Association of minimum dietary diversity and minimum meal frequency with anthropometric parameters among children of 6 to 23 months of age attending immunization clinic of a tertiary care hospitals

Kinjal H. Solanki, Malangori A. Parande, Nandkumar M. Salunke, Kiran Sangwan, Muralidhar P. Tambe


Background: The age of 6–23 months is the golden period in the first 1000 days of life. Insufficient quantities, frequencies, and inadequate quality of complementary feedings have a negative effect on child health and growth, especially in the first two years of life.

Methods: A hospital based descriptive type of observational study was carried out in the immunization clinic. The source population were the mothers who had children in age group of 6-23 months brought to the clinic in the month of January 2021 comprise the “target population”. The sample size of 102 was calculated with 80% of power, confidence level of 95% and considering prevalence of MDD as 15.2%. Purposive sampling technique was employed for selection of study sample. Proportion of Minimum Meal Diversity and Minimum Meal Frequency was calculated and their association was assessed with anthropometric characteristics.

Results: Proportion of MDD was found to be 72.5% (Figure 1) whereas Proportion of MMF was found to be 87.3 %. The proportion of MDD was significantly high among the children who had minimum meal frequency. MDD and MMF were protective against the acute malnutrition among the children.

Conclusions: This study shows that consumption of a diverse diet and MMF is associated with a reduction in undernutrition among children of 6 to 23 months of age. Measures to improve the type of complementary foods given to children to meet their needs for energy and nutrients should be considered.



Minimum dietary diversity, Minimum meal frequency, Immunization clinic, Children, Anthropometric parameters

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Temesgen H, Negesse A, Woyraw W, Mekonnen N. Dietary diversity feeding practice and its associated factors among children age 6-23 months in Ethiopia from 2011 up to 2018: a systematic review and meta-analysis. Ital J Pediatr. 2018; 44(1):109.

Sekartaji R, Suza DE, Fauziningtyas R, Almutairi WM, Susanti IA, Astutik E et al. Dietary diversity and associated factors among children aged 6-23 months in Indonesia. J Pediatr Nurs. 2020;56:30-4.

Belew AK, Ali BM, Abebe Z, Dachew BA. Dietary diversity and meal frequency among infant and young children: a community based study. Ital J Pediatr. 2017;43(1):73.

WHO. 2008. Indicators for assessing infant and young child feeding practices. Part I, Definitions – Conclusions of a consensus meeting held 6–8 November 2007 in Washington, DC, USA.

WHO, UNICEF. Global Nutrition Monitoring Framework: operational guidance for tracking progress in meeting targets for 2025. Geneva: World Health Organization. 2017. Available at: Accessed on 200 May 2021.

Beckerman-Hsu JP, Kim R, Sharma S, Subramanian SV. Dietary Variation among Children Meeting and Not Meeting Minimum Dietary Diversity: An Empirical Investigation of Food Group Consumption Patterns among 73,036 Children in India. J Nutr. 2020;150(10):2818-24.

Masuke R, Msuya SE, Mahande JM, Diarz EJ, Stray-Pedersen B, Jahanpour O et al. Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study. PLoS One. 2021;16(5):e0250562.

Ariff S, Saddiq K, Khalid J, Sikanderali L, Tariq B, Shaheen F et al. Determinants of infant and young complementary feeding practices among children 6-23 months of age in urban Pakistan: a multicenter longitudinal study. BMC Nutr. 2020;6(1):75.

Satapathy DM, Karmee N, Sahoo SK, Patro SK, Pandit D. Effect of feeding practices on nutritional status of infant and young children residing in urban slums of berhampur: A decision tree approach. Indian J Public Health. 2021;65(2):147-51.

Patel A, Pusdekar Y, Badhoniya N, Borkar J, Agho KE, Dibley MJ. Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005-2006. Matern Child Nutr. 2012;1(1):28-44.

Samuel F O, Adetunmbi A J, Ariyo O. Dietary diversity and anthropometric charactersitics of in-school adolescents in the university of Ibadan Community. WAJFN. 2015;13(1):56-65.

Beyene M, Worku AG, Wassie MM. Dietary diversity, meal frequency and associated factors among infant and young children in Northwest Ethiopia: a cross- sectional study. BMC Public Health. 2015;15:1007.

Khamis AG, Mwanri AW, Ntwenya JE, Kreppel K. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr. 2019;19(1):518.

Khan AM, Kayina P, Agrawal P, Gupta A, Kannan AT. A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi. Indian J Public Health. 2012;56(4):301-4.

International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS.

Sié A, Tapsoba C, Dah C, Ouermi L, Zabre P, Bärnighausen T et al. Dietary diversity and nutritional status among children in rural Burkina Faso. Int Health. 2018;10(3):157-62.

Rah JH, Akhter N, Semba RD, De Pee S, Bloem MW, Campbell A et al. Low dietary diversity is a predictor of child stunting in rural Bangladesh. Eur J Clin Nutr. 2010;64(12):1393.

Motbainor A, Worku A, Kumie A. Stunting is associated with food diversity while wasting with food insecurity among underfive children in east and west Gojjam zones of Amhara region Ethiopia. PloS One. 2015;10(8):e0133542.

Moursi MM, Arimond M, Dewey KG, Treche S, Ruel MT, Delpeuch F. Dietary diversity is a good predictor of the micronutrient density of the diet of 6-to 23-month-old children in Madagascar. J Nutr. 2008;138(12):2448-53.

Marriott BP, White A, Hadden L, Davies JC, Wallingford JC. Original Article World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries. Matern child Nutr. 2015;2015)2000):354-70.

WHO. Guiding principles for complementary feeding of the breastfed child: Pan American Health Organization, World Health Organization. Div Heal Promot Prot Food Nutr Progr. 2003.

Saaka M, Wemakor A, Abizari AR, Aryee P. How well do WHO complementary feeding indicators relate to nutritional status of children aged 6–23 months in rural Northern Ghana? BMC Public Health. 2015;15(1):1-12.