Online Program

Could economic household surveys provide valid information to estimate nutrient adequacy of the diet? lessons from the Dominican Republic

Wednesday, November 6, 2013 : 12:30 p.m. - 12:50 p.m.

Omar Dary, Ph.D., Office of Health, Infectious Diseases and Nutrition Division, USAID, Bureau for Global Health, Washington DC, DC
Maria Teresa Menchu, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
Humberto Mendez, Monitoring and Evaluation Department, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
Introduction: Household Consumption and Expenditure Surveys (HCES), periodical studies to assess economic situation of countries, have been used to measure availability of food supply, estimate dietary diversity, and identify foods for fortification. However, type and amount of micronutrients to add to fortified foods are usually unknown. This study offers a practical alternative to laborious food intake surveys for identifying micronutrient inadequacies. Methods: We estimated the nutrient density per each 1000 kcal of the household diet using the Dominican Republic HCES-2007. Food acquisitions were transformed into food weights and then nutrient availability was estimated using a country-adjusted Food Composition Table. Dietary nutrient density was then compared with the Estimated Average Requirements (EAR) of each nutrient adjusted for the average energy intake as estimated by INCAP for the Central American population. Percent of households whose diet had an insufficient nutrient density was estimated. Results: Nutrient density for calcium, zinc, and iron were highly inadequate for all strata; followed by vitamin A, folate, vitamin B-12, and riboflavin in inverse correlation with socio-economic status; vitamin C was inadequate only for the two poorest strata; and thiamin, niacin, and vitamin B-6 were sufficient. Discussion: Although this method assumes that individuals consume all family-available food and in proportion to their energy requirements, it provides a practical, periodical, and objective way to support decisions on micronutrient interventions for the whole population without the need of estimating food intakes. It may also become a useful screening method for communities where more direct nutritional assessments should be done.

Learning Areas:

Program planning
Public health or related public policy
Public health or related research

Learning Objectives:
Describe secondary analysis of data from 2-3 year periodical economic surveys to estimate micronutrient inadequacies of different socio-economic, geographic, and urban and rural population strata of a country; demonstrate practicality of analyzing nutrient adequacy based on density per energy supply instead of absolute intakes for different family members sharing the same diet; and understand importance of designing nutrient interventions based on nutrient intake analysis instead of promoting “one-size fits all” solutions

Keyword(s): Food and Nutrition, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the design, interpretation, and reporting of the results, and I have been working in the use of Household Consumption and Expenditure Surveys (HCES) in several countries for making inferences about food intake and nutrient adequacy. I have also worked for more than 20 years in using nutrient intake data and biomarker analysis to design micronutrient interventions in developing countries
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.