Locks Lindsey M, Shah Miloni, Bhaise Shilpa, Hibberd Patricia L, Patel Archana
Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States.
Department of Global Health, School of Public Health, Boston University, Boston, MA, United States.
Front Pediatr. 2022 May 17;10:725812. doi: 10.3389/fped.2022.725812. eCollection 2022.
Sustainably addressing the crisis of undernutrition for children and adolescents in underserved and resource-limited communities will require, among other investments, interventions aimed at optimizing the diets of these vulnerable populations. However, to date, there are substantial global gaps in the collection of dietary data in children and adolescents. This review article summarizes the challenges and opportunities in assessing diet among children and adolescents in India. National surveys in India identify the scale of the triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in children and adolescents and assess key nutrition and food security indicators for making informed policy decisions. However, national surveys do not collect data on diet, instead relying on anthropometry, biomarkers of micronutrient deficiencies, and summary measures of diet, such as the WHO infant and young child feeding summary indicators. Sub-national surveys and the scientific literature thus fill important gaps in describing the nutrient intakes of children and adolescents in India; however large gaps remain. Future research can be improved by investments in infrastructure to streamline the assessment of diet in India. The current challenges confronting the collection and analysis of high-quality dietary data occur in both the data collection and data analysis phases. Common methods for assessing diets in low-resource settings-such as 24 h recalls and food frequency questionnaires are particularly challenging to implement well in young children and adolescents due to motivation and memory issues in young respondents. Additionally, there are challenges with parental recall including children having multiple caretakers and meals outside the home. Furthermore, analysis of dietary data is hindered by the lack of affordable, accessible software for dietary data analysis relevant to the diversity in Indian diets. New technologies can address some of the challenges in dietary data collection and analysis, but to date, there are no platforms designed for population-level dietary assessment in India. Public and private sector investment in dietary assessment, as well as collaboration of researchers and the creation of open-source platforms for the sharing of data inputs (local food lists, recipe databases, etc.) will be essential to build infrastructure to better understand the diets of children and adolescents in India and improve dietary interventions in these target groups.
要可持续地解决服务不足和资源有限社区中儿童和青少年的营养不良危机，除其他投资外，还需要采取旨在优化这些弱势群体饮食的干预措施。然而，迄今为止，全球在儿童和青少年饮食数据收集方面存在巨大差距。这篇综述文章总结了印度儿童和青少年饮食评估中的挑战与机遇。印度的全国性调查确定了儿童和青少年营养不良（营养不足、微量营养素缺乏和营养过剩）三重负担的规模，并评估关键的营养和粮食安全指标，以便做出明智的政策决策。然而，全国性调查不收集饮食数据，而是依赖人体测量、微量营养素缺乏的生物标志物以及饮食的汇总指标，如世界卫生组织婴幼儿喂养汇总指标。因此，次国家级调查和科学文献填补了描述印度儿童和青少年营养摄入方面的重要空白；然而，仍然存在很大差距。通过投资基础设施来简化印度饮食评估，可以改进未来的研究。目前在高质量饮食数据收集和分析方面面临的挑战出现在数据收集和数据分析阶段。在资源匮乏地区评估饮食的常用方法，如24小时回忆法和食物频率问卷法，由于年轻受访者的动机和记忆问题，在幼儿和青少年中实施起来特别具有挑战性。此外，家长回忆也存在挑战，包括儿童有多个照顾者以及在家外就餐。此外，由于缺乏适用于分析与印度饮食多样性相关的饮食数据的经济实惠且易于获取的软件，饮食数据分析受到阻碍。新技术可以解决饮食数据收集和分析中的一些挑战，但迄今为止，印度没有专门用于人群水平饮食评估的平台。公共和私营部门对饮食评估的投资，以及研究人员的合作和创建用于共享数据输入（当地食物清单、食谱数据库等）的开源平台，对于建立基础设施以更好地了解印度儿童和青少年的饮食并改善这些目标群体的饮食干预至关重要。
