Hlaing Lwin Mar, Fahmida Umi, Htet Min Kyaw, Utomo Budi, Firmansyah Agus, Ferguson Elaine L
1Department of Public Health,National Nutrition Center,Ministry of Health,Nay Pyi Taw 100604,Myanmar.
2South East Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON),University of Indonesia,Jakarta 10430,Indonesia.
Br J Nutr. 2016 Jul;116 Suppl 1:S16-26. doi: 10.1017/S000711451500481X. Epub 2015 Dec 23.
Poor feeding practices result in inadequate nutrient intakes in young children in developing countries. To improve practices, local food-based complementary feeding recommendations (CFR) are needed. This cross-sectional survey aimed to describe current food consumption patterns of 12-23-month-old Myanmar children (n 106) from Ayeyarwady region in order to identify nutrient requirements that are difficult to achieve using local foods and to formulate affordable and realistic CFR to improve dietary adequacy. Weekly food consumption patterns were assessed using a 12-h weighed dietary record, single 24-h recall and a 5-d food record. Food costs were estimated by market surveys. CFR were formulated by linear programming analysis using WHO Optifood software and evaluated among mothers (n 20) using trial of improved practices (TIP). Findings showed that Ca, Zn, niacin, folate and Fe were 'problem nutrients': nutrients that did not achieve 100 % recommended nutrient intake even when the diet was optimised. Chicken liver, anchovy and roselle leaves were locally available nutrient-dense foods that would fill these nutrient gaps. The final set of six CFR would ensure dietary adequacy for five of twelve nutrients at a minimal cost of 271 kyats/d (based on the exchange rate of 900 kyats/USD at the time of data collection: 3rd quarter of 2012), but inadequacies remained for niacin, folate, thiamin, Fe, Zn, Ca and vitamin B6. TIP showed that mothers believed liver and vegetables would cause worms and diarrhoea, but these beliefs could be overcome to successfully promote liver consumption. Therefore, an acceptable set of CFR were developed to improve the dietary practices of 12-23-month-old Myanmar children using locally available foods. Alternative interventions such as fortification, however, are still needed to ensure dietary adequacy of all nutrients.
不良喂养习惯导致发展中国家幼儿营养摄入不足。为改善喂养习惯，需要制定基于当地食物的辅食喂养建议（CFR）。这项横断面调查旨在描述伊洛瓦底江地区12至23个月大的缅甸儿童（n = 106）当前的食物消费模式，以确定难以通过当地食物满足的营养需求，并制定经济实惠且切实可行的CFR，以提高饮食充足性。通过12小时称重饮食记录、单次24小时回顾和5天食物记录来评估每周的食物消费模式。通过市场调查估算食物成本。使用世界卫生组织的Optifood软件通过线性规划分析制定CFR，并在20名母亲中使用改进做法试验（TIP）进行评估。研究结果表明，钙、锌、烟酸、叶酸和铁是“问题营养素”：即使饮食得到优化，这些营养素也未达到100%的推荐营养素摄入量。鸡肝、凤尾鱼和玫瑰茄叶是当地可获得的营养密集型食物，可以填补这些营养缺口。最终的六套CFR将以每天271缅元的最低成本确保12种营养素中的5种达到饮食充足（基于数据收集时900缅元/美元的汇率：2012年第三季度），但烟酸、叶酸、硫胺素、铁、锌、钙和维生素B6仍存在不足。TIP表明，母亲们认为肝脏和蔬菜会导致蠕虫和腹泻，但这些观念可以被克服，以成功促进肝脏的消费。因此，制定了一套可接受的CFR，以使用当地可获得的食物改善12至23个月大的缅甸儿童的饮食习惯。然而，仍需要强化等替代干预措施来确保所有营养素的饮食充足性。
