Dietary Diversity and Child Malnutrition in Ghana: A Nationally Representative Analysis of Socioeconomic Gradients and Effect Modification
1
Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
2
Dental School, University of Ghana, Accra, Ghana
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Inadequate dietary diversity during complementary feeding contributes to high childhood malnutrition rates in sub-Saharan Africa. Understanding relationships between dietary quality and nutritional outcomes is essential for designing effective interventions.
OBJECTIVE:
We examined associations between dietary diversity and nutritional status among children aged 0-23 months in Ghana, with attention to effect modification by socioeconomic factors.
METHODS:
We analyzed data from 2,031 children in the Ghana Demographic and Health Survey 2022. Dietary diversity was assessed using WHO minimum dietary diversity (≥5 of 7 food groups in 24 hours). Nutritional status was evaluated through anthropometric measurements converted to WHO z-scores. Stunting, wasting, and underweight were defined as z-scores below -2 SD. Multivariable logistic regression examined associations adjusting for child, maternal, household, and geographic factors. Stratified analyses tested effect modification.
RESULTS:
Only 31.8% of children aged 6-23 months achieved minimum dietary diversity, with substantial disparities by wealth (16.3% poorest vs. 52.7% richest quintile) and residence (24.6% rural vs. 41.7% urban). Stunting affected 17.8% of children, increasing from 8.9% (0-5 months) to 23.2% (12-23 months). In fully adjusted models, minimum dietary diversity was associated with 39% reduction in stunting odds (OR=0.61, 95%CI:0.38-0.97, p=0.04) and 51% reduction in wasting odds (OR=0.49, 95%CI:0.29-0.82, p=0.006). Each additional food group conferred 11% reduction in stunting (OR=0.89, 95%CI:0.82-0.97, p=0.008) and 13% reduction in wasting (OR=0.87, 95%CI:0.79-0.96, p=0.006), demonstrating dose-response relationships. Protective associations appeared strongest among poorest children (OR=0.32, 95%CI:0.14-0.74, p=0.007), rural residents (OR=0.42, 95%CI:0.23-0.76, p=0.004), and those with uneducated mothers (OR=0.27, 95%CI:0.10-0.71, p=0.008).
CONCLUSIONS:
Dietary diversity shows robust protective associations with malnutrition among Ghanaian children, with stronger effects among disadvantaged populations. Findings support prioritizing dietary diversity improvement in equity-focused nutrition interventions addressing structural determinants of food access.
Inadequate dietary diversity during complementary feeding contributes to high childhood malnutrition rates in sub-Saharan Africa. Understanding relationships between dietary quality and nutritional outcomes is essential for designing effective interventions.
OBJECTIVE:
We examined associations between dietary diversity and nutritional status among children aged 0-23 months in Ghana, with attention to effect modification by socioeconomic factors.
METHODS:
We analyzed data from 2,031 children in the Ghana Demographic and Health Survey 2022. Dietary diversity was assessed using WHO minimum dietary diversity (≥5 of 7 food groups in 24 hours). Nutritional status was evaluated through anthropometric measurements converted to WHO z-scores. Stunting, wasting, and underweight were defined as z-scores below -2 SD. Multivariable logistic regression examined associations adjusting for child, maternal, household, and geographic factors. Stratified analyses tested effect modification.
RESULTS:
Only 31.8% of children aged 6-23 months achieved minimum dietary diversity, with substantial disparities by wealth (16.3% poorest vs. 52.7% richest quintile) and residence (24.6% rural vs. 41.7% urban). Stunting affected 17.8% of children, increasing from 8.9% (0-5 months) to 23.2% (12-23 months). In fully adjusted models, minimum dietary diversity was associated with 39% reduction in stunting odds (OR=0.61, 95%CI:0.38-0.97, p=0.04) and 51% reduction in wasting odds (OR=0.49, 95%CI:0.29-0.82, p=0.006). Each additional food group conferred 11% reduction in stunting (OR=0.89, 95%CI:0.82-0.97, p=0.008) and 13% reduction in wasting (OR=0.87, 95%CI:0.79-0.96, p=0.006), demonstrating dose-response relationships. Protective associations appeared strongest among poorest children (OR=0.32, 95%CI:0.14-0.74, p=0.007), rural residents (OR=0.42, 95%CI:0.23-0.76, p=0.004), and those with uneducated mothers (OR=0.27, 95%CI:0.10-0.71, p=0.008).
CONCLUSIONS:
Dietary diversity shows robust protective associations with malnutrition among Ghanaian children, with stronger effects among disadvantaged populations. Findings support prioritizing dietary diversity improvement in equity-focused nutrition interventions addressing structural determinants of food access.
| eISSN: | 2654-1459 |
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