Factors Influencing Dietary Diversity among Primary School Adolescents in Addis Ababa, Ethiopia: A Cross‐Sectional Study

Objective: To investigate the factors influencing dietary diversity of 24-hour meals among primary school adolescents in Addis Ababa, Ethiopia.Design: A cross-sectional study was conducted.Setting: Public primary schools in Addis Ababa, Ethiopia.Participants: A total of 293 students were selected through simple random sampling, ensuring a representative sample of the adolescent population.Outcome Measure (s): Dietary diversity was assessed using the Food and Agriculture Organization's (FAO) 12 food group categories. The Individual Dietary Diversity Score (IDDS) was calculated to quantify dietary diversity.Analysis: Bivariable and multivariable analyses were performed to identify associations between dietary diversity and potential influencing factors. Odds ratios (OR) with 95% confidence intervals (CI) were calculated, with significance set at P < 0.05.Results: The average Dietary Diversity Score (DDS) for school meals was 3.45 (±1.16), while for outside-school meals, it was 3.59 (±1.13). The proportion of students with adequate dietary diversity was 52.24% for within-school meals and 56.68% for outside-school meals. Significant factors influencing dietary diversity included higher family income (adjusted odds ratio [AOR] = 2.5, 95% CI = 1.574-4.877), higher education level of parents (AOR = 4.3, 95% CI = 1.358-13.44), smaller family size (AOR = 2.6, 95% CI = 1.02-6.702), and medium-sized family (AOR = 2.42, 95% CI = 1.199-4.88).Conclusions and implications: Promoting dietary diversity among adolescents is crucial for fostering healthier eating habits and improving nutritional outcomes. Key factors influencing dietary diversity include family income, parental education, and family size. Interventions should focus on enhancing food access, addressing income disparities, providing educational resources on nutrition, and collaborating with local food suppliers. Prioritizing dietary diversity in school feeding programs can significantly improve health outcomes and establish lifelong healthy eating habits. Comprehensive strategies involving schools, families, community stakeholders, and policymakers are essential for effective implementation. Future research should evaluate the long-term impacts of these interventions on dietary diversity and overall health outcomes among adolescents.