Alternatif Indeks Gizi Seimbang untuk Menilai Kualitas Konsumsi Pangan Anak Usia 2-12 Tahun di Indonesia
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Date
2015Author
Hardiansyah, Angga Hardiansyah
Hardinsyah
Sukandar, Dadang
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Currently, there are many Indonesian children who experience nutritional problems. 19.6 % of children under five years are underweight, more than 30% are stunted. On the other hand ,11.9% of children are overweight in 2013. The Ministry of Health developed Guidelines for Balanced Diet in 2014 as healthy eating guidelines for all age groups, including children to control these nutritional problems. Although the balanced dietary guideline is available, Indonesia has yet developed a practical and comprehensive instrument to assess children’s food consumption quality. Other countries, e.g. United States of America, Australia and Thailand had developed such instrument called Healthy Eating Index (balanced diet index) for all age groups. Indonesia’s Healthy Eating Index or Balanced Diet Index was only developed for adult group. Therefore, this study was aimed generally to develop the balanced diet index (BDI) for Indonesian children aged 2-12 years. The specific purposes of this study were to analyze food consumption of Indonesian children aged 2-12 years, to develop several alternatives of BDIs for Indonesian children aged 2-12 years, and to select the most appropriate BDI for Indonesian children. The study was conducted from September 2014 to May 2015. Subjects were healthy children aged 2-12 years from the Basic Health Research (Riskesdas) in 2010. 38890 children were selected as final subjects after data cleaning based on exclusion criteria. The development of balanced diet index (BDI) was performed in three steps, namely 1) the classification of food, 2) the development of BDI alternatives and assessment systems, and 3) validation of the BDI using correlation test between BDI alternatives with the nutritional quality (NQ) of the diet of the subject. Mean adequacy level of 15 nutrients was included in the calculation of NQ of the subjects’ diet, i.e. energy, protein, fat, carbohydrate, water, vitamin A, vitamin B1, vitamin B9 (folate), vitamin B12, vitamin C, sodium, calcium, iron, phosphorus, and zinc. The nutrient intake data were obtained from conversion of food consumption data of Riskesdas 2010 using Indonesian food composition tables, nutrition fact of labeled foods, the USDA nutrient database, and nutrisurvey software. 12 alternatives of BDI were developed in this study. The difference of each BDI was on the scoring systems and the components that were included in the assessment. The study results showed that all of BDI developed positively correlated with the NQ value of the subjects (r = 0.27 – 0.60). BDIC-60, BDI with continuous scoring system, consisting of six components of the assessment and 0 food aspects related to noncommunicable diseases (NCDs) was the most valid BDI (r = 0.6). BDI3-60, BDI with 3-level discrete scoring systems, consisting of six components of the assessment and 0 food aspects related to NCDs was the most practical and valid BDI (r = 0.58). BDIC-104, BDI with continuous scoring system, consisting of 10 components of the assessment and 4 food aspects related to NCDs was the most complete BDI to assess the quality of the diet of the subjects (r = 0.42). BDI3-60 was a valid index that can be used practically to assess the quality of children’s food consumption. The BDI modification in the form of practical card is needed to make it more user-friendly. Further study should also be conducted to study the relationship between BDIC-104 score and nutrition or health outcomes. The assessment with BDIC-60, BDI3-60, and BDIC-104 showed that the consumption of carbohydrate foods for Indonesian children should be limited, and the consumption of vegetables, fruits, animal protein foods (including dairy), and plant protein foods should be improved.
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