Doing a Dietary Assessment
Dietary Assessment
Having designed your M&E Framework it is time to design the data collection for the indicators that you have identified in the framework.
Here we will go through how to collect dietary data by way of an example. This will be one of the most useful indicators for nutrition and most projects would benefit from collecting dietary data. So that is why we are starting here.
Why collect dietary data?
- It is a crucial link between food production and nutrition
- It is usually necessary to improve diets to improve nutrition (might not be enough)
- Everyone eats and can in theory change diet related to circumstances
- It is reasonably straightforward to collect
The idea behind collecting dietary data is to know whether diets improve as a result of the Permaculture Project in the population covered by the project. Even if production of nutritious food has increased, it is good to know whether this has resulted in dietary change.
Why Dietary Diversity?
All foods have a range of nutrients, and different foods tend to have higher levels of some and less of others. For example, green leafy vegetables have high levels of anti-oxidant vitamins because they need these to protect their tissues from damaging effects of oxygen. Seeds contain high levels of carbohydrate, ready as a fuel for germination. Nuts have high content of oils for the same reason. Meat is rich in iron because of the high content of haemoglobin.
To have the best chance of meeting all requirements, it is therefore good to have a diverse diet, and a diverse diet is an indicator of a balanced diet.
There are several indicators related to diet. Dietary diversity scores have been validated for particular food groups as a good indicator of micronutrient adequate diets. We can use the scores for other demographic groups too.
Dietary diversity indicators.
More details are available in the course on ‘Indicators’
- Infant and Young Child Feeding practices
- Minimum Dietary Diversity (6 mo to 2yr) (7 food groups)
Minimum Dietary Diversity (MDD) | INDDEX Project (tufts.edu)
- Individual Dietary Diversity
- Individuals over 2 years (10 food groups)
- Minimum Dietary Diversity for Women aged 15 to 49 (10 food groups)
https://www.fao.org/nutrition/assessment/tools/
- Global Dietary Quality Score GDQS- incorporates ultra processed with negative scores
- Dietary Species Richness DSR – detailed for each food
- Food Frequencies for individual foods
Here we will use an individual dietary diversity score that is useful for children and adults over 2 years by way of example. A different list of foods is used for young children under 2 years.
How to do an assessment for Individual Dietary Diversity Score
This score is based on the consumption at least once in a 24-hour period of any food from 10 distinct food groups. (see below)
A full explanation of how to do this is available
Guidelines for measuring household and individual dietary diversity (fao.org)
Minimum Dietary Diversity for Women (MDD-W) | INDDEX Project (tufts.edu)
Preparation for this exercise
Who is going to do the assessment?
Identify the person who is going to go through the dietary information and classify it according the food groups. This person, we will call ‘the enumerator’.
You need to decide whether the household members can record information themselves or you need the enumerator to interview people.
Sampling
Ideally you will do a sample size calculation based on the known variability of dietary diversity score in the community and a planned change you are hoping to see (see the lesson on ‘how to do sampling’).
However, in practice you may not know the variability and you are not sure how much change you are hoping to achieve. So sample size is a pragmatic consideration in many cases based on:
- Do you want to include multiple people in one household or just one person? From a sample size point of view 2 people in the household are not independent so the sample size is not helped by having more than one person unless you want to include them in different groups – such as men and women.
- How many people is feasible to include based on who is doing the assessment and how much time they have
- How many subgroups you want to have: do you want a separate analysis by gender, village, district etc. You may also have a comparison group. The more subgroups the larger the sample size.
In practice, this probably means a sample size from 50 to 100 per subgroup.
Timings
- If you are doing a baseline and follow-up, it is important to do the assessments at the same season otherwise things like the hunger season or post-harvest season will skew your results.
- Because you are only collecting data for 1 day you probably want to avoid special days such as feast days, holidays and Ramadan.
- The time of day should not matter too much
Food Groups
The 10 foods that will be recorded as part of this exercise:
The ten food groups
- Grains, white roots and tubers, and plantains
- Pulses (beans, peas and lentils)
- Nuts and seeds
- Milk and milk products
- Meat, poultry and fish
- Eggs
- Dark green leafy vegetables
- Other vitamin A-rich fruits and vegetables
- Other vegetables
- Other fruits
The enumerator will familiarise themselves with the 10 food groups and write down some examples of foods that will be classified in each group. Holding a group meeting to discuss these food groups and to add local foods to the 10 groups is recommended. A translator can help with translating the foods to and from local languages.
