Use of Linear Programming to Develop Complementary Feeding Recommendations to Improve Nutrient Adequacy and Dietary Diversity Among Breastfed Children in the Rural Philippines

2021 ◽  
pp. 037957212199812
Author(s):  
Karen Kay Mejos ◽  
Maria Socorro Ignacio ◽  
Rohan Jayasuriya ◽  
Jayashree Arcot
Keyword(s):  
Linear Programming ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Age Group ◽  
Dietary Intakes ◽  
Food Groups ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nutrient Adequacy ◽  
Programming Tool

Background: Lack of dietary diversity in complementary feeding contributes to nutrient gaps leading to undernutrition. Food-based strategies have been successfully used to enrich the complementary diets of infants and young children. However, context-specific recommendations based on an objective diet optimization is needed to formulate sound and practical nutritional guidelines. Objectives: The present study aimed to identify problem nutrients in complementary diets and formulate complementary feeding recommendations (CFRs) using linear programming analysis for children aged 6 to 23 months in the rural Philippines. Methods: A cross-sectional survey was conducted in the municipality of Mercedes, Philippines. Dietary intakes of breastfed children 6 to 8, 9 to 11, and 12 to 23 months of age (n = 297) were assessed using a multipass 24-hour recall method with 7-day food consumption frequency. A linear programming tool was used to identify the recommended nutrient intakes that could not be met within the existing local food patterns and develop CFRs that would best fulfil nutrient adequacy for 11 modelled micronutrients. Results: Problem nutrients in the current diets were iron and calcium in any age-group, zinc for 6 to 8 and 9 to 11 months old, and thiamine and folate for 12 to 23 months old children. Adoption of CFRs with 4 to 5 food groups in the diet would ensure the adequacy of 7 to 8 nutrients, depending on the age-group. Conclusion: Within the boundaries of local dietary patterns, adequacy for most nutrients could be achieved by promoting realistic servings of nutrient-dense foods and food groups. The linear programming results provide an evidence-based strategy in designing interventions to improve the quality of Filipino complementary diets.

scholarly journals Evaluating Interventions With Special Fortified Products and Complementary Feeding Recommendations to Best Achieve the Nutrient Adequacy in Filipino Complementary Diets

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 667-667
Author(s):  
Karen Kay Mejos ◽  
Jayashree Arcot ◽  
Maria Socorro Ignacio ◽  
Rohan Jayasuriya
Keyword(s):  
Complementary Feeding ◽  
The Philippines ◽  
Dietary Intakes ◽  
Cross Sectional Survey ◽  
Fortified Foods ◽  
Cross Sectional ◽  
Nutrient Adequacy ◽  
Funding Sources ◽  
Micronutrient Powder ◽  
Filipino Children

Abstract Objectives The objective of this study was to predict the intervention scenarios that best fulfil the nutrient adequacy in Filipino complementary diets in rural settings using linear programming (LP) analyses of special fortified foods, alone or in combination with complementary feeding recommendations (CFRs). Methods A cross-sectional survey was conducted in the municipality of Mercedes, Camarines Norte Province. Dietary intakes of breastfed children 6–8, 9–11 and 12–23 months of age (n = 297) were assessed using a multi-pass 24-hour recall method with 7-day food consumption frequency. Optifood, an LP tool was used to formulate age-specific CFRs and determine the extent to which special fortified foods, namely micronutrient powder (MNP), small-quantity lipid-based nutrient supplements (LNS-SQ) and fortified blended food with micronutrient powder (FBF + MNP), can contribute towards nutrient adequacy in complementary diets. Results LP analyses show that for 6–8 and 9–11-month-old infants, requirements for iron will be difficult to meet even with four serves of MNP per week, while for 9–11 and 12–23-month-old young children, calcium adequacy would remain a challenge even with daily serves of LNS-SQ per week. Adequacy for 11 modelled micronutrients could only be achieved if CFRs that modify current dietary patterns were fully adopted along with supplementation of LNS-SQ 5–7 times per week. Conclusions Adoption of food-based CFRs with special fortified products is necessary to best fulfil the gaps of essential micronutrients in the diets of rural Filipino children aged 6–23 months. The findings provide insight into the current program in the Philippines. The MNP supplementation with the usual ration of MNP 3 to 4 times per week would not be sufficient to ensure adequacy for iron in 6–8 and 9–11-month-old infants unless the frequency is increased to 5 times per week. Empirical intervention studies are needed to confirm the LP simulations and feasibility of the CFRs. Funding Sources The authors received no funding for this work.

