Problem Nutrients and Food-Based Recommendations for Pregnant Women and Under-Five Children in High-Stunting Districts in Indonesia

Umi Fahmida; Indriya Laras Pramesthi; Sari Kusuma; Giri Wurjandaru; Doddy Izwardy

doi:10.1093/cdn/nzac028

Problem Nutrients and Food-Based Recommendations for Pregnant Women and Under-Five Children in High-Stunting Districts in Indonesia

Curr Dev Nutr. 2022 Mar 8;6(5):nzac028. doi: 10.1093/cdn/nzac028. eCollection 2022 May.

Authors

Umi Fahmida¹, Indriya Laras Pramesthi¹, Sari Kusuma¹, Giri Wurjandaru², Doddy Izwardy²

Affiliations

¹ Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia.
² Directorate of Public Health Nutrition, Indonesian Ministry of Health, Jakarta, Indonesia.

Abstract

Background: Stunting and anemia in pregnant women and under-five children remain a challenge in developing countries, including Indonesia. One of the significant contributors to these problems is inadequate nutrient intake.

Objectives: The aim of the study was to identify, using a linear programming (LP) approach, problem nutrients and optimized food-based recommendations for under-five children and pregnant women in 10 stunting-prioritized districts in Indonesia.

Methods: LP analysis was done using the Optifood tool on dietary data collected using single 24-h dietary recall in the National Monitoring of Nutrient Consumption (Pemantauan Konsumsi Gizi), conducted by the Ministry of Health from 10 stunting-prioritized districts in Indonesia. Problem nutrients and nutrient-dense foods were identified, and all alternative food-based recommendations or complementary feeding recommendations were compared to identify which recommendation will best contribute to fulfill dietary adequacy.

Results: The number of problem nutrients in each district ranged from 0 to 7 nutrients for under-five children and 1 to 6 nutrients for pregnant women. The top 3 problem nutrients were: iron, zinc, and folate (for children aged 6-11 mo); zinc, folate, and calcium (for 12-23-mo-olds and 24-35-mo-olds); folate, zinc, and vitamin C/riboflavin (for 36-59-mo-olds); and iron, folate, and calcium (for pregnant women). The findings showed that problem nutrients identified using LP were in line with nutritional problems in under-five children (stunting and anemia) and pregnant women (anemia). Food-based recommendations (FBRs)/complementary feeding recommendations were developed that best meet dietary adequacy for the nutrients.

Conclusions: Despite the similarity in stunting prevalence across the districts, there was variation in number and types of problem nutrients. The developed FBRs that promoted nutrient-dense foods suited to the problem nutrients in each area need to be promoted to improve nutrient intakes of under-five children and pregnant women in these areas with high stunting prevalence.

Keywords: Indonesia; complementary feeding recommendation; food-based recommendation; linear programming; pregnant women; problem nutrients; stunting; under-five children.