Minimum dietary diversity in Mexico: establishment of cutoff point to predict micronutrients adequacy

Objective To establish the cutoff point for a Minimum Dietary Diversity (MDD) that most accurately predicts the Mean Probability Adequacy (MPA) of 11 micronutrients in the Mexican population, and estimate the population prevalence above it. Subjects and methods We analyzed a 24 h-recall collected in a sample of 10,087 participants (≥1-year-old) from the 2012 Mexican National Health and Nutrition Survey. Foods were classified into ten food group indicators (FGIs) of the Food Agriculture Organization (FAO). The cutoff points of MDD were established as follows: (1) sum of the number of FGIs in the participant's diet; (2) micronutrient intake adequacy estimated by the probability approach method of the FAO; (3) Receiver operating characteristic curves generated by age groups to assess the performance of the number FGIs consumed in predicting the MPA. Results The cutoff points of MMD established by age groups were: ≥4 FGIs in preschool-aged children (75.94% of sensitivity and 72.55% of specificity); ≥5 FGIs in school-aged children (60.51% of sensitivity and 72.82% of specificity) and adolescents (70.01% of sensitivity and 59.38% of specificity); and six in adults (62.26% of sensitivity and 70.33% of specificity) and elders (66.67% of sensitivity and 73.33% of specificity). Based on these cutoff points, we observed that 75% of the preschool-aged children, ~60% of school-aged children and adolescents, and less than 40% of adults and elders were above the MDD. Conclusion This study provides novel insight into the specific MDD cutoff point to predict micronutrient adequacy in the Mexican population.