scholarly journals “I feel like eating rice 24 hours per day, 7 days a week”: A Study of Dietary Diversity Among Asylum Seekers in Norway (OR21-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sigrun Henjum ◽  
Laura Terragni
Keyword(s):  
Dietary Intake ◽  
Asylum Seekers ◽  
Dietary Diversity ◽  
Living Condition ◽  
Dietary Quality ◽  
Dietary Intakes ◽  
Food Groups ◽  
Cross Sectional ◽  
Adequate Diet ◽  
Adequate Food

Abstract Objectives Poor nutrition and food insecurity is highly prevalent among asylum seekers residing in western countries. Lack of economic resources, unfamiliarity with new foods, and language barriers are some challenges that asylum seekers encounter upon resettlement. Despite the importance of an adequate diet for good health, limited knowledge, exist on food intake and dietary quality among asylum seekers. We described dietary intake and assessed dietary quality among asylum seekers at Norwegian reception centers. Methods In 2017, a cross-sectional study in eight ordinary asylum reception centers in the South Eastern part of Norway were performed and 205 asylum seekers (131 men and 74 women) were included. Dietary intake was assessed by 24-hour dietary recall and dietary diversity score (DDS) calculated according to FAO and FANTA, 2014. In addition, field notes of the asylum seekers thoughts on dietary intake and living condition provided contextual aspects of their nutritional situation. Results Two-third of the asylum seekers had dietary intakes with low quality; they ate from less than five food groups (low DDS). The asylum seekers ate in average two meals per day and one-third ate their first meal after noon. Meals tend to consist of food that was familiar in their country of origin. Women had significantly higher DDS than men with a higher consumption of vegetables and fruits. Asylum seekers residing in Norway for a longer time had a higher dietary diversity, than asylum seekers with a shorter stay. Most asylum seekers told about a reduced dietary intake, few meals and by the end of the month, hunger. They chose the cheapest food, food on sale or food that had expired and chose quantity over quality. The kitchen facilities at the reception centers were inadequate with limited storage place, low quality of the cooking equipment and crowded kitchen. Conclusions The asylum seekers had a monotonous diet with few meals, in contrast to the food abundance that most Norwegian are accustomed to, revealing, the emergence of new groups and new forms of poverty and social exclusion also in rich countries with otherwise good welfare state systems. The situation appear particularly critical given Norway's commitment through the United Nations (UN) International Covenant on Economic, Social and Cultural Rights to ensure human rights such as the right to adequate food and health. Funding Sources The study was funded by Oslo Metropolitan University, Norway.

scholarly journals Pattern and Extent of Street Food Consumption in Hohoe, Volta Region, Ghana: A Community-Based Cross-Sectional Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Winnifred Ekua Baidoe ◽  
Mark Kwame Ananga ◽  
Elorm Kwame Nyinaku
Keyword(s):  
Food Consumption ◽  
Dietary Diversity ◽  
Sampling Technique ◽  
Food Group ◽  
Daily Basis ◽  
Food Groups ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Street Food

Background. For most people in developing countries, street food is a major source of sustenance, and Ghana is no exception. Street food vending has seen tremendous growth in Ghana as a result of the insurgence of urbanisation. Despite being one of the largest sectors of national economy in terms of employment and sales of food, very little is known about street food consumption patterns in Ghana. The current study explored the patterns and extent of street food consumption in the Hohoe township. Methods. A cross-sectional design which recruited 403 subjects through a multistage sampling technique. A semistructured questionnaire was used to gather information on demographics, types of street foods, extent of street food consumption, safety concerns, and diversity of street foods patronised. Means, standard deviations, and Chi-square tests were used to determine the association between selected variables at <0.05 level of significance. Results. The top 5 foods mostly patronised by respondents are porridge foods-Koko (17.9%), rice and stew (17.4%), banku (12.6%), waakye (11.5%), and kenkey (8.7%) with porridge foods consumed almost on a daily basis. Convenience (37.2%) and affordability (17.1%) greatly influenced the choice of street foods among consumers. Occupation and the level of education are strongly correlated with the concern for safety of street foods {(X2 = 17.3094, P<0.008); (X2 = 17.1731, P<0.002)}. The dietary diversity score of most respondents was in the high tercile (77.7%) (≥6 food groups), whilst the cereals dominate the food group mostly consumed by respondents. Conclusion. The study suggests that patronising street food is very high in Hohoe municipality, irrespective of the gender, occupation, or educational level. As an “informal” sector of food business, street foods often escape formal inspection and control. They can, therefore, both be the source of food safety problems and contribute to the deterioration of environmental hygiene. This is a call on policy makers and regulators to take a critical look at the sector.

