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OBJECTIVE: To explore multiple methods of calculating diet diversity scores (DDS) to maximize associations with predicted dietary micronutrient adequacy among schoolchildren in rural Kenya. DESIGN: Up to three 24 h recall interviews were administered for each child for a total of 1544 d of intake from all schoolchildren. Daily amounts of food consumed were assigned to one of eight food groups. Five DDS were developed based on various minimum intake amounts from each food group: (i) 1 g; (ii) 15 g; (iii) a variable minimum based on the content of a target nutrient for each group; (iv) the median intake level for each group; and (v) the 90th percentile intake level for each group. A diet was assigned 1 point towards the daily DDS if the food group intake was above the defined minimum level. Five scores were calculated for each child, and bivariate longitudinal random-effects models were used to assess the correlation between each DDS and the mean probability of adequacy for fourteen nutrients. SETTING: Embu District, Kenya. SUBJECTS: Schoolchildren (n 529), mean age 7·00 (sd 1·41) years. RESULTS: Only DDS based on a 15 g minimum and DDS based on nutrient content were significantly associated with mean probability of adequacy after adjusting for energy intake (0·21 and 0·41, respectively). CONCLUSIONS: A DDS using minimum intakes based on nutrients contributed by a food group best predicted nutrient adequacy in this population. These analyses contribute to the continued search for simpler and more valid dietary quality indicators among low-income nations.

ObjectiveTo examine changes in energy intake along with markers of dietary quality (animal-source energy and protein intakes) among household members in the presence of supplementary school feeding in rural Kenya.DesignA 2-year, longitudinal, randomized controlled feeding intervention study.SettingKyeni South Division, Embu District, Kenya.SubjectsA total of 182 schoolchildren and selected household members.ResultsThere was no evidence that schoolchildren who received supplementary snacks at school experienced reduced intakes at home or that intakes by other family members were increased at the expense of the schoolchild's intake.ConclusionsThis analysis highlights a number of factors useful in planning for supplementary feeding interventions in rural Kenya and similar communities. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the effects of animal-source foods on toddler growth.DesignA 5-month comparison feeding intervention study with one of three millet-based porridges randomized to eighteen feeding stations serving 303 children aged 11–40 months. Feeding stations served plain millet porridge (Plain group), porridge with milk (Milk group) or porridge with beef (Meat group). Anthropometry, morbidity and food intake were measured at baseline and regular intervals. Longitudinal mixed models were used to analyse growth.SettingEmbu, Kenya.SubjectsTwo hundred and seventy-four children were included in final analyses.ResultsLinear growth was significantly greater for the Milk group than the Meat group (P = 0·0025). Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group (P = 0·0046), while the Milk group's mid-upper arm circumference growth rate was significantly greater than the Meat group's (P = 0·0418). The Milk and Plain groups’ measures did not differ.ConclusionsMilk and meat porridges did not have a significantly greater effect on growth than plain porridge in this undernourished population. Linear growth was influenced by more than energy intakes, as the Plain group's total body weight-adjusted energy intakes were significantly greater than the Meat group's, although linear growth did not differ. Energy intakes may be more important for growth in arm muscle. The diverse age distribution in the study makes interpretation difficult. A longer study period, larger sample size and more focused age group would improve clarity of the results. [ABSTRACT FROM AUTHOR]