INDDEX Project - Household Dietary Diversity Score (HDDS) - 2019-02-13

Data4Diets: Building Blocks for
Diet-related Food Security Analysis

Accessed on 25 December 2022
Household Dietary Diversity Score (HDDS)
Overview
The Household Dietary Diversity Score (HDDS) was released in 2006 as part of the FANTA II Project as a population-
level indicator of household food access. Household dietary diversity can be described as the number of food groups
consumed by a household over a given reference period, and is an important indicator of food security for many
reasons. A more diversified household diet is correlated with caloric and protein adequacy, percentage of protein from
animal sources, and household income (Swindale & Bilinsky, 2006 [1]). The HDDS indicator provides a glimpse of a
household’s ability to access food as well as its socioeconomic status based on the previous 24 hours (Kennedy et
al., 2011 [2]).
Method of Construction
The following 12 food groups are used to calculate the HDDS indicator:
A.Cereals
B. Roots and tubers
C. Vegetables
D. Fruits
E. Meat, poultry, offal
F. Eggs
G. Fish and seafood
H. Pulses, legumes, nuts
I. Milk and milk products
J. Oil/fats
K. Sugar/honey
L. Miscellaneous
Each food group is assigned a score of 1 (if consumed) or 0 (if not consumed). The household score will range from 0
to 12 and is equal to the total number of food groups consumed by the household:
The average household dietary diversity score for the population of study can be calculated as follows:
If using data that were not initially collected using the HDDS questions, such as Household Consumption and
Expenditure Surveys [3] (HCES) data, the food items must be regrouped according to the 12 HDDS groups to
calculate the indicator. Although there is no universal cut-off or target level that indicates that a household is
sufficiently diverse, FANTA suggests two alternatives for using this indicator in a performance reporting context. One
option is to use the dietary diversity patterns of wealthier households as a target (the richest 33%), which requires the
assumption that poorer households will increase their dietary diversity as their incomes rise. A second option is to
establish a target using the average dietary diversity of the 33% of households with the highest diversity. For more
information on how to set these targets, see Swindale & Bilinsky (2006) [1].
Uses
The HDDS is a population-level indicator that is used as a proxy measure of household food access (Swindale &
Bilinksy, 2006 [1]).
Unlike measures of dietary diversity collected at the individual level (e.g. Minimum Dietary Diversity for Women [4]
[MDD-W] and Minimum Dietary Diversity [5] [MDD] for children 6-23 months), this indicator has not been validated as
a proxy for adequacy of specific macronutrients or micronutrients. If the primary concern or research objective is to
assess nutrient adequacy of the population, then dietary diversity should be collected using dietary diversity
indicators at the individual, not household, level (e.g. MDD-W [4] and MDD [5]). However, if the objective is to assess
economic access to food, or to estimate which food groups households are consuming, then the household-level
indicator is a more appropriate measure (Food and Agriculture Organization [FAO], 2011 [2]). Because household
dietary diversity generally increases as income increases, this indicator is sometimes used as a proxy for the access
dimension of food insecurity, and is one of the indicators frequently used to assess how interventions designed to
increase household income have affected food consumption (Swindale & Bilinsky, 2006 [1]).
The HDDS can be used in conjunction with other indicators of food security status (e.g. Household Food Insecurity
Access Scale [6] [HFIAS]) to understand household access to certain food groups (Cafiero et al., 2014 [7]). The
components of the indicator can also be used to examine dietary patterns (e.g., what percentage of households
consume any type of animal source foods?). This indicator is required for all USAID Food for Peace (FFP) projects
and must be collected at the projects’ baseline and endline to assess the resilience of vulnerable communities and
households (USAID, 2017 [8]). FAO also uses this indicator and developed a set of guidelines for its use in different
contexts (FAO, 2011 [2]).
The HDDS and Food Consumption Score [9] (FCS) are highly correlated and can be used interchangeably as a
measure of household-level diet diversity and as a validated proxy for energy sufficiency in most contexts (Maxwell et
al., 2013 [10]); however, neither of these indicators has been validated as a proxy for micronutrient adequacy.
Therefore, before they are used to proxy nutrient adequacy they require further validation (Leroy et al., 2015 [11]).
Since the HDDS and FCS provide very similar information, the selection of one over the other can often be driven by
the need for comparability with other surveys or by institutional preference. In other words, if an organization or
individual is interested in comparing their results to those of a World Food Programme survey, it makes sense to
collect the FCS, while a comparison with other surveys may be more appropriately based on the HDDS, if the HDDS
had been used previously.
Strengths and Weaknesses