Below is an expanded list that you can use as a starting point and then add local foods to it.
If in doubt about any foods, it is possible to use a very complete list (FAO 2014)
Guidelines for Measuring Individual and Household Dietary Diversity https://www.fao.org/3/i1983e/i1983e.pdf.
The 10 food groups include these examples
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1 CEREALS corn/maize, rice, wheat, sorghum, millet or any other grains or foods made from these (e.g. bread, noodles, porridge or other grain products) local foods e.g. ugali, nshima,
WHITE ROOTS AND TUBERS white potatoes, white yam, white cassava, or foods made from roots PLANTAINS
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2 PULSES dried beans, dried peas, lentils, (eg. hummus)
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3 NUTS and SEEDS nuts, seeds or foods made from these, peanut butter
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4 MILK AND MILK PRODUCTS milk, cheese, yogurt or other milk products
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5 FLESH MEATS beef, pork, lamb, goat, rabbit, game, chicken, duck, other birds, insects
ORGAN MEAT liver, kidney, heart or other organ meats or blood-based foods FISH AND SEAFOOD fresh or dried fish or shellfish
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6 EGGS from chicken, duck, guinea fowl or any other egg
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7 DARK GREEN LEAFY VEGETABLES dark green leafy vegetables, including wild forms + locally available vitamin A rich leaves such as amaranth, cassava leaves, kale, spinach
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8 OTHER VITAMIN A RICH VEGETABLES AND TUBERS pumpkin, carrot, squash, or sweet potato that are orange inside + other locally available vitamin A rich vegetables (e.g. red sweet pepper)
VITAMIN A RICH FRUITS ripe mango, cantaloupe, apricot (fresh or dried), ripe papaya, dried peach, and 100% fruit juice made from these + other locally available vitamin A rich fruits
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9 OTHER VEGETABLES other vegetables (e.g. tomato, onion, eggplant) + other locally available vegetables that are not high in vitamin A
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10 OTHER FRUITS other fruits, including wild fruits and 100% fruit juice made from these
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The Assessment
Find out how many of these 10 food groups have been consumed by an individual within the 24 hour period preceding the assessment.
From the number of food groups, it is a simple matter of adding up the number of food groups consumed in a day.
There are 3 ways of doing this:
- individuals record their own diets for a day and then a member of the project team (or volunteer) goes through these records and works out how many food groups have been consumed. Children can also record their own foods consumed in a day so it is a good way to involve the children themselves unless they are very young in which case the carer will fill in for the child.
- A member of the project team (or another volunteer) interviews the household or individuals to find out what has been consumed. As the person recalls what they ate in the previous day, the interviewer records whether each food group has been consumed or not. This might be a good option where people are illiterate.
- A mobile phone record could be kept for a day and sent to the project team. This could include photos of foods
Recording form for Individuals
You need to include identification information on the form: this includes date, a unique identification number for each individual, and the subgroup they are in (e.g. village, gender etc) as well as the meals they have consumed.
‘Please describe the foods (meals and snacks) that you ate or drank yesterday during the day and night, whether at home or outside the home. Start with the first food or drink of the morning. Write down all foods and drinks. When composite dishes are mentioned, list of ingredients.’
Meal | Ingredients | Food Group | From where? |
Recording form for the 10 food groups for each individual
Record a 1 in the column if the individual consumed the food group at least once in the past 24 hours and 0 if the food was not consumed at all
Name or id number:
Subgroup:
|
Date: |
Food group | Consumed in past 24 hours
1= yes 0=no |
1. Grains, white roots and tubers, and plantains | |
2. Pulses (beans, peas and lentils) | |
3. Nuts and seeds | |
4. Milk and milk products | |
5. Meat, poultry and fish | |
6. Eggs | |
7. Dark green leafy vegetables | |
8. Other vitamin A-rich fruits and vegetables | |
9. Other vegetables | |
10. Other fruits | |
TOTAL |
Data recording and analysis
Once you have competed the above information for each individual in your sample. It is a matter of recording the data in a simple spreadsheet with one row for each individual.
Date | Subgroup | Unique identifier | Dietary Diversity score |
When you come back to the data for your follow up assessment, you can record another column of data then work out the average Dietary Diversity Score for each subgroup and any changes that have occurred.
References
FAO (2014). Guidelines for Measuring Individual and Household Dietary Diversity.