Abstract
Objective
This study aimed to present an overview of the association between dietary diversity
(DDiv) and growth outcomes (stunting, wasting, and underweight) in children aged <
5 years.
Design
This systematic review was performed according to Preferred Reporting Items for Systematic
Reviews and Meta-Analysis guidelines.
Setting and Participants
PubMed, Scopus, Embase, Cochrane library, and Google Scholar databases were searched
up to February, 2021, using relevant keywords as follows: “Dietary diversity or diet
diversity or food diversity or diet variety or dietary variety or food variety,” “under-nutrition
or stunting or wasting or underweight or nutritional status,” and “children or infants.”
Original articles published in English were eligible for this review. Newcastle-Ottawa
scales and the Cochrane Collaboration's tool were used to assess the quality and risk
of bias of the articles.
Main Outcome Measures, Analysis, and Results
Totally, 81 articles (70 cross-sectional, 4 longitudinal cohort, 5 case-control, and
2 randomized controlled trials) were included in this review. Of the studies, 45 focused
on infants and 36 on children aged < 5 years. The reviewed articles had good quality
and low risk of bias (scores > 6). In infants, low DDiv was associated with stunting,
wasting, and being underweight (79%, 57%, and 68% of the studies, respectively). Among
children aged < 5 years, the association was observed in 75%, 56%, and 57% of the
studies, respectively, for stunting, wasting, and underweight.
Conclusions and Implications
The findings indicate a possible association between low DDiv of infants and children
aged < 5 years with stunting. However, this association remained uncertain with wasting
and being underweight.
Key Words
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Article info
Publication history
Accepted:
August 29,
2021
Footnotes
Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.
Identification
Copyright
© 2021 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
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