One strength of the HDDS is that the standardized questions are simple and can be easily understood by both
enumerators and respondents, and the full set of questions usually takes less than 10 minutes per respondent (
Swindale & Bilinsky, 2006 [1]). However, the standardized questionnaire provided by the 2011 FAO guidelines [2]is
not culture or population specific, so it should be adapted appropriately in adherence with the guidelines before use
in a specific context (Kennedy et al., 2011 [2]). For example, while the standard module does not explicitly ask about
consumption of food away from home, enumerators could be trained to probe about additional foods consumed
outside the home.
A drawback of the HDDS is that, because data are collected at the household level, it does not provide any
information on the consumption of different food groups or overall dietary diversity by individuals in the household.
Accordingly, the HDDS does not provide any information on intra-household food distribution. As mentioned above,
the indicator has not been validated against any standard of adequacy to allow a judgement on what number of food
groups constitute a "sufficiently diverse," versus "not sufficiently diverse" diet at the household level. There is no
universally accepted cut-off for this indicator that could separate households that have a "sufficiently diverse" diet
from those that do not.
Data Source
The source of data for the HDDS is based on a recall of food groups consumed by the household in the previous 24
hours, reported by the person primarily responsible for food preparation in the household. Other data sources can
often be used to construct the HDDS indicator, including 24-hour Dietary Recall [12], Food Frequency Questionnaires
[13] (FFQs), and Household Consumption and Expenditure Survey [3] (HCES) data, where information on food
consumption is collected through a fixed list of foods or food groups.
Links to guidelines
Swindale and Bilinsky, (2006). "Household Dietary Diversity Score (HDDS) for Measurement of Household
Food Access: Indicator Guide" [1]
Kennedy et al., (2011). "Guidelines for Measuring Household and Individual Dietary Diversity" [2]
Links to validation studies

Hoddinott and Yohannes, (2002). "Dietary Diversity as a Household Food Security Indicator" [14]
Links to illustrative analyses

Jones et al., (2014). "Farm production diversity is associated with greater household dietary diversity in Malawi:
Findings from nationally representative data." [15]
Olney et al., (2015). "A 2-year integrated agriculture and nutrition health behavior change communication
program targeted to women in Burkina Faso" [16]
Expert review conducted by:

Dr. Marie Ruel, Director of Poverty, Health and Nutrition Division, International Food Policy Resarch Institute
(IFPRI)
Food Security Dimensions

Quantity [18]
Quality [19]
Data Collection Levels

Household [20]
Data Sources and Methods

Dietary Diversity
24-Hour Dietary Recall (24HR)
Household Consumption and Expenditure Surveys (HCES)
Food Frequency Questionnaire (FFQ)
Requires Food Composition Database

No [21]
Please cite as: INDDEX Project (2018), Data4Diets: Building Blocks for Diet-related Food Security Analysis. Tufts
University, Boston, MA. https://inddex.nutrition.tufts.edu/data4diets. Accessed on 25 December 2022.

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INDDEX Project - Household Dietary Diversity Score (HDDS) - 2019-02-13

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Data4Diets: Building Blocks for

Diet-related Food Security Analysis

Household Dietary Diversity Score (HDDS)

Strengths and Weaknesses

consumption is collected through a fixed list of foods or food groups.

Links to validation studies

Links to illustrative analyses

Expert review conducted by:

Food Security Dimensions

Data Collection Levels

Data Sources and Methods

Requires Food Composition Database

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