Food-based complementary feeding and its impact on growth: Southeast Asian perspectives

Abstract

The objective of this chapter is to present evidence from Southeast Asian countries regarding complementary feeding practices, quantity and quality of complementary foods - in relation to the recommendations - potential impact on growth, and potential strategies for improving nutrient adequacy from food-based complementary foods. Complementary foods in Southeast Asian countries are characterized by rice-based diets with predominantly plant protein, small intake of animal protein, and high phytate content. Iron, calcium, and zinc are the main problem nutrients and the problems remain even when diet is optimized, due to limited gastric capacity of the infants to consume high amount of foods and low affordability of the families to buy animal protein foods. Early complementary feeding (less than 6 months of age) is prevalent, even as early as the first month of age. Early introduction of complementary feeding and inadequate nutrient intake has negative consequences on growth especially height and may explain the high prevalence of stunting in many Southeast Asian countries. While increasing intake of nutrient-dense foods is the most ideal, for infants it is difficult to achieve due to their limited gastric capacity. Fortified foods are likely to be more effective for infants, and current levels of fortification in fortified infant cereal need to be increased especially for iron, zinc, and calcium. Given that the majority of the population in Southeast Asian countries are of lower socio-economic status, fortification of staple foods or energy-rich foods (e.g., rice and noodles) is more affordable for the community and is expected to be more effective.