged from 62% in May to 72% in January, but region-season interactions were apparent, perhaps due to agro-ecological variability. Large variance existed for the MDD indicator for many datasets, with mean scores showing greater stability across seasons. Conclusions There can be periods of seasonal stability as observed in Senegal and the first two years of Nepal data, but also sustained change. Relative national stability can obscure seasonal patterns by, as seen in Peru. Variability by season may influence conclusions about change over time in some contexts if month of data collection is not considered. Funding Sources Bill & Melinda Gates Foundation and Feed the Future Innovation Lab for Nutrition, funded by the United States Agency for International Development under grant ID: AID-OAA-L-1–00006.

scholarly journals Implications of Updating the Minimum Dietary Diversity for Children Indicator for Tracking Progress in the Eastern and Southern Africa Region

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Rebecca A Heidkamp ◽  
Yunhee Kang ◽  
Kudakwashe Chimanya ◽  
Aashima Garg ◽  
Joan Matji ◽  
...  
Keyword(s):  
Southern Africa ◽  
Dietary Diversity ◽  
Population Level ◽  
Dietary Quality ◽  
Food Groups ◽  
Middle Income ◽  
Country Level ◽  
The Difference ◽  
Eastern And Southern Africa ◽  
Minimum Dietary Diversity

ABSTRACT Minimum dietary diversity (MDD), a population-level dietary quality indicator, is commonly used across low- and middle-income countries to characterize diets of children aged 6–23 mo. The WHO and UNICEF recently updated the MDD definition from consumption of ≥4 of 7 food groups in the previous 24 h (MDD-7) to ≥5 of 8 food groups (MDD-8), adding a breastmilk group. The implications of this definition change were examined across 14 countries in Eastern and Southern Africa where improving complementary feeding is a policy priority. A lower MDD-8 score was found compared with MDD-7 across all countries; in 3 countries the difference between indicators was >5 percentage points. Country-level variability is driven by differences in breastfeeding rates and dietary diversity score. As countries transition to the new indicator it is important to actively publicize changes and to promote valid interpretation of MDD trends.

scholarly journals Household Water Insecurity Is Common and Associated With Higher Odds of Hunger and Lower Dietary Diversity Across Sub-Saharan Africa and Asia

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 668-668
Author(s):  
Joshua Miller ◽  
Sera Young ◽  
Elizabeth Bryan ◽  
Claudia Ringler
Keyword(s):  
International Development ◽  
Food Policy ◽  
Dietary Diversity ◽  
Well Being ◽  
The United States ◽  
Sub Saharan Africa ◽  
Food Groups ◽  
Random Coefficient Models ◽  
Water Insecurity ◽  
Household Water

Abstract Objectives Household water insecurity may exacerbate poor nutrition (e.g., via limited water to produce or prepare preferred foods) and health, but comparable quantification of water access and use has only recently become possible. We therefore aimed to assess the prevalence of household water insecurity and estimate its association with dietary diversity, hunger, and illness. Methods The International Food Policy Research Institute is conducting panel phone surveys among a random subsample of men and women in ongoing studies to understand the impacts of the COVID-19 pandemic. Surveys last 20–30 minutes and include information about respondent and household characteristics; experiences with household water insecurity [using the Household Water Insecurity Experiences Scale-4 (HWISE-4), range: 0–12], hunger, and illness in the prior 2 weeks; and 24-hour dietary recall (range: 0–10 food groups). We assessed the relationship between water insecurity and dietary diversity, hunger, and illness using random coefficient models (which account for variation by site and adjust for measured confounders) among sites with available baseline data: Senegal (interviews conducted June 2020, n = 501), Nepal (July 2020, n = 759), Ghana (September 2020, n = 543), Nigeria (September 2020, n = 501), Kenya (October 2020, n = 547), and Niger (October 2020, n = 364). Additional data from other sites and timepoints are forthcoming. Results The prevalence of water insecurity (HWISE-4 scores > 3) ranged from 8.9% of sampled households in Nepal to 47.4% in Ghana. In bivariate analyses for each site, household water insecurity did not differ by respondent sex but was consistently lower among households that had an on-premises compared to off-premises water source [e.g., mean, 2.3 vs. 3.7, p < 0.001 in Senegal]. In adjusted models across all sites, greater water insecurity was associated with lower dietary diversity (B: –0.08; 95% CI: –0.10, –0.05), and higher odds of experiencing hunger (OR: 1.10; 95% CI: 1.08, 1.14) and having an ill household member (OR: 1.04; 95% CI: 1.01, 1.07). Conclusions Water insecurity is experienced by many households and may be an important determinant of nutritional and physical well-being. Funding Sources The Bureau for Resilience and Food Security at the United States Agency for International Development.

