Balanced Diet Index Development of Adult Females in Indonesia
Perdana, Silvia Mawarti
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The objective of this study was to develop a balanced diet index (BDI) in relation to nutritional quality of the diet (NQ) of adult females in Indonesia. The specific objectives was (1) analyze food consumption pattern of Indonesia adult females, (2) develop BDI alternatives of Indonesia adult females, (3) select the most valid BDI of Indonesia adult females, (4) analyze determinant factors of BDI of Indonesia adult females. This study used food consumption data from the Basic Health Research (Riskesdas) of 2010 collected by the Agency for Research and Health Development of the Ministry of Health. The food consumption data were collected using 24-h food recall method through a cross-sectional study design of 68486 adult females 19-55 years on May-August 2010. This study conducted on June-November 2013 in IPB Dramaga, Bogor, West Java. The final sample of this study was 61759 adult females. Ten alternatives of balanced diet indexes (BDI) were developed based on food groups, their intake, and three to four scoring system levels. The NQ of 16 nutrients was used as a gold standard in the validity testing. The results showed that the most food group consumed was carbohydrate food 539.5 ± 216.2 g (99.9%), whereas the least food groups consumed was the fruit, added sugar, and milk with average consumption was 31.0 ± 86.0 g (22.0%), 2.4 ± 12.5 g (7.6%), and 3.1 ± 24.0 g (4.8%). The intake of all nutrients, except sodium, did not meet the nutritional requirements per day. NQ of adult females in Indonesia was still relatively less (44.0 ± 13.2). Alternatives of BDI was developed based on the food groups/nutrients, quantity, and the score level, which consists of: BDI 3-50, BDI 3-60, BDI 3-61, BDI 3-83, BDI 3-105, BDI 4-50 , BDI 4-60, BDI 4-61, BDI 4-83, and BDI 4-105. The simplest and the most valid measurement was BDI 3-60 (correlation coefficients with the NQ 0.70) which is based on three levels of scoring system (zero, five, and 10) and six food groups (carbohydrate food, animal protein food, plant protein food, vegetable, fruit, and milk), without considering fat, saturated fat, cholesterol, and sodium. The mean score of BDI 3-60 was 31.0 ± 12.1. BDI 3-60 affected by marital status, economic status, education, occupation, and age. Adult females who married had 29% higher scores of BDI 3-60 than others. Medium to high economic status (quintiles 3, 4, and 5) had 39% higher scores of BDI 3-60 than the low economic status (quintiles 1 and 2). Middle and high school education had opportunities 17% and 30% higher scores of BDI 3-60 than elementary education, respectively. Civil servants and self-employed/others had opportunities 11% and 5% higher scores of BDI 3-60 than subjects who did not work/school, respectively. Females aged 30-49 years and 50-55 years had opportunities 23% and 25% higher scores of BDI 3-60 than females aged 19-29 years, respectively. BDI 3-60 which developed based on three levels of scores and six food groups (carbohydrate food, animal protein food, plant protein food, vegetable, fruit, and milk) can be used as a simple way of evaluating NQ of adult females in vii Indonesia because the assessment was based only on the number of servings of food groups consumed/nutrients intake. BDI 3-105 might be more valid than BDI 3-60 if more complete calculation of nutrients (cholesterol, saturated fat, and sodium) of Indonesian food. Promotion of balanced diet necessary to improve the quality of food consumption for adult females of Indonesia. Promotion of balanced diet is needed, especially for the consumption of animal protein food, vegetables, and fruits. Further study can be done by developing balanced diet index for other age groups by adjusting the food servings with nutritional requirements; and analyze the relationship between the score of BDI 3-60 with nutrition and health outcomes, such as nutritional status of next generation .
- MT - Human Ecology