scholarly journals Dietary Sources and Nutrient Adequacy Potential of Local Foods among Children (6–23 Months) in Urban Slums of West Oromia (Ethiopia)

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Wondu Garoma Berra
Keyword(s):  
Vitamin A ◽  
Vitamin C ◽  
Substantial Improvement ◽  
Model Parameters ◽  
Local Foods ◽  
Dietary Intakes ◽  
Analysis Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nutrient Adequacy

Background. Identifying the combination of local foods that optimize nutrient intake is challenging. This study addressed how local foods could be rationally combined to provide basic nutritional needs, while limiting the use of commercial foods among children in Ethiopia. Methods. A cross-sectional survey was carried out to estimate dietary intakes of 396 children (6–23 months of age) using 24-hour recall and WDR. Anthropometrics (weight and height) of the children was taken to calibrate energy and protein requirements to body sizes during ProPAN analysis. Model parameters were defined using dietary and market-survey data. ProPAN (2.0), SAS (9.2), and NutriSurvey for Windows were used for data analysis. Results. Age-specific optimal combinations of local foods that achieve nutrient adequacy set by the WHO/FAO (≥70% RDA) for 9 nutrients were successfully generated. Overall, the percentage of children consuming ≥ EAR for most nutrients obtained from median servings was 54.3%, 89.9%, 61.8%, 12.9%, 85.6%, 79.7%, and 34.2% for energy, protein, iron, zinc, vitamin A, vitamin C, and calcium, respectively. The percentage of RDA was 46.3% for zinc, 56.7% for vitamin A, 24.3% for vitamin C, and 40% for calcium among infants (6–11 months), whereas the respective percentage of RDA was 78.1% for zinc, 100% for vitamin A, 43.3% for vitamin C, and 50% for calcium in older children (12–23 months of age). However, careful combination of local foods, slightly complimented by commercial foods, has shown substantial improvement in nutrient adequacy, ensuring ≥99% RDA for all target nutrients. Conclusions. Careful combinations of local foods have the potential to achieve optimum dietary intakes of essential nutrients. However, minimal consideration of commercial foods has been inevitable, especially for infants aged 6–11 months.

scholarly journals Hubungan Riwayat Pemberian Makanan Pendamping ASI (MP-ASI) dengan Persepsi Perilaku Picky Eater pada Anak Usia 12-36 Bulan (Studi di Wilayah Kerja Sidotopo Surabaya)

2019 ◽  
Vol 3 (3) ◽  
pp. 171
Author(s):  
Arian Susanti Dewi Cahyani
Keyword(s):  
Random Sampling ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Simple Random Sampling ◽  
Food Allergies ◽  
School Age Children ◽  
Food Groups ◽  
Chi Square ◽  
Cross Sectional ◽  
History Of

