Abstract
BackgroundPlant-based diets in lower-income countries are often associated with inadequate protein nutrition and adverse health outcomes.ObjectiveTo examine the diversity of protein food sources, in both animal and plant, across diverse socio-demographic groups in Indonesia as compared to Malaysia.DesignThe SCRiPT (Socio Cultural Research in Protein Transition) study was based on population-based samples recruited in Indonesia (N = 1665) and in Malaysia (N = 1604). Data from 24-h in-person dietary recalls in each country were used to construct the frequency counts of protein sources by food group. Protein sources were defined as fish, poultry, red meat (beef, pork, and mutton), eggs, dairy, and plants (cereals, pulses, and tubers). The percent reported frequencies for animal and plant proteins were compared across socio-demographic strata and by country. Analyses were based on one-way Anovas and general linear model regressions adjusting for covariates.ResultsAnimal protein frequency counts were 34% of total in Indonesia, but 50% in Malaysia's. Higher reported consumption frequencies for poultry and red meat in both countries were associated with urban living, greater modernization, and higher socioeconomic status, with stronger social gradients observed in Indonesia. Reported fish consumption was higher in Indonesia than in Malaysia. Fish was more likely to be listed by rural island populations in Indonesia and was associated with lower education and incomes. Consumption frequencies for plant-based proteins were associated with lower socio-economic status in Indonesia and in Malaysia.ConclusionsMore affluent groups in both countries reported higher frequencies for meat, eggs, and dairy as opposed to fish. Greater economic development in Southeast (SE) Asia is associated with more animal protein, particularly from poultry, which may displace fish, the traditional source of high quality protein for the region.
Highlights
Economic development in SE Asia has been accompanied by a protein transition, described as a dietary shift from plant- to animal-source proteins [1, 2]
Protein nutrition is of concern to Indonesia, which was recently downgraded to a lower middle-income country status by the World Bank [7]
In Indonesia, food balance sheets show that the annual fish consumption has risen from an average of 10.6 kg per capita in the 1970s to 28.9 kg in 2011, with further growth projected [8]
Summary
Economic development in SE Asia has been accompanied by a protein transition, described as a dietary shift from plant- to animal-source proteins [1, 2]. Plant proteins from grains, tubers, and legumes are progressively replaced by animal proteins from poultry, eggs, dairy, and red meat [3–5]. Analyses of food balance sheets from the Food and Agriculture Organization (FAO) of the United Nations point to the importance of meat, eggs, and dairy in assuring the optimal protein nutrition across the low- and middle-income countries (LMIC) [6]. Protein nutrition is of concern to Indonesia, which was recently downgraded to a lower middle-income country status by the World Bank [7]. Current estimates place per capita daily protein intake from fish in Indonesia at no more than 8.5 grams per person per day [10]. Plant-based diets in lower-income countries are often associated with inadequate protein nutrition and adverse health outcomes
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