The link between child dietary diversity and child anemia: The power of colorful plates

Nutritional anemias are the most common causes of anemia worldwide, and the extent is greater in the sub-Saharan African (SSA) region. Dietary diversification is among the strategies to prevent anemia due to nutrient deficiencies. There is a lack of evidence on the effect of dietary diversity on anemia, particularly in children. We evaluated the influence of child dietary diversity on anemia among children aged 6-23 months. We used the recent nationally representative cross-sectional surveys from 23 SSA countries. A child with inadequate dietary diversity (treated group) was matched with a child with adequate dietary diversity (control group) based on selected covariates and calculated propensity scores to match 11,742 children in both groups. The effect of child dietary diversity on child anemia was evaluated using independent t-tests, binomial regression, and linear regression. Children with inadequate dietary diversity had a -0.082g/dl (95% CI = -0.137 - -0.027) and p-value < 0.005 lower hemoglobin concentration than children with adequate dietary diversity. Children with inadequate dietary diversity had a 3% increased risk of anemia, compared to children having adequate dietary diversity, RR = 0.97, (95% CI = 0.95 - 0.99) and p-value < 0.05. A one-unit increase in child dietary diversity score was associated with a 0.05 g/dl increase in child hemoglobin (β = 0.05, 95% CI: 0.03 - 0.06), with p-value of < 0.001. One unit increase in dietary diversity score among lower dietary diversity groups resulted in a 0.12 g/dl, (95% CI 0.09 - 0.15g/dl) increase in child hemoglobin level (p-value < 0.001). Inadequate dietary diversity significantly increases the risk of anemia in children. Adequate dietary diversity in children resulted in small but significantly higher mean hemoglobin concentration. To effectively combat anemia in children it is imperative to implement multifaceted interventions that promote dietary diversity and improve food security.