scholarly journals Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 178
Author(s):  
Zizwani Brian Chilinda ◽  
Mark L. Wahlqvist ◽  
Meei-Shyuan Lee ◽  
Yi-Chen Huang
Keyword(s):  
Young Children ◽  
Dietary Diversity ◽  
World Health ◽  
Food Groups ◽  
Water Access ◽  
Direct Role ◽  
Cross Sectional ◽  
Child Undernutrition ◽  
Health Organization ◽  
Minimum Dietary Diversity

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother–child dyads, respectively, (26.8 ± 6.8 years, range 15–49 years) and (13.9 ± 4.9 months, range 6–23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother–child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24–2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.

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

2006 ◽  
Vol 9 (5) ◽  
pp. 644-650 ◽  
Author(s):  
NP Steyn ◽  
JH Nel ◽  
G Nantel ◽  
G Kennedy ◽  
D Labadarios
Keyword(s):  
Sensitivity And Specificity ◽  
Dietary Diversity ◽  
Pearson Correlation ◽  
Child Growth ◽  
World Health ◽  
Food Groups ◽  
Nutrient Adequacy ◽  
Z Scores ◽  
Food Variety ◽  
The Mean

AbstractObjectiveTo 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.MethodsSecondary 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.ResultsThe 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.ConclusionEither FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

scholarly journals “I feel like eating rice 24 hours per day, 7 days a week”: A Study of Dietary Diversity Among Asylum Seekers in Norway (OR21-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sigrun Henjum ◽  
Laura Terragni
Keyword(s):  
Dietary Intake ◽  
Asylum Seekers ◽  
Dietary Diversity ◽  
Living Condition ◽  
Dietary Quality ◽  
Dietary Intakes ◽  
Food Groups ◽  
Cross Sectional ◽  
Adequate Diet ◽  
Adequate Food

Abstract Objectives Poor nutrition and food insecurity is highly prevalent among asylum seekers residing in western countries. Lack of economic resources, unfamiliarity with new foods, and language barriers are some challenges that asylum seekers encounter upon resettlement. Despite the importance of an adequate diet for good health, limited knowledge, exist on food intake and dietary quality among asylum seekers. We described dietary intake and assessed dietary quality among asylum seekers at Norwegian reception centers. Methods In 2017, a cross-sectional study in eight ordinary asylum reception centers in the South Eastern part of Norway were performed and 205 asylum seekers (131 men and 74 women) were included. Dietary intake was assessed by 24-hour dietary recall and dietary diversity score (DDS) calculated according to FAO and FANTA, 2014. In addition, field notes of the asylum seekers thoughts on dietary intake and living condition provided contextual aspects of their nutritional situation. Results Two-third of the asylum seekers had dietary intakes with low quality; they ate from less than five food groups (low DDS). The asylum seekers ate in average two meals per day and one-third ate their first meal after noon. Meals tend to consist of food that was familiar in their country of origin. Women had significantly higher DDS than men with a higher consumption of vegetables and fruits. Asylum seekers residing in Norway for a longer time had a higher dietary diversity, than asylum seekers with a shorter stay. Most asylum seekers told about a reduced dietary intake, few meals and by the end of the month, hunger. They chose the cheapest food, food on sale or food that had expired and chose quantity over quality. The kitchen facilities at the reception centers were inadequate with limited storage place, low quality of the cooking equipment and crowded kitchen. Conclusions The asylum seekers had a monotonous diet with few meals, in contrast to the food abundance that most Norwegian are accustomed to, revealing, the emergence of new groups and new forms of poverty and social exclusion also in rich countries with otherwise good welfare state systems. The situation appear particularly critical given Norway's commitment through the United Nations (UN) International Covenant on Economic, Social and Cultural Rights to ensure human rights such as the right to adequate food and health. Funding Sources The study was funded by Oslo Metropolitan University, Norway.

scholarly journals Dietary diversity predicts dietary quality regardless of season in 6–12-month-old infants in south-west Ethiopia

2016 ◽  
Vol 19 (14) ◽  
pp. 2485-2494 ◽  
Author(s):  
Mekitie Wondafrash ◽  
Lieven Huybregts ◽  
Carl Lachat ◽  
Kimberley P Bouckaert ◽  
Patrick Kolsteren
Keyword(s):  
Dietary Diversity ◽  
Characteristic Curve ◽  
Dietary Quality ◽  
Research Centre ◽  
Food Groups ◽  
Linear Regression Models ◽  
South West ◽  
South West Ethiopia ◽  
Breast Fed

