1. INTRODUCTION TO
NUTRITION ANALYSIS :
POLICY PARAMETERS
Lalita Bhattacharjee
Nutritionist
Training Workshop on Analysis of Data for Measuring
Availability, Access and Nutritional Status Assessment
of Nutritional Status
14 -26 January 2012

2. DIETARY ASSESSMENT AND
NUTRITIONAL
ASSESSMENT : KEY TERMS
 A DIETARY ASSESMENT : comprehensive evaluation of a person's
food intake. It is one of the established methods of nutritional
assessment. Dietary assessment techniques range from food records
to questionnaires and biological markers.
 NUTRITIONAL ASSESSMENT : more comprehensive and includes
determining nutritional status by analyzing the individual’s brief socio
economic background, medical history, dietary, anthropometric,
biochemical, clinical data and drug –nutrient interactions
 NUTRITIONAL STATUS : measurement of the extent to which an
individual’s physiologic need for nutrients is being met
 NUTRIENT INTAKE : depends on actual food consumption which is
influenced by factors such as economic situation, eating behaviour,
emotional climate, cultural influences, effects of disease states on
appetite and the ability to absorb nutrients
 NUTRIENT REQUIREMENTS : are determined and influenced by age,
sex, BMR, physiological status, activity patterns, physiologic stressors
(infection, disease) and psychological stress

3. OPTIMAL NUTRITIONAL
STATUS
Source: Mahan and Stump, 2000

4. DIETARY ASSESSMENT
PRINCIPLES
Adequacy : a diet that provides enough energy and nutrients to
meet the needs according to the recommended dietary
intakes/allowances (for healthy and active life)
Balance : a diet that provides enough, but not too much of each
type of food ( adequacy of basic food groups)
Variety : a diet that includes a wide selection of foods within each
food group (dietary diversity/ includes biodiversity – species, varieties, cultivars)
Nutrient Density : a diet that includes foods that provide the
most nutrients for the least number of calories
(nutrient dense foods)
Moderation : A diet that limits intake of foods high in sugar
and fat (nutrient intake goals/guidelines)

5. WHAT IS DIETARY DIVERSITY
Dietary diversity is
a qualitative
measure of food
consumption that
reflects household
access to a variety
of foods and is
also a proxy for
nutrient adequacy
of the diet of
individuals

6. HHDDS and IDDS
Measures no. of different food groups
consumed over a given reference period
i.e. 24 hours/1 day
HDD is also a proxy for HH socio
economic status, whereas IDD is purely a
proxy measure of an individual’s quality of
diet.

7. WHEN TO MEASURE DIETARY
DIVERSITY
Objective Timing
Assessment of the typical diet of When food supplies are still
HHs/individuals adequate (may be 4-5 mo after the
main harvest)
Assessment of the FS situation in During periods of greatest food
rural, agriculture based communities shortage, such as immediately prior
to the harvest/immediately after
emergencies or natural disasters
Assessment of FS situation in non- At the moment of concern to identify
agricultural communities a possible food security problem
Monitoring of FS/N programmes or Repeated measures to assess
agricultural interventions such as impact of the intervention on the
crop/livelihood diversification quality of the diet, conducted at the
same time of the year as te baseline
(avoid interference due to seasonal
factors)

8. Foods/food groups
HDDS WDDS 9-group WDDS 13-group IYCF DD
Q Food Group Q Food Group Q Food Group Q Food Group
1. Cereals 1,2 Starchy staples 1,2 Starchy staples 1,2 Starchy staples
2. White tubers & roots 4 Dark green leafy 4 Dark green leafy
vegetables vegetables
3,4, Vegetables 3,6 Vitamin A rich fruits 3 Vitamin A rich 3,4,6 Vitamin A rich fruits &
5 & vegetables vegetables vegetables
5,7 Other fruits & 6 Vitamin A rich 5,7 Other fruits &
vegetables fruits vegetables
5 Other vegetables
6,7 Fruits 7 Other fruits
8,9 Meat 8 Organ meat 8 Organ meat
11 Fish and other sea 9,11 Meat and fish 9,11 Meat and fish 8,9,1 Flesh foods
food 1
10 Egg 10 Egg 10 Egg 10 Egg
12 Legumes, nuts & 12 Legumes, nuts & 12 Legumes, nuts & 12 Legumes, nuts &
seeds seeds seeds seeds
13 Dairy 13 Dairy 13 Dairy 13 Dairy
14 Oils & fats
15 Sweets
PracticalCondiments &
16 Exercise 3: Use of dietary diversity in food security and nutrition surveillance – Jillian L. Waid
beverages

9. Methods for data analysis
 Cut offs :Not universally defined
 FANTA 2: Less than 5 ( out of 9 or 13 food
groups) is inadequate
 Programmatically :
 Goal to raise the mean overall to the mean of the
top third of the respondents

10. HDDS Calculation
Step 1: Assign 1 if the food group/item consumed; 0
not consumed. Sum all the scores for various food
groups. Sum will be between 0-12.
Step 2: The average HDDS for the sample
population
Sum HDDS
Total no. of households
Setting HDDS Threshold:
Option 1: From a baseline survey take the HDDS for the
richest income tercile (33%)
Option 2: From a baseline survey take HDDS of the upper
tercile of diet diversity (33%)

11. Different Types of Childhood
Malnutrition
Normal height for age
Children
Wasted Stunted Underweight
Normal
Low weight for height Low height for age Low weight for age

12. Why is nutrition not improving?
 Knowledge: do people know what foods they should
consume by age, sex, occupation, physiological
status?
 Do families have the resources/motivation to convert
knowledge to practice
 If food intakes (energy and nutrients) are adequate,
could there be intervening factors e.g. illness
 Pre-disposing factors: maternal undernutrition
seasonal food/income shortages, migration, illness
outbreaks, hygiene/sanitation, emergencies
 Importance of under 2’s

13. Illustration of association
between dietary adequacy and
anthropometry
Prevalence of % with % with Total under
under inadequate adequate or
nutrition diet diet adequate
% <-2SDs 20 10 30
nutrition
% > -2SDs 0 70 70
Total sample 20 80 100
Note: 10% have adequate diets but are still undernourished due to other causes
Source : Mason, 2002 in “Measurement and Assessment of Food Deprivation and Undernutrition”, FAO