Background : Pre-school age children often have picky eater behavior. Perception of picky eater usually describes as the strong preference of children for food, inadequate of dietary diversity, restrain of certain food groups and won’t try new food. One of factors that causes this behavior is history of complementary feeding.Objectives: This study purposes was to analyze correlation between history of complementary feeding and perception of picky eater behavior among children age 12-36 month oldMethods: This study was analytic observasional study with cross-sectional design. The research was conducted in Sidotopo Health Center Surabaya City. There were 75 children age 12-36 month old. The inclusion criteria are children who have no history of food allergies. Sample was chosen by simple random sampling. Data collected by interview using questionnaires included characteristics of children and mothers, history of complementary feeding and perceptions of picky eater behavior. The data was analyzed by chi-square test.Results: The result show that inappropriate history of complementary feeding in children was 66.7% and prevalensi perception of picky eater behavior in children was 48.7%. There was significant correlation between history of complementary feeding and perception of picky eater behavior (p<0.001). Conclusions : There was a relationship between history of complementary feeding and perceptions of picky eater behavior among children age 12-36 month. Children with inappropriate history of complementary feeding tend to have picky eater behavior.ABSTRAKLatar Belakang : Anak usia pra-sekolah sering mengalami perilaku picky eater. Persepsi perilaku picky eater digambarkan bahwa anak cenderung memiliki preferensi makanan yang kuat, konsumsi makanan yang kurang beragam, membatasi asupan beberapa kelompok makanan tertentu dan tidak mau mencoba makanan baru. Salah satu faktor yang melatarbelakangi picky eater adalah riwayat pemberian Makanan Pendamping ASI (MP-ASI).Tujuan : Tujuan dari penelitian ini untuk menganalisis hubungan riwayat pemberian MP-ASI dengan persepsi perilaku picky eater pada anak usia 12-36 bulan.Metode : Jenis penelitian ini merupakan observasional analitik menggunakan desain penelitian cross-sectional. Penelitian ini dilaksanakan di wilayah kerja Puskesmas Sidotopo Surabaya. Sampel penelitian sebesar 78 anak berusia 12-36 bulan. Kriteria inklusi yang ditetapkan adalah anak tidak memiliki riwayat alergi makanan. Pengambilan sampel dengan menggunakan teknik simple random sampling. Pengumpulan data dengan wawancara menggunakan kuesioner meliputi karakteristik anak dan ibu, riwayat pemberian makanan pendamping ASI (MP-ASI) dan persepsi perilaku picky eater. Data dianalisis dengan menggunakan uji statistik Chi-Square.Hasil :  Hasil penelitian menunjukkan bahwa riwayat pemberian MP-ASI pada anak sebagian besar tidak sesuai yaitu 66,7% dan prevalensi persepsi perilaku picky eater pada anak sebesar 48,7%. Terdapat hubungan antara riwayat pemberian MP-ASI dengan persepsi perilaku picky eater (p<0,001).Kesimpulan : Terdapat hubungan antara riwayat pemberian MP-ASI dengan persepsi perilaku picky eater pada anak usia 12-36 bulan. Anak dengan riwayat pemberian MP-ASI yang tidak sesuai cenderung memiliki perilaku picky eater.

Factors Associated With Feeding And Caregiving Practices For Children Under Five In Lowland Nepal: A Community-Based Cross-Sectional Survey

2021 ◽  
Author(s):  
Sophiya Dulal ◽  
Audrey Prost ◽  
Surendra Karki ◽  
Dafna Merom ◽  
Bhim Prasad Shrestha ◽  
...  
Keyword(s):  
Early Childhood ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Controlled Trial ◽  
Childhood Development ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Access To Books

Abstract Background: While nurturing care, including adequate nutrition and responsive caregiving and early learning, is critical to early childhood development, national surveys in Nepal highlight inequalities in feeding and parental caregiving practices. This study aimed to document and analyse infant and young child feeding (IYCF) and cognitive and socio-emotional caregiving practices among caregivers of children under age five in Dhanusha district, Nepal. Methods: We used a subset of data from the MIRA Dhanusha cluster randomised controlled trial, including mother-child dyads (N=1360) when children were aged 0-12 months and a follow-up survey of the same mother-child dyads (N=1352) when children were 7-59 months. We used World Health Organization IYCF indicators and questions from the Multiple Indicator Cluster Survey-4 tool to obtain information on IYCF and cognitive and socio-emotional caregiving practices, respectively. We collected data on breastfeeding practices in a postpartum 6-week questionnaire and on complementary feeding and caregiving practices in the follow-up survey. Using multivariable logistic regression models, potential explanatory household, parental and child-level variables were tested to determine their independent associations with IYCF and caregiving indicators. Results: The prevalence of feeding indicators varied. Ever breastfed (99%), exclusive breastfeeding in past 24-hours at 0-12 months (89%), and vegetable or fruit consumption (84%) were common, and minimum dietary diversity reached 63%. Problem areas were early initiation of breastfeeding (16%), feeding of colostrum (67%), no pre-lacteal feeding (53%), timely introduction of complementary feeding (56%), and animal-source food consumption (29%). Amongst caregiving indicators, access to books (7%), early stimulation and responsive caregiving (11%), and access to early childhood education (27%) were of particular concern, while 64% had access to toys and 71% received adequate care. Only 38% of children were developmentally on track. Younger children from poor households with young mothers who had not received antenatal visits and delivered at home were at risk of poor IYCF and caregiving practices. Conclusions: Poor IYCF and cognitive and socio-emotional caregiving practices are widely prevalent in lowland Nepal, which highlights the importance of improved integrated nutrition and caregiving interventions in resource-constrained settings.

