Prevalence and determinants of inadequate dietary diversity among 5-9 years old children in Bangladesh: findings from a nationally representative cross-sectional survey.

OBJECTIVES: To assess the inadequate dietary diversity (IDD) and factors associated with it among 5-9 years old children in Bangladesh. DESIGN: The study was based on cross-sectional data from the second wave of a longitudinal food security and nutrition surveillance in 2023. SETTING: Data were collected from 90 clusters (64 rural, 16 non-slum urban and 10 slums) in all 8 administrative divisions of Bangladesh. PARTICIPANTS: A total of 5764 (2850 boys and 2914 girls) children were included in the study. Information was collected from their mothers. OUTCOME MEASURES: The primary outcome measure was IDD. Dietary data were collected using a list-based (24 food categories) recall method, which was further grouped into 10 food groups. IDD was defined as consumption of fewer than 5 food groups out of 10. RESULTS: More than half of the children (52.7%) had IDD (<5 recommended food groups), with slightly higher prevalence among boys (55.0%) than girls (53.2%). Poor parental education (e.g., grade 0-4 (adjusted prevalence ratio (APR): 1.22 for mother, 1.15 for father), grade 5-9 (APR: 1.16 for mother)), unimproved sanitation (APR: 1.07), mild food insecurity (APR: 1.09), severe food insecurity (APR: 1.12) and lower household wealth (APR: 1.19 for the poorest, 1.18 for the poorer), increased the prevalence of IDD. However, children aged 8-9 years (APR: 0.94) and being overweight or obese (APR: 0.82) had a decreased prevalence of IDD compared with their counterparts. CONCLUSIONS: To address IDD among children, multisectoral interventions should be targeted linking improving household wealth and sanitation, reducing food insecurity and advancing parental education.