Novel Method for Estimating Nutrient Intakes Using a Semistructured 24-Hour Diet Recall for Infants and Young Children in Rural Bangladesh

Zaynah T Chowdhury, Kristen M Hurley, Rebecca K Campbell, Saijuddin Shaikh, Abu Ahmed Shamim, Sucheta Mehra, Parul Christian, Zaynah T Chowdhury, Kristen M Hurley, Rebecca K Campbell, Saijuddin Shaikh, Abu Ahmed Shamim, Sucheta Mehra, Parul Christian

Abstract

Background: Nutrient-level intakes from home-prepared complementary foods are rarely estimated among infants and young children in low-income settings. The major constraints are related to lack of standard recipes and ingredients and portion sizes.

Objectives: This article describes the feasibility, applicability, and validity of a post hoc qualitative methodology to estimate nutrient intakes in children using 24-h dietary recall.

Methods: Semistructured, interviewer-administered caregiver 24-h diet recalls were conducted to assess food intake among children participating in a randomized trial of complementary food supplementation at ages 6, 9, 12, 15, 18, and 24 mo in rural Bangladesh. At the end of the diet data collection, focus group discussions with mothers (n = 6) and cooking activities (n = 5) were conducted to obtain standard recipes (and ingredients) and portion sizes for reported foods given at different ages. Nutrient intakes were calculated for children in the control group (n = 1438), and convergent validity of the data was tested by examining the association of energy and protein intakes with child age and socioeconomic status (SES).

Results: Focus group discussions generated standardized recipes for 21 commonly consumed mixed dishes being fed to children. These recipes were cooked, and portion sizes of standardized measures used in 24-h recalls were quantified in grams. For discrete foods, we quantified women's perceptions of "small," "medium," and "large" in grams. Across all ages, food groups consumed consisted mostly of staples, with the most common being rice, potatoes, and biscuits. Using portion size data and recipe ingredients, the 24-h dietary data, and Bangladeshi food composition tables, we successfully estimated nutrient intakes in children. Convergent validity analysis showed that energy and protein intakes were strongly associated with age and SES (both P < 0.001).

Conclusions: We demonstrated the use of a validated, qualitative methodology for estimating nutrient intakes in young children from complementary foods in undernourished contexts. This trial was registered at clinicaltrials.gov as NCT01562379.

Keywords: 24-h dietary recall; complementary foods; infants and children; nutrient intake; qualitative data.

Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.

Figures

FIGURE 1
FIGURE 1
Energy intake by living standards index (low compared with high) and child age.
FIGURE 2
FIGURE 2
Protein intake by living standards index (low compared with high) and child age.

