nutrients Article Characteristics of Distinct Dietary Patterns in Rural Bangladesh: Nutrient Adequacy and Vulnerability to Shocks Zakari Ali 1, * , Pauline F. D. Scheelbeek 2,3 , Kazi Istiaque Sanin 4 , Timothy S. Thomas 5 , Tahmeed Ahmed 4 , Andrew M. Prentice 1 and Rosemary Green 2,3, *   Citation: Ali, Z.; Scheelbeek, P.F.D.; Sanin, K.I.; Thomas, T.S.; Ahmed, T.; Prentice, A.M.; Green, R. Characteristics of Distinct Dietary Patterns in Rural Bangladesh: Nutrient Adequacy and Vulnerability to Shocks. Nutrients 2021, 13, 2049. https://doi.org/10.3390/nu13062049 Academic Editors: Joanne E. Cecil and Samantha Caton Received: 1 June 2021 Accepted: 10 June 2021 Published: 15 June 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Nutrition Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia; Andrew.Prentice@lshtm.ac.uk 2 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Pauline.Scheelbeek@lshtm.ac.uk 3 Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK 4 Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh; sanin@icddrb.org (K.I.S.); tahmeed@icddrb.org (T.A.) 5 International Food Policy Research Institute, 1201 Eye Street, Washington, DC 20005, USA; tim.thomas@cgiar.org * Correspondence: zali@mrc.gm (Z.A.); rosemary.green@lshtm.ac.uk (R.G.) Abstract: Food security in Bangladesh has improved in recent years, but the country is now facing a double burden of malnutrition while also being highly vulnerable to climate change. Little is known about how this may affect food supply to different sectors of the population. To inform this, we used a national dietary survey of 800 rural households to define dietary patterns using latent class analysis. Nutrient adequacy of dietary patterns and their potential vulnerability to climate shocks (based on diversity of calorie sources) were assessed. We fitted mixed effects logistic regression models to identify factors associated with dietary patterns. Four dietary patterns were identified: rice and low diversity; wheat and high diversity; pulses and vegetables; meat and fish. The wheat and high diversity and meat and fish patterns tended to be consumed by households with higher levels of wealth and education, while the rice and low diversity pattern was consumed by households with lower levels of wealth and education. The pulses and vegetables pattern was consumed by households of intermediate socio-economic status. While energy intake was high, fat and protein intake were suboptimal for all patterns except for the wheat and high diversity pattern. All patterns had fruit and vegetable intake below the WHO recommendation. The wheat and high diversity pattern was least vulnerable to shocks, while the rice and low diversity pattern was the most vulnerable, relying mainly on single cereal staples. The diets showed “double vulnerability” where the nutrient inadequate patterns were also those most vulnerable to shocks. Keywords: staples; dietary pattern; latent class analysis; farm production; diet vulnerability; nutri- tion transition 1. Introduction Bangladesh is one of the most populous countries in the world and will be home to a significant proportion of the world’s population in the near future despite declines in population growth rates over the last decade [1]. The country has undergone one of the most rapid declines in poverty in the world in the last 30 years, and this has been accompanied by major improvements in food security. However, this progress has not occurred equally across all population groups, and large sections of the population are still vulnerable to food insecurity [2]. The country is, thus, currently facing a double burden of malnutrition where both over- and under-nutrition persist in the same society [3,4]. Recent estimates show that 31% of children under five years are stunted [5], yet overweight and Nutrients 2021, 13, 2049. https://doi.org/10.3390/nu13062049 https://www.mdpi.com/journal/nutrients