Minimum Dietary Diversity for Women

The two indicators were developed for different purposes and validated separately. The MDD-W ten-group list — grains/roots/tubers, pulses, nuts and seeds, dairy, meat/poultry/fish, eggs, dark green leafy vegetables, other vitamin-A-rich produce, other vegetables, and other fruits — was selected through the consensus process led by Martin-Prevel specifically to predict micronutrient adequacy in women of reproductive age. The IDDS nine-group schema serves a more general individual diet-quality purpose. Because the lists differ, MDD-W scores are not interchangeable with IDDS scores.

The threshold of five out of ten was chosen empirically. Using pooled datasets, the developers compared candidate cut-offs by how well each classified women as meeting or not meeting their micronutrient requirements, balancing sensitivity and specificity. Five groups gave the best overall trade-off across the validation samples, so a woman reaching at least five of the ten groups is classified as achieving minimum dietary diversity. It is a population-optimized cut-off, not a clinical diagnostic boundary for any individual.

Only if more than a minimal amount was eaten. MDD-W applies a minimum-quantity rule — conventionally about 15 grams — so that condiment-sized amounts used purely for flavor, such as a spoonful of tomato in a sauce, do not count a whole food group toward the score. Enumerators are trained to probe quantities of borderline items. Ignoring this rule inflates scores by crediting nutritionally trivial amounts, so it is an important part of correct measurement.