(P21-19-26) Nutrient Adequacy and Diet Quality Among Women of Reproductive Age in Sri Lanka

Objectives: Assess usual nutrient intake, micronutrient adequacy and diet quality among women of reproductive age (WRA) in selected rural and urban communities from Badulla and Ratnapura districts, Sri Lanka.

Methods: Cross-sectional analyses used baseline data from a cluster-randomized controlled trial (June–October 2024). Dietary intake of WRA aged 20–49 years (n=2,380) was assessed using phone-based multiple-pass 24-hour dietary recalls, with >20% repeat recalls. Usual nutrient intakes and probability of adequacy for 11 micronutrients were estimated using the National Cancer Institute method. Diet quality was evaluated using Minimum Dietary Diversity for Women (MDD-W) and Global Diet Quality Score (GDQS). Rural-urban differences were examined using cluster-adjusted regression models.

Results: Mean usual energy intake was 1,507 kcal/day, with 70% consuming below 85% of estimated energy requirements (rural:73% vs. urban:66%). Carbohydrates contributed 59% of total energy, fat 30%, and protein 12%, with diets dominated by refined grains (50%). Mean probability of adequacy across the 11 micronutrients was 14%. No participant met requirements for riboflavin or calcium, fewer than 5% for thiamin, niacin, or vitamin B12, and fewer than 20% for folate, vitamin A, vitamin B6, and zinc and about one third for iron and vitamin C. Intakes of animal-source foods, nuts and seeds, fruits and vegetables were insufficient. Fruit and vegetable intake averaged 207 g/day, with only 12% meeting WHO's 400 g/day recommendation. Mean MDD-W score was 4.7/10, with 55% of women meeting the minimum threshold (urban:64% vs. rural:50%). Mean GDQS was 18/49, with 77% at moderate risk of poor diet quality. Urban WRA demonstrated slightly higher micronutrient adequacy and dietary diversity than rural counterparts, though gaps were substantial in both settings.

Conclusions: These findings reveal pervasive dietary inadequacy among WRA in Sri Lanka, with rural residents particularly disadvantaged. Multifaceted strategies addressing the affordability, accessibility, and availability of nutrient-rich foods are needed to support the design of effective nutrition-sensitive interventions for WRA.

Funding Sources: CGIAR Trust Fund contributors