To what Extent Can Food-based Approaches Ensure Dietary Adequacy for Women and Young Children in SE Asia.

Objectives: To predict whether food-based approaches can ensure dietary adequacy for 6-23 month old children and women of reproductive age in SE Asia and to identify problem nutrients. Methods: Linear programming was used to determine whether nutritionally adequate diets based on locally available non-fortified foods (11 micronutrients ≥ WHO/FAO RNI, assuming moderate iron and zinc bioavailability) could be formulated for women and young children in 5 countries. Model parameters were defined using nationally representative (Indonesia, Thailand, Vietnam, Cambodia) or locally representative (Laos, Cambodian children<12 months) 24-hour recall dietary data. Problem nutrients were defined as those <100% RNI in a diet where intakes were maximised. Nutrient adequacies, for food-based recommendations (FBR), were defined as those >65% RNI, when intakes were minimised, in diets achieving the FBR. Results: Numbers of problem nutrients ranged from 2-9, 1-8 and 0-5, for 6-8 mo, 9-11 mo and 12- 23 mo old children; and from 3-7, 2-4 and 1-4 for pregnant, lactating and non-pregnant- nonlactating women, respectively, depending on the country. In most countries, modeled FBRs ensured adequacy for ≥7 (children) and ≥5 (women) nutrients. In all countries, FBRs did not ensure adequate iron (all groups) and folate (women) intakes. Conclusions: Interventions, such as food fortification or the promotion of unutilized nutrient dense foods, are likely required to ensure dietary adequacy, for women and young children, in SE Asia. Funding: The European Commission, FP7, GA-2896-16.

Iron Status is Associated with Body Composition in Cambodian Infants and Young Children.

Objectives: Malnutrition in early childhood predisposes to a higher risk for non-communicable diseases such as obesity and cardio-vascular diseases later in life through not fully understood metabolic alterations. Little is known about body composition in early childhood in relation to micronutrient status. Methods: Infants were recruited through the WinFood project which studied the effectiveness of fortified complementary foods (FCF) in improving health and growth. Anthropometry (weight, height, MUAC, skinfolds), body composition (deuterium dilution) and micronutrient status (iron, zinc, vitamin A) were measured at 6 mo and 15 mo of age. Results: From 269 Cambodian infants data on body composition and micronutrient status were available for both time-points. Lean body mass increased with 1.96 ±0.59 kg, whereas percentage body fat decreased from 21.7% to 14.9% over the study period (P<0.001). At 6 and 15 mo of age, body fat was strongly correlated to ponderal growth (WHZ, P<0.01) but not to length growth (HAZ) or gender. Vitamin A and zinc status were not related to fat mass. Iron status at 6 and 15 months of age significantly correlated with body composition, with infants with no iron stores at endpoint having a higher fat mass (14.0% vs 15.5%, P=0.02). Infants without iron deficiency during the study had significant lower fat mass (13.3%) than infants who were iron deficient at both timepoints (16.4%, P<0.01) Conclusions: Iron status, but not vitamin A or zinc status, was related to body composition in Cambodian infants. FCF aimed at improving iron status in early childhood may have long-term health benefits.