Objective: To formulate age-and context-specific complementary feeding recommendations (CFR) for infants and young children (IYC) and to compare the potential of filling population-level nutrient gaps using common sets of CFR across age groups.

A barrier to using Optifood linear programming (LP), which identifies nutrient gaps and supports population‐specific food‐based recommendation (FBR) development, is the requirement for dietary intake data. We investigated whether Household Consumption and Expenditure Surveys (HCESs) could be used instead of individual‐level 24‐h recalls (24HRs). The 24HR data from 12‐ to 23‐month‐old breastfeeding children in rural Kenya, Uganda, Guatemala, and Bangladesh were paired with HCES food consumption data from similar areas (n = 8) and time periods. HCES food intakes (g/week) were estimated using adult male equivalents, adjusted for breastfeeding. Paired HCES‐ and 24HR‐defined LP inputs and outputs were compared using percentage agreement. Mean overall percentage agreements were 42%, 63%, and 80%, for food, food subgroup, and food‐group model parameters, respectively. HCES food lists were on average 1.3 times longer than 24HR. Similar nutrient gaps (77–100% agreement), food sources of nutrients (71–100% agreement), and FBRs (80–100% agreement) were identified. The results suggest that HCES data can be used in Optifood analyses for 12‐ to 23‐month‐old children, despite recognized challenges of using it to estimate dietary intakes of young children compared with older age groups. Further analyses, however, are required for different age groups and locations to confirm expectations that it would perform equally well.

Globally, dietary intake of calcium is often insufficient, and it is unclear if adequacy could be achieved by promoting calcium‐rich local foods. This study used linear programming and household consumption data from Uganda, Bangladesh, and Guatemala to assess whether local foods could meet calcium population reference intakes (Ca PRIs). The most promising food‐based approaches to promote dietary calcium adequacy were identified for 12‐ to 23‐month‐old breastfed children, 4‐ to 6‐year‐old children, 10‐ to 14‐year‐old girls, and nonpregnant and nonbreastfeeding (NPNB) women of reproductive age living in two regions of each country. Calcium‐optimized diets achieved 75–253% of the Ca PRI, depending on the population, and were <100% for 4‐ to 6‐year‐olds in one region of each country and 10‐ to 14‐year‐old girls in Sylhet, Bangladesh. The best food sources of calcium were green leafy vegetables and milk, across geographic locations, and species of small fish, nixtamalized (lime‐treated) maize products, sesame seeds, and bean varieties, where consumed. Food‐based recommendations (FBRs) achieving the minimum calcium threshold were identified for 12‐ to 23‐month‐olds and NPNB women across geographic locations, and for 4‐ to 6‐year‐olds and 10‐to 14‐year‐old girls in Uganda. However, for 4‐ to 6‐year‐olds and 10‐ to 14‐year‐old girls in Bangladesh and Guatemala, calcium‐adequate FBRs could not be identified, indicating a need for alternative calcium sources or increased access to and consumption of local calcium‐rich foods.