Improving the intake of nutritious food in children aged 6-23 months in Wuyi County, China – a multi-method approach

Abstract

AimTo develop affordable, appropriate, and nutritious recipes based on local food resources and dietary practices that have the potential to improve infant feeding practices.MethodsWe carried out a mixed methods study following the World Health Organization’s evaluation guidelines on the promotion of child feeding. We recruited caregivers with children aged 6-23 months in Wuyi County, Hebei Province, China. The study included a 24-hour dietary recall survey, local food market survey, and development of a key local food list, food combinations, and recipes. Mothers tested selected recipes at their homes for two weeks. We interviewed mothers to obtain their perceptions on the recipes.ResultsThe 24-hour dietary recall survey included 110 mothers. Dietary diversity was poor; approximately 10% of children consumed meat and only 2% consumed vitamin A-rich vegetables. The main reason for not giving meat was the mothers’ belief that their children could not chew and digest meat. With the help of mothers, we developed six improved nutritious recipes with locally available and affordable foods. Overall, mothers liked the recipes and were willing to continue using them.ConclusionsThis is the first study using a systematic evidence-based method to develop infant complementary recipes that can address complementary feeding problems in China. We developed recipes based on local foods and preparation practices and identified the barriers that mothers faced toward feeding their children with nutritious food. To improve nutrition practices, it is important to both give mothers correct feeding knowledge and assist them in cooking nutritious foods for their children based on locally available products. Further research is needed to assess long-term effects of those recipes on the nutritional status of children.

Prevalence and causes of anaemia in children aged 6–23 months in rural Qinghai, China: findings from a cross-sectional study

“…Our analysis showed that eating meat was a protective factor of child anaemia; however, few caregivers gave meat to their children of this age due to the wrong beliefs that they could not digest meat. In addition, some caregivers did not know how to prepare meat for young infants, especially at the very beginning of complementary feeding,31 thus infant feeding counselling should include these specific issues to provide caregivers accurate knowledge and help them solve problems, such as demonstration of the preparation of meat instead of just giving information.…”

Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6- to 23-Month-Old Children in Low- and Middle-Income Countries

“…The restriction to studies published in English language, the small sample size in some of the observed intake studies, 23,31,38,42 and the fact that some studies sampled deliberately children from rural 22,29,31,32,[34][35][36]39,40 and/or poor communities 27,28,32,37,42 may raise questions on how representative the data from the observed intake studies are for usual dietary intakes of children in that specific country or region. In addition, the quality of some of the observed intake studies can be questioned since dietary assessment methods are generally recognized to be prone to biases.…”

“…The modeled intake studies modeled theoretical intakes or nutrient densities against recommended intakes or nutrient densities. Six [19][20][21][22][23][24] of the modeled intake studies used linear programming, a mathematical tool, that can be used among others to formulate optimized complementary feeding diets, which resemble current dietary practices as closely as possible while at the same time ensuring optimal nutrient intakes. 25 Details of the linear programming process and its challenges have been described before.…”

“…All models were based on frequently consumed foods and take into account constraints such as diet's energy content, food consumption frequency patterns, food portion sizes, and costs. Wu et al 22 created nutritious food combinations using the ProPAN tool. Adrianopoli et al 23 used NutriSurvey as linear modeling tool and optimized intakes using different combinations of food amount constraints.…”

Achieving Millennium Development Goals 4 and 5: Do every mother and child really count?

“…In a logical sequence they cover a continuum of maternal, newborn, and child health topics. Chen et al and UNICEF's China office compare the quality of antenatal care in public and private sector in rural China (11), while Wu et al investigate approaches to improve the intake of nutritious foods in infants and young children (12). Jackson et al offer a series of meta-analyses to summarize the importance and contribution of different risk factors to severe episodes of acute lower respiratory infections (ALRI) (13).…”