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

Abstract

BackgroundStunting 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. ObjectivesThe 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. MethodsLP 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. ResultsThe 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. ConclusionsDespite 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.