AbstractObjectiveSimple, cost-effective and convenient instruments like food group-based scores are proposed to assess micronutrient adequacy of children in developing countries. We assessed the predictive ability and seasonal stability of a dietary diversity score (DDS) to indicate dietary quality of infants.DesignA 24 h dietary recall assessment was carried out on a sample of 320 and 312 breast-fed infants aged 6–12 months during harvest (HS) and pre-harvest (PHS) seasons, respectively, in Ethiopia. DDS was calculated based on seven food groups, while mean micronutrient density adequacy (MMDA) was calculated for eight micronutrients. Multiple linear regression models were used to assess the relationship between DDS and MMDA, and differences in nutrient intake between the two seasons. A receiver-operating characteristic curve analysis was performed to derive DDS cut-offs that maximized sensitivity and specificity of assessing dietary quality.SettingThe study was conducted in the catchment of the Gilgel Gibe Field Research Centre of Jimma University, south-west Ethiopia.ResultsThe mean (sd) DDS for HS and PHS was 2·1 (0·94) and 2·3 (1·1), respectively. The DDS was associated with MMDA (β=0·045, P<0·0001 in HS; β=0·044, P<0001 in PHS). A DDS of ≤2 food groups best predicted ‘low’ MMDA (<50 %) with 84 % and 92 % sensitivity, 36 % and 43 % specificity, and 47 % and 51 % correct classification for the HS and PHS, respectively.ConclusionsDDS is predictive of dietary quality of breast-fed infants. The study supports the use of DDS to indicate inadequate intakes of micronutrients by breast-fed infants in different seasons.

scholarly journals The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Food Group ◽  
Limited Information ◽  
Food Groups ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Nutritional Status Of Children ◽  
Minimum Dietary Diversity

Abstract Background Undernutrition poses a serious health challenge in developing countries. Tanzania has the highest undernutrition burdens in East and Southern Africa. Poor infant and young child feeding practices including consumption of undiversified diet are the main cause for undernutrition. There is limited information regarding the association between dietary diversity and undernutrition in Tanzania. The objective of this paper was to examine to what extent the dietary diversity is associated with undernutrition of children of 6 to 23 months in Tanzania.Methods This is a secondary data analysis from data collected by the Tanzania Demographic and Health Survey of 2015-2016. Stunting, wasting and underweight were calculated from Z-scores based on 2006 WHO standards. A dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, a Minimum Dietary Diversity (MDD) indicator was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the odds ratios of becoming undernourished.Results A total of 2,960 children were enrolled in this study. The majority (73.9%) of children did not reach the recommended Minimum Dietary Diversity (MDD). The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food group consumed increased. Children who did not received an MDD diet had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal source foods has been found to be associated with reduced stunting among children.Conclusion Consumption of a diverse diet was associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals Maternal minimum dietary diversity and associated factors among pregnant women, Southwest Ethiopia, 2021

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Abel Girma Tilahun ◽  
Abebaw Molla Kebede
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Nutrition Education ◽  
Associated Factors ◽  
Dietary Diversity ◽  
Systematic Sampling ◽  
Age Group ◽  
Food Groups ◽  
Minimum Dietary Diversity

Abstract Background Inadequate dietary diversity intake during pregnancy increases risks of intrauterine growth restriction, abortion, low birth weight, preterm birth, prenatal and infant mortality,and morbidity and has long-lasting health impacts. Dietary diversity during pregnancy promotes the health status of the mother and her fetus. This study aimed to assess the magnitude of minimum dietary diversity and associated factors among pregnant women attending antenatal care. Methods A facility-based cross-sectional study was conducted among 274 pregnant women who attended antenatal care at Wacha primary hospital from January to February 2021. A systematic sampling method was used to select the study participants. The data were collected through face-to-face interviews using a structured and semi-structured questionnaire. Bivariate logistic regression was done to identify factors associated with maternal dietary diversity. Finally, multivariate logistic regression was done, and variables that showed P values of < 0.05 were considered statistically significant. Result The magnitude of minimum dietary diversity was 51% (95% CI: 44.5, 56.7). The mean (±SD) minimum dietary diversity score was 4.5 (± 1.268) with a minimum of 1 anda maximum of 8 food groups consumed out of ten food groups. Age fewer than 25 years (AOR 4.649; 95% CI; 1.404, 15.396), and the age group between 25 to 34 years (AOR 3.624; 95% CI: 1.315, 10.269), husband age group of 26 to 34 years (AOR 2.238; 95% CI; 1.028,4.873), and 35 to 44 years (AOR 3.555; 95% CI; 1.228,10.292) and nutrition awareness of women (AOR 2.182; 95% CI; 1.243, 3.829) were significantly associated with minimum dietary diversity. Conclusion The consumption of minimum dietary diversity of the pregnant mothers was found to be low. Women aged less than 25 and age between 25 to 34 years, husband’s age between 26 to 34 and 35 to 44 years, and nutrition awareness were the factors significantly associated with minimum dietary diversity. Therefore, providing nutrition education and counseling service warranted to promote maternal dietary diversity.

