Using the global diet quality score to assess women’s dietary intake in three sub-Saharan African countries

Dietary inadequacies are of serious concern for women in sub-Saharan Africa. Understanding dietary patterns is key to improving health and nutrition outcomes, but limited resources and non-standardized data collection methods hinder comprehensive dietary intake assessments in the region. The Global Diet Quality Score (GDQS) offers a novel, validated approach to assess diet quality at the population level, capturing both food group quantities and unhealthy dietary risk factors. This study utilized the GDQS to assess the diet quality and associated risks for women of reproductive age in Cameroon, the Democratic Republic of the Congo (DRC) and Nigeria. Data were collected from mothers, or primary caregivers, of children aged 6-59 months, through surveys conducted in the three countries. A 24-hour open-recall was employed to assess dietary intake, with foods categorized into 25 food groups and scored based on consumption levels. Points were assigned to reflect higher consumption of healthy foods and lower intake of unhealthy foods. Study outcomes included mean GDQS (25 food groups), mean GDQS ‘positive’ (16 healthy food groups), and mean GDQS ‘negative’ (7 unhealthy + 2 food groups unhealthy when consumed in excess). The study included 3,820 women from Cameroon (N=2,604), the DRC (N=321), and Nigeria (N=895). In all countries, the mean GDQS was 17-18 (out of 49), mean GDQS+ was 5-7 (out of 32), and mean GDQS- was 11-12 (out of 17). The majority of women (62-78%) were at moderate risk for nutrient inadequacy and diet-associated non-communicable diseases, while approximately 20% of women in Cameroon and the DRC and 30% in Nigeria were considered to be at high risk based on their dietary intake. The findings revealed concerningly poor diets, with nearly all women at moderate or high risk for adverse diet-related health and nutrition outcomes. Timely and actionable data, such as the GDQS, are important for creating awareness at all levels and for developing context-specific nutrition-centered strategies that address the barriers to women consuming healthy and diverse diets. Key words: diet, GDQS, nutrition, sub-Saharan Africa, women of reproductive age