The study links poor food variety in children to higher health costs

Recently BMC Public Health study investigates the consequences of low food diversity on children’s health and the economy.

Study: Food diversity: its relationship to child health and the resulting economic burden. Image Credit: Mohammad Bash / Shutterstock.com

To investigate the relationship between dietary diversity and childhood malnutrition

Millions of children under the age of five around the world are obese or develop vitamin or mineral deficiencies. In 2022, the World Health Organization reported a significant increase in stunted growth in children from South Asia and Sub-Saharan Africa. As a result many counties affiliated to the World Health Assembly joined the Scaling Up Nutrition (SUN) program to reduce the rate of stunting by 2025.

Although a higher prevalence of child malnutrition and stunted growth was reported in Indonesia, these numbers have recently decreased; however, this reduction fell short of the WHO target of less than 20%. Lack of dietary diversity has been found to be the main problem with nutritional nutrition in developing countries.

Developing countries rely heavily on cereal staple foods, with limited intake of animal proteins, vegetables and fruit. Social and economic status, cultural traditions, financial allocations, food preferences, and practices influence the quality and variety of nutrition.

The Dietary Diversity Score (DDS) and the dietary serving score (DSS) are often used to determine the quality of food variety and adequacy. Reduced dietary variety is associated with malnutrition, such as stunted growth, as well as an increased risk of developing cardiovascular disease, metabolic syndrome, and dyslipidemia. Children who eat a variety of foods usually have a higher food intake and good metabolism.

A recent study conducted in West Java, Indonesia, showed that eating a more varied diet reduces the risk of malnutrition. However, another study contradicted this view, reporting low food quality and diversity among vulnerable populations in West Java. These conflicting observations highlight the importance of further studies to clarify the effect of eating similar types of food in children.

About the study

The current study assessed the correlation between food diversity and children’s health. Food diversity was calculated based on DDS and DSS, where DDS was used to assess the quality of food diversity, and DSS quantified food diversity. It was also considered that the economic burden on parents and governments due to low nutritional diversity in children would understand the severity of this issue.

The population of Tasikmalaya City was considered in the present study due to the prevalence of stunted growth in children above the provincial average. Since stunting is related to diet and nutrition of children, it is assumed that Tasikmalaya City has low levels of food diversity.

Data were collected on six different food groups, including meat/fish/eggs, vegetables, grains, fruit, whole grains, and milk/dairy products consumed by children in the past 24 hours. Children between the ages of two and 14 were looked at. Sociodemographic data, food groups consumed, health status, and expenses incurred due to child illness in the past month were also reported.

Results of the study

The average monthly household income was 2.29 million rupiah. Most of the study participants lived more than one kilometer from a health care facility.

Most of the children ate three meals a day, and 25% of the cohort had health complaints. There were equal numbers of boys and girls in the study cohort.

Lower DDS and DSS scores were associated with more health complaints in children. Each child with low DDS and DSS scores costs $75 USD; therefore, improved quality and quantity of food variety could avoid these high costs.

DDS can be used to determine nutritional adequacy, indicating proper macro- and micronutrient consumption in children. Better adherence to the portion of the meal recommended by the Balanced Diet Guidelines was more associated with better health conditions in children.

Conclusions

The current study highlights the importance of dietary diversity for children’s health. Inadequate food variety can lead to illness, which increases overall family health care costs.

It is recommended to improve the quality and quantity of dietary diversity to improve children’s health conditions. In the future, better programs related to food and nutrition must be promoted to raise awareness, which can improve health conditions and reduce health care costs.

As agriculture plays an important role in the Indonesian economy, improved agroecological practices, including crop diversification, mixed cropping, agroforestry and livestock, may have positive effects on dietary diversity.