Correlates of Individual Dietary Diversity and Its Association with Psychosocial Functioning of Adults in Rural Uganda

Background: Minimal dietary diversity remains a critical challenge in rural Uganda. Forty-three percent of rural households consume foods that do not meet the minimum level of a diverse diet. Minimal dietary diversity is associated with poor nutritional and physiological health outcomes for children, youth, and adults. Evidence also points to negative association between food security and psychosocial functioning. However, limited evidence exists to support the connection between dietary diversity, a component of food security, and psychosocial functioning. Additionally, we know little about the role of instrumental support, financial status, and living conditions on consumption of a diversified diet. This study examines the correlates of dietary diversity and its association with psychosocial functioning.

Methods: A cross-sectional sample of 326 rural adults living in 12 villages in Masindi District in Western Uganda was surveyed using a questionnaire that included items on individual dietary diversity (IDD), psychosocial functioning, and social and economic characteristics. We calculated IDD scores using three methods suggested in the literature, including the World Food Programme’s calculation of a food consumption score (FCS). We defined psychosocial functioning as ability to complete activities of daily living or to engage in future-oriented behaviors. We used multivariable linear and logistic regression to examine correlates of IDD and its association with orientation toward success, future expectations, and self-rated health.  

Results: Multivariable results indicated that being satisfied with current household financial status, living in better dwelling conditions, ownership of livestock, and higher levels of instrumental support were significantly associated with higher IDD scores. Household size and age were negatively associated with IDD scores (p ≤ .05). IDD was positively associated with psychosocial functioning, including orientation toward success, expectations for future economic conditions, and self-rated health (p ≤ .05). Furthermore, results were consistent across the three models of estimating IDD scores: FCS, food variety score, and food consumption score based on principal component analysis

Conclusions: Study findings expand evidence on the potential effects of IDD on health and suggest that the positive association extends to psychosocial functioning. Additionally, identification of modifiable individual and household risk factors is essential to achieving the numerous health benefits of dietary diversity. Malleable factors, including asset ownership, household financial status, and instrumental support should be considered when developing dietary diversity programs. Further, age and household size should be considered when targeting vulnerable individuals and households. Food security programs may be appropriate in enhancing and sustaining dietary diversity if they provide opportunities that improve social and economic status, for example, through livelihood development, income generation, or asset accumulation.