References

    1. Dewey KG, Brown KH. Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs. Food Nutr Bull. 2003;24(1):5–28.
    1. Black MM, Hurley KM. Helping children develop healthy eating habits. In: Tremblay RE, Boivin M, Peters RDeV, editors. Encyclopedia on early childhood development [online]. 2013; [Internet]. [Accessed 2020 Apr 15]. Available from:.
    1. WHO, UNICEF, USAID, AED, UC Davis, IFPRI Indicators for assessing infant and young child feeding practices. Part II: measurement. Geneva (Switzerland): WHO; 2010.
    1. Lassi ZS, Rind F, Irfan O, Hadi R, Das JK, Bhutta ZA. Impact of infant and young child feeding (IYCF) nutrition interventions on breastfeeding practices, growth and mortality in low- and middle-income countries: systematic review. Nutrients. 2020;12(3):722.
    1. Das JK, Salam RA, Hadi YB, Sadiq Sheikh S, Bhutta AZ, Weise Prinzo Z, Bhutta ZA. Preventive lipid-based nutrient supplements given with complementary foods to infants and young children 6 to 23 months of age for health, nutrition, and developmental outcomes. Cochrane Database Syst Rev. 2019;2019(5):CD012611.
    1. Gibson RS. Principles of nutritional assessment. 2nd ed New York: Oxford University Press; 2005.
    1. Christian P, Shaikh S, Shamim AA, Mehra S, Wu L, Mitra M, Ali H, Merrill RD, Choudhury N, Parveen M et al. . Effect of fortified complementary food supplementation on child growth in rural Bangladesh: a cluster-randomized trial. Int J Epidemiol. 2015;44(6):1862–76.
    1. Christian P, Kim J, Mehra S, Shaikh S, Ali H, Shamim AA, Wu L, Klemm R, Labrique AB, West KP Jr.. Effects of prenatal multiple micronutrient supplementation on growth and cognition through 2 years of age in rural Bangladesh: the JiVitA-3 Trial. Am J Clin Nutr. 2016;104(4):1175–82.
    1. Shaheen N, Rahim ATMA, Mohiduzzaman M, Banu CP, Bari ML, Tukum AB, Mannan M, Bhattacharjee L, Stadlmayr B. Food composition table for Bangladesh. Dhaka (Bangladesh): Institute of Nutrition and Food Science, Centre for Advanced Research in Sciences, University of Dhaka; 2013.
    1. USDA, Agricultural Research Service USDA national nutrient database for standard reference, release 26. Beltsville (MD): USDA; 2013.
    1. Institute of Nutrition, Mahidol University ASEAN food composition database, electronic version 1. Bangkok (Thailand): Institute of Nutrition, Mahidol University; 2014.
    1. Gopalan C, Rama Sastri BV, Balasubramanian SC. Nutritive value of Indian foods. Hyderabad (India): National Institute of Nutrition, Indian Council of Medical Research; 1971.
    1. National Nutrition Program Food composition table for Nepal. Kathmandu (Nepal): Nepal Government Ministry of Agriculture Development; 2012.
    1. Lukmanji Z, Hertzmark E, Mlingi N, Assey V, Ndossi G, Fawzi W. Tanzania food composition tables. Dar es Salaam (Tanzania): Muhimbili University of Health and Allied Sciences, Tanzania Food and Nutrition Centre, and Harvard School of Public Health; 2008.
    1. Public Health England McCance & Widdowson's composition of foods integrated dataset (CoF IDS). London (UK): Public Health England: 2002.
    1. Vásquez-Caicedo AL, Bell S, Hartmann B. Report on collection of rules on use of recipe calculation procedures including the use of yield and retention factors for imputing nutrient values for composite foods. Brussels (Belgium): European Food Information Resource Network; 2008.
    1. WHO Complementary feeding of young children in developing countries. Geneva (Switzerland): WHO; 1998.
    1. WHO, FAO Vitamin and mineral requirements in human nutrition. 2nd ed Geneva (Switzerland): WHO; 2004.
    1. FAO, United Nations University, WHO Human energy requirements: report of a Joint FAO/WHO/UNU expert consultation. Rome (Italy): FAO; 2004.
    1. DeVellis RF. Scale development: theory and applications. 2nd ed Los Angeles (CA): Sage; 2012.
    1. Gunnsteinsson S, Labrique AB, West KP Jr, Christian P, Mehra S, Shamim AA, Rashid M, Katz J, Klemm RDW. Constructing indices of rural living standards in northwestern Bangladesh. J Health Popul Nutr. 2010;28(5):509–19.
    1. Nguyen PH, Avula R, Ruel MT, Saha KK, Ali D, Tran LM, Frongillo EA, Menon P, Rawat R. Maternal and child dietary diversity are associated in Bangladesh, Vietnam, and Ethiopia. J Nutr. 2013;143(7):1176–83.
    1. Arsenault JE, Yakes EA, Islam MM, Hossain MB, Ahmed T, Hotz C, Lewis B, Rahman AS, Jamil KM, Brown KH. 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. 2013;143(2):197–203.
    1. Campbell RK, Hurley KM, Shamim AA, Shaikh S, Chowdhury ZT, Mehra S, de Pee S, Ahmed T, West KP Jr, Christian P. Effect of complementary food supplementation on breastfeeding and home diet in rural Bangladeshi children. Am J Clin Nutr. 2016;104(5):1450–68.
    1. Campbell RK, Hurley KM, Shamim AA, Shaikh S, Chowdhury ZT, Mehra S, Wu L, Christian P. Complementary food supplements increase dietary nutrient adequacy and do not replace home food consumption in children 6–18 months old in a randomized controlled trial in rural Bangladesh. J Nutr. 2018;148(9):1484–92.
    1. Kimmons JE, Dewey KG, Haque E, Chakraborty J, Osendarp SJM, Brown KH. Low nutrient intakes among infants in rural Bangladesh are attributable to low intake and micronutrient density of complementary foods. J Nutr. 2005;135(3):444–51.
    1. Institute of Medicine Dietary Reference Intakes: the essential guide to nutrition requirements. Otten JJ, Hellwig JP, Meyers LD, editors Washington (DC): National Academy Press; 2006.
    1. Arsenault JE, Brown KH. Dietary protein intake in young children in selected low-income countries is generally adequate in relation to estimated requirements for healthy children, except when complementary food intake is low. J Nutr. 2017;147(5):932–9.

Source: PubMed

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