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Identifying Dietary Strategies to Improve Nutrient Adequacy among Ethiopian Infants and Young Children Using Linear Modelling

Samuel, Aregash, Osendarp, Saskia J. M., Ferguson, Elaine, Borgonjen, Karin, Alvarado, Brenda M., Neufeld, Lynnette M., Adish, Abdulaziz, Kebede, Amha, Brouwer, Inge D.
Nutrients 2019 v.11 no.6
Estimated Average Requirement, Nationwide Food Consumption Survey, calcium, children, complementary foods, computer software, folic acid, infants, iron, linear models, linear programming, niacin, nutrients, nutrition risk assessment, powders, thiamin, vitamin B12, zinc
Nutrient adequacy of young children&rsquo;s diet and best possible strategies to improve nutrient adequacy were assessed. Data from the Ethiopian National Food Consumption Survey were analysed using Optifood (software for linear programming) to identify nutrient gaps in diets for children (6&ndash;8, 9&ndash;11 and 12&ndash;23 months), and to formulate feasible Food-Based Dietary Recommendations (FBDRs) in four regions which differ in culture and food practices. Alternative interventions including a local complementary food, micronutrient powders (MNPs), Small quantity Lipid-based Nutrient Supplement (Sq-LNS) and combinations of these were modelled in combination with the formulated FBDRs to compare their relative contributions. Risk of inadequate and excess nutrient intakes was simulated using the Estimated Average Requirement cut-point method and the full probability approach. Optimized local diets did not provide adequate zinc in all regions and age groups, iron for infants <12 months of age in all regions, and calcium, niacin, thiamine, folate, vitamin B12 and B6 in some regions and age-groups. The set of regional FBDRs, considerably different for four regions, increased nutrient adequacy but some nutrients remained sub-optimal. Combination of regional FBDRs with daily MNP supplementation for 6&ndash;12 months of age and every other day for 12&ndash;23 months of age, closed the identified nutrient gaps without leading to a substantial increase in the risk of excess intakes.