Prevalence and Risk Factors of Inadequate Micronutrient Intake among Children Aged 6-23 Months in Indonesia
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Background: Poor quality and quantity are the main factors that contribute to the increasing inadequacy of micronutrients intake such as Iron, Calcium, Zinc, Vitamins A, and C since the complementary food was introduced at 6 months of infant's age.
Objectives: To analyze the prevalence and risk factors of inadequate micronutrients intake among children aged 6-23 months in Indonesia.
Methods: A cross-sectional study used Individual Food Consumption Survey 2014 data from Indonesian Health Study and Development Agency involving 1575 children aged 6-23 months as the total subjects. Minimum Dietary Diversity (MDD) was measured by eight food groups for children under two years old. The prevalence of inadequate micronutrients intake used the probability approach. Binary logistic regression was used as a multivariate test to determine the risk factors of inadequate micronutrients intake.
Results: The highest prevalence of inadequate micronutrients intake was vitamin C, while the lowest was zinc, with overall inadequate multiple micronutrients intake being 61.9%. About 57.7% and 15.9% of subjects were low in energy intake and achieved the MDD, respectively. Lived in rural area [OR=1.37(95%CI:1.06-1.77)], low education mother [OR=1.71(95%CI:1.32-2.22)], low energy intake [OR=6.22(95%CI:4.84-7.99)] and not achieved MDD [OR=4.84(95%CI:3.47-6.75)] were more likely to have inadequate micronutrients intake, while not consuming breast milk were less likely to have inadequate micronutrients intake in children [OR=0.55(95%CI:0.43-0.71)].
Conclusions: Almost two-thirds of subjects were inadequate in overall multiple micronutrients. Low energy intake and not achieved MDD were the highest risk of inadequate micronutrients intake of subjects, instead of low mother education and living in rural areas.
Ministry of Health od Republic Indonesia. Basic Health Research. https://www.litbang.kemkes.go.id/laporan-riset-kesehatan-dasar-riskesdas/ (2018).
World Bank. Repositioning Nutrition as Central to Development : A Strategy for Large Scale Action. (World Bank, 2006).
Fahmida, U., Santika, O., Kolopaking, R. & Ferguson, E. Complementary feeding recommendations based on locally available foods in Indonesia. Food Nutr. Bull. 35, S174–S179 (2014).
Fatmaningrum, D. & Wiradnyani, A. Inadequacy of Macronutrient and Micronutrient Intake in Children Aged 12-23 Months Old: An Urban Study in Central Jakarta, Indonesia. Int. J. Nutr. Food Eng. 8, 94–97 (2015).
Arsenault, J. E. et al. Very low adequacy of micronutrient intakes by young children and women in rural Bangladesh is primarily explained by low food intake and limited diversity. J. Nutr. 143, 197–203 (2013).
World Health Organization. Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. (WHO Press, 2019).
WHO. Infant and Young Child Feeding: Model Chapter for Testbooks for Medical Students and Allied Health Professionals. (WHO Press, 2009).
Kabir, I. et al. Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: secondary data analysis of Demographic Health Survey 2007. Matern. Child Nutr. 8, 11–27 (2012).
Sirait, A. R. A. & Achadi, E. L. Factors Associated with Minimum Dietary Diversity among Breas tfed Children Aged 6-23 Months in Indonesia (Analysis of Indonesia DHS 2017). Indones. J. Public Heal. Nutr. 1, 13–23 (2020).
Arimond, M. & Ruel, M. T. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J. Nutr. 134, 2579–2585 (2004).
Wado, L. A. L., Sudargo, T., A. Sosio Demografi Ketahanan Pangan Keluarga Dalam Hubungannya Dengan Kejadian Stunting Pada Anak Usia 1 – 5 Tahun (Studi Di Wilayah Kerja Puskesmas Bandarharjo Kelurahan Tanjung Mas, Kecamatan Semarang Utara, Kotamadya Semarang, Provinsi Jawa Tengah). J. Ketahanan Nas. 25, 178–203 (2019).
Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 2 Tahun 2020 Tentang Standar Antropometri Anak. (2020).
Council, N. R. Nutrient Adequacy:: Assessment Using Food Consumption Surveys. (National Academies Press, 1986).
Arcus-Arth, A., Krowech, G. & Zeise, L. Breast milk and lipid intake distributions for assessing cumulative exposure and risk. J. Expo. Sci. Environ. Epidemiol. 15, 357–365 (2005).
Michaelsen, K. F. Complementary Feeding of Young Children in Developing Countries: a Review of Current Scientific Knowledge: edited by Kenneth Brown, Kathryn Dewey, and Lindsay Allen, 1998, 178 pages, softcover. World Health Organization, Geneva. (2000).
Institute of Medicine. Dietary Ref-erence Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Pro-tein, and Amino Acids (Macronutrients). (National Academies Press., 2005).
World Health Organization. Global Nutrition Monitoring Framework: operational guidance for tracking progress in meeting targets for 2025. (WHO regional publications, 2017).
Sanin, K. I. et al. Micronutrient adequacy is poor, but not associated with stunting between 12-24 months of age: A cohort study findings from a slum area of Bangladesh. PLoS One 13, e0195072 (2018).
Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (National Academies Press (US), 2001).
