Association between dietary diversity and nutritional status of adults (18-65 years) and children (1-5 years) in urban and rural communities of the northwest region of Cameroon

Abstract

Consuming diets of low diversity may lead to micronutrient deficiencies and non-communicable diseases (NCDs). Dietary diversity (DD) has become a popular indicator to assess the quality of diets as well as nutrient adequacy of food intake among adults and children. With the high prevalence of malnutrition in the Northwest Region (NWR) of Cameroon, the objective of this study was to determine the DD of the diet and nutritional status of adults (18-65 years) and children (1-5 years) in four selected rural (Mankon and Mendakwe) and urban (Mankon and Nkwen) communities. Cross-sectional study design was used with multistage sampling technique to select the participants and study sites. The study sample consisted of a total of 1248 participants. Nutritional status of adults was determined using body mass index (BMI) and waist circumference (WC), while weight-for-age, weight-for-height, height-for-age and mid-upper arm circumference (MUAC) were used for children. Dietary diversity (DD) of adults and children was determined using individual DD questionnaire. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 25. A significant number of adults from Nkwen (urban) were either overweight (n=74; 47.4%) or obese (n=44; 28.2%) with 43.6% (n=68) from urban Mankon. A significant number of adults from rural Mankon were normal weight (49.4%; n=77), while 2.6% (n=4) from Mendakwe (rural) were underweight and 64.1% (n=100) were normal weight. Children in the rural areas were severely underweight (n=45; 14.4%), while children in the urban areas were either normal (n=158; 50.6%) or overweight (n=43; 13.8%). Mid-upper arm circumference (MUAC) values indicated that most children in both urban and rural areas were not acutely malnourished. The food groups that were consumed most across all age groups in all areas were grains, roots and tubers, fats and oils. The least consumed were fruit and vegetables, including vitamin A-rich plant foods as well as milk and milk products. There was a significant relationship between poor DD and weight-for-height (MAM) among 1-3 year old children in urban Nkwen (p=0.03) and urban Mankon (p=0.04). Although there was no significant association between DD, BMI and WC across all areas, most of the adults who had good DD were either of normal weight, overweight or obese. Overweight and obesity were more prevalent in the urban areas compared to the rural areas. There is a need to investigate the association between overall dietary intake and nutritional status and not specifically DD. Key words: Malnutrition, nutritional status, dietary diversity, association, obesity, rural, urban, Cameroon