scholarly journals Diet quality among Iranian adolescents needs improvement

2014 ◽  
Vol 18 (4) ◽  
pp. 615-621 ◽  
Author(s):  
Leila Azadbakht ◽  
Fahime Akbari ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Diet Quality ◽  
Dietary Diversity ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Dietary Intakes ◽  
Quality Indices ◽  
Cross Sectional ◽  
Nutrient Adequacy ◽  
Mean Adequacy Ratio ◽  
Systematic Cluster

AbstractObjectiveDiet in adolescence is important not only because of adolescents’ rapid growth but also due to its influence on future chronic diseases. On the other hand, dietary quality indices are noteworthy and useful approaches to evaluate dietary intakes. Thus the present study was conducted to assess dietary quality indices in adolescents.DesignCross-sectional.SettingsThe data were collected from schools in Isfahan, Iran.SubjectsFemale students (n 265) aged 11–13 years were enrolled using systematic cluster-random sampling in Isfahan (Iran). Dietary intakes were assessed by a validated FFQ. Diet quality indices including dietary diversity score (DDS), the Healthy Eating Index (HEI) and mean adequacy ratio (MAR) across ten nutrients were calculated.ResultsMean DDS, HEI score and MAR were 6·15 (sd 1·61) out of 10 points, 63·90 (sd 19·86) out of 100 points and 1·32 (sd 0·61), respectively. Mean nutrient adequacy ratio of all nutrients was above 1 except for vitamin D (0·53 (sd 0·51)). Those in the highest tertile of DDS had the most favourable anthropometric variables in comparison to the lowest tertile. There were no significant associations between HEI score and BMI, central or abdominal obesity and blood pressure. Those in the highest tertile of MAR had higher BMI, waist circumference and hip circumference.ConclusionsDiet quality of Isfahani adolescents needs improvement. It may imply the necessity of implementing nutritional instructive policies in this age group and their parents.

scholarly journals Dietary intakes and iron status of vegetarian and non-vegetarian children in selected communities in Accra and Cape Coast, Ghana

2012 ◽  
Vol 12 (49) ◽  
pp. 5822-5842
Author(s):  
K Osei-Boadi ◽  
◽  
A Lartey ◽  
GS Marquis ◽  
EK Colecraf ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Iron Status ◽  
Venous Blood ◽  
Dietary Intakes ◽  
Food Groups ◽  
Cape Coast ◽  
Cross Sectional ◽  
Food Recall

There is a scarcity of information on dietary intake and iron status of Ghanaian children raised on vegetarian diets. A cross-sectional study design was used to compare the diets and iron status of vegetarian children between the ages of 9 months and 11 years (n= 26) with matched controls, non-vegetarian children (n=26) of similar ages and same sex and living within the same communities in Accra and Cape Coast, Ghana. Dietary information was collected using 24-hr food recall and 12-hr home observation. Haemoglobin, plasma ferritin, C-reactive protein, and Transferrin Receptor (TfR) concentrations were determined on finger prick (haemoglobin) and venous blood samples collected during the study. Based on the 24-hr food recall, vegetarian children’s diets were devoid of vitamin B12whereas non-vegetarian children’s diets were not (0.0 ± 0.0 mg vs. 1.5 ± 1.8 mg, p<0.001). The dietary intake based on 12-hr home observation showed similar results. However, vegetarians had significantly higher intake of dietary fibre (17.1 ± 11.9 g vs. 8.4 ± 6.2 g, p= 0.002), thiamine (1.1 ± 0.8 mg vs. 0.5 ± 0.3 mg, p= 0.001) and vitamin A (1702 ± 1887 Retinol Equivalent (RE)vs. 671 ± 691 RE, p= 0.010) than non-vegetarian children. Dietary diversity based on nine food groups was similar between groups (5.8 ±1.0score). Plasma ferritin was higher for non-vegetarian children compared to the vegetarians (59.2± 48.2 ng/mL vs. 34.1± 25.8ng/ml, p= 0.012) but there was no group difference in plasma TfR. The prevalence of anaemia was about 25% in both groups. Typical diets of Ghanaian children lack variety and both vegetarian and nonvegetarian diets are insufficient to support adequate iron status. Iron-rich foods such as meat or supplements are needed. There is urgent need for immediate vitamin B12 supplementation for all vegetarian children and a general need for nutrition education to diversify all children’s diets.

