Dietary intake and stunting in children aged 6-23 months in rural Sumba, Indonesia
Keywords:
stunting, complementary feeding, dietary intake, dietary diversity, macronutrient and micronutrient, Indonesia
Abstract
Background Linear growth retardation in the first two years of life leads to numerous harmful consequences. Lack of diversity in the diet and inadequate amounts of complementary food have been associated with stunted growth in children.
Objective To assess the dietary intake and investigate for associations with stunting among children aged 6-23 months.
Methods This case-control study compared the dietary intake of children aged 6-23 months with and without stunting in the South and West Wewewa subdistricts of Southwest Sumba, East Nusa Tenggara, Indonesia. Complementary food types, dietary diversity, and nutritional intake were assessed and compared between groups. Nutrient intake sufficiency and stunting were analyzed by logistic regression.
Results A total of 200 participants were equally allocated into groups with and without stunting. Only 6% of stunted children received adequate complementary food diversity compared to 14% of non-stunted children (P=0.05). The stunted group had significantly lower consumption of flesh foods (beef, fish, poultry, organ meat, and other kinds of meat) compared to the non-stunted group (7% vs. 16% of subjects, respectively; P<0.05). The median total protein intake was also significantly lower in stunted children compared to non-stunted children [7.72 (IQR 6.46, 11.31) g vs. 10.02 (IQR 6.53, 13.95) g, respectively; P<0.05] although no association was found between protein intake sufficiency and stunting in the multivariate analysis. Only maternal unemployment was positively associated with stunting (OR 2.32; 95%CI 1.26 to 4.26).
Conclusion Overall, most subjects did not receive sufficient amounts of nutrients. Although dietary diversity was not found to be significantly different between those with and without stunting, a significantly lower proportion of stunted children consumed flesh food. The stunted group also received significantly lower protein from their diet although no association was found between nutrient intake sufficiency and stunting. Further studies are needed to longitudinally assess the effects of macronutrient and micronutrient intake sufficiency on linear growth in children.
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14. Muslimatun S, Wiradnyani LAA. 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. 2016;116Suppl. 1:S27-35. DOI: https://doi.org/10.1017/S0007114515005395
15. Tessema M, Gunaratna N, Brouwer I, Donato K, Cohen J, McConnell M, et al. Associations among high-quality protein and energy intake, serum transthyretin, serum amino acids and linear growth of children in Etiopia. Nutrients. 2018:10:1776. DOI: https://doi.org/10.3390/nu10111776
16. Branca F, Ferrari M. Impact of micronutrient deficiencies on growth: the stunting syndrome. Ann Nutr Metab. 2002;46Suppl. 1:8–17. DOI: https://doi.org/10.1159/000066397.
17. Mardewi KW, Sidiartha IGL, Gunawijaya E. Low serum zinc and short stature in children. Paediatr Indones. 2016;56:171–5. DOI: https://doi.org/10.14238/pi56.3.2016.171-5.
18. Limardi S, Hasanah DM, Utami NMD, Sidiartha IGL. Investigating Minimum Acceptable Diet and Infant and Child Feeding Index as indicators of stunting in children aged 6-23 months. Paediatr Indones. 2020;60:259–68. DOI: https://doi.org/10.14238/pi60.5.2020.259-68.
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26. Millward DJ, Jackson AA. Protein/energy ratios of current diets in developed and developing countries compared with a safe protein/energy ratio: implications for recommended protein and amino acid intakes. Public Health Nutr. 2004;7:387–405. DOI: 10.1079/PHN2003545.
27. Dewey KG, Finley DA, Lönnerdal B. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr. 1984;3:713–20. DOI: https://doi.org/10.1097/00005176-198411000-00014.
28. World Health Organization. Complementary feeding: family foods for breastfed children [Internet]. France: World Health Organization; 2000 [cited 2021 Apr 1]. Available from: https://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_00.1/en/
29. Briefel RR, Kalb LM, Condon E, Deming DM, Clusen NA, Fox MK, et al. The Feeding Infants and Toddlers Study 2008: study design and methods. J Am Diet Assoc. 2010;110(12 Suppl):S16-26. https://doi.org/DOI: 10.1016/j.jada.2010.09.005.
30. Onyango AW, Receveur O, Esrey SA. The contribution of breastmilk to toddler diets in western Kenya. Bull World Health Organ. 2002;80:292–9. PMID: 12075365.
31. Yagi T, Iwamoto S, Mizuseki R, Furuya M, Nakayama K. Contents of all forms of vitamin B6, pyridoxine-?-glucoside and 4-pyridoxic acid in mature milk of Japanese women according to 4-pyridoxolactone-conversion high performance liquid chromatography. J Nutr Sci Vitaminol (Tokyo). 2013;59:9–15. DOI: https://doi.org/10.3177/jnsv.59.9.
32. Dórea JG. Magnesium in human milk. J Am Coll Nutr. 2000;19:210–9. DOI: https://doi.org/10.1080/07315724.2000.10718919.
33. McCrory MA, Campbell WW. Effects of eating frequency, snacking, and breakfast skipping on energy regulation: symposium overview. J Nutr. 2011;141:144–7. DOI: 10.3945/jn.109.114918.
34. Chairunnisa E, Kusumastuti AC, Panunggal B. [Vitamin D, calcium, and phosphorus intake of children 12 - 24 momths with and without stunting in Semarang]. Article in Indonesian. J Nutr Coll. 2018;7:39–44. DOI: https://doi.org/10.14710/jnc.v7i1.20780.
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Published
2022-11-09
How to Cite
1.
Limardi S, Hasanah D, Utami N. Dietary intake and stunting in children aged 6-23 months in rural Sumba, Indonesia. PI [Internet]. 9Nov.2022 [cited 22Dec.2024];62(5):341-6. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2739
Section
Pediatric Nutrition & Metabolic Disease
Copyright (c) 2022 Suryadi Limardi, Dini Mutia Hasanah, Ni Made Dwiyathi Utami
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Received 2021-08-07
Accepted 2022-11-02
Published 2022-11-09
Accepted 2022-11-02
Published 2022-11-09
