Fahmida Umi, Pramesthi Indriya Laras, Kusuma Sari, Sudibya Arienta R P, Rahmawati Rahmawati, Suciyanti Dini, Gusnedi Gusnedi, Diana Aly
Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, East Jakarta, Indonesia.
Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
PLoS One. 2024 Dec 19;19(12):e0314552. doi: 10.1371/journal.pone.0314552. eCollection 2024.
In Indonesia, food security and dietary patterns varied by regions. This might lead to differences in problem nutrients (PN) and should be considered in developing local-specific food-based recommendations (FBRs) for stunting prevention.
This study aims to identify PNs in diet of under-five children in selected 37 stunting priority districts in Indonesia and assess whether the number of PNs was associated with district food security status.
Linear programming analysis (LP) using Optifood was done using single 24-hour dietary recall data Ministry of Health 2016 Food Consumption Survey. PN was defined as nutrient which did not meet 100% Recommended Nutrient Intake (RNI) based on Indonesian-RNI in the 2-best-diets scenario. District's food security status was determined using Food Security Vulnerability Atlas 2018.
The top three PNs amongst under-five childrenwere iron, folate, vitamin B12 (6-11mo); folate, calcium, zinc (12-23mo); folate, calcium, vitamin C (24-35mo); and calcium, folate, vitamin C (36-59mo). There were no significant differences in number of PNs based on food security status. After integrating the nutrient-dense foods into FBRs, the number of districts with dietary inadequacy decreased for the top-3 problem nutrients in each age group, with the exception of iron for infants.
Our findings showed that problem nutrients and dietary inadequacy were prevalent in diet of under-five children, even in food-secure areas. Promoting locally available nutrient-dense foods through FBRs (nutrition-specific intervention) and ensuring availability and access to these foods (nutrition-sensitive intervention) are recommended. Additional intervention(s), particularly for iron in infants, are required.
在印度尼西亚，粮食安全和饮食模式因地区而异。这可能导致问题营养素（PN）存在差异，在制定预防发育迟缓的地方特色食物本位建议（FBR）时应予以考虑。
本研究旨在确定印度尼西亚37个发育迟缓重点地区5岁以下儿童饮食中的问题营养素，并评估问题营养素的数量是否与地区粮食安全状况相关。
利用2016年卫生部食品消费调查的单一日24小时饮食回忆数据，使用Optifood进行线性规划分析（LP）。问题营养素定义为在两种最佳饮食情况下未达到基于印度尼西亚推荐营养素摄入量（RNI）的100%推荐营养素摄入量的营养素。使用《2018年粮食安全脆弱性地图集》确定地区的粮食安全状况。
5岁以下儿童中排名前三的问题营养素分别是铁、叶酸、维生素B12（6 - 11个月）；叶酸、钙、锌（12 - 23个月）；叶酸、钙、维生素C（24 - 35个月）；以及钙、叶酸、维生素C（36 - 59个月）。基于粮食安全状况的问题营养素数量没有显著差异。将营养丰富的食物纳入食物本位建议后除婴儿的铁元素外，各年龄组排名前三的问题营养素饮食不足的地区数量有所减少。
我们的研究结果表明，即使在粮食安全地区，问题营养素和饮食不足在5岁以下儿童的饮食中也很普遍。建议通过食物本位建议（营养特定干预）推广当地可得的营养丰富的食物，并确保这些食物的供应和获取（营养敏感干预）。还需要额外的干预措施，特别是针对婴儿的铁元素。
