Publication: Ranking Predictors of Child Dietary Diversity in Nepal Using a Decision Tree
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Date
2025
Article Type
Original Article
Journal Title
Journal ISSN
3059-9547
Volume Title
Pages
Pages: 1 - 6
Publisher
Public Health Concern Trust-Nepal (phect-NEPAL)
Abstract
Abstract:
Introduction: Minimum dietary diversity among children (MDD-C) remains low in Nepal, contributing to persistent malnutrition. This study aimed to rank and characterize the association of dietary, socioeconomic, and health-related predictors of MDD-C among children aged 6–59 months in Madhyapur Thimi Municipality of Nepal.
Method: A secondary analysis of survey data from 375 children was conducted. Chi-squared tests were used to identify baseline associations of the predictors with MDD-C. A Chi-squared Automatic Interaction Detection (CHAID) decision tree was then fitted to identify key split variables and interaction structures. A CHAID-based sensitivity analysis was used to estimate food groups’ contributions to predicted dietary adequacy by toggling individual food groups from absent to present. Bootstrap resampling was used to quantify the internal variability of these estimates.
Result: Overall, 73.6% of children were predicted to achieve MDD-C. The decision tree placed other fruits and vegetables (Group G) at the root level, followed by splits on eggs (Group E), legumes and nuts (Group B), and vitamin A–rich foods (Group F). Sensitivity analysis suggested that enabling consumption of Group G or Group E was associated with the largest expected improvements in predicted dietary adequacy, and bootstrap resampling indicated that this ranking was relatively stable across resamples.
Conclusion: This model-based analysis indicates that Group G and Group E foods are strong positive predictors of adequate dietary diversity and offer the largest expected gains among diet-deficient children. Hence, access to Group G and Group E foods could be prioritized as dietary interventions to improve child nutrition.
Description
Dipesh Baral
Department of Mathematics and Statistics, Washington State University, Washington, USA
Dindu Lama
Department of Business and Economics, Wittenberg University, Ohio, USA
Archana Dangal
Paradise Creek Health and Rehabilitation of Cascadia, Idaho, USA
Dinesh Baral
Independent Researcher, USA
Jiban Kharel
Independent Researcher, USA
Abhishek Thapa
Independent Researcher, USA
Pragati Dahal
Department of Agricultural and Applied Economics, Virginia Polytechnic Institute and State University, Virginia, USA
Swastika Baral
Independent Researcher, USA
Keywords
Bootstrap, Children, Decision Tree, Nutrition, Sensitivity Analysis
Identifier
https://doi.org/10.63455/jew8tz06