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Food Diversity and Nutritional Status in School Children in Morocco

In Morocco about 20 % of children under the age of 15 years are stunted or delayed in growth. Dietary quality is much associated with dietary diversity. Recent FAO/WHO recommendations emphasized food diversification intake to combat many nutrition related diseases. Dietary diversity is used for the assessment of diet quality and food security. Morocco still bears a heavy burden of many micronutrient deficiencies and child stunting. Stunting reflects chronic under nutrition and nutritional insecurity. The purpose of the study was to assess dietary diversity by comparing a dietary diversity score (DDS) and a weekly food frequency score (WFFS) and study their relationship to stunting in school-age children in the province of Kenitra (Morocco). The study was carried out in urban and rural areas of Kenitra. After administrative authorizations and parents’ clearance and children’s consent. The study team surveyed seven different schools representing all the principal communities of Kenitra and its region. A structured questionnaire composed of different items: Household demographic data, socio-economic data, anthropometric measurements, food and nutrition evaluation was delivered to get answers. A stratified random sample of 263 pupils with average age of 12.9 ± 0.9 years including one-third from rural schools were administered a weekly food frequency questionnaire. A health team assessed the anthropometric status. Dietary diversity was appraised with two types of indices: a dietary diversity score (DDS) based on the number of food categories consumed over a week, and a weekly food frequency score (WFFS) which also takes into account the frequency of food intake. The DDS was significantly higher in rural than in urban children, whereas the WFFS was lower, in rural children owing primarily to less frequent intake of fruits and vegetables than in the urban children. Maternal level of instruction was also positively associated with a higher consumption of fruits and vegetables and milk, and with a higher WFFS. Both indices were significantly associated with stunting. The study suggested that diet quality is associated with height status and food diversity indices that take food frequency into account which may provide a better reflection of diet quality.

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