scholarly journals Dr. Adequacy of nutrient intakes among pregnant Women in Northern Ghana

2020 ◽  
Vol 11 (1) ◽  
pp. 145-164
Author(s):  
Mahama Saaka
Keyword(s):  
Pregnant Women ◽  
Dietary Diversity ◽  
Average Energy ◽  
Cross Sectional Study ◽  
Northern Ghana ◽  
Food Groups ◽  
Nutrient Intakes ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Nutrient Adequacy

Introduction: Adequate nutrition during pregnancy is a pre-requisite for good pregnancy outcomes as well as future wellbeing, development and quality of life of the unborn child. This analytical cross-sectional study evaluated the adequacy of nutrient intakes of pregnant women resident in northern Ghana. Methods: A total of 400 pregnant women in 25 communities in the Northern, Upper East and Upper West regions of Ghana were interviewed at the household level. The nutrient intakes were assessed using a structured 24-hour dietary recall questionnaire. A dietary diversity score (DDS) was measured as a count of food groups. A nutrient adequacy ratio (NAR) of 14 nutrients as well as mean adequacy ratio (MAR) were calculated based on the 24-hour dietary recall. Results: The average energy, protein and fat intakes were 2,770.8 ± 1,127.5 Kcal/day, 59.2 ±27.5 g/day, and 105.25±58.0 g/day, respectively. The proportion of women meeting the recommended dietary allowance (RDA) of these macro-nutrients were 58.8%, 27.0% and 50.3% respectively. The average MAR of 14 nutrients was calculated to be 68% as the overall measure of nutrient adequacy. MAR correlated positively with DDS (r = 0.24 P < 0.001). Over 50% pregnant women obtained less than 66% of the RDA for iron, calcium, riboflavin, folic acid and vitamin B12. Conclusion: Diets of the majority of these pregnant women were deficient in several nutrients. Dietary diversity scores served as a useful proxy indicator of nutrient adequacy in this sample. In order to meet the requirements for essential nutrients, more effort should be made to promote dietary diversity among pregnant women in northern Ghana.

scholarly journals Development of complementary feeding recommendations for 12–23-month-old children from low and middle socio-economic status in West Java, Indonesia: contribution of fortified foods towards meeting the nutrient requirement

2016 ◽  
Vol 116 (S1) ◽  
pp. S8-S15 ◽  
Author(s):  
Umi Fahmida ◽  
Otte Santika
Keyword(s):  
Complementary Feeding ◽  
Economic Status ◽  
Portion Size ◽  
Cross Sectional Survey ◽  
Fortified Foods ◽  
West Java ◽  
Cross Sectional ◽  
Nutrient Adequacy ◽  
Food Pattern ◽  
Poor Access

AbstractInadequate nutrient intake as part of a complementary feeding diet is attributable to poor feeding practices and poor access to nutritious foods. Household socio-economic situation (SES) has an influence on food expenditure and access to locally available, nutrient-dense foods and fortified foods. This study aimed to develop and compare complementary feeding recommendations (CFR) for 12–23-month-old children in different SES and evaluate the contribution of fortified foods in meeting nutrient requirements. A cross-sectional survey was conducted in low and medium SES households (n 114/group) in urban Bandung district, West Java province, Indonesia. Food pattern, portion size and affordability were assessed, and CFR were developed for the low SES (LSES) and middle SES (MSES) using a linear programming (LP) approach; two models – with and without fortified foods – were run using LP, and the contribution of fortified foods in the final CFR was identified. Milk products, fortified biscuits and manufactured infant cereals were the most locally available and consumed fortified foods in the market. With the inclusion of fortified foods, problem nutrients were thiamin in LSES and folate and thiamin in MSES groups. Without fortified foods, more problem nutrients were identified in LSES, that is, Ca, Fe, Zn, niacin and thiamin. As MSES consumed more fortified foods, removing fortified foods was not possible, because most of the micronutrient-dense foods were removed from their food basket. There were comparable nutrient adequacy and problem nutrients between LSES and MSES when fortified foods were included. Exclusion of fortified foods in LSES was associated with more problem nutrients in the complementary feeding diet.

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