scholarly journals Participation in communal day care centre feeding programs is associated with higher diet quantity but not quality among rural Ghanaian children

2012 ◽  
Vol 12 (49) ◽  
pp. 5802-5821
Author(s):  
KB Harding ◽  
◽  
GS Marquis ◽  
EK Colecraft ◽  
A Lartey ◽  
...  
Keyword(s):  
Day Care ◽  
Dietary Diversity ◽  
Dietary Quality ◽  
Dietary Intakes ◽  
Food Groups ◽  
Sustainable Food ◽  
Feeding Programs ◽  
Iron And Zinc ◽  
Day Care Centres ◽  
Daily Intakes

Communal School Feeding Programs (SFP) are based on local foods brought by children from home which are cooked and shared at school. These programs may be a sustainable food-based strategy for improving children’s diets in low-resource areas. The objective of this study was to compare the dietary intakes of children who attend Day Care Centres (DCC) with communal SFP to children who do not attend any DCC or school in rural Ghana. Interviewer-administered questionnaires were used to collect dietary and other household information for 104 DCC and 89 non-DCC children aged two to five years living in two communities. In addition, the DCC lunches (ingredients and servings of each food preparation) were weighed. The Day Care Centres’ lunch was higher in energy (by 64 kcal; p<0.001), but lower in calcium (by 18 mg; p=0.002), iron (by 1.3 mg; p<0.001) and zinc (by 0.2 mg; p=0.046) than the non-DCC lunch. DCC children ate more times in a day (4.2 ± 0.8 vs. 3.4 ± 0.6, p<0.001), had greater dietary diversity (7.2 ± 0.6 vs. 6.7 ± 1.0 food groups, p<0.001) and had higher daily intakes of energy (1140 ± 320 vs. 878 ± 240 kcal; p<0.001), calcium (282 ± 139 vs. 244 ± 118 mg; p=0.048), iron (12.4 ± 6.4 vs. 10.7 ± 4.7 mg; p=0.048) and zinc (0.40 ± 0.15 vs. 0.35 ± 0.11 mg; p=0.019) than non-DCC children. However, after controlling for total energy intake and other dietary, health and sociodemographic variables, daily iron and zinc intakes were lower in the DCC compared to the non-DCC group. Participation in the communal SFP was associated with higher quantity but not quality of children’s diets. Communal SFP offer an opportunity to address specific population’s micronutrient needs, using interventions to improve dietary quality such as point-of-use fortification, commercially fortified foods, or processed animal source food products.

scholarly journals A Cross Sectional Analysis Of Dietary Practices And Nutrition Status Of Female Undergraduate Students At Kenyatta University, Kenya

2019 ◽  
Author(s):  
Grace Waweru ◽  
Peter Chege ◽  
Eunice Njogu
Keyword(s):  
Undergraduate Students ◽  
Dietary Diversity ◽  
Eating Habits ◽  
Female Students ◽  
Nutrition Status ◽  
Food Groups ◽  
Female Undergraduate ◽  
Dietary Practices ◽  
Cross Sectional ◽  
Minimum Dietary Diversity

Abstract Background The rapid changes in eating habits and lifestyles in Kenya have resulted to the overweight/obesity transition. Students are likely to make poor food choices which may affect their nutrition status during the beginning of college and this may continue throughout their life. This study aimed to establish the dietary practices, assess nutrition status based on body mass index and the relationship between dietary diversity and nutrition status of female undergraduate students at Kenyatta University, Kenya.Method s: The study adopted a cross-sectional analytical design involving sample of 422 female undergraduate students randomly selected from Kenyatta University. Minimum Dietary Diversity – Women and Food Frequency Questionnaire were used to assess the dietary practices of the female students. Weight and height were measured to assess the nutrition status of the female students.Results The results showed that 64.0% of the participants had consumed ≥ 5 food groups while 36% had consumed <5 food groups over a period of 24 hours. In terms of nutrition status, 68.4% of the participants had normal Body Mass Index while 23.9% were overweight, 5.55% were underweight and 2.3% were obese. Minimum Dietary Diversity – Women was significantly associated with nutrition status (p=0.044).Conclusion The results illustrated unhealthy eating habits and sub-optimal nutrition status among a significant number of the female students. Policy makers should scale up interventions that would help improve dietary practices of women of reproductive age particularly university students.

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