World Health Organization. Nutrition Landscape Information System (NLIS) country profile indicators: interpretation guide. (2019).
Abeshu, M. A., Lelisa, A. & Geleta, B. Complementary feeding: review of recommendations, feeding practices, and adequacy of homemade complementary food preparations in developing countries–lessons from Ethiopia. Front. Nutr. 3, 41 (2016).
Shanshan, G., Jingqiu, M. A., Shanshan, L. I. U. & Jie ZHANG, X. S. Lack of dietary diversity contributes to the gaps in micronutrient status and physical development between urban and rural infants. Iran. J. Public Health 47, 958 (2018).
Solomon, D., Aderaw, Z. & Tegegne, T. K. Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Int. J. Equity Health 16, 1–9 (2017).
Bhattacherjee, S., Datta, S., Ray, K. & Mukhopadhyay, D. K. Nutrient adequacy and its correlation in a sub-Himalayan region of West Bengal, India. J. Fam. Med. Prim. care 5, 314 (2016).
Abdu, A. O. & Mekonnen, B. A. Determinants of Dietary Adequacy Among School Age Children in Guraghe Zone, Southern Ethiopia. Int. J. Public Heal. Sci. 8, 211–218 (2019).
Huriah, T., Trisnantoro, L., Haryanti, F. & Julia, M. Malnutrisi Akut Berat dan Determinannya pada Balita di Wilayah Rural dan Urban. J. Kesehat. Masy. Nas. 9, 50–57 (2014).
Sebataraja, L. R., Oenzil, F. & Asterina, A. Hubungan Status Gizi dengan Status Sosial Ekonomi Keluarga Murid Sekolah Dasar di Daerah Pusat dan Pinggiran Kota Padang Lisbet Rimelfhi Sebataraja. J. Kesehat. Andalas 3, (2014).
Sandjaja, S. et al. Food consumption and nutritional and biochemical status of 0· 5–12-year-old Indonesian children: the SEANUTS study. Br. J. Nutr. 110, S11–S20 (2013).
Na, M., Aguayo, V. M., Arimond, M. & Stewart, C. P. Risk factors of poor complementary feeding practices in Pakistani children aged 6–23 months: A multilevel analysis of the Demographic and Health Survey 2012–2013. Matern. Child Nutr. 13, e12463 (2017).
Damayanti, R. A., Muniroh, L. & Farapti, F. Perbedaan Tingkat Kecukupan Zat Gizi dan Riwayat Pemberian ASI Eksklusif pada Balita Stunting dan Non-Stunting. Media Gizi Indones. 11, 61–69 (2016).
Feyisa, B. B., Tefera, G. M., Endris, B. S., Asayehu, T. T. & Gebreyesus, S. H. Feeding practice, energy, and nutrient intake adequacy among children aged 6–23 months in Southern Ethiopia: a community based cross"sectional study. Food Sci. Nutr. 8, 6680–6690 (2020).
Sumedi, E. & Sandjaja, S. Intake of iron, vitamin a and zinc for Indonesian children aged 6-23 months. Nutr. Food Res. 38, 167–175 (2019).
Herawati, A. N., Palupi, N. S., Andarwulan, N. & Efriwati, E. Kontribusi asupan zat besi dan vitamin c terhadap status anemia gizi besi pada balita Indonesia. Penelit. Gizi dan Makanan (The J. Nutr. Food Res. 41, 65–76 (2018).
Septiawahyuni, H. D. & Suminar, D. R. Kecukupan Asupan Zink Berhubungan dengan Perkembangan Motorik pada Balita Stunting dan Non-Stunting. Amerta Nutr. 3, 1–6 (2019).
Sotero, Andréa Marques, Poliana Coelho Cabral, and G. A. P. da S. Socioeconomic, cultural and demographic maternal factors associated with dietary patterns of infants. Rev. Paul. Pediatr. 33, 445–452 (2015).
Radix, I., Vadivel, V., Nohr, D. & Biesalski, H. K. Dietary formulation to overcome micronutrient deficiency status in Indonesia. Nutr. Food Sci. (2012).
Muslimatun, S. & Wiradnyani, L. A. A. Dietary diversity, animal source food consumption and linear growth among children aged 1–5 years in Bandung, Indonesia: A longitudinal observational study. Br. J. Nutr. 116, S27–S35 (2016).
Andadari, D. P. P. S. & Mahmudiono, T. Keragaman Pangan dan Tingkat Kecukupan Energi serta Protein Pada Balita. Amerta Nutr. 1, 172–179 (2017).
Wang, H., Denney, L., Zheng, Y., Vinyes-Pares, G., Reidy, K., Wang, P., & Zhang, Y. Food sources of energy and nutrients in the diets of infants and toddlers in urban areas of China, based on one 24-hour dietary recall. BMC Nutr. 1, 1–15 (2015).
Khamis, A. G., Mwanri, A. W., Ntwenya, J. E., & Kreppel, K. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr. 19, 1–9 (2019).
Michaelsen, K. F. Feeding and nutrition of infants and young children: guidelines for the WHO European region, with emphasis on the former Soviet countries. (WHO Regional Office Europe, 2000).
Dewey, K. G. The challenge of meeting nutrient needs of infants and young children during the period of complementary feeding: an evolutionary perspective. J. Nutr. 143, 2050–2054 (2013).
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