Dietary diversity and its correlates among pregnant adolescent girls in Ghana

Abstract BackgroundDietary diversity, a qualitative measure of dietary intake, which reflects the variety of foods consumed has been recommended to assuage nutritional problems related to insufficient micronutrients and food insecurity. To better understand the underlying factors for poor birth outcomes in Ghana, we assessed factors associated with dietary diversity among rural and urban pregnant adolescents in the Ashanti Region of Ghana. MethodsAs part of a larger longitudinal cohort of 416 pregnant adolescents, the FAO women’s dietary diversity index was used to determine dietary diversity score (DDS) of the participants from a 3-day repeated 24-hour dietary recall data. The household hunger scale (HHS) and lived poverty index (LPI) were used to determine hunger and socioeconomic status. Eating behavior and socio-demographic data were gathered using interviewer-administered questionnaires. ResultsThe mean DDS for participants was 4.3 but 59.7% of participants were below the minimum DD. More rural (67.1%) than urban dwellers (53.9%) had inadequate DDS (p=0.008). Urban dwelling adolescents recorded higher odds for adequate DD (OR=1.8 CI =1.0-2.8, p=0.034) compared to the rural respondents. Other factors associated with higher odds for adequate DD are income (OR=12.1, p = 0.043, 95%CI= 1.1-136.8), moderate (OR=2.1, p = 0.019, 95%CI=1.1-3.8) and high LPI (OR=2.2, p=0.007, 95%CI=1.2-3.9), practicing food aversion (OR=1.6, p = 0.046, 95%CI= 1.0-2.4), and pica (OR 1.6, p =0.043, 95%CI= 1.0-2.5). ConclusionsLow DD is common among pregnant adolescents in this study and associated with poverty, food insecurity, rural living, pica practice, and food aversions. Livelihood support for pregnant teenagers and nutrition education are recommended interventions to improve dietary quality and limit the consequences of poor dietary diversity.