Researchers in Ethiopia tested whether a simple tool that counts how many different food groups children eat can accurately predict if they’re getting enough vitamins and minerals. They studied 457 children aged 6-23 months and found that the standard version of this tool (which looks for 5 food groups) doesn’t work well in Ethiopia. However, when they adjusted it to look for just 3 food groups instead, it worked much better. This suggests that different countries might need different versions of this tool based on what foods families actually eat in their area.

The Quick Take

  • What they studied: Can a simple test that counts different types of food a child eats accurately tell us if the child is getting enough vitamins and minerals?
  • Who participated: 457 children between 6 and 23 months old living in North Mecha District in Northwest Ethiopia, selected randomly from the community
  • Key finding: The standard tool (looking for 5 food groups) didn’t work well, but adjusting it to look for 3 food groups worked much better at predicting whether children got enough nutrients
  • What it means for you: If you’re tracking your child’s nutrition in Ethiopia or similar areas, this suggests that simpler food variety goals might be more realistic and useful than the international standard. However, this finding is specific to Ethiopia and may not apply everywhere.

The Research Details

Researchers conducted a community-based study in Ethiopia where they visited families and asked them to describe everything their children ate over a 24-hour period. This is called a 24-hour dietary recall. They collected this information from 457 randomly selected families between February 2-18, 2023. The researchers then counted how many different food groups each child ate and compared this to a detailed calculation of whether the child was getting enough vitamins and minerals. They used statistical tests to see how well the simple food group count matched up with the detailed nutrient calculations.

This research approach is important because it tests whether a simple, easy-to-use tool actually works in real-world settings. The tool being tested is used by health organizations worldwide to quickly check if children are eating well. However, what people eat varies greatly between countries and regions. This study checks whether the same tool works the same way in Ethiopia as it does in other places.

This study has several strengths: it used a random sample of 457 children, which is a decent size; it collected detailed dietary information using a standard method; and it used appropriate statistical tests. However, the study only looked at one region in Ethiopia during a short time period (two weeks), so the results might not apply to all of Ethiopia or to other seasons. The study was published in PLoS ONE, a well-respected scientific journal that requires rigorous peer review.

What the Results Show

When researchers used the international standard (looking for 5 or more food groups), the tool was not very good at predicting whether children had enough nutrients. It correctly identified only 22.4% of children who actually had adequate nutrients (this is called sensitivity), but it was very good at identifying children who didn’t have enough nutrients (91.4% specificity). This means the standard tool would miss many children who were actually doing fine nutritionally.

When researchers adjusted the tool to look for just 3 or more food groups instead, it worked much better. It correctly identified 85.5% of children with adequate nutrients while still correctly identifying 62.9% of children without adequate nutrients. This adjustment made the tool much more balanced and useful.

Overall, the simple food group count had a moderate correlation with detailed nutrient measurements, meaning it generally pointed in the right direction but wasn’t perfect. The researchers found that the tool could predict nutrient adequacy fairly well when using the adjusted 3-group cutoff.

The study showed that Ethiopian children’s eating patterns are different from the patterns the international tool was designed for. The food groups that are common in Ethiopia are different from those in other countries, which explains why the standard cutoff didn’t work as well. This finding suggests that many countries might need to adjust the tool based on their own local food patterns.

Previous research in other countries has shown that counting food groups can be a useful way to estimate nutrient intake, but this is one of the first studies to carefully test whether the international standard works in Ethiopia. The study confirms what some researchers suspected: that a one-size-fits-all approach doesn’t work well across different countries with different food cultures.

This study only looked at children in one district in Ethiopia during a two-week period, so the results might not apply to other regions of Ethiopia or to different seasons when different foods are available. The study also relied on parents’ memory of what their children ate, which might not be perfectly accurate. Additionally, the study was conducted in 2023, so food availability and eating patterns may have changed. The findings are specific to Ethiopia and may not apply to other countries.

The Bottom Line

If you live in Ethiopia or a similar region and want to check if your child is eating a good variety of foods, aiming for at least 3 different food groups per day appears to be a reasonable goal based on this research (moderate confidence). The international standard of 5 food groups may be too strict for Ethiopian conditions. However, this is just one tool—it’s still important to work with healthcare providers to ensure your child is growing well and getting regular check-ups.

This research is most relevant to health workers, nutritionists, and parents in Ethiopia and countries with similar dietary patterns. It’s also important for international health organizations like WHO and UNICEF that set nutrition guidelines. Parents in other countries should continue following their local health guidelines, as this study is specific to Ethiopia.

If you adjust your child’s diet to include more food variety, you won’t see immediate changes. It typically takes several weeks to months of consistent dietary changes to see improvements in a child’s growth and development. Regular health check-ups are the best way to track whether your child is getting adequate nutrition.

Want to Apply This Research?

  • Track the number of different food groups your child eats each day for one week. Record: grains, legumes, vegetables, fruits, meat/fish, dairy, and oils/fats. Aim to see at least 3 different groups per day and work toward more variety over time.
  • If your child is currently eating from fewer than 3 food groups daily, set a goal to add one new food group this week. For example, if your child eats grains and vegetables, try adding a legume-based dish or dairy product. Track which new foods your child accepts and enjoys.
  • Weekly food group tracking: Create a simple chart showing which food groups were eaten each day. Review it weekly to identify patterns and gaps. Take monthly photos of typical meals to visually track dietary diversity. Schedule quarterly check-ins with a health worker to monitor your child’s growth and adjust dietary goals as needed.

This research is specific to Ethiopia and may not apply to other countries or regions. The findings suggest adjustments to how nutrition is assessed in Ethiopia but should not replace professional medical advice. Parents and caregivers should consult with local healthcare providers, pediatricians, or nutritionists for personalized nutrition guidance for their children. This study helps inform policy and practice but is one piece of evidence among many. Always seek professional medical advice for concerns about your child’s growth, development, or nutrition.