To what Extent Can Food-based Approaches Ensure Dietary Adequacy for Women and Young Children in SE Asia?
Elaine Ferguson *
London School of Hygiene and Tropical Medicine, London, UK.
Mary Chea
Ministry of Health National Maternal and Child Health Centre, Phnom Penh, Cambodia.
Uraiporn Chittchang
Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand.
Daovieng Douangvichit
National Institute of Public Health, Vientiane, People's Democratic Republic of Lao.
Umi Fahmida
SEAMEO-Recfon, Jakarta, Indonesia.
Sengchanh Kownnavong
National Institute of Public Health, Vientiane, People's Democratic Republic of Lao.
Mai Le Bach
National Institute of Nutrition, Hanoi, Vietnam.
Nipa Rojroongwasinkul
Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand.
Otte Santika
SEAMEO-Recfon, Jakarta, Indonesia.
Jutta Skau
University of Copenhagen, Copenhagen, Denmark.
Do Tran
National Institute of Nutrition, Hanoi, Vietnam.
Lua Tran
National Institute of Nutrition, Hanoi, Vietnam.
Manithong Vonglokham
National Institute of Public Health, Vientiane, People's Democratic Republic of Lao.
*Author to whom correspondence should be addressed.
Abstract
Objectives: To predict whether food-based approaches can ensure dietary adequacy for 6-23 month old children and women of reproductive age in SE Asia and to identify problem nutrients.
Methods: Linear programming was used to determine whether nutritionally adequate diets based on locally available non-fortified foods (11 micronutrients ≥ WHO/FAO RNI, assuming moderate iron and zinc bioavailability) could be formulated for women and young children in 5 countries. Model parameters were defined using nationally representative (Indonesia, Thailand, Vietnam, Cambodia) or locally representative (Laos, Cambodian children<12 months) 24-hour recall dietary data. Problem nutrients were defined as those <100% RNI in a diet where intakes were maximised. Nutrient adequacies, for food-based recommendations (FBR), were defined as those >65% RNI, when intakes were minimised, in diets achieving the FBR.
Results: Numbers of problem nutrients ranged from 2-9, 1-8 and 0-5, for 6-8 mo, 9-11 mo and 12-23 mo old children; and from 3-7, 2-4 and 1-4 for pregnant, lactating and non-pregnant- non-lactating women, respectively, depending on the country. In most countries, modeled FBRs ensured adequacy for ≥7 (children) and ≥5 (women) nutrients. In all countries, FBRs did not ensure adequate iron (all groups) and folate (women) intakes.
Conclusions: Interventions, such as food fortification or the promotion of unutilized nutrient dense foods, are likely required to ensure dietary adequacy, for women and young children, in SE Asia.
Funding: The European Commission, FP7, GA-2896-16.