Development of Food-Based Complementary Feeding Recommendations for 9- to 11-Month-Old Peri-Urban Indonesian Infants Using Linear Programming

• Published in: The Journal of nutrition Vol. 139; no. 1; pp. 135 - 141
• Main Authors: Santika, Otte, Fahmida, Umi, Ferguson, Elaine L
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Nutrition 2009
• Subjects: animal-based foods; bananas; Biological and medical sciences; biscuits; Breast Feeding; calcium; complementary foods; Culture; Diet - standards; diet-related diseases; dietary nutrient sources; dietary recommendations; disease prevention; Feeding. Feeding behavior; Food; fortified foods; Fundamental and applied biological sciences. Psychology; Health Promotion; Humans; Indonesia; Infant; infant feeding; Infant Nutritional Physiological Phenomena - standards; infants; iron; linear models; livers as food; meals (menu); Micronutrients - deficiency; Models, Biological; niacin; nutrient requirements; Nutrition Policy; nutritional adequacy; Nutritional Requirements; optimal nutrition; serving size; snack foods; spinach; tempeh; tofu; traditional foods; urban areas; Urban Population; Vertebrates: anatomy and physiology, studies on body, several organs or systems; zinc; Indonesia; Asia; Human; Feeding behavior; Nutrition; Development; Infant; Recommendation; Food; Feeding
• ISSN: 0022-3166; 1541-6100
• DOI: 10.3945/jn.108.092270

Effective population-specific, food-based complementary feeding recommendations (CFR) are required to combat micronutrient deficiencies. To facilitate their formulation, a modeling approach was recently developed. However, it has not yet been used in practice. This study therefore aimed to use this approach to develop CFR for 9- to 11-mo-old Indonesian infants and to identify nutrients that will likely remain low in their diets. The CFR were developed using a 4-phase approach based on linear and goal programming. Model parameters were defined using dietary data collected in a cross-sectional survey of 9- to 11-mo-old infants (n = 100) living in the Bogor District, West-Java, Indonesia and a market survey of 3 local markets. Results showed theoretical iron requirements could not be achieved using local food sources (highest level achievable, 63% of recommendations) and adequate levels of iron, niacin, zinc, and calcium were difficult to achieve. Fortified foods, meatballs, chicken liver, eggs, tempe-tofu, banana, and spinach were the best local food sources to improve dietary quality. The final CFR were: breast-feed on demand, provide 3 meals/d, of which 1 is a fortified infant cereal; greater-than-or-equal5 servings/wk of tempe/tofu; greater-than-or-equal3 servings/wk of animal-source foods, of which 2 servings/wk are chicken liver; vegetables, daily; snacks, 2 times/d, including greater-than-or-equal2 servings/wk of banana; and greater-than-or-equal4 servings/wk of fortified-biscuits. Results showed that the approach can be used to objectively formulate population-specific CFR and identify key problem nutrients to strengthen nutrition program planning and policy decisions. Before recommending these CFR, their long-term acceptability, affordability, and effectiveness should be assessed.