The Global Diet Quality Score predicts diet quality of women of reproductive age in Addis Ababa, Ethiopia.

Improving diet quality is recognized as a double-duty action that can simultaneously address multiple forms of malnutrition. This study aimed to assess diet quality among non-pregnant non-lactating women of reproductive age (WRA) in Addis Ababa, Ethiopia and compare. A one-day quantitative 24h-recall was conducted among 653 non-pregnant/non-lactating women. Diet quality, assessed using the women dietary diversity score (WDDS), the Global Diet Quality Score (GDQS), and the Nova 4 classification reflecting consumption of ultra-processed foods (UPFs) were compared. The proportion that meets the minimum dietary diversity for women (MDD-W) was estimated. The average MDD-W score was 2.6 ± 0.9, with only 3% of women meeting the MDD-W (≥ 5 food groups). Consumption of wholegrain and legumes was high, but UPFs were also consumed by 9% of the women. GDQS was positively associated with WDDS, age, skipping breakfast; and was negatively associated with eating out of home, and UPF consumption (P<0.05). The multivariate regression model showed that GDQS (total) was not associated with wealth, but was significantly associated with both UPF and WDDS (P<0.001). Unlike UPF and WDDS alone, GDQS was able to predict both nutrient adequacy and unhealthy dietary practices. The diet quality of WRA in Addis Ababa is low in diversity, possibly exposing them to higher risk of nutrient inadequacy and NCDs as reflected by the low GDQS. Understanding what drives food and dietary choices in urban settings is urgently needed.