ICMR-NIN develops diet diversity score to identify micronutrient deficiencies in children
HYDERABAD: Researchers at the ICMR-National Institute of Nutrition (ICMR-NIN) have developed a simple dietary screening tool to assess diet diversity and identify school-age children at risk of micronutrient deficiencies. The findings have been published in the European Journal of Clinical Nutrition.
Tool aims to improve nutritional screening in children
Micronutrient deficiencies remain a major public health challenge in India and other low- and middle-income countries. Deficiencies of iron, calcium, vitamin B12 and vitamin A can affect children’s growth, immunity, cognitive development and academic performance, even when there are no visible signs of malnutrition.
Building on the recommendations of the ICMR Dietary Guidelines for Indians 2024, the researchers designed a Diet Diversity Score (DDS) for children aged six to 10 years. The tool uses a questionnaire based on 13 food groups classified according to their micronutrient content.
Unlike conventional dietary assessments, the researchers subdivided broad food groups to better reflect nutrient differences. For example, vitamin A-rich foods such as green leafy vegetables, carrots, capsicum, onion stalk, papaya and mango were grouped separately to improve the assessment of micronutrient intake.
Five-gram threshold captures small but meaningful food intake
The DDS also incorporates a minimum intake threshold of five grams for each food group. This allows the tool to account for small but nutritionally significant quantities of foods commonly consumed in mixed dishes, such as pulses, fruits, vegetables and milk.
The researchers validated the tool by comparing children’s dietary scores with the adequacy of 10 essential micronutrients and selected nutritional biomarkers. The study found a significant correlation between the DDS, overall micronutrient adequacy and haemoglobin levels.
According to the study, children who consumed foods from at least 10 of the 13 food groups, with a minimum intake of five grams from each group, were significantly more likely to meet at least 70% of their daily micronutrient requirements.
Researchers call for wider validation before implementation
“Diet diversity is one of the most practical indicators of diet quality. By converting complex dietary assessment into an easy-to-use scoring tool, this DDS offers a promising approach to identify children at risk of micronutrient inadequacy and supports timely nutrition interventions,” said Dr M. SubbaRao Gavaravarapu, Scientist G at ICMR-NIN, who led the study.
ICMR-NIN Director Dr Bharati Kulkarni said the tool could support school health programmes, the Integrated Child Development Services (ICDS), teachers, parents, nutritionists and public health professionals in screening children’s dietary quality.
“However, further multicentric validation across diverse regions and food environments in India is essential before large-scale implementation,” she said.
The researchers said the study marks an important step towards developing field-friendly, evidence-based nutritional screening tools to help address micronutrient malnutrition among children.
The full research paper has been published in the European Journal of Clinical Nutrition.
